Traveler Gold Product – Schedule of Benefits

*Excess on medical expenses applies depending on age and whether cover is Worldwide Excluding Countries or Worldwide Including Countries.

A. Plan Specifications

The travel assistance plan covers and assists travelers anywhere in the world in the event of a sudden illness or accident during journeys outside their Country of Permanent Residence. The issuer of this medical coverage under this agreement is Syrian Kuwaiti Insurance Co.

B. Definitions

Accident or Sudden Illness or Sudden Injury

A sudden, unexpected, unusual, specific, unforeseen, external event which occurs at a single identifiable time and place and independently of all other causes, resulting directly, immediately and solely in physical bodily injury or trauma and requiring immediate medical intervention/treatment. An event which directly or indirectly exacerbates a previously existing pathology and/or a physical bodily injury is not considered an Accident.

Assistance Company

Refers to Eurocross Assistance or any of its appointed assistance providers worldwide. The Assistance Company provides services and pays expenses on behalf of the Insurance Company.

Beneficiary

Any of the covered persons whose name is stated on the certificate of coverage.

Country of Permanent Residence

The country in which the Beneficiary normally resides, whether or not he/she holds its citizenship.

Deductible

The first amount of the claim which is payable by the Beneficiary, where applicable.

Insurance Company

Refers to Syrian Kuwaiti Insurance Co.

Medical Emergency

An unforeseen and non-recurrent sudden pathology which requires an emergency treatment to prevent or alleviate existing danger to life or health. An emergency no longer exists when medical evidence indicates that the Beneficiary is able to return to his/her Country of Permanent Residence to seek and/or continue treatment. A pathology related to a pre-existing medical condition does not fall under the definition of a sudden pathology. Each time the patient is able to visit the doctor’s office in person, the case is not considered an emergency.

Pre-existing Medical Condition

A pre-existing physical defect, infirmity, injury, sickness, pathology, disease, affliction, anomaly (congenital or acquired), major risk factor, or any other medical condition, whether known or unknown to the Beneficiary, which he/she was suffering from prior to the date of travel from the Country of Permanent Residence.

Worldwide Excluding Countries

All countries worldwide excluding USA, Canada, Japan, Australia and Singapore.

Worldwide Including Countries

All countries worldwide including USA, Canada, Japan, Australia and Singapore.

C. Benefits

1. Travel Information Service

Before departure, the Beneficiary may call the Assistance Alarm Center to obtain administrative or medical advice regarding passports and visas, vaccination requirements, taxes, customs duties, currencies and other travel requirements.

2. Delivery of Urgent Messages

In an emergency, the Assistance Company will transmit urgent messages from the Beneficiary to family or employer and keep them informed of arrangements made.

3. Dispatch of a Specialist Physician

When medical repatriation is impossible due to the patient’s condition, the Insurance Company may, at its discretion, pay for a specialist physician to be dispatched to evaluate the case on site and arrange eventual medical repatriation.

4. Long Distance Medical Advice

When medical advice is needed and not available locally, the Beneficiary may call the Alarm Center and receive advice from a qualified physician by telephone. This is considered advice only and not a diagnosis.

5. Referral to Medical Correspondents Abroad

The Beneficiary may call the Alarm Center to obtain referral to a medical correspondent in the area where he/she is located. Most appointed physicians speak English.

6. Cover of Medical Expenses and Hospitalization Abroad

The Insurance Company covers only reasonable medical emergency expenses for Accidents and medical emergencies, as well as resulting hospitalization costs, up to the limit specified in the certificate of coverage and according to standard local costs.

This coverage is complementary and applies only if no other medical or insurance coverage is available. The Company reserves the right of recovery if the Beneficiary has other valid medical insurance providing travel cover abroad.

Deductibles per person per claim:

• USD 100 if the Beneficiary is under 71 years old.
• USD 250 if between 71 and 75 years old.
• USD 1,500 (Worldwide Excluding Countries) if between 76 and 80 years old.
• USD 3,000 (Worldwide Including Countries) if between 76 and 80 years old.

