bmo total travel and medical protection€¦ · certificate of insurance inside you’ll find all...

BMO® TotalTravel and MedicalProtectionC E R T I F I C A T E O F I N S U R A N C E

Inside You’ll find all You need to know about the

BMO Total Travel and Medical Protection

features and benefits offered to BMO MasterCard®*

Cardholders.

CERTIFICATE OF INSURANCE

IMPORTANT NOTICE

Read This Certificate Of Insurance CarefullyThis Certificate of Insurance is designed to coverlosses arising from sudden and unforeseeablecircumstances only. It is important that You read andunderstand this Certificate of Insurance as Yourcoverage is subject to limitations and exclusions.

This insurance coverage is available only if You areunder age seventy-five (75). This includes thePrimary Cardholder, his/her Spouse and DependentChildren. Emergency Medical coverage is for the firstthirty-one (31) days of Your Trip only. For Trips of alonger duration You may be able to purchaseadditional coverage. Call 1-877-704-0341 or(519) 741-0782.

Right to examine this insurance: If You notify Us thatthis insurance does not meet Your needs withinten (10) days of the date of issue, We will provide a fullrefund if You have not already departed on a Trip andhave not incurred a claim. Refunds are only availablewhen the Operations Centre receives Your request fora refund before Your scheduled Departure Date.

Warning: This Certificate of Insurance contains a Pre-existing Conditions Exclusion for Trip Cancellation,Trip Interruption/Trip Delay, Flight Delay andEmergency Medical benefits. The Pre-existingConditions Exclusion is applicable to MedicalConditions and/or symptoms that existed on or priorto the date Your Coverage Period began.

There is no coverage under this Certificate ofInsurance for Pre-existing Conditions as describedin the Exclusions and Limitations sections 4.3.4and 4.5.2 of this Certificate of Insurance.

You must notify Mondial Assistance through theOperations Centre when You need medicalTreatment, within twenty-four (24) hours whenbeing admitted to a Hospital, or as soon asreasonably possible. Alternatively, someone elsemay call on your behalf if Your Medical Conditionprevents You from calling. If You do not notify theOperations Centre as soon as possible You mayreceive inappropriate or unnecessary medicalTreatment which may not be covered by thisinsurance.

Please note that Your prior medical history may bereviewed by Us, when a claim is reported.

The Common Carrier Accidental Death and Dismemberment benefitsdescribed in this Certificate of Insurance are underwritten by ChubbInsurance Company of Canada under Group Policy No. 6477-45-30. TheOut-of-Province/Out-of-Country Emergency Medical benefits describedherein are underwritten by Allianz Global Risks US Insurance Company(“Allianz”) under Group Policy No. FC310000-A. Collectively GroupPolicy No. 6477-45-30 and Group Policy No. FC310000-A are referred toherein as (the “Policy”) issued to Bank of Montreal (the “Policyholder”,“BMO”). All other benefits, such as Car Rental Collision Damage Waiver,Car Rental Accidental Death and Dismemberment, Car Rental PersonalEffects, Trip Cancellation, Trip Interruption/Trip Delay, Flight Delay andBaggage and Personal Effects insurance are offered by Allianz to Youunder an individual policy. Your BMO MasterCard number is Your policynumber with respect to any such individual insurance. The insurancedescribed in this Certificate of Insurance is for eligible MasterCardPrimary Cardholders of the Policyholder whose Accounts are in GoodStanding and where specified, their Spouses, Dependent Children and/orcertain other persons (referred to herein as “You” or “Your”). Thisinsurance is administered by Mondial Assistance through the OperationsCentre with the exception of Common Carrier Accidental Death andDismemberment benefits which are administered by CSI Brokers Inc.

This Certificate of Insurance is effective on the later of July 1, 2010, or thedate BMO receives and approves the Primary Cardholder’s request thatthis insurance be included as a feature of their MasterCard.

The Out-of-Province/Out-of-Country Emergency Medical benefits aresubject, in every respect, to the terms of the Policy, which alone constitutesthe agreement under which payments are made. Only BMO may determinewho is a Primary Cardholder, whether an Account is in Good Standing.

No person is eligible for coverage under more than one certificate ofinsurance providing insurance coverage similar to that providedhereunder. In the event that any person is recorded by Us as an “InsuredPerson” under more than one such certificate or policy, such person shallbe deemed to be insured only under the certificate or policy, which affordsthat person the greatest amount of insurance coverage. In no event will acorporation, partnership or business entity be eligible for this insurancecoverage. This Certificate of Insurance supersedes any certificatepreviously issued to You.

TABLE OF CONTENTS

1 Definitions .......................................................... 32 Certificate Effective And Termination Date ... 83 Eligibility ............................................................ 8Section A – Your Car Rental, Trip Assistance, Trip

Cancellation, Trip Interruption/TripDelay, Flight Delay, Baggage &Personal Effects and Out-of-Province/Out-of-Country Emergency MedicalBenefits from Allianz Global Risks USInsurance Company............................. 9

4 Benefits – Coverage Period and Descriptionof Coverages........................................................ 94.1 Car Rental Benefits .................................. 94.1.1 Collision Damage Waiver (CDW)

Benefits ................................................... 104.1.2 Car Rental Accidental Death and

Dismemberment Benefits ......................124.1.3 Car Rental Personal Effects Benefits .... 14

4.1.4 Car Rental Benefits Exclusions andLimitations ..............................................14

4.1.4.1 General Car Rental Benefits Exclusionsand Limitations........................................14

4.1.4.2 Collision Damage Waiver BenefitsExclusions and Limitations....................16

4.1.4.3 Car Rental Personal Effects BenefitsExclusions and Limitations....................17

4.2 Trip Assistance ....................................... 184.2.1 Trip Assistance Services ........................ 184.2.2 Legal Assistance Services ..................... 194.3 Trip Cancellation, Trip Interruption/

Trip Delay and Flight Delay Benefits.....194.3.1 Trip Cancellation Benefits

(Prior to Departure).................................194.3.2 Trip Interruption/Trip Delay Benefits

(Post Departure) ......................................224.3.3 Flight Delay Benefits...............................244.3.4 Trip Cancellation, Trip Interruption/Trip

Delay and Flight Delay BenefitsExclusions and Limitations....................25

4.4 Baggage and Personal Effects Benefits ..274.4.1 Coverage Period and Benefits ................274.4.2 Baggage and Personal Effects Benefits

Exclusions................................................294.5 Out-of-Province/Out-of-Country

Emergency Medical Benefits..................294.5.1 Coverage Period and Benefits ................294.5.2 Out-of-Province/Out-of-Country

Emergency Medical Benefits Exclusions and Limitations....................33

4.5.3 What Should You Do in the Event of a Medical Emergency?............................36

4.5.4 Out-of-Province/Out-of-Country Emergency Medical Assistance Services....................................................37

5 Conditions..........................................................386 General Provisions............................................407 Claim Filing Procedures...................................418 Protecting Your Personal Information ...........43Section B - Your Common Carrier Accidental Death

and Dismemberment Insurance fromChubb Insurance Company of Canada45

9 Definitions .........................................................4510 Benefits – Coverage Period and Description

Of Coverages......................................................4610.1 Accidental Death and Dismemberment

Benefits.....................................................4610.2 Accidental Death And Dismemberment

Exclusions And Limitations ...................4811 Claim Filing Procedures ..................................49

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In this Certificate of Insurance, certain terms havedefined meanings. Those defined terms (other thanthose specifically defined in Section B of thisCertificate of Insurance) are as follows. Definedterms are capitalized throughout this document.

1 DEFINITIONSAccidental Bodily Injurymeans bodily Injury causeddirectly and independently of all other causes byexternal and purely accidental means. The accidentmust occur during the Coverage Period and the loss towhich the insurance applies must result within threehundred and sixty-five (365) days of the date of thebodily Injury and must not result from any of theexclusions.

Accountmeans the Primary Cardholder’s MasterCardaccount, which is in Good Standing.

Actual Cash Valuemeans We will pay the lesser of:• the actual purchase price of a similar item; • the actual cash value of the item at the time of loss,

which includes deduction for depreciation (foritems without receipts, the insurance will pay upto 75% of the determined depreciated value); or

• the cost to repair or replace the item.

Baggage means luggage and personal possessions,whether owned, borrowed or rented, and taken by Youon the Trip.

Certificate of Insurance means a summary of thebenefits provided under the Group Policy issued toBMO covering accident and sickness, and the policy ofinsurance for all other benefits.

Common Carrier means any land, air or waterconveyance for regular passenger service, which isfully licensed to carry passengers for compensation orhire and which undertakes to carry all personsindifferently as to who may apply for passage, so longas there is room and there is no legal excuse forrefusal.

Coverage Period means the time insurance is ineffect, as indicated in the various sections of thisCertificate of Insurance.

Covered Servicemeans a service or supply, specifiedherein, for which We provide benefits under thisCertificate of Insurance.

Departure Date means the date on which You departon Your Trip.

Dependent Child(ren) means an unmarried natural,adopted or stepchild of a Primary Cardholder

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dependent on the Primary Cardholder formaintenance and support who is:• under twenty-one (21) years of age; or• under twenty-six (26) years of age and a full-time

student attending a recognized college oruniversity; or

• twenty-one (21) years of age or older andpermanently mentally or physically challengedand incapable of self-support and became sowhile eligible as a dependent child.

Emergency Dental Care means the services orsupplies provided by a licensed dentist, Hospital orother licensed provider that are immediately andMedically Necessary.

Essential Items means necessary clothing and/ortoiletries purchased during the time period in whichchecked Baggage has been delayed.

Family Cardholder means a Primary Cardholder’sSpouse and/or Dependent Child who have been issueda supplemental MasterCard on the Account by BMO.

GHIP means the Government Health Insurance Planof Your Canadian province or territory of residence.

Good Standing means being in full compliance withall of the provisions of the Cardholder Agreement inforce between the Primary Cardholder and BMO, asamended from time to time.

Hospital means an institution which is licensed toprovide, on an Inpatient basis, medical care andTreatment of sick and injured persons throughmedical, diagnostic and major surgical facilities,under the supervision of a staff of Physicians and withtwenty-four (24) hour a day service; however, Hospitaldoes not include any institution or part of aninstitution which is licensed or used principally as aclinic, a continued care or extended care facility, aconvalescent home, a rest home, a nursing home or ahome for the aged, or a health spa or a treatment centrefor drug addiction or alcoholism.

Immediate Family Member means the InsuredPerson’s Spouse, child including adopted children andstepchildren, parent, sibling, legal guardian, parent-in-law, grandparents, grandchildren, daughter-in-law,son-in-law, brother-in-law and sister-in-law.

Injury means any bodily harm caused by an accidentwhich results in a covered loss and which requires theimmediate medical care or Treatment of a Physician.

