Insurance Glossary

Acquired Immune Deficiency Syndrome as that term is defined by the United States Centers for Disease Control and Prevention.

An attending physician statement (APS) is a report by a physician, hospital or medical facility who has treated, or who is currently treating, a person seeking insurance. In traditional underwriting, an APS is one of the most frequently ordered additional sources of medical background information. Insurance companies that use medical underwriting request an APS during the application process and this can delay the application approval by many weeks while the insurance company waiting for the clinic/doctor/hospital to return it then it gets evaluated and a decision made (medical underwriting process).

AIDS Related Complex as that term is defined by the United States Centers for Disease Control and Prevention.

Death of the Insured Person resulting from an accident.

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Complete severance from the body of one or more limbs or eyes resulting from an Accident. For purposes of the Accidental Dismemberment benefits provided by this insurance, the term “limb” shall mean: the arm, when the severance is at or above (toward the elbow) the wrist, or the leg, when the severance is at or above (toward the knee) the ankle. Loss of eye(s) shall include complete, permanent and irrevocable loss of sight.

In the context of INC membership:

The costs of accommodation and essential subsistence (including food, clothing and necessary toiletries) incurred by You for or on behalf of a member following a crisis evacuation, provided that:

1. the amount of Accommodation and Subsistence Expenses payable under this program will not exceed USD 10,000 per day per member; and
2. the period for which Accommodation and Subsistence Expenses are payable under this program will not exceed thirty days, starting from the date of the crisis evacuation.

An act, including but not limited to the threat or use of force or violence of any person or group of persons whether acting alone or on behalf of any organisations or governments, committed for political, religious, ideological or similar purpose or reasons include the intention to influence governments, and or put the public, or any section of the public, in fear.

The replacement cost of an item, less proper deduction for depreciation at the time of the loss.

The sudden onset of a medical condition which is likely to respond quickly to medical treatment and is aimed to return you to the state of health you were in immediately before suffering the medical condition or which leads to your full recovery.

Admission – hospital inpatient care for any medical condition.

As defined for add-on to the World Explorer plan:

A sporting activity undertaken for the purposes of recreation or an unusual experience or excitement, typically performed outdoors, and involving a medium degree of risk, including only the following:

• Abseiling,
• BMX,
• Bob-sledding,
• Bungee jumping,
• Canyoning,
• Caving,
• Downhill and/or cross-country snow skiing and snowboarding and snowmobiling, provided that such activity is not in any violation of applicable laws, rules or regulations or away from prepared and marked in-bound, patrolled territories or against the advice of the local ski school or local authoritative body,
• Hot air ballooning,
• Kitesurfing and Kiteboarding,
• Mountaineering below 4,500 meters from ground level,
• Motorcycle riding as a driver or passenger,
• Zip lining,
• Parachuting,
• Paragliding,
• Parascending,
• Rappelling,
• Scuba diving or sub-aqua pursuits at less than depth of 50 meters,
• Skydiving,
• Spelunking,
• Whitewater kayaking or whitewater rafting (in water less than Class V difficulty),
• Wildlife Safaris,
• Windsurfing

Any information, consultation or treatment received from a nurse, physician or specialist; including the issuing of any medication or prescription.

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Health services provided to members who are not confined to a health care institution. Ambulatory services are often referred to as “outpatient” services.

All hospital services for a patient other than room and board and professional services. Laboratory tests and radiology are examples of Ancillary Services.

The yearly maximum that a policy will cover, regardless of how many claims are made.

Appliances (in our International Health Insurance plans) means, Durable medical equipment that:

• Can be used more than once,
• Is used to serve a medical purpose,
• Is not used in the absence of a disease, illness, or injury, and
• Is fit for use in the home/everyday life.

An application form to become a Primary Member under the Policy. The application form will be completed with all the necessary details, including the names of each of the Covered Persons requested to be covered under the Primary Member’s policy and a health declaration and medical confidentiality waiver signed by the Primary Member and each other Covered Person (as applicable) over age 18. A declaration given by the applicant over the phone is considered a valid signature if the call is recorded with the consent of the Primary Member.

The task of locating a hospital/facility that will accept an injured (or especially when critically ill) is called bed finding. Excellent providers of this service are Going Home Medical (USA) and Mayday Group (UK and global). The case managers will step in to identify the best medical facilities along with the most qualified accepting physicians to address all of the medical needs of the patient.