Coverage is only valid for sudden illness or injury with no relation to any pre-existing medical condition or major risk factor (known or unknown) prior to the travel departure date.

7. Evacuation and/or Medical Repatriation

If Assistance Company physicians decide medical transportation is necessary, the Insurance Company will arrange and cover evacuation expenses (by helicopter, road or air ambulance, scheduled airline flight or other suitable transport) to a hospital where adequate treatment can be provided and, when the condition permits, repatriation to the Country of Permanent Residence, up to the limit shown on the certificate of coverage.

8. Repatriation of Mortal Remains

In case of death due to a sudden pathology, the Insurance Company will assist with formalities and cover transportation expenses for repatriation of the mortal remains to a location selected by the legal representative, up to the specified limit. Administration and funeral expenses (including the coffin) are not covered.

9. Transportation to Join Beneficiary

If a Beneficiary travelling alone is hospitalized for more than 10 days, the Insurance Company will provide an economy class round-trip air ticket or regular train ticket for a person appointed by the Beneficiary (same country of residence) to join him/her, plus an allowance of 80 USD per day for up to 10 days to cover basic stay expenses.

10. Return of Dependent Children

If dependent children are left unattended due to the Beneficiary’s accident or sudden illness, the Insurance Company will arrange and cover one-way economy transportation for the children back to their place of residence, with a qualified attendant if needed.

11. Emergency Dental Care

Covers emergency dental expenses arising from bodily injury or acute and sudden illness, excluding any prosthesis and/or definitive fillings. Coverage is restricted to treatment of pain, infection and removal of affected tooth, up to 600 USD, with 60 USD excess per claim.

12. Contribution to Sea & Mountain Rescue

If the Beneficiary is reported missing during the journey, the Insurance Company will contribute up to 25,000 USD towards expenses of sea and mountain search and rescue operated by local official authorities.

13. Cover of Winter Sports (Ski)

In case of an accident while skiing on regular ski slopes, the Insurance Company covers assistance and medical expenses up to 10,000 USD, subject to a 250 USD deductible per person per claim. Accidents occurring outside ski slopes are not covered.

14. Loss of Passport, Driving License, National Identity Card Abroad

In case of loss of these documents while abroad, the Assistance Company will cover expenses necessary to obtain replacements or consular documents up to 300 USD, subject to a police report certifying the loss or theft.

15. Total Loss or Disappearance of Luggage

If personal luggage is totally lost while in the custody of an air carrier outside the Country of Permanent Residence, the Assistance Company reimburses necessary costs of purchasing replacement clothing, toiletries and similar items during the first 24 hours after arrival at the scheduled destination, up to 800 USD.

16. Delay of Luggage (8 Hours Delay)

If checked-in luggage is temporarily delayed for more than eight (8) hours (outside the home country), the Assistance Company will indemnify the Beneficiary for emergency purchases of essential clothing and toiletries at the scheduled destination, up to 300 USD (and up to 48 hours of delay), upon presentation of airline documentation.

17. Flight Delay (8 Hours Delay)

If pre-booked transport services are delayed by at least eight (8) hours or cancelled after such a delay due to covered causes (e.g. strike, hijack, terrorist act, riot, fire, flood, adverse weather, mechanical breakdown, etc.), the Insurance Company will indemnify the Beneficiary for additional transport and hotel accommodation expenses, up to 1,000 USD, upon presentation of supporting documents.

D. Obligations of the Beneficiary & Claims Conditions

In case of accident or sudden illness, the Beneficiary releases from professional secrecy all doctors and paramedical staff who examine him/her before and after the accident and must fully cooperate with the Insurance Company, providing all required documents.

Claims Conditions – Contact within 48 hours:

To receive benefits, the Beneficiary must contact the appropriate Alarm Center within 48 hours of the event by phone or email:

If the Beneficiary is unable to contact the Alarm Center, notification by a close person, police, hospital, fire brigade or any intervening person is accepted. Required documents must be submitted within two months of the occurrence, and original documents within twelve months where coverage is approved.