Inpatient means a person who is treated as aregistered bed patient in a Hospital or other facilityand for whom a room and board charge is made.

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Insured Person means those persons covered for thebenefits described in this Certificate of Insurance asspecifically defined in each of the benefit sections.

MasterCardmeans a MasterCard issued by BMO andfor which BMO has received and approved thePrimary Cardholder’s request to include thisinsurance as a feature of the card.

Medical Condition means any Sickness, Injury orsymptom.

Medical Emergency means any unforeseen Sicknessor Injury, which occurs during a Trip. A medicalemergency ends when the Sickness or Injury has beentreated such that Your condition has stabilized.Treatment provided when medical evidence indicatesYou could delay Treatment or return to Canada forsuch Treatment is not considered a medicalemergency and is not covered.

Medically Necessary or Medical Necessitymeans theservices or supplies provided by a Hospital, Physician,licensed dentist or other licensed provider that arerequired to identify or treat Your Sickness or Injuryand that We determine are:• Consistent with the symptom or diagnosis and

Treatment of Your condition, Sickness, ailment orInjury;

• Appropriate with regard to standards of goodmedical practice;

• Not solely for the convenience of You, a Physicianor other licensed provider; and

• The most appropriate supply or level of servicethat can be safely provided to You.

When applied to the care of an Inpatient, it furthermeans that Your medical symptoms or conditionrequire that the services cannot be safely provided toYou as an Outpatient.

Mysterious Disappearancemeans when the article ofpersonal property in question cannot be located, andthe circumstances of its disappearance cannot beexplained and do not lend themselves to a reasonableinference that a theft occurred.

Occupyingmeans in, upon, entering into or alightingfrom.

Operations Centre means the Operations Centermaintained by Mondial Assistance. From Canada andthe U.S. call 1-877-704-0341. From elsewhere callcollect 1-519-741-0782.

Outpatient means someone who receives a CoveredService while not an Inpatient.

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Physician means a person, other than an InsuredPerson or member of the Insured Person’s family (byblood or marriage), who is a medical practitioner andwhose legal and professional standing within his orher jurisdiction is equivalent to that of a doctor ofmedicine (M.D.) licensed in Canada.

Personal Effects means property normally worn ordesigned to be carried on or by an Insured Personsolely for private purposes and not used for business.

Primary Cardholder means the cardholder who hassigned an application for a MasterCard, as primarycardholder, and for whom the MasterCard Account isestablished and for whom BMO has received andapproved a request to include this insurance as afeature of the MasterCard.

Reasonable and Customary Charges means chargeswhich do not exceed the general level of charges madeby other providers of similar standing in the locality orgeographical area where the charges are incurred,when furnishing comparable Treatment, services orsupplies for a similar Medical Emergency.

Recurrence means the appearance of symptomscaused by or related to a Medical Condition, whichwas previously diagnosed by a Physician or for whichTreatment was previously received.

Rental Car means a land motor vehicle with fourwheels, that is designed for use mainly on public roadsand which You have rented from a commercial rentalagency for Your personal use for the period of timeshown on the Rental Car Agreement. Certain motorvehicles are not covered, please refer toSection 4.1.4.2. With regards to the Collision DamageWaiver Benefit described under Section 4.1.1 a Rentalcar may also include a commercial car sharingprogram of which You are a member.

Rental Car Agreement means the entire writtencontract that You receive when renting a car from acommercial rental car agency that describes in full allof the terms and conditions of the rental, as well as theresponsibilities of all parties under the rental caragreement. With regards to the Collision DamageWaiver Benefit described under Section 4.1.1 a rentalcar agreement may also include a commercial carsharing program of which You are a member and theterms and conditions thereof.

Sickness means any sudden illness or diseaserequiring the immediate medical care or Treatment ofa Physician.

Spousemeans the person who is legally married to thePrimary Cardholder; or if there is no such person, the

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person who has been living with the PrimaryCardholder in a conjugal relationship and who residesin the same household as the Primary Cardholder andis publicly represented as the spouse of the PrimaryCardholder. For the purposes of this insurance thePrimary Cardholder may have only one (1) spouse.

Terrorism means the unsanctioned and illegal use offorce that causes destruction of property, Injury ordeath by an individual or group for the expresspurpose of achieving a political, ethnic or religiousgoal or result.

Ticketmeans evidence of full fare paid for travel on aCommon Carrier, which has been partially orcompletely charged to the Primary or FamilyCardholder’s Account. Ticket(s) obtained through theredemption of loyalty points earned under theMasterCard reward program are eligible for coverage.

Travel Advisorymeans a formal written notice issuedby the Canadian government to advise travelersagainst non-essential travel to a foreign country or agiven region in that country. This does not includetravel information reports.

Travel Companion is any person who travels with thePrimary Cardholder for the entire Trip and whose farefor transportation and/or accommodation was entirelyprepaid at the same time as the Primary Cardholder.

Treatmentmeans medical advice, care and/or serviceprovided by a Physician. This includes, but is notlimited to, diagnostic measures and prescribed drugs(including pills and inhaled or injected medications).It does not include checkups or cases where You haveno specific symptoms.

Tripmeans a defined period of travel of definite lengthfor which the full cost, or portion of the cost, of YourTicket has been charged to the Primary or FamilyCardholder’s Account. Tickets obtained through theredemption of loyalty points earned under theMasterCard reward program are eligible for coverage.

Please note: You do not need to charge Your Trip toYour MasterCard to be eligible for Out-of-Province/Out-of-Country Emergency Medicalcoverage, providing Your MasterCard Account is inGood Standing.

We, Our, Usmeans Allianz Global Risks US InsuranceCompany.

You or Yourmeans the Insured Person.

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2 CERTIFICATE OF INSURANCEEFFECTIVE AND TERMINATION DATE

Except as otherwise stated herein, this Certificate ofInsurance shall come into effect on the date BMOreceives and approves the Primary Cardholder’srequest to include this insurance as a feature of theirMasterCard.

Except as otherwise stated herein, this Certificate ofInsurance shall terminate for all insureds on theearliest of:1. the date the Insured Person is no longer eligible to

participate; 2. the date the eligible Account is defined as

ineligible by BMO; 3. 00:01h of the date the Primary Cardholder cancels

this coverage, or otherwise chooses to close theMasterCard Account; or

4. the date the Policy is terminated.

3 ELIGIBILITYYou are eligible for this insurance while You meet all ofthe following conditions:1. You are under age seventy-five (75) at time of

purchase or on Your annual renewal date, (forDependent Children see the definition for agelimits);

2. You are a resident of Canada with a BMOMasterCard Account in Good Standing;

3. You are covered by a Canadian GovernmentHealth Insurance Plan to be eligible for the Out-of-Province/Out-of-Country Emergency MedicalBenefits.

If You are age 75 or older and wish to obtain alternativeoptional coverage, please contact the OperationsCentre. From Canada and the U.S. call 1-877-704-0341. From elsewhere call collect 1-519-741-0782.

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SECTION A – YOUR CAR RENTAL , TRIPASSISTANCE, TRIP CANCELLATION,TRIP INTERRUPTION/TRIP DELAY,FLIGHT DELAY, BAGGAGE & PERSONALEFFECTS AND OUT-OF-PROVINCE/OUT-OF-COUNTRY EMERGENCYMEDICAL BENEFITS FROM ALLIANZGLOBAL RISKS US INSURANCECOMPANY

4 BENEFITS – COVERAGE PERIODAND DESCRIPTION OF COVERAGES

4.1 CAR RENTAL BENEFITS

Coverage EligibilityThe Car Rental Benefits apply when You enter into anon-renewable Rental Car Agreement for a four-wheelpassenger vehicle, where the total rental period doesnot exceed forty-eight (48) days, subject to exclusionsand limitations (as outlined in Section 4.1.4) and thefollowing requirements:1. the Rental Car must be rented by the Primary

Cardholder, or a Family Cardholder; and2. the Rental Car must be rented from a commercial

car rental agency; and 3. the full cost, or portion of the rental cost, must be

either charged to the Account or paid through theredemption of loyalty points earned under theMasterCard reward program. An eligible RentalCar included in a pre-paid travel package iscovered if the full cost, or portion of the cost, of thetravel package was charged to the Account; orpaid through the redemption of loyalty pointsearned under the MasterCard reward program;and

4. You must not rent more than one vehicle at a timeduring a rental period; and

5. You must decline the collision damage waiverbenefits (or similar provisions, such as “lossdamage waiver”) offered by the rental agency(when not prohibited by law). If there is no spaceon the Rental Car Agreement to decline coverage,You must write on the contract “I decline the CDWprovided by the Rental Agency.” If such coverageis not available from the rental agency, then CDWbenefits are not available under this Certificate ofInsurance; and

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6. the Rental Car must have been operated by thePrimary Cardholder, a Family Cardholder, thePrimary Cardholder’s Spouse or Dependent Childlisted on the Rental Car Agreement andauthorized to operate the Rental Car under theRental Car Agreement in accordance with itsconditions when the loss occurs.

Coverage PeriodFor a rental vehicle to be eligible for coverage, thisinsurance must be a feature of the MasterCard prior toentering into the Rental Car Agreement or prior to theInsured Person taking control of the Rental Car.Insurance coverage begins as soon as the PrimaryCardholder, the Family Cardholder, the PrimaryCardholder’s Spouse or Dependent Child who isauthorized to operate the Rental Car under the RentalCar Agreement takes control of the Rental Car. Thetotal rental period must not exceed forty-eight (48)consecutive days. In order to break the consecutiveday cycle, a full calendar day must exist betweenrental periods. If the rental period exceeds forty-eight (48) consecutive days, coverage under thisCertificate of Insurance will be void.

Insurance coverage ends at the earliest of:1. the time when the rental agency assumes control

of the Rental Car, whether it be at its place ofbusiness or elsewhere. Rental keys left in a lockeddrop box does not constitute that the rentalagency has assumed control of the Rental Car;

2. the end of the chosen rental period; or3. the date on which the Primary Cardholder’s

coverage is terminated in accordance with the“Certificate Effective and Termination Date”provision set out above.

4.1.1 COLLISION DAMAGE WAIVER(CDW) BENEFITS

Insured Personmeans the Primary Cardholder, FamilyCardholder, Primary Cardholder’s Spouse orDependent Child(ren).

Coverage BenefitsSubject to the terms and conditions, You are coveredfor Rental Cars with a Manufacturer’s Suggested RetailPrice (MSRP), in its model year, up to a maximum of$65,000 for:

1. damage to the Rental Car; and2. theft of the Rental Car or any of its respective parts

or accessories; and

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3. rental agency charges for valid loss-of-use, whilethe Rental Car is being repaired; and

4. reasonable and customary charges for towing theRental Car to the nearest available facility.

