Glossary

Acute Onset of Pre-existing Condition

Sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage.

AD&D (Accidental Death & Dismemberment)

Insurance coverage in case of death or dismemberment due to accident. Dismemberment is loss of one or more limbs (arms or legs) or eyes.

Administrator

Company that administers insurance policy by providing services such as policy marketing, policy purchase process, service provider lookup, benefits approval, claims processing, customer support, etc.

Policy holder never interacts with underwriter as all services are provided by administrator.

For few policies, claims administrator and policy administrator are different. This information is clearly indicated on insurance card.

AM Best Rating

A.M. Best Company is a global credit rating agency for insurance companies. It provides Credit Ratings as an opinion of the financial strength and creditworthiness of risk-bearing entities and investment vehicles.

Baggage Upgrade

Rider to provide additional benefits in case of Lost Baggage/Theft.

Beneficiary

Person(s) designated by the insured to receive the proceeds of an insurance policy upon the death of the insured.

Benefit Period

Duration of time following a covered Injury or Sickness in which to receive Medically Necessary Covered Expenses. If Your policy terminates during Your Benefit Period, You will still be eligible to receive Treatment so long as the treatment is within Your Benefit Period.

Benefits

Expenses which are for Medically Necessary services, supplies, care, or Treatment due to Illness or Injury.

Cancelable

A Policy is cancelable if terminating the policy prior to policy end date would result in a prorated refund.

Certificate of Coverage

Document listing benefits, limitations and exclusions of purchased policy in its entireity.

Claim

Submission of request by insured to administrator for services rendered by health care provider to get reimbursed.

Co-Insurance

Percentage or amount of covered expenses that insured pays. You start paying coinsurance after you've paid your policy's deductible.

Co-Pay

Fixed amount you pay for a health care service, usually when you receive the service irrespective of deductible is met or not. The amount can vary by the type of service. Co-pay is generally not used in visitor insurance policies.

Common Carrier

A vehicle operating for commercial purposes and carrying fare-paying passengers on regularly scheduled and published routes.

Common Carrier AD&D

Accidental Death & Dismemberment occured while traveling on common carrier. Some policies provide different benefits based on carrier type.

Coverage Period

Period or duration between policy start date and policy end date including those days.

Deductible

Amount of expenses that must be paid out of pocket before insurance company will pay any expenses. Premium will be lower if higher deductible is chosen.

Dental Emergency/Accident

Emergency Dental Treatment necessary to restore or replace sound natural teeth lost or damaged in an Accident.

Emergency Medical Evacuation and Emergency Reunion

Emergency Medical Evacuation benefit covers evacuation of insured to the nearest qualified medical facility under emergency conditions and also cost of returning to initial evacuation location or home country, up to eligible limit.

Emergency Reunion benefit covers transportation, lodging, and meal costs for a relative to join insured in case of emergency. Insured needs to get pre-certification to avail this benefit.

Enhanced AD&D

Rider offered by some plans which provides additional Accidental Death & Dismemberment benefits.

Evacuation Plus

Rider offered by some plans which provides additional Evacuation benefits.

Exclusions

Services which are not covered by policy. These are listed in Certificate of Coverage document of the policy.

Felonious Assault

It is willful or unlawful use of force upon the Insured: (1) with the intent to cause bodily Injury to the Insured; and (2) that results in bodily harm to the Insured; and (3) that is a felony or a misdemeanor in the jurisdiction in which it occurs. This benefit is offered by some plans.

Hazardous Sports Coverage

Rider offered by some plans which provides additional coverage for activities such as motorcycle/motor scooter riding (whether as a passenger or a driver), hang gliding, parachuting, bungee jumping, water skiing, wakeboard riding, jet skiing, paragliding, windsurfing, snow skiing, snowmobiling, and snowboarding.

Health Care Provider

Health care providers provide health care services to the patients such as doctors, hospitals, pharmacies etc.

Home Country

Country where you have your true, fixed and permanent residence.

Home Country Coverage

Coverage of insured after returing to home country for injury or illness begin while insurance is in effect. The coverage duration after after returning to home country is generally dependent on original policy duration. If the policy duration is 6 months then home country coverage for most plans is 1 month.

Hospital Indemnity

Benefit which pays fixed amount for each day while insured is hospitalized. This benefit is generally not subjected to deductible or co-insurance.

Inpatient

Health care service which requires insured's overnight stay at the medical care facility.

Insured

Person who is covered by insurance policy purchased.