On the World Explorer plans, the beneficiary is the individual named in the Insured Person’s Application to be the recipient of any Accidental Death or Common Carrier Accidental Death benefit.
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For Insured Persons age eighteen (18) and older who do not designate a Beneficiary on the Application, the Beneficiary is automatically as follows:
1) Spouse (if any),
2) Children (if any) equally,
3) Estate of the Insured Person.

For Insured Persons who are under age eighteen (18) who do not designate a Beneficiary on their Application, the Beneficiary is automatically as follows:
1) Custodial parent(s) (if any),
2) Siblings (if any) equally,
3) Estate of the Insured Person.

Personal Data protection policies adhered to by a controller or processor established on the territory of a Member State for transfers or a set of transfers of personal data to a controller or processor in one or more third countries within a group of undertakings or group of enterprises engaged in a joint economic activity.

An intermediary, who acts on behalf of a person who is applying for insurance. They earn a commission from the insurer; however, they have a responsibility to obtain cover appropriate to the needs of the insured. In certain circumstances a broker can also act as an agent for the insurer in terms of issuing a policy or collecting a premium.

The document issued to You stating details of the Policyholder, the Insured Persons, the period of Cover, the Date of Entry of each Insured Person, the Area of Cover, the Plan level, the name of the Insurer, the medical underwriting terms including any special exclusions or restrictions to the Plan.

The Certificate Period is the period of time beginning on the Certificate Effective Date and ending on the Certificate Termination Date.

Medical costs incurred relating to routine vaginal childbirth and cesarean childbirth when medically necessary. Any complications shall be covered by the “hospitalization” benefit.

Babysitting, daycare, nanny, and/or other costs related to the supervision of a Child/Children under age 18 of a Covered Person in the following situations:

• If the Child/Children remain in the Country of Destination while both the Covered Person and his/ her Partner are outside the Country of Destination due to medical treatment,
• During a covered Hospitalization of a parent who is a Covered Person, or
• If the Child/Children are not with the Covered Person or his/her Partner during a covered delayed return trip.

In the context of INC:
A substantial violent uprising by a group of persons assembled together and acting with common purpose of religious, ideological or political intent.

In the context of INC:
Civil War means a hostile contention by armed forces carried on between opposing citizens or subjects of the same country or nation.

The percentage of the cost of a covered service that the Covered Person must pay. The Covered Person shares in this cost with the Insurer. There may be a maximum on the amount of coinsurance a Covered Person will pay, as outlined in the table of benefits.

The cost of flight and hotel for one trip for one family member to visit the Covered Person currently receiving Medical Treatment.

In the context of INC, the benefit includes:

In the event of Conflict in the Country of Assignment (or where travel is taking place to) of the member(s), the program will cover the costs of Crisis Evacuation by the Emergency Response Provider for member(s) and Additional Costs if:

1. The increase in Conflict in the Country of Assignment (or where travel is taking place to) materially contributes to the Risk Rating equaling or exceeding the relevant Risk Rating Trigger Point for that country set out in the Schedule; and/or
2. The increase in Conflict in the Country of Assignment (or where travel is taking place to) that in the opinion of Response Consultants and with Our agreement places the member in physical danger.
3. Acts of Terrorism, Strikes, Riots or Civil Commotion event in the Country of Assignment (or where travel is taking place to) that in the opinion of Alert 24 and with Our agreement places the member(s) in physical danger

Any disease or illness, abnormality, birth defect, premature birth, or malformation present at birth, including any related condition, whether diagnosed or not.

Any freely given, specific, informed, and unambiguous indication of the data subject’s wishes by which he or she, by a statement or by clear affirmative action, signifies agreement to the processing of personal data relating to him or her.

An arrangement where the covered person pays a specified amount for various services and the health care provider pays the remainder. The covered person usually must pay his or her share when the service is rendered. Similar to coinsurance, except that coinsurance is usually a percentage of certain charges where the co-payment is a dollar amount.

Any Personal Data Processed by a contracted Data Processor and/or Sub-Processor on behalf of the Data Controller or Corporate Group Member of the Data Controller pursuant to or in connection with the relevant Administrative Agreements including but not limited to the signatories to the Administrative Agreement(s) and the present DPA, and any Confidential Information which relates to the Parties’ businesses and/or customers or employees of the Parties.

The country outside the Home Country and Country of Residence (if applicable), which was indicated on the Application Form, in which the Covered Person intends to stay for a period of more than sixty (60) consecutive days or in which the Primary Member is already residing, and based on that information, the Insurer has agreed to accept him/her to the insurance policy.

A country in which the Covered Person legally resides and for which he/she has a permanent address (where applicable).