This coverage does not provide any form of thirdparty automobile, property damage or personalinjury liability insurance. It is the responsibility ofthe Insured Person to have adequate third partyinsurance, either through their own automobileinsurance policy or by accepting the insuranceoffered through the rental agency.

The amount of the benefit payable will be equal to thecost of the repair (including loss-of-use) orreplacement cost of Your Rental Car which has beendamaged or stolen, less any amount or portion of theloss assumed, waived or paid by the car rental agency,its insurer, or a third party insurer.

In the event of a claim, the Insured Person mustcontact the Operations Centre as soon as possible orwithin forty-eight (48) hours. We will need thefollowing information:• a copy of the driver’s license of the person who

was driving the Rental Car at the time of theaccident;

• a copy of the loss/damage report You completedwith the rental agency;

• a copy of the original police report when theresulting loss from damage or theft was over $500;

• a copy of Your MasterCard sales draft, and Yourstatement of Account showing the rental charge.This charge must appear on Your credit cardstatement within ninety (90) days of the incident;

• the original front and back pages of the openedand closed-out Rental Car Agreement, or ifapplicable, a copy of Your membership agreementwith the car sharing program, a copy of the visualinspection report completed prior to assumingcontrol of the vehicle and confirmation of Yourtime booked;

• a copy of the itemized repair estimate, finalitemized repair bill and parts invoices;

• original receipt(s) for any repairs for which Youmay have paid; and

• if the loss-of use is charged, a copy of the rentalagency’s daily utilization log from the date theRental Car was not available for rental, to the datethe Rental Car became available to rent.

Please see section 4.1.4 for applicable exclusionsand limitations.

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4.1.2 CAR RENTAL ACCIDENTALDEATH AND DISMEMBERMENTBENEFITS

Insured Person means the Primary Cardholder andhis/her Spouse and Dependent Child(ren) whileOccupying an eligible Rental Car.

Coverage Benefits Car Rental Accidental Death and DismembermentInsurance covers an Insured Person who suffers a“loss”, as defined as follows, arising as a result of anAccidental Bodily Injury to the Insured Person whileOccupying an eligible Rental Car.

“Loss of hand or foot” means dismemberment bycomplete and permanent severance at or above thewrist or ankle joint. “Loss of thumb and index finger”means complete and permanent severance of thethumb and index finger on the same hand. “Loss ofsight” means complete and irrecoverable loss of allvisual acuity and it must be the direct result of physicaldamage to the eye and/or optic nerve. Legal blindnessis not the standard for determining Loss of sight underthis Certificate of Insurance. “Loss of speech orhearing” must be complete and irrecoverable.

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Loss means one of the following losses as definedherein:

Amount of BenefitPrimary EachCardholder Additional

InsuredPerson

Loss

Loss of Life $200,000 $20,000

Loss of Both Hands or Feet $200,000 $20,000

Loss of One Foot orOne Hand and theEntire Sight of One Eye $200,000 $20,000

Loss of Entire Sightof Both Eyes $200,000 $20,000

Loss of One Handand One Foot $200,000 $20,000

Loss of Speech and Hearing $200,000 $20,000

Loss of One Handor One Foot $100,000 $10,000

Loss of Entire Sightof One Eye $100,000 $10,000

Loss of Speech $100,000 $10,000

Loss of Hearing $100,000 $10,000

Loss of Thumb andIndex Finger onthe Same Hand $ 50,000 $ 5,000

The maximum benefit payable for any one accident is$300,000. If more than one of the described Losses issustained by an Insured Person in any one accident,then the total benefit payable for that accident islimited to the greatest amount payable for any one ofthe Losses sustained.


Exposure and DisappearanceIf by reason of an accident covered by this Certificateof Insurance an Insured Person is unavoidablyexposed to the elements and as a result of suchexposure suffers a loss for which indemnity isotherwise payable hereunder, such loss will becovered hereunder.

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If the body of an Insured Person has not been foundwithin twelve (12) months after the date ofdisappearance as the result of the sinking or wreckingof a vehicle in which the Insured Person was riding atthe time of the accident and under such circumstancesas would otherwise be covered hereunder, it will bepresumed that the Insured Person suffered loss of liferesulting from Accidental Bodily Injury.

Beneficiary Any accidental death benefit payable under thisCertificate of Insurance will be paid to the PrimaryCardholder, if living, otherwise to the estate of thePrimary Cardholder, unless a beneficiary designationhas been filed with Mondial Assistance. All otherbenefits are payable to the Primary Cardholder.

4.1.3 CAR RENTAL PERSONALEFFECTS BENEFITS

Insured Person means the Primary Cardholder,his/her Spouse and Dependent Child(ren) travellingwith the Primary Cardholder or Family Cardholderwho has rented the Rental Car.

Coverage BenefitsThis Personal Effects insurance covers theft or damageto Personal Effects belonging to an Insured Personwhile such Personal Effects are in a Rental Car duringa Trip for the duration of an eligible rental period.

Coverage during such rental period will be the ActualCash Value of Your Personal Effects up to a maximumof $1,000 for each Insured Person, per occurrence.Total benefits during each rental period are limited to$2,000 per Account.


4.1.4 CAR RENTAL BENEFITSEXCLUSIONS AND LIMITATIONS

4.1.4.1 GENERAL CAR RENTALBENEFITS EXCLUSIONS ANDLIMITATIONS

This insurance does not cover certain risks. We willnot pay any of the Car Rental benefits if a claim isdirectly or indirectly a result of one or more of thefollowing:

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Damage - wear and tear, gradual deterioration,mechanical or electrical breakdown or failure, insectsor vermin, inherent flaw or damage; damage causedby the use of incorrect fuel type; or

Loss of Vehicle Entry Device – loss, damage ormisplacement of vehicle entry devices; or

Diminished Value - the amount by which the resalevalue of a damaged (or damage repaired) Rental Carhas been reduced for having a significant damagehistory; or

Violation of Rental Car Agreement - operation of theRental Car in violation of the terms of the Rental CarAgreement; or

Intentional Acts - damage due to intentional acts,while sane or insane; or

Off-road operation - damage caused to the Rental Carby use off of publicly maintained roads; or

Speed Contests - damage caused to the Rental Carwhile driving at a rate of speed that is a markeddeparture from the lawful rate of speed; or

Intoxication - any event which occurs while theInsured Person is under the influence of illicit drugs oralcohol (where the concentration of alcohol in theInsured Person’s blood exceeds eighty (80) milligramsof alcohol in one hundred (100) millilitres of blood) orwhen the Insured Person illustrates a visibleimpairment due to alcohol or illicit drugs); or

Drugs orPoison - any voluntary taking of poison, toxicsubstances or non-toxic substances or drugs, sedativesor narcotics, whether illicit or prescribed, in suchquantity that they become toxic, or voluntaryinhalation of a gas; or

Disease - bodily or mental infirmity, Sickness, illness,or disease of any kind; or

Medical Complications - medical or surgicaltreatment or complications arising therefrom, exceptwhen required as a direct result of an AccidentalBodily Injury; or

Suicide - suicide, attempted suicide or self-inflictedInjury while sane or insane; or

Illegal Trade - transporting contraband or illegaltrade; or

Criminal Offence - committing or attempting tocommit a criminal offence or dishonest or fraudulentacts, or committing or provoking an assault; or

War or Insurrection - declared or undeclared war, orany act of war, riot or insurrection; or service in the

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armed forces of any country or internationalorganization; or hostilities, rebellion, revolution orusurped power; or

Liability - other than for loss of, or damage to, theRental Car; or

Expenses - assumed waived or paid by thecommercial car rental company or its insurers orpayable under any other insurance; or

Confiscation - confiscation by order of anygovernment or public authority; or

Seizure or destruction - seizure or destruction undera quarantine or customs regulation.

4.1.4.2 COLLISION DAMAGE WAIVERBENEFITS EXCLUSIONS ANDLIMITATIONS

In addition to the General Car Rental BenefitsExclusions and Limitations, these specific exclusionsand limitations apply to Collision Damage Waiverbenefits:1. There is no coverage for any vehicle with a

Manufacturer’s Suggested Retail Price (MSRP) inits model year, over $65,000.

2. There is no coverage for additional rental feescharged by the rental agency for a replacementvehicle if required by You for the remainder of theoriginal rental period.

3. This coverage does not apply to Rental Cars whenYour rental period is more than forty-eight (48)consecutive days, or Your rental period isextended for more than forty-eight (48) days byrenewing or taking out a new rental agreementwith the same or another rental agency for thesame vehicle or other vehicles.

4. This coverage will not pay for the cost of anyinsurance offered by or purchased through the carrental company, even if such cost is mandatory orincluded in the price of the vehicle rental.

5. Vehicles which belong to the following categoriesare not covered:• vans (except as defined below);• trucks (including pick-ups) or any vehicle thatcan be spontaneously reconfigured into a pick-up truck;

• campers or trailers; • vehicles towing or propelling trailers or anyother object;

• off-road vehicles (Sport Utility Vehicles arecovered, provided they are not used as off-road

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vehicles, are driven on maintained roads anddo not have an open cargo bed);

• motorcycles, mopeds or motorbikes;• expensive or exotic vehicles; • antique vehicles; • recreational vehicles or vehicles not licensedfor road use; and

• leased vehicles, with buyback guarantee.

Vans are not excluded provided that they:1. are for private passenger use with seating for no

more than eight (8) occupants including thedriver; and

2. do not exceed a “3/4 ton” rating; and3. are not designed for recreational use (such as but

not limited to camping, operation on roads notmaintained by a federal, provincial, state or localauthority and is designed and manufactured foroff road use); and

4. are not to be used for hire by others.

An expensive or exotic vehicle is any vehicle with anMSRP, in its model year, greater than $65,000.

An antique vehicle is one which is over twenty (20)years old or when its model has not beenmanufactured for ten (10) years or more.

Limousines are not covered. However, standardproduction models of these vehicles that are not usedas limousines are not excluded provided that theyhave an MSRP, in their model year, of $65,000 or less.

4.1.4.3 CAR RENTAL PERSONALEFFECTS BENEFITSEXCLUSIONS ANDLIMITATIONS

In addition to the General Car Rental BenefitsExclusions and Limitations, these specific exclusionsand limitations apply to this Personal Effectsinsurance.1. Personal Effects do not include money (whether

paper or coin), tickets, consumable or perishablegoods, bullion, banknotes, negotiable instrumentsor other numismatic property.

2. Benefits are not paid if loss results fromMysterious Disappearance.

3. Reasonable effort must have been made by theInsured Person to protect their Personal Effects(e.g. locking Your Personal Effects in the trunk ofthe Rental Car instead of the front or back seat). Ifclaiming as a result of theft, evidence of forcibleentry into the vehicle while all its doors, windows

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and other openings are closed and locked must besubmitted.