Examples of required documents include:

• Official statement of accident (police).
• Copy of passport and visa (if applicable).
• Complete medical file, prescriptions, medical and hospital bills.
• For luggage: copy of check reimbursed from airline and airline letter.
• For flight delay: boarding passes, airline letters, flight history and proof of delay/cancellation.

E. Limitation of Coverage

• Coverage ceases automatically on the expiration date of the contract. No renewal is granted unless a new contract is signed from the issuing country.
• Coverage is secondary: the Company will not pay costs recoverable from other insurance/funds, except for eligible amounts exceeding those limits.
• The Company is not liable for consequences of medical malpractice or inadequate treatment.
• The Company is not liable for any medical post-treatment or follow-up incurred by the incident.

F. Exoneration from Providing Benefits

The Insurance Company is released from obligations in cases including (non-exhaustive):

• Failure to notify the Assistance Company within 48 hours.
• Bills handled without guarantee of payment/prior written authorization (reimbursed only at Company standard prices if accepted).
• Failure to submit all requested documents.
• Accidents caused by a crime or offense committed by the Beneficiary.
• Refusal to obtain compulsory prior approval for treatments, transfers or procedures during hospitalization.
• Failure to declare other insurance covering the same risks.
• Failure to take reasonable measures to avoid the accident.
• Failure to provide honest and complete information.
• Refusal of agreed benefits proposed by the Insurance Company and its doctors.

G. Exclusions

Expenses and damages resulting from the following are not covered (summary – see full terms for complete wording):

• Reckless undertakings or needless risk (except attempts to save human life).
• Brawls or violent disputes.
• High-risk sports (e.g. parachuting, spelunking, motor racing, boxing, scuba diving, rafting, climbing, etc.) and professional competition sports.
• War, revolution, terrorism, riots, and measures taken to restore order.
• Natural catastrophes (earthquakes, floods, volcanic eruptions, etc.).
• Alcohol or drug abuse.
• Nuclear radiation, biological and/or chemical materials used to harm.
• Mental and psychiatric disorders.
• Suicide or attempted suicide.
• Organ/tissue/cell ablation or transplantation.
• Pregnancy, breastfeeding, abortions, deliveries and related events.
• Prostheses, devices, walking aids, splints and related operations/physiotherapy.
• Convalescent home or rehabilitation stays.
• Congenital or acquired malformations treatments.
• Endemic, epidemic and pandemic diseases.
• Venereal and sexually transmitted infections.
• Out-of-hospital benefits and outpatient doctor visits, spontaneous doctor consultations and check-ups.
• Pre-existing medical conditions and any related treatment, repatriation, evacuation or ER expenses.
• Subsequent admissions related to a first admission unless considered emergency.
• Gallstones, nephrolithiasis, ureterolithiasis and complications.
• Vascular, cardiovascular and cerebrovascular illnesses and related complications.
• Conditions where the Beneficiary did not follow recommended treatment or medications in the Country of Permanent Residence.
• Medicines prescribed outside emergency or follow-up hospitalization.
• Unconventional trips or non-urgent hospital admissions without prior authorization.
• Systemic, rheumatologic, endocrine, autoimmune, vascular and chronic diseases, and allergic reactions.
• Hospitalizations for diagnostic search only or where no urgent intervention happens within 24–48 hours.
• Investigations/treatments that can safely wait until return to the Country of Permanent Residence.
• Diagnostic investigations for pre-existing conditions excluded under this plan.
• Cases where another valid medical or insurance coverage exists outside the Country of Permanent Residence.

Trips are not covered when undertaken:

• Against medical advice.
• After diagnosis of a terminal illness.
• With the intention of receiving medical treatment/investigation for a pre-existing condition.
• During periods of illness, major treatment or incapacity to work.
• When a doctor has ordered an operation that has not yet been performed.

H. Jurisdiction

Any dispute resulting from the execution or interpretation of this agreement shall be settled by the competent tribunal of the coverage issuer’s country.