A charge incurred for Your Medically Necessary Treatment which is Reasonable and Customary and incurred during the Period of Cover.

In the context of INC:

An Expatriate Crisis Evacuation and/or a National Crisis Evacuation.

A Covered Person is the Primary Member and/or other person covered through the Primary Member’s coverage as a Dependent of the Primary Member as defined herein.

The sudden, violent and illegal overthrow of a sovereign government.

The following items exclusively:

• Mobile phones,
• Tablets,
• Laptop computers.

Covered Sports Equipment, Covered Photography Equipment and Covered Electronics and Communication Equipment exclusively.

The following items exclusively:

• Skis,
• Ski boots,
• Ski poles,
• Snowboards,
• Snowboard boots,
• Golf clubs,
• Golf bags,
• Tennis rackets.

Processing of Personal Data that takes place in the context of the activities of establishments in more than one Member State of a Data Controller or Data Processor in the European Union where the Data Controller or Data Processor is established in more than one Member State; or processing of Personal Data which takes place in the context of the activities of a single establishment of a Data Controller or Data Processor in the European Union but which substantially affects or is likely to substantially affect Data Subjects in more than one Member State.

A twenty-four (24) hour period during which an Insured Person engages in normal daily activities including but not limited to eating, drinking and washing.

Personal data, sensitive data, and other information made available by the Data Controller to the Data Processor or made available by the Data Processor to Data Controller in connection with the Agreement, and any other data and information processed by the Data Processor in connection with the Agreement, including the personal data of the signatories to the Agreement and the present Addendum, and that which relates to the Parties’ businesses and/or customers or employees of the Parties.

Natural or legal person, public authority, agency, or other body which, alone or jointly with others, determines the purposes and means of the processing of Personal Data. The role of the Controller is not determined by who collects the data or who has access to them but by who determines the purposes and the means of the processing. Legal Entities without own legal personality may be controllers different from the parent company where they determine the purposes and means of the processing performed on their behalf. Where the purposes and means of such processing are determined by Union or Member State law, the controller or the specific criteria for its nomination may be provided for by Union or Member State law.

Any operation or set of operations which is performed by a Data Processor on behalf of a Data Controller, on Personal Data or onsets of Personal Data, whether or not by automated means, such as collection, recording, organization, structuring, storage, adaptation or alteration, retrieval, consultation, use, disclosure by transmission, dissemination or otherwise making available, alignment or combination, restriction, erasure, or destruction.

Natural or legal person and/or legal entity, public authority, agency, or other body which processes Personal data on behalf of the Data Controller. Existence of a Processor depends on a decision taken by the controller, who can decide either to process data within his organization or to delegate all or part of the processing activities to an external organization.

Defining elements:

• Separate legal entity
• Processing of data on behalf of the controller
• Processor is called to implement the instructions given by the controller, at least with regard to the purpose of the processing and the essential elements of the means

All applicable current and/or future international, regional, federal, or national Data Protection Laws, regulatory guidance, legislation, statutes, codes, regulations, recommendations, and/or opinions issued by a relevant data protection authority in any jurisdiction relating to the Processing of Personal Data, including the privacy and security of Personal Data, in accordance with the Federal Data Protection Act of 30 June 2017 ((Federal Law GazetteI p. 2097) Bundesdatenschutzgesetz (BDSG), German Social Security Codes (Sozialgesetzbücher), which include provisions for processing of medical, social and other personal data, as well as, provided in Section 213 of the German Insurance Act, the Amended French Data Protection Act no. 78-17 of 06.01.1978 on Information Technology, Data Files and Civil Liberties and, in particular, the General Data Protection Regulation 2016/679 of 27 April 2016 and any European Union or EU Member State legislation, regulation, recommendation or opinion replacing, adding to or amending, extending, repealing or consolidating the Data Protection Law relating to the requirements on collection, processing and use of Personal Data by Data Processors on behalf of Data Controllers.

An independent public authority which is established by a Member State pursuant to Article 51 of the Regulation; a supervisory authority which is concerned by the processing of personal data because:

• The controller or processor is established on the territory of the Member State of that supervisory authority;
• Data subjects residing in the Member State of that supervisory authority are substantially affected or likely to be substantially affected by the processing; or
• A complaint has been lodged with that supervisory authority;

The French Data Protection Authority (Commission Nationale de l‘Informatique et des Libertés, hereinafter referred to as the “CNIL”) is the French Supervising Authority. The CNIL is an independent administrative authority responsible for ensuring that information technology remains at the service of citizens and does not jeopardize human identity or breach human rights, privacy, or individual or public liberties. It supervises enforcement of Data Protection Agreement and frequently issues decisions and guidelines relating thereto. www.cnil.fr/english/

The identified or identifiable natural living person to whom the personal data relates; an identifiable natural living person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier, or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.