4. Personal Effects coverage is in excess of all otherapplicable valid insurance, indemnity orprotection available to the Insured Person inrespect of the item subject to the claim. We will beliable only for the excess of the amount of the lossor damage over the amount covered under suchother insurance, indemnity or protection and forthe amount of any applicable deductible, only ifall other insurance has been exhausted andsubject to the exclusions, terms and limits ofliability set out in this Certificate of Insurance.This coverage will not apply as contributinginsurance and this “non-contribution” shallsupersede despite any “non-contributionprovision” in other insurance indemnity orprotection policies or contracts.

4.2 TRIP ASSISTANCE

4.2.1 TRIP ASSISTANCE SERVICES

Coverage EligibilityYou do not need to use Your MasterCard to be eligiblefor the following services.

Insured Person means the Primary Cardholder,Spouse and/or Dependent Child(ren).

Coverage Benefits

1. Emergency Cash TransferWhen You are travelling away from home, theOperations Centre will help You to obtain anemergency cash transfer which will be charged to YourAccount (subject to credit availability to a maximum of$5,000, cash advance fees may apply) or payment forsuch costs will be arranged, if reasonably possible,through family or friends if it cannot be charged toYour Account.

2. Lost Document and Ticket ReplacementThe Operations Centre will help You replace lost orstolen travel documents. The cost of obtainingreplacement documents will be charged to YourAccount (subject to credit availability) or payment forsuch costs will be arranged, if reasonably possible,through family or friends if they cannot be charged toYour Account.

3. Lost Luggage AssistanceThe Operations Centre will help You locate or replace

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lost or stolen luggage and Personal Effects. The cost ofobtaining replacement luggage and Personal Effectswill be charged to Your Account (subject to creditavailability) or payment for such costs will bearranged, if reasonably possible, through family orfriends if they cannot be charged to Your Account.

4. Pre-Trip InformationYou can call the Operations Centre to obtaininformation regarding passport and visa regulationsand vaccination and inoculation requirements for thecountry to which You are travelling.

4.2.2 LEGAL ASSISTANCE SERVICES

Coverage EligibilityYou do not need to use Your MasterCard to be eligiblefor the following services.


Coverage BenefitsIf while travelling You require legal assistance, Youcan call the Operations Centre for referral to a locallegal advisor and/or for assistance with arrangementsfor the posting of bail and the payment of legal fees, toa maximum of $5,000, which will be charged to YourAccount (subject to credit availability).

4.3 TRIP CANCELLATION, TRIPINTERRUPTION/TRIP DELAYAND FLIGHT DELAY BENEFITS

4.3.1 TRIP CANCELLATION BENEFITS(PRIOR TO DEPARTURE)

Coverage EligibilityCoverage applies only when You charge the full cost,or portion of the cost, of Your Trip to the Primary orFamily Cardholder’s MasterCard when booking YourTrip.


Coverage PeriodCoverage begins at the time of purchase of Yourprepaid Trip and before any cancellation penaltieshave been incurred. Coverage ends at the time of Yourscheduled departure or date of cancellation,whichever is earliest.

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Should You have to cancel a Trip before Yourscheduled Departure Date, You must cancel Your Tripwith the travel agent and notify the Operations Centrewithin forty-eight (48) hours of the event, whichcaused You to cancel Your Trip.

Coverage BenefitsYou will be reimbursed for the prepaid portion of YourTrip which is non-refundable or non-transferable toanother travel date, up to $2,500 per Insured Person toan overall maximum of $5,000 per Account. Coveragewill include any applicable fees associated with thereinstatement of BMO’s loyalty program’s miles orpoints.

Failure to notify Your travel agent and the OperationsCentre within forty-eight (48) hours may reduce theamount payable. Trip Cancellation benefits arepayable if You cancel a covered Trip when a coveredevent listed below occurs during the Coverage Period.1. The unexpected death, Sickness, Injury, or

quarantine of You, Your Immediate FamilyMember, Your Travel Companion or Your TravelCompanion’s Immediate Family Member.Sickness and Injury must require the care andattendance of a Physician and the Physician mustrecommend in writing cancellation of the Trip.

2. The unexpected death, Sickness or Injury of acaregiver with whom You have contracted to carefor a dependent in Your absence. Sickness andInjury must require the care and attendance of aPhysician and the Physician must thenrecommend in writing cancellation of the Trip.

3. Complications of Your, or Your TravelCompanion’s, pregnancy within the first twenty-eight (28) weeks of pregnancy or complicationsfollowing the normal full term birth of a child.

4. Side effects and/or adverse reactions tovaccinations required for Your Trip.

5. Hospitalization or death of the host at Yourprincipal destination.

6. Cancellation of a planned business meeting due todeath or hospitalization of the person with whomthe Insured Person is to meet, or cancellation of aconference (for which the Insured Person haspaid registration fees) due to circumstancesbeyond the control of the Insured Person or theiremployer. Benefits are only payable to InsuredPerson(s) who are attending the meeting. Proof ofregistration will be required in the event of aclaim.

7. You, or Your Travel Companion, are selected forjury duty or subpoenaed to appear as witness in

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court whereby the date of the hearing conflictswith the Trip.

8. A disaster renders Your, or Your TravelCompanion’s, principal residence uninhabitable,or Your or Your Travel Companion’s place ofbusiness unusable.

9. A transfer by Your employer necessitates a changeof Your permanent residence.

10. A call to service of the Insured Person(s) by theCanadian Government with respect to reservists,military, police or fire personnel.

11. Refusal of Your, or Your Travel Companion’s, visaapplication for the destination country providedthat documentation shows You are eligible toapply, that refusal is not due to late application,and that the application is not a subsequentattempt for a visa that had been previouslyrefused.

12. Involuntary loss of Your principal employmentprovided a letter of termination or official noticeof layoff is produced, and provided You had noknowledge of this loss at the time of Trip payment.

13. A Travel Advisory issued by the CanadianGovernment for Your ticketed destination afterYou book Your Trip.

14. Default whereby a contracted travel supplierstops all service completely as a result ofbankruptcy or insolvency.

15. As a result of the delay of a connecting vehicle,You miss the scheduled departure as ticketed dueto: inclement weather; mechanical failure oraccident of a Common Carrier; a traffic accident;or an emergency police-directed road closure.Such delay due to traffic accident or emergencypolice-directed road closure must besubstantiated by an official police report. All suchmisconnections are subject to the connectingvehicle arriving at the point of departure not lessthan two (2) hours prior to schedule departuretime. In the event of a misconnection thisInsurance covers the entire Trip, up to thecoverage limits, as originally ticketed or the costof a one-way economy fare, via the most cost-effective route, to catch up to the tour or tocontinue Your Trip as originally booked.

16. Weather conditions delay Your connectingscheduled carrier for 30% or more of the totalduration of the Trip and You elect not to continuewith the Trip.

Please note: 1. You are not covered for circumstances which You

were aware of at time of purchasing Your Trip.

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2. Should You have to cancel a Trip before Yourscheduled Departure Date, You must cancel YourTrip with the travel provider and notify theOperations Centre within forty-eight (48) hours ofthe event that caused You to cancel Your Trip.


4.3.2 TRIP INTERRUPTION/TRIPDELAY BENEFITS (POSTDEPARTURE)

Coverage EligibilityCoverage applies only when You charge the full cost,or portion of the cost, of Your Trip to the Primary orFamily Cardholder’s MasterCard prior to departure.


Coverage PeriodCoverage begins at the time of Your departure on YourTrip. Coverage ends at the time of Your return to Youroriginal point of departure.

Should You have to delay Your scheduled return date,You must notify the Operations Centre within forty-eight (48) hours of the event forcing Your delay, toenable the Operations Centre to assist You in makingalternative travel arrangements. Failure to notify theOperations Centre within forty-eight (48) hours mayreduce the amount payable.

Coverage BenefitsYou will be reimbursed for the extra cost of a one-wayeconomy airfare to Your departure point or to thedestination point and any unused non-refundable landarrangements up to a maximum of $2,000 per InsuredPerson. Trip Interruption or Trip Delay benefits arepayable when a covered event listed below occursbefore Your scheduled return date:1. The unexpected death, Sickness, Injury or

quarantine of You, Your Immediate FamilyMember, Your Travel Companion or Your TravelCompanion’s Immediate Family Member.Sickness and Injury must require the care andattendance of a Physician and the Physicianrecommends in writing that You interrupt ordelay Your Trip.

2. The unexpected death, Sickness or Injury of acaregiver with whom You have contracted to care

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for a dependent in Your absence. Sickness andInjury must require the care and attendance of aPhysician and the Physician recommend inwriting that You interrupt or delay Your Trip.

3. Complications of Your or Your TravelCompanion’s pregnancy within the first twenty-eight (28) weeks of pregnancy or complicationsfollowing the normal full term birth of a child.

4. Side effects and/or adverse reactions tovaccinations required for Your Trip.

5. Hospitalization or death of the host at Yourprincipal destination.

6. Cancellation of a planned business meeting due todeath or hospitalization of the person with whomthe Insured Person is to meet, or cancellation of aconference (for which the Insured Person haspaid registration fees) due to circumstancesbeyond the control of the Insured Person or theiremployer. Benefits are only payable to InsuredPerson(s) who are attending the meeting. Proof ofregistration will be required in the event of aclaim.

7. You or Your Travel Companion are selected forjury duty or subpoenaed to appear as witness incourt whereby the date of the hearing conflictswith the Trip.

8. A call to service of the Insured Person(s) by theCanadian Government with respect to reservists, military, police or fire personnel.

9. A disaster renders Your or Your TravelCompanion’s principal residence uninhabitableor Your or Your Travel Companion’s place ofbusiness unusable.

10. Weather conditions delay Your connectingscheduled carrier for 30% or more of the totalduration of the Trip and You elect not to continuewith the Trip.

11. Hijacking of Your Common Carrier while en routeto Your scheduled destination point.

12. A Travel Advisory against non-essential travel isissued by the Canadian Government at Yourticketed destination after You depart on Your Trip.

If for one of the reasons listed above You mustinterrupt an insured Trip already commenced or if Youmust delay Your return beyond the scheduled returndate, Your expenses will be reimbursed up to anaggregate of $2,000 per Insured Person for:• the extra cost to change Your return Ticket to a

one-way economy fare, via the most cost-effectiveroute, by regular scheduled transportation back toYour departure point; or

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• if Your existing Ticket cannot be changed, the costof a one-way economy fare by regular scheduledtransportation to Your departure point; and

• the non-refundable portion of any unused prepaidtravel arrangements if Your insured Trip isinterrupted; and

• if Your Travel Companion’s Trip is interrupted forany of the reasons stated under the TripInterruption/Trip Delay benefits, You will bereimbursed for the cost incurred to adjust Yourprepaid accommodations to a single supplement.

