1)       the end of the month in which they marry; or

2)       the end of the month in which they attain the age of nineteen (19) years.

The attainment of the limiting age will not operate to terminate the coverage of such child while the child is and continues to be both:

1)       incapable of self-sustaining employment by reason of mental retardation or physical handicap; and

2)       chiefly dependent upon the Insured Person for support and maintenance.

Proof of such incapacity and dependency shall be furnished to the Company: 1) by the Named Insured; and 2) within 31 days of the child’s attainment of the limiting age.  Subsequently, such proof must be given to the Company upon request following the child’s attainment of the limiting age.

If a claim is denied under the policy because the child has attained the limiting age for dependent children, the burden is on the Insured Person to establish that the child is and continues to be handicapped as defined by subsection (1) and (2).

EXCESS PROVISION means the plan benefits are payable for covered expenses not covered and payable by any other plan providing medical expense benefits. If there is no other valid and collectible benefits available from any other source, this plan will pay the covered expenses up to the limits of the policy.

HOSPITAL means a licensed or properly accredited general hospital which; 1) is open at all times; 2) is operated primarily and continuously for the treatment of and surgery for sick and injured person as inpatients; 3) is under the supervision of a staff of one or more legally qualified Physicians available at all times; 4) continuously provides on the premises 24 hour nursing service by Registered Nurses; 5) provides organized facilities for diagnosis and major surgery on the premises; and 6) is not primarily a clinic, nursing, rest or convalescent home, or an institution specializing in or primarily treating Mental and Nervous Disorders.

HOSPITAL CONFINED/HOSPITAL CONFINEMENT: means confined in a hospital for at least 18 hours by reason of an Injury or Sickness for which benefits are payable.

INJURY means bodily injury: 1) directly and independently caused by specific accident which is unrelated to any pathological, functional, or structural disorder or injury; 2) treated by a Physician within 30 days after the date of accident; and 3) which causes loss during the term of the policy.

INSURED PERSON means: 1) the Named Insured; and 2) Dependents of the Named Insured, if: 1) the Dependent is properly enrolled in the program; and 2) the appropriate dependent premium has been paid.  The term “insured” also means Insured Person.

INTENSIVE CARE means:

1)       a specifically designated facility of the Hospital that provides the highest level of medical care; and

2)       which is restricted to those patients who are critically ill or injured.

Such facility must be separate and a part from the surgical recovery room and from rooms, beds and wards customarily used for patient confinement.

MEDICAL EMERGENCY means the occurrence of a sudden, serious and unexpected sickness or injury.  In the absence of immediate medical attention, a reasonable person could believe this condition would result in:

1)       Death;

2)       Permanent placement of the Insured’s health in jeopardy;

3)       Serious impairment of bodily functions; or

4)       Serious and permanent dysfunction of any body organ or part.

Expenses incurred for “Medical Emergency” will be paid only for sickness or injury which fulfills the above conditions.  These expenses will not be paid for minor injuries or minor sicknesses.

MEDICAL NECESSITY means those services or supplies provided or prescribed by a hospital or physician which are:

1)       Essential for the symptoms and diagnosis or treatment of the Sickness or Injury;

2)       Provided for the diagnosis, or the direct care and treatment of the sickness or injury;

3)       In accordance with the standards of good medical practice;

4)       Not primarily for the convenience of the Insured, or the  Insured’s Physician; and

5)       The most appropriate supply or level of service which can safely be provided to the Insured.

The Medical Necessity of being hospital confined means that: 1) the Insured requires acute care as a bed patient; and 2) the Insured cannot receive safe and adequate care as an outpatient.  This policy only provides payment for services, procedures and supplies which in the judgment of the Company are a Medical Necessity.  No benefits will be paid for expenses which are determined not to be a Medical necessity, including any or all days of Hospital Confinement.

MENTAL AND NERVOUS DISORDER means a Sickness that is a mental, emotional or behavioral disorder.

NAMED INSURED means an eligible, registered or non-registered, student of the Policyholder if : 1) the student is properly enrolled in the program; an d2) the appropriate premium for coverage has been paid.

NEWBORN INFANT means any child born of an Insured while that person is insured under this policy.  Newborn infants will be covered under the policy for the first 31 days after birth.  Coverage for such child will be for Injury or Sickness, including medically diagnosed congenital defects, birth abnormalities, prematurity and nursery care; benefit swill be the same as for the Insured Person who is the child’s parent.

The Insured will have the right to continue such coverage for the child beyond the first 31 days.  To continue coverage the insured must, within the 31 days after the child’s birth: 1) apply to us; and 2) pay the required additional premium for the continued coverage.  If the Insured does not use this right as stated here, all coverage as to that child will terminate at the end of the first 31 days after the child’s birth.

PHYSICIAN means a person, other than the Insured or a member of the Insured’s family, who holds a medical license or medical certificate.

PHYSIOTHERAPY means any form of the following: physical or mechanical therapy; diathermy; ultra-sonic therapy; heat treatment in any form; manipulation or massage administered by a physician.

PRE-EXISTING CONDITION means any Injury or  Sickness that manifested itself, or for which a Physician was consulted, or for which treatment or dedication was prescribed within 6 months (12 months for insureds age 70 and older) prior to the effective date of an Insured  Person's coverage

PRE-EXISTING CONDITION WAIVER - Coverage for  pre-existing conditions will be provided for medical treatment of an  accidental bodily injury or sickness for an Insured who has maintained 6  months of continuous and uninterrupted coverage under this insurance  program. (12 months of continuous and uninterrupted coverage under this insurance program for Insureds age 70 and older)

PRESCRIPTION DRUGS means: 1) prescription legend drugs; 2) compound medications of which at least one ingredient is a prescription legend drug; 3) any other drugs which under the applicable state or federal law may be dispensed only upon written prescription of a physician; and 4) injectable insulin.

SICKNESS means sickness or disease of the Insured Person which causes loss, and originates while the Insured Person is covered under this policy.  All related conditions and recurrent symptoms of the same or similar condition will be considered one sickness.

SOUND, NATURAL TEETH  means natural teeth, the major portion of the individual tooth is present, regardless of fillings or caps; and is not carious, abscessed or defective.

USUAL AND CUSTOMARY CHARGES means a reasonable charge which is : 1) usual and customary when compared with the charges made for similar services and supplies; and 2) made to persons having similar medical conditions in the locality of the Provider.  No payment will be made under this policy for any expenses incurred which in the judgment of the Company are in excess of Usual and Customary Charges.

EXCLUSIONS

No benefits will be paid for loss or expense caused by contributed to, or resulting from:

(800) 551-0824  or  (302) 661-4176

Up-to-the-minute information available on:

Chartis Assist provides:

Chartis Assist can also:

The Chartis Assist communications network is available 24 hours a day, seven days a week to provide assistance to the traveler. In the United States and Canada call 1-800-626-2427. Outside of the United States call 0-713-267-2525 (collect call only).

SCHEDULE OF BENEFITS

PART A

Cancellation Policy

Refund of premium, less a $25 processing fee, will be considered only if Cancellation Form is received by the India Network Services prior to the effective date of coverage.  After that date, the premium is considered fully earned and non-refundable. All cancellation requests should be submitted by completing the Cancellation Form found under 'Print Forms' section of the web pages. The form can be faxed to 407-479-3289. Policy changes can not be made under any circumstances once the policy becomes effective.