A request from a Data Subject for access to, correction, amendment, transfer, or Deletion of the Personal Data of the person.

The processing or disclosure of personal data to any party who carries on business outside of the European Economic Area (EEA) in compliance with applicable data protection laws. The use of standard contractual clauses in Data Transfer Agreements entered into between Partiesor any other third parties upon approval of the Data Controller for the transfer of Personal data outside of the EEA (Commission Decision 2010/87/EU), or any replacement clauses subsequently approved by the European Commission shall be required. All data processing will be in accordance with the terms and conditions stipulated in all Data Transfer Agreements providing the Information on Personal Data Processing required by GDPR articles 13 and 14.

The actual date the Covered Person received medical treatment and/or other relevant services.

Medically Necessary Treatment received in a hospital that requires the use of an operating theatre, but where You are not admitted to a hospital bed overnight.

A benefit of World Explorer plans for emergency dental treatment necessary to restore or replace sound natural teeth lost or damaged in an accident which was covered under this insurance; however, loss or damage to sound natural teeth while eating or biting into hard objects such as, but not limited to, pencils, ice cubes, nuts, popcorn and hard candies, are not covered. It also includes limited dental treatment necessary to resolve acute onset of dental pain, subject to a maximum of $100 per insured person per certificate period, only if the certificate period is thirty (30) days or more.

A Dependent is described as follows:

1. Spouse/Civil Union Partner

A spouse not legally separated from the Primary Member, or his/her registered civil union partner, or Cohabiting Partner, as registered with the appropriate regulatory authority.

Both individuals are free from matrimonial ties; and

Cohabitation has been declared by the Primary Insured to the Policyholder, who shall communicate such information to the Insurer at the time of enrollment.

2. Cohabitating Partner (Common Law/Life Partner)

A spouse not legally separated from the Primary Member, or his/her registered civil union partner, or Cohabiting Partner, as

registered with the appropriate regulatory authority.

3. Dependent Child/Children

The unmarried Child/Children of the Primary Member and those of his/her spouse (or civil union partner or Cohabitating Partner)up to the age of 18, living in the household of Primary Member,whether legitimate, recognized, adopted or taken in, including minors who are under the protection of the Primary Member.

• • • The age limit of 18 is extended to 24 for Dependent Children who are full-time students.
    • The age limit of 18 is waived for handicapped/ disabled Dependent Children who are recognized by the relevant local governmental agency as legal dependents of the Primary Member.

Laboratory tests, X-rays, MRI, PET or CT scans which are ordered by a Physician or Specialist.

In the context of INC:

Targeted actions by the authorities and/or population of the Country of Assignment against foreigners or foreign-owned businesses in the Country of Assignment.

In the context of INC:

Earnings Expenses means:

a) Contractual Net Income paid by You to an Insured Person(s) who has been the subject of a Crisis Evacuation; and/or

b) Contingent Salary paid to an Insured Person(s).

c) reasonable expenses that have been agreed with Us prior to their expenditure by You or an Insured Person(s).

A treatment or procedure for which the need was expected and the admission of the Covered Person to a clinic was not based on a referral from the emergency room as an urgent event, but rather a referral from an outpatient specialist physician (including the outpatient clinic of a hospital).

An emergency is the onset of a sudden and unforeseen medical condition that requires urgent medical assistance. Only treatment commencing within 24 hours of the emergency event will be covered.

Emergency outpatient treatment is treatment received in a casualty ward or emergency room within 24 hours of an accident or sudden illness, where there is no medical necessity for you to occupy a hospital bed. If your policy includes an Outpatient Plan, it will cover you for outpatient treatment in excess of the limit on the ‘Emergency out-patient treatment’ benefit. In that case, the Outpatient plan terms will apply.

The dollar amount of Eligible Medical Expenses, specified in the Master Policy, that the Insured Person must pay before receiving benefits or coverage hereunder, not including any applicable Coinsurance.

The country declared as the Home Country on the Application Form for which the Primary Member holds a passport and/or in which the Primary Member has a permanent address.

The use of female hormones for the relief of symptoms resulting from the cessation of ovarian function, either at the time of natural menopause or following surgical removal of the ovaries.