• if for one of the reasons listed above You mustdelay an insured Trip, We will also pay thenecessary and reasonable costs of commercialaccommodation and meals up to $150 a day, perInsured Person on the Trip, when the returnportion of an insured Trip is delayed beyond thedate scheduled, as the result of a MedicalEmergency.

Expenses will be reimbursed when You provide, atOur request, any of the following when applicable:• a statement completed by the attending Physician

in attendance where the Sickness or Injuryoccurred, stating the diagnosis and the completereason for the necessity of Your Trip delay (ifapplicable);

• documentary evidence of the emergency situationwhich caused the delay;

• any Tickets or receipts for any extratransportation costs incurred.

Please note: You are not covered for circumstances which You wereaware of at time of purchasing Your Trip.


4.3.3 FLIGHT DELAY BENEFITS




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Coverage BenefitsFlight Delay Benefits are payable in the event of adelay of more than six (6) hours in the arrival ordeparture of Your regularly scheduled airline flight.You will be reimbursed up to a maximum of $500 perAccount per Trip, for reasonable, additionalaccommodation and travelling expenses. Expensesmust be incurred by You as a result of the delay. Youwill be required to submit original, itemized receiptsfor any expense that You incur in this regard. Prepaidexpenses are not covered.


4.3.4 TRIP CANCELLATION, TRIPINTERRUPTION/TRIP DELAYAND FLIGHT DELAY BENEFITSEXCLUSIONS AND LIMITATIONS

The insurance does not cover, provide services for orpay claims resulting from:

1. Pre-existing conditions applicable to InsuredPersons up to and including age 64:

This insurance will not pay for expenses incurredduring the Coverage Period related to: • the continuing Treatment, Recurrence, ormedically recognized complication relatingdirectly or indirectly to a Medical Condition,for which You consulted, investigated, werediagnosed or for which Treatment was taken byYou during the six (6) month periodimmediately before Your Coverage Periodbegan;

• the Treatment of, or relating to, a MedicalCondition for which a person exhibited anysymptom during the six (6) month periodimmediately before Your Coverage Periodbegan for which a reasonable person wouldhave made inquiries regarding their MedicalCondition, regardless of whether or not suchinquiries were made.

Please note: This exclusion does not apply to aMedical Condition controlled by the consistentuse of medication(s) taken as prescribed by aPhysician provided that during the six (6) monthperiod before Your Coverage Period began andthere has been no change in any medication(s)and no other Treatment has been taken orrecommended. A new medication or an alteration

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in usage or dosage of a medication constitutes achange in medication. This exclusion does notapply to the Flight Delay Benefit.

Pre-existing conditions applicable to InsuredPersons age 65 up to and including age 74

This insurance will not pay for expenses incurredduring the Coverage Period related to: • the continuing Treatment, Recurrence, ormedically recognized complication relatingdirectly or indirectly to a Medical Condition,for which You consulted, investigated, werediagnosed or for which Treatment was taken byYou during the twelve (12) month periodimmediately before Your Coverage Periodbegan;

• the Treatment of, or relating to, a MedicalCondition for which a person exhibited anysymptom during the twelve (12) month periodimmediately before Your Coverage Periodbegan for which a reasonable person wouldhave made inquiries regarding their MedicalCondition, regardless of whether or not suchinquiries were made.

Please note: This exclusion does not apply to aMedical Condition controlled by the consistentuse of medication(s) taken as prescribed by aPhysician provided that during the twelve (12)month period before Your Coverage Period beganand there has been no change in anymedication(s) and no other Treatment has beentaken or recommended. A new medication or analteration in usage or dosage of a medicationconstitutes a change in medication. Thisexclusion does not apply to the Flight DelayBenefit.

2. Pregnancy, miscarriage, childbirth orcomplications of any of these conditionsoccurring within nine (9) weeks of the expecteddate of birth.

3. Riot or civil disorder; committing or attempting tocommit a criminal offence.

4. Intentional self-injury, suicide or attemptedsuicide while sane or insane.

5. Abuse of any medication or non-compliance withprescribed medical treatment or therapy.

6. Mental, nervous or emotional disorders that donot require immediate hospitalization.

7. Any Injury or accident occurring while theInsured Person is under the influence of illicitdrugs or alcohol (where the concentration of

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alcohol in the Insured Person’s blood exceedseighty (80) milligrams of alcohol in onehundred (100) millilitres of blood or when theInsured Person illustrates a visible impairmentdue to alcohol or illicit drugs) and any chronicillness or hospitalization related to, orexacerbated by, the habitual use of alcohol orillicit drugs.

8. The Insured Person voluntarily and knowinglyexposing himself/herself to risk from: an act ofwar whether declared or undeclared; rebellion;revolution; hijacking or Terrorism; and anyservice in the armed forces.

9. Participation in professional sports; any speedcontest; SCUBA diving, unless the Insured Personholds a basic SCUBA designation from a certifiedschool or other licensing body; hang-gliding; skydiving; parachuting; bungee jumping; parasailing;spelunking; mountaineering; rock climbing or aflight accident, except as a passenger in acommercially licensed airline.

10. Any Trip commenced or continued against theadvice of the Insured Person’s Physician.

11. Failure of any travel supplier through which Youcontract for services if this supplier shall be, at thetime of booking, in bankruptcy, insolvency orreceivership; or in the case of U.S. Air Carriers,under Chapter 11 in the U.S. Bankruptcy Code. Noprotection is provided for failure of a travel agent,agency or broker.

12. Non-presentation of required travel documents,i.e., visa, passport, inoculation/vaccinationreports.

13. The death or serious and/or terminal illness of aperson when the purpose of the Trip is to providesupport and physical care for that person.

4.4 BAGGAGE AND PERSONALEFFECTS BENEFITS

4.4.1 COVERAGE PERIOD ANDBENEFITS



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Coverage BenefitsThis Baggage and Personal Effects insurance coversthe Actual Cash Value of Baggage and Personal Effectsup to $750 per Insured Person up to a maximum of$2,000 per Account per Trip for :1. Loss or damage of Baggage and/or Personal

Effects worn or used by You when accompanyingYou during the Trip. Coverage is limited to $500per item.

2. Theft, burglary, fire or transportation hazards toBaggage and/or Personal Effects worn or used byYou during the Trip. Coverage is limited to $500per item.

3. Loss or damage to camera equipment during theTrip. Camera equipment is collectivelyconsidered one item. Coverage is limited to $500per item.

4. Loss or damage to jewelry during the Trip.Jewelry is collectively considered one item.Coverage is limited to $500 per item.

5. Up to $200 will be reimbursed for the purchase ofEssential Items as a result of Your checkedBaggage being delayed by the Common Carrier fortwelve (12) hours or more, during the Trip enroute to Your destination and before returning toYour original point of departure. Proof of delay ofchecked Baggage from the Common Carrier alongwith receipts of purchases must accompany Yourclaim. Purchases must be made within thirty-six(36) hours of Your arrival at Your destination. Thecosts of items purchased under this benefit willreduce the maximum amount payable under theBaggage and Personal Effects benefit, if it is laterdetermined that Your personal Baggage has beenlost, stolen or damaged.

Additional Conditions specific to Baggage andPersonal Effects Insurance1. In the event of loss of an article which is part of a

pair or set, the measure of loss shall be at areasonable and fair proportion of the total value ofthe pair or set, giving consideration to theimportance of such article and with theunderstanding that such loss shall not beconstrued to mean total loss of the pair or set.

2. We shall not be liable beyond the Actual CashValue of the property at the time any loss occurs.

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We reserve the right to repair or replace anydamaged or lost property with other of like qualityand value, and to require submission of propertyfor appraisal of damage

4.4.2 BAGGAGE AND PERSONALEFFECTS BENEFITS EXCLUSIONS

This insurance does not cover, provide services for orpay claims resulting from:1. Loss caused by normal wear and tear, gradual

deterioration, moths, or vermin.2. Animals; automobiles (including equipment and

contents), trailers, motorcycles, bicycles, boats,motors, other conveyances or their accessories;souvenirs; fragile or collectible items;consumable or perishable goods; householdeffects and furnishings; contact lenses,prescription glasses, non-prescription sunglasses;artificial teeth and prostheses, medicalequipment and appliances; money, securities;tickets, documents; any property pertaining to abusiness, profession or occupation; personalcomputers; software; or cellular phones.

3. Loss or damage to jewelry, gems, watches and fursor garments trimmed with fur and cameraequipment while in the custody of an airline orCommon Carrier.

4. Loss of covered and non-covered items sustaineddue to any process or while being worked upon;radiation; confiscation by any governmentauthority; war (declared or undeclared); orcontraband or illegal transportation or trade.

5. Loss incurred while You are performing anegligent act(s) or criminal act(s).

6. Items specifically or otherwise insured.

4.5 OUT-OF-PROVINCE/OUT-OF-COUNTRY EMERGENCYMEDICAL BENEFITS

4.5.1 COVERAGE PERIOD ANDBENEFITS

Coverage EligibilityYou do not need to charge Your Trip to YourMasterCard to be eligible for this coverage, providingYour MasterCard Account is in Good Standing.


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Coverage PeriodYour thirty-one (31) day Coverage Period begins whenYou depart from Your province or territory ofresidence on Your Departure Date providing YourMasterCard Account is in Good Standing.

Your Coverage Period will terminate on the earliest ofthe following:1. The date You return to Your Canadian province or

territory of residence;2. The date Your MasterCard Account is cancelled;3. The date Your MasterCard Account is no longer in

Good Standing;4. Your next annual renewal date in the year You

attain age seventy-five (75); (for DependentChildren see the definition for age limits); or

5. At 00:01 a.m. on the 32nd day (including YourDeparture Date) after You leave on Your Trip.

Optional Extension of Coverage Your Coverage Period can be extended provided noevent has occurred that would give rise to a claimunder this insurance and provided You request anextension by phone prior to Your scheduled returndate. Your total Trip length including extensionscannot exceed 183 days (212 days if You reside inOntario or Newfoundland).

To arrange for an extension call the Operations Centreat 1-877-704-0341 while in North America, or ifelsewhere, call collect (519)-741-0782. Premiumpayment must be charged to Your BMO MasterCardAccount.

When making a claim hereunder, evidence of YourDeparture Date from, scheduled and actual returndates to, Your province or territory of residence will berequired.

Automatic Extension of Coverage When You are in Hospital due to a Medical Emergencyon Your scheduled return date, Your coverage willremain in force for as long as You are in Hospital plusa further period of three (3) days following Yourdischarge from Hospital.