Intensive Care Unit

Unit in the hospital where seriously ill patients are cared for by specially trained staff. It is also called intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU).

Lifetime Maximum

Maximum amount insurance company will pay during the lifetime of insurance policy.

Lost Baggage/Theft

Lost baggage benefit pays cost of lost luggage when such luggage is permanently lost in transit by common carrier.

Theft is assistance service provided in case of identity theft.

Out of Pocket Maximum

It is the most amount insured will pay during policy period before insurance company pays 100% of covered health benefits. This term is not used with visitor insurance plans as they have Lifetime Maximum limit unlike domestic insurance plans. After insurance company pays lifetime maximum amount of policy, insured needs to pay all health expenses out of pocket.

Outpatient

Health care service which does not require insured's overnight stay at the medical care facility.

Patriot T.R.I.P. Lite

Rider offered by Patriot plans which provides Trip Cancellation, Trip Interruption, Travel Delay, Missed Connection, Baggage Delay benefits.

Personal Liability

Rider which provides personal liability insurance such as injury to third party and damage to third party property.

Policy Maximum

Policy Maximum is the maximum amount paid by insurance company for covered expenses under all circumstances. Premium will be lower if lower policy maximum is chosen.

Political and Natural Disaster Evacuation

Benefit which pays for transportation to nearest place of safety or repatriation to insured's home country when home country government organization orders evacuation of insured from current visited country.

Pre-Certification

Most plans require you to contact insurance company to establish medical necessity before major care expenses such as hospitalization, surgery, CAT scan, MRI etc are incurred. This process is called pre-certification. Pre-certification doesn't guarantee those expenses will get paid. Payment of benefits are subject to terms, conditions, provisions and exclusions listed in master policy. For some plans, if pre-certification is not done, 50% of eligible medical expenses are treated as penalty and are not paid. So, please follow pre-certification requirements as mentioned in master policy.

Pre-Existing Conditions

It is any medical condition, sickness, injury, illness, disease, mental illness or mental nervous disorder, regardless of the cause including any congenital, chronic, subsequent, or recurring complications or consequences related thereto or resulting therefrom that with reasonable medical certainty existed at the time of application or within look back period duration (varies from plan to plan) immediately prior to the insured person’s Effective Date under the policy, whether or not previously manifested, symptomatic, known, diagnosed, treated or disclosed.

Pregnancy Complications

Illnesses whose diagnoses are distinct from Pregnancy, but are adversely affected by Pregnancy or caused by Pregnancy and not associated with a normal Pregnancy.

Premium

The amount you pay to purchase visitor insurance plan. The amount can be paid upfront or monthly depending on the policy.

Recreational Sports

Benefit which covers injuries occured while playing recreational sports or while involved in leisure activities.

Renewable

This indicates if a plan's coverage duration can be extended after purchasing plan. Renewing makes health conditions occured during initial coverage duration not to be treated as pre-existing conditions.

We recommend to purchase for shorter duration and renew as stay is extended. This helps pay less premium in the event of shortened trip and plan is not cancelable. The downside is to pay renewal fee (generally $5) on every renewal and also for Visitors Care plan, deductible will start all over when renewed. Note that purchasing for longer duration at once doesn't reduce premium per day. Make sure you purchase for minimal required initial purchase period for policy to be renewable.

Repatriation

Process of returning insured to their home country.

Return of Minor Children

When Insured traveling alone with dependent children gets hospitalized or dies, this benefit will reimburse traveling costs to home country for dependent children and a chaperone if necessary.

Return of Mortal Remains

This benefit will cover returning of bodily remains or ashes to home country if insured dies while traveling.

Rider

A provision of an insurance policy that is purchased along with basic insurance policy that provides additional benefits at additional cost.

Some insurance policies have riders to add to basic policy.

Trip Delay/Cancellation

Trip delay benefit pays fixed amount in case of trip delays due to common carrier.

Trip cancellation or Trip interruption benefit pays for itinerary changes of insured due to unexpected death of family member or substantial destruction of primary residence.

Underwriter

Insurance company that evaluates financial risks of insurance policy and sets premium prices for insurance policy. It bears certain risks for insured by providing benefits through insurance policy.

Usual, Customary and Reasonable Charges

Amount paid for a health care service in a geographic area based on what providers in the area usually charge for the same or similar service. Usual, Customary and Reasonable(UCR) amount sometimes is used to determine the allowed amount.

War and Terrorism

Rider which provides coverage for injury or illness resulting from war or terrorism.