A stay within a Hospital for diagnostic purposes and/ or to conduct an emergency and/or elective operation, including examinations and/or medications connected with the purpose of the hospitalization, all supervised by an attending physician. Hospitalization includes:

• Hospitalization in a public or private health facility
• Surgical operations during Hospitalization, including medical care relating to trauma and surgery performed under general or local anesthesia.
• Medical and paramedical ancillary costs incurred during Hospitalization
• Patient transportation*
• Any other medical treatment in a Hospital, and
• MRI, PET Scans, or similar imaging tests.

*In case of Hospitalization, transportation is covered within the same country between the patient‘s home or the place of Accident and the nearest health facility located in the same country. It is also covered if the hospitalized patient‘s condition requires his/her transfer from the host health facility to another nearby health facility.

All invasive investigative procedures necessary to establish the cause of infertility, such as hysterosalpingogram, laparoscopy, or hysteroscopy. It also covers treatment like InVitro Fertilisation (IVF) for diagnosed cases of infertility. Examples of benefits that cover non-invasive investigation procedures are ‘Diagnostic tests,’ ‘Medical practitioner fees,’ and ‘Specialist fees.’

A physician, Hospital, or another service provider that has entered into an agreement with the Plan Administrator and the name of whom will be indicated on a periodically publicized list created by the Plan Administrator.

Treatment for medical reasons that normally means that you have to stay in Hospital accommodations overnight or longer (not including waiting to be seen in an emergency room or waiting for a diagnosis).

A medical and/or other service provided to the Covered Person following a medical need as specified in the table of benefits.

Dental implants (metal or ceramic) which are embedded as a substitute for the root of a tooth or in the toothless jaw.

In the context of INC:

A violent uprising of citizens in resistance to their government.

In the context of World Explorer travel insurance this is a period of time not to exceed fourteen (14) days during a Certificate Period during which an Insured Person is covered for Eligible Medical Expenses incurred in his or her Home Country. An Incidental Trip Home begins on the date and time the Insured Person departs his or her Host Country to return to his or her Home Country, and ends on the next date and time the Insured Person departs his or her Home Country, subject to a maximum of 14 days. The Incidental Trip Home benefit is only available to Insured Person’s with Certificate Periods of ninety (90) days or more.

An insurance policy providing coverage for ransom or extortion costs and related expenses. Also referred to as K&R.  Available on our World Explorer Hotspot plans for short term travel.

The termination of a policy due to failure to pay the required renewal premium.

In respect to either Party, a related legal entity is a controlling legal entity and its controlled legal entities:

a.a controlling corporate body;

a.a controlled corporate body affiliate; or

b.a controlled corporate body affiliate of a controlling corporate body.

For the purposes of this definition:

• Corporate Body Affiliate means a legal entity that owns or controls, is owned or controlled by, or is under common control or ownership with Company where control is defined as the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of an entity, whether through ownership of voting securities, by contract or otherwise;
• Corporate Group Member means Corporate Body or any Corporate Body Affiliate;
• Corporate PersonalData means any Personal Data Processed by a Contracted Processor on behalf of a Corporate Group Member pursuant to or in connection with the relevant Administrative Agreements;
• One corporate body controls another when at the relevant time:

a. it owns either directly or indirectly or is otherwise in a position to cast, or control the casting of, not less than 50% of the shares entitled to vote at general meetings of that other corporate body; or

b. it controls the composition of a majority of the board of that other corporate body.

Services for a Covered Person who cannot care for themselves and require assistance from a third party while in a Hospital, hospice, nursing home, or being nursing at the Covered Person’s personal accommodation.

The maximum amount of coinsurance a Covered Member will need to pay during a plan year, if applicable, as outlined in the table of benefits.

A normal state of pregnancy of the Covered Person, including monitoring the pregnancy, childbirth, and the treatment of the mother and child during the Hospitalization after the birth, including routine post-natal medical monitoring of the mother. In this matter, “a normal state of pregnancy” is the course of the pregnancy until childbirth, for which no medical intervention is required beyond the routine monitoring checks according to the accepted criteria, including a healthy child born of vaginal delivery (including forceps or vacuum delivery).

Any abnormal state of pregnancy; an abortion (other than for personal and/or socio-economic reasons); an abnormal delivery.