The Coverage Period is also automatically extendedfor three (3) days when:• The delay of a plane, bus, ship or train in which

You are a passenger causes You to miss Yourscheduled return date; or

• The personal means of transportation in whichYou are travelling is involved in an accident ormechanical breakdown that prevents You from

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returning on or before Your scheduled returndate; or

• You must delay Your scheduled return due to theMedical Emergency of another Insured Person.

This insurance covers the Reasonable and CustomaryCharges up to a maximum of $2,000,000 (unlessspecified otherwise below for a specific benefit)incurred by an Insured Person for the medicalTreatment and Covered Services listed below arisingfrom a Medical Emergency which occurs during theCoverage Period.

Following are eligible expenses covered by thisinsurance, subject to all exclusions and limitationsdescribed in this Certificate of Insurance. AnyTreatment or service not listed below is not covered.Neither We, nor the Operations Centre, nor thePolicyholder are responsible for the availability,quality or results of any medical Treatment ortransportation, or the failure of an Insured Person toobtain medical Treatment.

Coverage BenefitsThis Out-of-Province/Out-of-Country EmergencyMedical insurance covers Reasonable and CustomaryCharges for the following Covered Services arisingfrom a Medical Emergency of an Insured Personoccurring during the Coverage Period.

Emergency Hospital, Ambulance & Medical Expenses1. Hospital room and board charges, up to semi-

private or the equivalent. If Medically Necessary,expenses for Treatment in an intensive orcoronary care unit are covered;

2. Treatment by a Physician;3. X-rays and other diagnostic tests;4. Use of an operating room, anesthesia and surgical

dressings;5. The cost of licensed ambulance service;6. Emergency room charges;7. Prescription drugs and medication, limited to a

thirty (30) day supply;8. The cost for rental or purchase of minor medical

appliances such as wheelchairs and crutches.

Private Duty Nursing ExpensesBenefits are payable to a maximum of $5,000 perInsured Person for the professional services of aregistered nurse (not related to You by blood ormarriage) while hospitalized, provided these servicesare Medically Necessary and prescribed by theattending Physician.

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Emergency Air Transportation or EvacuationThe following are covered expenses provided they areapproved and arranged in advance by the OperationsCentre:1. Air ambulance to the nearest appropriate medical

facility or to a Canadian Hospital;2. Transport on a licensed airline for emergency

return to the Insured Person’s province orterritory of residence for immediate medicalattention; and

3. A medical attendant to accompany You on theflight back to Canada.

All air transportation expenses must be approvedand arranged in advance by the Operations Centre.

Other Professional ServicesWhere the professional services of a physiotherapist,chiropractor, osteopath, chiropodist or podiatrist areMedically Necessary, coverage will be provided to amaximum of $150 per Insured Person per discipline.

Emergency Dental ExpensesThis insurance covers the cost to repair or replacenatural teeth or permanently attached artificial teethrequired as the result of an Injury to the mouth, to amaximum of $2,000 per Insured Person. Chewingaccidents are not covered. To be eligible for coverage,dental Treatment must take place during Your Trip.

Treatment for the emergency relief of dental pain iscovered to a maximum of $150 per Insured Person.

Transportation to the BedsideThis insurance covers one round-trip economy airfareby the most direct and cost effective route fromCanada, plus lodging and meals up to a maximum of$250, for any one Immediate Family Member to:

a) Be with an Insured Person who is travellingalone and has been admitted to a Hospital as anInpatient. The Insured Person must beexpected to be an Inpatient for at least seven (7)days outside their home province or territoryand have verification from the attendingPhysician that the situation is serious enough torequire the visit; or

b) Identify a deceased Insured Person prior torelease of the body, where necessary.

Return of DeceasedIn the event of the death of an Insured Person while ona Trip, this insurance covers up to $3,000 for thepreparation (including cremation) and transportationof the deceased’s remains to his/her province or

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territory of residence. The cost of a burial coffin or urnis not covered.

Additional Hotel and Meal ExpensesIf Your return to Canada is delayed due to a MedicalEmergency, this insurance covers the cost for hoteland meal expenses incurred after Your planned returndate up to $200 a day to a maximum of ten (10) daysper Account. To receive reimbursement, originalreceipts must be submitted.

Return of VehicleIf neither You nor anyone travelling with You is able tooperate Your owned or rented vehicle due to Sickness,Injury or death while travelling outside Your provinceor territory of residence, You will be reimbursed up toa maximum of $1,000 for the costs associated with thereturn of the vehicle. Eligible for reimbursement is thecost of the return performed by a professional agency;or the following necessary and reasonable expensesincurred by an individual returning the vehicle by adirect route and in a reasonable time frame on behalfof the Insured Person: fuel, meals, overnightaccommodation and one-way economy airfare.Benefits will only be payable when the return of thevehicle is pre-approved and/or arranged by theOperations Centre and the vehicle is returned to Yournormal place of residence or the nearest appropriaterental agency within thirty (30) days of Your return toCanada.

To receive reimbursement, original itemizedreceipts must be submitted. Any other expenses arenot covered. Expenses incurred by anyone travellingwith the person returning the vehicle are not covered.

4.5.2 OUT-OF-PROVINCE/OUT-OF-COUNTRY EMERGENCYMEDICAL BENEFITSEXCLUSIONS AND LIMITATIONS

The insurance does not cover, provide services or payclaims resulting from:

1. Pre-existing conditions applicable to InsuredPersons up to and including age 64:

This insurance will not pay for expenses incurredduring the Coverage Period related to:• the continuing Treatment, Recurrence, ormedically recognized complication relatingdirectly or indirectly to a Medical Condition,for which You consulted, investigated, were

3 4

diagnosed or for which Treatment was taken byYou during the six (6) month periodimmediately before Your Coverage Periodbegan;

• the Treatment of, or relating to, a MedicalCondition for which a person exhibited anysymptom during the six (6) month periodimmediately before Your Coverage Periodbegan for which a reasonable person wouldhave made inquiries regarding their MedicalCondition, regardless of whether or not suchinquiries were made.

Please note: This exclusion does not apply to aMedical Condition controlled by the consistentuse of medication(s) taken as prescribed by aPhysician provided that during the six (6) monthperiod before Your Coverage Period began therehas been no change in any medication(s) and noother Treatment has been taken or recommended.A new medication or an alteration in usage ordosage of a medication constitutes a change inmedication.

Pre-existing conditions applicable to InsuredPersons age 65 up to and including age 74

This insurance will not pay for expenses incurredduring the Coverage Period related to: • the continuing Treatment, Recurrence, ormedically recognized complication relatingdirectly or indirectly to a Medical Condition,for which You consulted, investigated, werediagnosed or for which Treatment was taken byYou during the twelve (12) month periodimmediately before Your Coverage Periodbegan;

• the Treatment of, or relating to, a MedicalCondition for which a person exhibited anysymptom during the twelve (12) month periodimmediately before Your Coverage Periodbegan for which a reasonable person wouldhave made inquiries regarding their MedicalCondition, regardless of whether or not suchinquiries were made.

Please note: This exclusion does not apply to aMedical Condition controlled by the consistentuse of medication(s) taken as prescribed by aPhysician provided that during the twelve (12)month period before Your Coverage Period beganand there has been no change in anymedication(s) and no other Treatment has beentaken or recommended. A new medication or an

3 5

alteration in usage or dosage of a medicationconstitutes a change in medication.

2. The continued Treatment, Recurrence orcomplication of a Medical Condition followingemergency Treatment of that Medical Conditionduring Your Trip, if the medical advisors of theOperations Centre determine that the InsuredPerson is able to return to Canada and the InsuredPerson chooses not to return.

3. A Medical Condition for which You delayed orrefused further Treatment or investigation, whichwas recommended by Your Physician before YourDeparture Date.

4. Surgery, including but not limited to angioplastyand/or cardiac surgery, and any associateddiagnostic charges, which are not approved by theOperations Centre prior to being performedexcept in extreme circumstances where surgery isperformed on an emergency basis immediatelyfollowing admission to a Hospital.

5. The following procedures, including anyassociated charges, which are not authorized inadvance by the Operations Centre: MRI (MagneticResonance Imaging); CAT (Computer AxialTomography) scans; sonograms; ultrasounds; andbiopsies.

6. Emergency air transportation, which is notapproved in advance by the Operations Centre.

7. Treatment not performed by or under thesupervision of a Physician or dentist.

8. Pregnancy, routine pre-natal care, miscarriage,childbirth or complications of any of theseconditions occurring within nine (9) weeks of theexpected date of birth.

9. Riot or civil disorder; committing or attempting tocommit a criminal offence.

10. Intentional self-injury, suicide or attemptedsuicide while sane or insane.

11. Abuse of any medication or non-compliance withprescribed medical Treatment or therapy.

12. Mental, nervous or emotional disorders that donot require immediate hospitalization.

13. Any Injury or accident occurring while theInsured Person is under the influence of illicitdrugs or alcohol (where the concentration ofalcohol in the Insured Person’s blood exceedseighty (80) milligrams of alcohol in onehundred (100) millilitres of blood or when theInsured Person illustrates a visible impairmentdue to alcohol or illicit drugs) and any chronicillness or hospitalization related to, orexacerbated by, the habitual use of alcohol orillicit drugs.

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14. The Insured Person voluntarily and knowinglyexposing himself/herself to risk from: an act ofwar whether declared or undeclared; rebellion;revolution; hijacking or Terrorism; and anyservice in the armed forces.

15. Drugs and medication, which are commonlyavailable without a prescription or which are notlegally registered and approved in Canada.

16. Prescription refills.17. Replacement of lost or damaged eyeglasses,

contact lenses or hearing aids.18. Participation in professional sports; any speed

contest; full contact bodily sports; SCUBA diving,unless the Insured Person holds a basic SCUBAdesignation from a certified school or otherlicensing body; hang-gliding; skydiving;parachuting; bungee jumping; parasailing;spelunking; mountaineering; rock climbing; heli-skiing; skiing outside of marked trails; or air travelother than as a ticketed passenger.

19. Any Treatment or surgery, where the InsuredPerson can return to his/her province or territoryof residence for such Treatment withoutadversely affecting his/her Medical Condition.

20. Any Treatment or surgery during the Trip, whenthe Trip is undertaken for the purpose of securingor with the intent of receiving medical or Hospitalservices, whether or not such Trip is on the adviceof a Physician.

21. Any Trip commenced or continued against theadvice of the Insured Person’s Physician.

22. Regular care of a chronic Medical Condition;elective Treatment; cosmetic Treatment, or anyTreatment or surgery that is not required for reliefof acute pain or suffering.

23. Your travel to a country for which the Canadiangovernment has issued a Travel Advisory inwriting prior to Your Departure Date.

4.5.3 WHAT SHOULD YOU DO IN THEEVENT OF A MEDICAL EMERGENCY?

You must contact the Operations Centre in the event ofa Medical Emergency.