In this matter, the following medical situations will be deemed to be complications of pregnancy: preeclampsia, toxemia, kidney infection, gestational diabetes, anemia, bladder infection, location and/or severance of the placenta, a tear in the womb, an infection of the placenta, endometriosis, late delivery (42 weeks and more), RH sensitivity in the blood of the fetus, premature labor pains, premature rupture of membranes (more than 12 hours before the delivery), the neck of the womb has ceased to extend, labor pains for over 20 hours, stillbirth, ectopic pregnancy, extreme vomiting, or associated or similar pathologies.

In this matter, the following conditions will be considered as complications of childbirth and/or the fetus and/or the newborn child: a cesarean operation, an anomalous presentation of the fetus, induction of Iabor for medical reasons, abnormality of the amniotic fluid, a slow or fast heartbeat, prolapse of the umbilical cord, embolism of the amniotic fluid in the lungs, a birth weight below 2 kilograms, a premature birth (before the 37th week of pregnancy), a delivery while the mother is under general anesthetic, congenital anomalies, or similar or associated pathologies.

It includes customary examinations required to assess the integrity and basic function of the child’s organs and skeletal structures. These essential examinations are carried out immediately following birth. The coverage doesn’t include further preventive diagnostic procedures, such as routine swabs, blood typing, and hearing tests. If the insured wants to add their newborn to the policy, they need to contact the underwriting team within four weeks after birth (with the birth certificate attached). With the exception of multiple birth babies, the newborn can be accepted without medical underwriting if the birth parent or intended parent (in the case of surrogacy) has been insured by this policy for a minimum of eight continuous months. In this case, coverage will start at birth.

Emergency transportation by air and/or sea, as a result of the Covered Person’s state of health, to a Hospital or to an airfield closest to the Hospital to which the Covered Person is referred or transferred to the Country of Origin, all at the discretion of the Plan Administrator, including any emergency land evacuation that is necessary before or after the transport. The Plan Administrator’s obligation pursuant to this Section is only if all the cumulative conditions specified below have been met:

A. The Covered Person is in need of essential medical treatment to save his/her life.

B. The essential medical treatment cannot be administered to the

Covered Person in the place he/ she is located.

C. Transportation other than emergency evacuation is likely to end in the death of the Covered Person.

D. That stated in the above paragraphs is requested by a specialist and authorized at the discretion of the Plan Administrator.

The increase in healthcare costs associated with medical trends and developments. It often includes the costs of advanced treatments and procedures, and the increased availability and usage around the world. Therefore, the expenditure on health has increased year to year, affecting governments, employers, insurance companies and individuals.

Medical practitioners providing treatment, and medical providers and facilities, who are authorized by the local governing body.

In the International Health Insurance policy:

The party in respect of which the risk is insured. For the purpose of this policy, this refers to the main Member and, where relevant, his/her Dependents.

In the context of INC:

The person who has access to the membership program called INC for 12 months from the start of the membership granting access to ancillary services and features not related to the insurance policy.

In the context of INC, this benefit includes:

The program will cover the costs of Crisis Evacuation by the Emergency Response Provider for the member(s) and Additional Costs if there is a Natural Catastrophe occurring in or in close proximity to the Country of Assignment (or where travel is taking place to) which, in the opinion of the Emergency Response Provider, and with Our agreement, places the member(s) in physical danger and causes the location in which the member(s) is located to suffer any one of the following difficulties (a) loss of all power and/or utilities, (b) the closure of all medical facilities, and/or(c) a shortage of reliable and/or safe sources of food, water and/or fuel, and such difficulties result in the complete cessation of Your operations in that location.

In the context of INC:

Widespread disruption of human lives by disasters such as flood, drought, tidal wave, fire, hurricane, earthquake, windstorm or other storm, landslide or other natural catastrophe or event resulting in immigration of human population for its safety. The occurrence must be a disaster that is due entirely to forces of nature and could not reasonably have been prevented.

Any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.

The amount of money charged for the insurance coverage reflecting an expectation of loss

A savings program for when you are in the United States that is simple to register for online then simply present your ScriptSave WellRx card at any of the thousands of participating pharmacies nationwide to receive your instant savings. It’s that easy! Just show your card to the pharmacist each time you pick up your prescription, whether you’re filling for the first time or refilling. There is no paperwork to complete and no limit on usage.

Breach of security leading to the accidental or unlawful destruction, loss, alteration, unauthorized disclosure of, or access to, personal data transmitted, stored, or otherwise processed.

Health Insurance plans by Insured Nomads have a PPO when in the USA, it is a network/managed care organization through the Aetna network you to go to for preferred hospitals, clinics and doctors, and if you go to a provider outside the PPO you will be penalized.  We use the Aetna PPO, Group #863956-24-0100

It is a managed care organization of doctors, hospitals and other health care providers who have agreed with an insurer or a third-party administrator to provide healthcare at reduced rates to the top insurer’s or administrator’s clients. A PPO administrator executes a contract with a benefit plan sponsor, third party administrator, or insurance carrier by whose terms the payer agrees to pay bills submitted by medical service providers, within a certain time period and with certain restraints on what the payer can do with the claims, in exchange for the provider accepting a reduced (discounted) payment as payment in full (meaning the provider will not balance bill the patient). The PPO administrator executes a contract with medical service providers as well, regarding the same arrangement.

Any medical condition diagnosed before completion of the Application Form. The diagnosis may be in the form of a documented medical diagnosis (no time limit) or a documented medical procedure that was conducted in the six months that proceeded the date the Application Form was submitted.

The person who completed the Application Form, who was approved for Policy coverage by the Association, who is the principal insured under the Policy.

The processing of personal data in such a manner that the personal data can no longer be attributed to a specific data subject without the use of additional information, provided that such additional information is kept separately and is subject to technical and organizational measures to ensure that the personal data are not attributed to an identified or identifiable natural person.

Medically required treatment to treat a diagnosed mental condition of the Covered Person, including eating disorders, by someone who is legally qualified and is permitted to practice as a Psychiatrist in the country where the treatment is received.

Medically Required treatment to treat a diagnosed condition of the Covered person, provided by someone who is legally qualified and is permitted to practice as a Psychotherapist in the country where the treatment is received.

In the context of INC:

A deliberate, organized and open resistance by force of arms to the laws or operations of a government by its citizens or subjects.

A natural or legal person, public authority, agency, or another body to which the personal data are disclosed, whether a third party or not. However, public authorities who may receive personal data in the framework of a particular inquiry in accordance with Union or Member State law shall not be regarded as recipients; the processing of those data by those public authorities shall be in compliance with the applicable data protection rules according to the purposes of the processing.

A transaction between a primary insurer and another licensed (re) insurer where the reinsurer agrees to cover all or part of the losses and/or loss adjustment expenses of the primary insurer. The assumption is in exchange for a premium. Indemnification is on a proportional or non-proportional basis.

As applicable, any person or law enforcement or other agency having Regulatory, supervisory, or governmental authority (whether under a statutory scheme or otherwise)over all or any part of the Processing of Personal Data in connection with the provision or receipt of the Services, including, without limitation, the European Data Protection Supervisory Authorities.

In the context of INC:

The cost of economy class fares on any licensed common carrier operating from a published timetable in the course of Relocation, provided always that such costs and expenses so incurred shall not be payable where incurred beyond a period of one hundred and twenty days from the completion of the Crisis Evacuation.

This shall include repatriation of mortal remains of the Covered Person to their Home Country.

In the context of INC:

The overthrow of a regime or political system by its citizens.

The contractual clauses stipulated in a Data Transfer Agreement executed by and between a Data Controller and a Data Processor and/or a Data Controller and a DataController, transferring Personal Data from the EEA to a Data Processor or other Data Controller in a Third Country, which is subject to the Data Protection Laws of a given country or territory, to reflect (to the extent possible without material uncertainty as to the result) any change (including any replacement) made in accordance with those Data Protection Laws, in particular, pursuant to the European Commission‘s decision of 5 February 2010 on Standard Contractual Clauses for the transfer of Personal Data to processors established in Third Countries.

Personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person’s sex life or sexual orientation.

• ‘Genetic data’ means personal data relating to the inherited or acquired genetic characteristics of a natural person which give unique information about the physiology or the health of that natural person and which result, in particular, from an analysis of a biological sample from the natural person in question;
• ‘Biometric data’ means personal data resulting from specific technical processing relating to the physical, physiological, or behavioral characteristics of a natural person, which allows or confirms the unique identification of that natural person, such as facial images or dactyloscopy data;
• ‘Data concerning health’ means personal data related to the physical or mental health of a natural person, including the provision of health care services, which reveal information about his or her health status.

An illness or disease or body impairment, which is not a consequence of an Accident and which requires Treatment.

A Physician who is classified by the country’s health authorities as a Physician with superior or special expertise in specified fields of medicine or dentistry.

An insurer’s rights at law to take over the insured’s rights, following a claim payment to recover the payment from a third party responsible for the los

Any Third Party subcontractor (excluding employees of a Data Controller or any employees of a sub-contractor of a Data Controller) appointed on behalf of a Data Controller by a Data Processor to Process Personal Data – also may be referred to as a Contracted Sub-Processor or Subcontractor for purposes of applicable Data Protection Laws.