From Canada and the United States call:1-877-704-0341

From elsewhere call collect: 1-519-741-0782Fax: 1-519-742-8553

Assistance coordinators are available twenty-four (24)hours a day, every day of the year. The Operations

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Centre will assist in finding and arranging medicalcare; provide claims management and paymentassistance under this insurance; pay Hospitals andother medical providers directly whenever possible;and coordinate claims with Your GHIP wheneverpossible.

If the covered medical expense is relatively small, theHospital or Physician may ask You to pay. You will bereimbursed for covered expenses upon submission ofa claim.

In order to benefit from payment assistance and otherassistance services, You must notify the OperationsCentre when You need medical Treatment withintwenty-four (24) hours or as soon as reasonablypossible after being admitted to a Hospital. If You donot notify the Operations Centre at an early stage inYour claim, You may receive inappropriate orunnecessary medical Treatment, which may not becovered by this insurance.

Note: Failure to contact the Operations Centre couldresult in Your expenses not being covered, denial ora delay in the settlement of Your claim.

4.5.4 OUT-OF-PROVINCE/OUT-OF-COUNTRY EMERGENCYMEDICAL ASSISTANCE SERVICES

In addition to the medical insurance benefits, thefollowing Assistance Services are provided:

Medical Assistance and ConsultationYou will be directed to the nearest appropriate medicalfacility wherever possible.

Payment AssistanceSubject to the limitations of this insurance, theOperations Centre will offer to all Hospitals, whichprovide an Insured Person with Medically NecessaryTreatment, a guarantee of coverage for CoveredServices. If the guarantee is not accepted, theOperations Centre will assist in arranging andcoordinating payment wherever possible.

Note: If You do not contact the Operations Centre assoon as possible, and receive medical attention, Youmay be responsible for paying the bills andsubmitting a claim after You return to Your provinceor territory of residence.

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Emergency Message CentreIn case of a Medical Emergency, the Operations Centrecan help to relay important messages to or from Yourfamily, business or Physician.

Please call the Operations Centre at1-877-704-0341 or 1-519-741-0782 if You haveany questions regarding what is not covered.

5 CONDITIONS1. In consultation with the Insured Person’s

attending Physician, We reserve the right totransfer the Insured Person to another Hospital orto return the Insured Person to his/her province orterritory of residence. Refusal to comply by theInsured Person will release Us of any liability forexpenses incurred after the proposed transferdate.

2. Due Diligence: The Primary Cardholder and anyInsured Person shall use diligence and do allthings reasonable to avoid or diminish any loss ofor damage to property protected by thisinsurance.

3. False Claim: If a Primary Cardholder or InsuredPerson makes any claim knowing it to be false orfraudulent in any respect, coverage under thisCertificate of Insurance shall cease and there shallbe no payment of any claim made under thisCertificate of Insurance or the Policy.

4. In the event of a payment under this Certificate ofInsurance, We have the right to proceed in thename of any Insured Person against third partieswho may be responsible for giving rise to a claimunder this insurance. We have full rights ofsubrogation. The Insured Person will execute anddeliver such documents, and fully cooperate withUs, so as to allow Us to fully assert Our right tosubrogation. The Insured Person will not doanything after the loss to prejudice such rights.

5. You must repay to Us amounts paid or authorizedfor payment on Your behalf if We later determinethe amount is not payable under this insurance.

6. You, or someone acting on Your behalf, must givewritten notice of a claim to the Operations Centrenot later than thirty (30) days from the date theclaim arises. The Operations Centre must beprovided by You or someone acting on Your behalfwith satisfactory proof of loss no later than ninety(90) days from the date the claim arises.Satisfactory proof of loss means proof satisfactoryto Us of:• the Departure Date;

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• the occurrence of the Injury or thecommencement of the Sickness;

• the cause or nature of the Injury or Sickness;• the loss, expense or service for which benefitsare being claimed (original itemized receipts);

• the Primary Cardholder’s age;• the claimant’s age; and• the right of the claimant to receive payment;Satisfactory proof of loss specific to Car RentalBenefits:• the occurrence of the Accidental Bodily Injury,the theft of or damage to the Rental Car, or thedeath of You or Your Immediate FamilyMember;

• the cause or nature of the event resulting in theAccidental Bodily Injury, the theft of or damageto the Rental Car, or the death of You or YourImmediate Family Member;

• the loss, expense or service for which benefitsare being claimed (original itemized receipts);

• the right of the claimant to receive payment.7. Failure to give notice of claim or furnish proof of

loss within the time prescribed does notinvalidate the claim if it is shown that it was notreasonably possible to give notice or furnish proofwithin the time so prescribed and if the notice orproof is given or furnished as soon as reasonablypossible, and in no event later than one (1) yearfrom the date of the event for which benefits arebeing claimed. Failure to provide the requesteddocumentation to substantiate Your claim underthis Certificate of Insurance will invalidate Yourclaim.

8. You agree to cooperate fully with Us, and as acondition precedent to the payment of benefits,the Operations Centre reserves the right to obtainall pertinent records or information from anyPhysician, dentist, practitioner, Hospital, clinic,insurer, individual or institution to assess thevalidity of a claim submitted by or on behalf of anyInsured Person. Failure to provide the requesteddocumentation to substantiate Your claim underthis Certificate of Insurance will invalidate Yourclaim.

9. Physical Examination: The Operations Centrehas the right to investigate the circumstances ofloss and to require a medical examination; and inthe event of death to require an autopsy at the costof the Insurer, if not prohibited by law.

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6 GENERAL PROVISIONS1. The Out-of-Province/Out-of-Country Emergency

Medical Insurance provided herein issupplemental in that it pays for covered expensesin excess of Your GHIP and any other insuranceplan. Benefits payable under any other insuranceplan under which You may have coverage will becoordinated in accordance with the currentguidelines issued by the Canadian Life & HealthInsurance Association. Payment under theinsurance and any other plan shall not exceed100% of the eligible charges incurred. Thisinsurance also allows Us/the Operations Centre toreceive in Your name, and endorse and negotiateon Your behalf, these eligible payments. WhenGHIP and other insurance payments have beenmade, this releases GHIP and the other insurersfrom any further liability in respect of that eligibleclaim.

2. All amounts stated in the Certificate of Insuranceare in Canadian currency unless otherwiseindicated. If You have paid a covered expense, Youwill be reimbursed in Canadian currency at theprevailing rate of exchange on the date the servicewas provided.

3. Payment of Benefits: Benefits payable under thisCertificate of Insurance will be paid withinsixty (60) days of receipt of satisfactory proof ofloss. Payment made in good faith will dischargeUs to the extent of this claim.

4. Legal Action: Any action or arbitrationproceeding to recover benefits hereunder cannotbe taken prior to sixty (60) days after satisfactoryproof of loss has been furnished in accordancewith the requirements of this Certificate ofInsurance. Any legal action or arbitrationproceeding against Us for the recovery of a claimunder this Certificate of Insurance shall not becommenced more than one year after theoccurrence, which gave rise to the claim. If,however, this limitation is invalid according to thelaws of the province or territory where thisCertificate of Insurance was issued, You mustcommence Your action or arbitration proceedingwithin the shortest time permitted by the laws ofthat province or territory. In addition You, Yourheirs and assigns consent to the venue of anyaction or arbitration being only in the province orterritory where the Certificate of Insurance wasissued and at a venue We and/or MondialAssistance choose.

5. Notwithstanding anything to the contrary, no

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provision of this Certificate of Insurance shall bedeemed to have been waived, either in whole or inpart, unless the waiver is clearly stated in writingand signed by Us.

6. The benefits, terms and conditions of thisCertificate of Insurance shall be governed by theinsurance laws of the province or territory inCanada where the Insured Person normallyresides.

7. Any provision of this Certificate of Insurance,which is in conflict with any federal, provincial orterritorial law of the Insured Person’s place ofresidence, is hereby amended to conform to theminimum requirements of that law.

7 CLAIM FILING PROCEDURESPlease contact Us at 1-877-704-0341 or 519-741-0782 toobtain a claim form.

This insurance will not pay for any interest.

As a condition to the payment of benefits under thisinsurance, We will need certain information from Youif You need to file a claim. This documentation willinclude, at a minimum and is not limited to, thefollowing:

1. General Documentation• Receipts and itemized bills for all expenses.• Originals of any refunds or expense allowancesreceived from Your tour operator, travel agency,Common Carrier or other entity.

2. Collision Damage Waiver (CDW) Benefits• A copy of the original police report when theresulting loss from damage or theft was over$500.

• The original front and back pages of the openedand closed-out Original Rental Car Agreement.

• An itemized statement of repairs for the rentalvehicle (unless Our representative has seen thecar).

3. Car Rental Accidental Death &Dismemberment Benefits• Certified death certificate.• Medical records pertaining to the accident.• Police report or any other accident reportsfiled.

4. Car Rental Personal Effects Benefits• Original police report or other report to localauthorities.

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• An itemization and description of the stolen ordamaged items and their estimated value.

• A copy of the receipts, credit card statements,or cancelled cheques for the personal propertystolen or damaged.

• Estimate of repairs, if applicable.• Photo of the damaged item, if applicable.• Declaration page from any other applicableinsurance or a notarized statement that anInsured Person has no other insurance.

• Original Rental Car Agreement.• A copy of an Insured’s monthly billingstatement reflecting the charge for the RentalCar.

5. Trip Cancellation, Trip Interruption/Trip DelayBenefits• Any appropriate documentation that officiallyexplains the cause of Your Trip cancellation,delay or interruption.

• The report of Your physical examination (ifapplicable), and any explanation of diagnosisalong with original itemized bills, receipts, andproof of other insurance payments.

• Certified death certificate in the event of adeath.

• Original unused Tickets, copies of invoices,proof of payments, and other documents thatsubstantiate the cost or occurrence of the Tripcancellation, delay or interruption.

• Documentation of refunds received from thetravel supplier(s) and/or Common Carrier(s).

• Copy of the supplier’s literature that describespenalties.

• A letter of the tour operator or an itemized billfrom the travel agent stating the non-refundable amounts of the Trip costs.

6. Flight Delay Benefits• Original police, Common Carrier or otherreport that verifies the cause and duration ofthe delay.

• Original, itemized receipts.

7. Baggage and Personal Effects Benefits• Original claim determination from theCommon Carrier, if applicable.

• Original police report or other report of localauthorities.

• Original receipts and list of stolen, lost ordamaged items.

• Statement of loss providing amount of loss,date, time and cause of loss.

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8. Out-of-Province/Out-of-Country EmergencyMedical Benefits• Any explanation of diagnosis(es) along withYour original itemized bills and receipts.

• The claimant’s enrollment in his/herprovincial or territorial GHIP, and valid healthcard number.

• The provision of an authorization to securemedical records.