For purposes of applicable Data Transfers Outside the EEA, as stipulated herein, a contracted Sub-Processor means any processor engaged by a Data Importer or by any other Sub-Processor of the Data Importer who agrees to receive from the Data Importer or from any other Sub-Processor of the Data Importer Personal Data exclusively intended for Processing activities to be performed on behalf of the Data Exporter after the transfer in accordance with his instructions, the terms of the Clauses, and the terms of the written subcontract.

Those measures aimed at protecting Personal Data against accidental or unlawful destruction or accidental loss, alteration, unauthorized disclosure, or access, particularly where the processing involves the transmission of Data over a network, and against all other unlawful forms of processing.

Those measures aimed at protecting Personal Data against accidental or unlawful destruction or accidental loss, alteration, unauthorized disclosure, or access, particularly where the processing involves the transmission of Data over a network, and against all other unlawful forms of processing.

A country or Recipient: (i) not recognized by the European Commission as providing an adequate level of protection for Personal Data; and (ii) not covered by a suitable framework recognized by the relevant authorities or courts as providing an adequate level of protection for Personal Data.

A natural or legal person, public authority, agency or body other than the data subject, controller, processor, and persons who, under the direct authority of the controller or processor, are authorized to process personal data;

AWP Health &Life SA is a limited company with a capital of €65,190,446, governed by the FrenchInsurance Code, with its registered office at Eurosquare 2, 7 rue DoraMaar, 93400 Saint-Ouen, France. Registered in France: 401 154 679 RCS Bobigny. VAT number: FR 84 401 154 679.

Allianz Partners and Allianz Care are registered business names of AWP Health & Life SA.

A third-party administrator (TPA) is an organization that processes one ore more of the following services for a separate entity (insurance company); claims, assistance, customer support, emergency response, and underwriting. A legal entity entrusted by the Insurer to carry out legal actions, services or specific activities on its behalf.

Transplants are subject to the prior written authorization of the Plan Administrator and must be performed at an In-Network Provider. Benefit maximums outlined in the table of benefits include the assessment of a medical Specialist before the transplant, the transplant procedure, any follow-up treatment, and the cost of harvesting the organ in a Hospital other than an effective purchase or acquisition of an organ or tissue.

A benefit on Health Insurance plans that is payable for covered charges received outside Your Geographical Treatment Area for new incidents of Accidents and Illnesses, which you would not have reasonably expected prior to traveling. Each period of travel covered by this Benefit is subject to the trip being for no more than 42 days in total duration from the date you leave Your Geographical Treatment Area to the date that you return to Your Geographical Treatment Area.

Published statement or website document issued by the UK FCO, US Department of State, Bureau of Consular Affairs, Centers for Disease Control and Prevention, United Nations, World Health Organization or similar government or nongovernmental agency of the Insured Person’s Home Country, warning that travel to specified countries, regions or locations poses serious risks to safety and security or exposes the Insured Person to a greater likelihood of life-threatening risks, including, without limitation, US Department of State Travel advisory levels “3 – Reconsider travel” and “4 – Do not travel”.

Any period, specified in days or months, beginning on the Policy Effective Date, during which the Covered Person may not be covered for specific medical services in accordance with the table of benefits.

Insurance underwriters assume the risk involved in a contract with an individual or entity.

The underwriter for World Explorer Travel Insurance plans (Triptime) is Point Comfort Underwriters, an approved Coverholder for Lloyd’s, London and as such, has authority to quote, bind and administer a range of insurance products on their behalf.

The underwriter for World Explorer Guardian plans is Nationwide Mutual Insurance Company (USA). Nationwide® holds financial strength ratings of A1 by Moody’s (received 10/17/2002; affirmed 12/22/2021), A+ by Standard and Poor’s (received 12/22/2008; affirmed 5/7/2021) and A+ by AM Best (received 10/17/2022; affirmed 12/22/2021)

The underwriter for Health Insurance plans is AWP Health & Life S.A. (Allianz Partners). Allianz holds a financial strength rating* of A+ by AM Best, Aa3 by Moody’s, and AA by S&P.

The underwriter for World Explorer Hotspot is underwritten by Opportuna Insurance PCC Limited, and serviced by Hotspot Cover.

A medical facility that can provide medical treatment for a disease/injury which is urgent but not life-threatening.

Injections required by the Health Authorities of the country of expatriation or the country of origin.