• The provision of any forms or authorizationsrequired to pursue reimbursement from YourGHIP, any other insurance and/or any thirdparties.

• Your Departure Date and Your scheduled andactual dates of return.

8 PROTECTING YOUR PERSONALINFORMATION

Travel Insurance Personal Information NoticeAllianz Global Risks US Insurance Company,Canadian Branch (the “insurer”) and the insurer’stravel insurance administrator, Mondial Assistance,and the insurer’s agents, representatives andreinsurers (for the purpose of this Travel InsurancePersonal Information Notice collectively “we” “us” and“our”) require personal information for the followinginsurance purposes when offering and providingtravel insurance and related services:

• To identify and communicate with individuals• To consider any application for insurance • If approved, to issue a Certificate of insurance• To administer insurance and related benefits• To investigate claims and to determineeligibility for insurance benefits

• To provide assistance services • For fraud prevention and debt collectionpurposes

We only collect personal information necessary to theinsurance purposes from individuals who apply forinsurance, Certificate holders, insureds, claimants. Insome cases we also collect personal information frommembers of a Certificate holder’s, insured’s orclaimant’s family or their friends when they areunable, for medical or other reasons, to communicatedirectly with us. We also collect and discloseinformation for the insurance purposes from, to andwith, third parties such as, but not necessarily limitedto, health care practitioners and facilities in Canadaand abroad, government and private health insurersand family members and friends of the insured,

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Certificate holder or claimant. We may also use anddisclose information from our existing files for theinsurance purposes.

When an individual applies for, purchases, or iscovered by one of our insurance policies or submits aclaim for insurance benefits, he or she is presumed toconsent to the personal information practicesdescribed in this notice. If an individual does not wishto have their personal information used for theoptional purposes they need only notify MondialAssistance. A person may decline to have theirinformation collected, used or disclosed for theinsurance purposes but in that instance we will likelybe unable to provide insurance and related services.

Personal information is maintained in the Certificateholder’s, insured’s or claimant’s file that we establishand maintain in the offices of Mondial Assistance. Insome instances we may additionally maintain orcommunicate or transfer information to health careand other service providers located outside of Canada.As a result, personal information may be accessible toregulatory authorities in accordance with the law ofthese other jurisdictions.

Individuals have a right to request to access or correctpersonal information we have on file by contacting thePrivacy Officer at [email protected] orby writing to:

Privacy OfficerMondial Assistance4273 King Street EastKitchener, ON N2P 2E9

For a complete copy of our Travel Insurance PrivacyPolicy, please visit www.mondial-assistance.ca

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SECTION B - YOUR COMMON CARRIERACCIDENTAL DEATH ANDDISMEMBERMENT INSURANCE FROMCHUBB INSURANCE COMPANY OFCANADA

In Section B of this Certificate of Insurance,certain terms have defined meanings. Thosedefined terms are as follows. Defined terms arecapitalized throughout this document.

9 DEFINITIONSAccountmeans the Primary Cardholder’s MasterCardaccount, which is in Good Standing with thePolicyholder.

Benefit Amount means the Loss amount applicable atthe time the entire cost of the Passenger Fare(s) ischarged to Your MasterCard Account.

Common Carrier means any land, water or airconveyance operated by those whose occupation orbusiness is the transportation of persons withoutdiscrimination and for hire.

Dependent Child(ren) means an unmarried natural,adopted or stepchild of a Primary Cardholderdependent on the Primary Cardholder formaintenance and support who is: 1. under twenty-one (21) years of age; 2. under twenty-six (26) years of age and a full-time

student attending a recognized college oruniversity; or

3. twenty-one (21) years of age or older andpermanently mentally or physically challengedand incapable of self-support and became sowhile eligible as a dependent child.

Family Cardholder means a Primary Cardholder’sSpouse and/or Dependent Child who have been issueda supplemental MasterCard by the Policyholder.

Good Standing means being in full compliance withall of the provisions of the Cardholder Agreement inforce between the Primary Cardholder and thePolicyholder, as amended from time to time.

Insured Person means the Primary Cardholder, theirSpouse and Dependent Children.

Loss means, with respect to a hand, completeseverance throughout or above the knuckle joints of atleast four (4) fingers on the same hand; with respect to

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a foot, complete severance through or above the anklejoint. The Company will consider it a loss of hand orfoot even if they are later reattached.

MasterCard means a MasterCard card issued by thePolicyholder.

Passenger Faremeans a ticket for travel on a CommonCarrier which has been completely charged to theAccount. Tickets obtained through the redemption ofloyalty points earned under the MasterCard rewardprogram are eligible providing that all applicable taxesand/or fees have been charged to the Primary orFamily Cardholder’s Account or paid through theredemption of loyalty points earned under theMasterCard reward program.

Primary Cardholder means the cardholder who hassigned an application for a MasterCard, as primarycardholder, and for whom the MasterCard Account isestablished.

Spousemeans the person who is legally married to thePrimary Cardholder; or if there is no such person, theperson who has been living with the PrimaryCardholder in a conjugal relationship and who residesin the same household as the Primary Cardholder andis publicly represented as the spouse of the PrimaryCardholder. For the purposes of this insurance thePrimary Cardholder may have only one (1) spouse.

We, Us, Our means Chubb Insurance Company ofCanada.

You or Yourmeans the Insured Person.

10 BENEFITS – COVERAGE PERIODAND DESCRIPTION OF COVERAGES

10.1 ACCIDENTAL DEATH ANDDISMEMBERMENT BENEFITS

Coverage EligibilityThis travel insurance plan is provided to Bank ofMontreal MasterCard cardholders automatically whenthe entire cost of the Passenger Fare(s) is charged toYour MasterCard Account while the insurance iseffective. Passenger fare(s) obtained through theredemption of loyalty points earned under theMasterCard reward program are also coveredproviding that all applicable taxes and/or fees havebeen charged to the Primary or Family Cardholder’sAccount or paid through the redemption of loyaltypoints earned under the MasterCard reward program.

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It is not necessary for You to notify the administrator orthe insurance company when tickets are purchased.

Insured PersonAs a Bank of Montreal MasterCard Cardholder, You,Your Spouse and Your Dependent Child(ren) will beautomatically insured against accidental loss of life,limb, sight, speech or hearing while riding as apassenger in, entering or exiting any licensedCommon Carrier, provided the Passenger Fare ischarged to Your MasterCard Account. If the PassengerFare has been charged to Your MasterCard Accountprior to departure for the airport, terminal or station,coverage is also provided for Common Carrier travel(including taxi, bus, train or airport limousine, but notincluding courtesy transportation provided without aspecific charge), immediately, a) preceding Yourdeparture, directly to the airport, terminal or station b)while at the airport, terminal or station, and c)immediately following Your arrival at the airport,terminal or station of Your destination. If the PassengerFare has not been charged to Your Account prior toYour arrival at the airport, terminal or station,coverage begins at the time the entire cost of the travelPassenger Fare is charged to Your MasterCardAccount.

Coverage BenefitsThe full Benefit Amount is payable for accidental lossof life, two (2) or more members, sight of both eyes,speech and hearing or any combination thereof. Onehalf of the Benefit Amount is payable for accidentalloss of: one (1) member, sight of one (1) eye, speech orhearing. “Member” means hand or foot. One quarter ofthe Benefit Amount is payable for the accidental loss ofthe thumb and index finger of the same hand. The lossmust occur within one (1) year of the accident. TheCompany will pay the single largest applicable BenefitAmount. In no event will duplicate request forms ormultiple charge cards obligate the InsuranceCompany in excess of the stated Benefit Amounts forany one loss sustained by any one individual insuredas the result of any one accident.

The limit of coverage for an Insured Person whosecoverage has become effective shall be:

CAD Dollar MasterCard – $500,000 CADAccidental Death Insurance

U.S. Dollar MasterCard – $100,000 CADAccidental Death Insurance

In the event of multiple accidental deaths per creditcard Account arising from any one accident, the

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Company’s liability for all such losses will be limitedto a maximum limit of insurance equal to three timesthe applicable Benefit Amount for loss of life. Benefitswill be proportionately divided among the InsuredPersons up to the maximum limit of insurance.

BeneficiaryThe Loss of Life benefit will be paid to the beneficiarydesignated by the Insured Person. If no suchdesignation has been made, that benefit will be paid tothe first surviving beneficiary in the following order:

a) the Insured Person’s Spouse, b) the Insured Person’s children, c) the Insured Person’s parents, d) the Insured Person’s brothers and sisters, e) the Insured Person’s estate.

All other indemnities will be paid to the InsuredPerson.

If you wish to designate a specific beneficiary, pleasecontact 1-800-337-2632.

10.2 ACCIDENTAL DEATH ANDDISMEMBERMENT EXCLUSIONSAND LIMITATIONS

This insurance does not cover loss resulting from:

1. an Insured Person’s emotional trauma, mental orphysical illness, disease, pregnancy, childbirth ormiscarriage, bacterial or viral infection (exceptbacterial infection caused by an accident or fromaccidental consumption of a substancecontaminated by bacteria), or bodilymalfunctions;

2. suicide, attempted suicide or intentionally selfinflicted injuries; and

3 declared or undeclared war, but war does notinclude acts of terrorism.

This insurance also does not apply to an accidentoccurring while an Insured Person is in, entering, orexiting any aircraft while acting or training as a pilot orcrew member, but this exclusion does not apply topassengers who temporarily perform pilot or crewfunctions in a life threatening emergency.

This description of coverage is not a contract ofinsurance but is simply an informative statement ofthe principal provisions of the insurance while ineffect. Complete provisions pertaining to this plan ofInsurance are contained in the master policy on filewith the Policyholder. If a statement in this description

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of coverage and any provision in the policy differ, thepolicy will govern. Any terms of this policy which arein conflict with the applicable statutes, laws orregulations of the province or territory in which thispolicy is issued are amended to conform with suchstatutes.

11 CLAIM FILING PROCEDURESFOR AD&D CHUBB CLAIMS

Answers to specific questions can be obtained bywriting the Plan Administrator. To make a claimplease contact the Plan Administrator.

Plan AdministratorCSI Brokers Inc.1 Yonge Street, Suite 1801Toronto, ONM5E 1W7

U.S. Administrator – DFS&A Insurance Agency, Inc.800-337-2632

As a condition to the payment of benefits under thisinsurance, We will need certain information from Youif You need to file a claim. This documentation willinclude, at a minimum and is not limited to, thefollowing:

• A copy of the invoice showing Your MasterCardAccount and/or loyalty points earned under theMasterCard reward program as the method ofpayment;

• Certified death certificate;• Medical records pertaining to the accident; and• Police report or any other accident reportsfiled.

33469338/10034426 (11/10)

® Registered trademark of Bank of Montreal.®* Registered trademarks of MasterCard International Incorporated.

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