Glossary of travel insurance terms - Québec Blue Cross

Accident
Means an event due to an external cause and of a violent nature which causes, directly and independently of any other cause, bodily injury while the insurance is in effect. The accident is always unforseen, sudden, unintentional and does not in any way mean illness or infection.

Act of terrorism
Means an act or threat made with or without the use of force or violence, including hijacking or kidnapping of an individual or group for the purpose of intimidating or terrorizing a government, group, association or population for religious, political or ideological purposes.

Age
Refers to the age of the time of purchase or renewal of your contract.

Aircraft
Refers to a multi-engine transport-type aircraft with a maximum authorized take-off weight greater than 10,000 lb (4,540 kg), and that is:

• Used for the transportation of passengers
• Used between licensed airports for authorized flights
• Operated by an air carrier holding a valid license delivered by the Canadian Transportation Agency or its foreign equivalent
   

Blue Cross Travel Assistance
Means CanAssistance, the company appointed by the insurer to offer assistance services to insured persons.

Business meeting
Means a private meeting organized in advance between non-affiliated companies pertaining to your full-time occupation or profession and which represents the only reason for the trip (written proof of meeting arrangements is required). In no case can a business meeting include legal proceedings.

Contract expiry date
Means the date the coverage ends. This date is indicated on the insurance certificate.

Contract holder
Means the person named as such on the insurance certificate.

Coverage period
Means the period between the effective date of the contract and the contract expiry date indicated on the insurance certificate.

Customary and reasonable expenses
Means charges incurred for goods and services that are comparable to what other providers charge for similar goods and services in the same geographical area.

Deductible
Means the part of the eligible expenses in the contract for which you are responsible and that you must pay when claiming under the Emergency Medical Care coverage. The deductible applies per trip and per insured person once the benefits covered by government programs are paid. If you have decided to include a deductible on your contract, the amount will be indicated on your insurance certificate.

Dependent child
Means a child of the contract holder, their spouse, or both and who is over 30 days old at the departure date or at the time of adoption, who is unmarried and depends on the contract holder for support.

Also, to be considered a dependent child, the child must be:

• 20 years of age or under, or
• 21 to 24 years of age and attends an educational institution as a full-time student, or
• Physically or mentally disabled, no matter the age

For international adoption, a child who is over 30 days old, not a Canadian resident and who is in the process of being adopted abroad by a Canadian resident is considered to be a dependent child from the moment the required documents have been completed and when the competent authorities of the country where the adoption takes place hand over the child, definitively and without appeal, to the physical, visual and exclusive custody of the adoptive parents or of the person who will accompany the child until their arrival in Canada. A child in the process of adoption does not have to be a beneficiary of the Health Insurance Act or the Hospital Insurance Act of a Canadian province.

Effective date of the contract
Means the date the coverage begins. This date is indicated on the insurance certificate.

Family member
Means the spouse, father, mother, grandparents, grandchildren, parents-in-law, a child (not only a dependent child) of the insured person and/or the spouse, a brother, a sister, a half-brother, a half- sister, a brother-in-law, a sister-in-law, a son-in-law, a daughter-in-law, an uncle, an aunt, a nephew, a niece.

High-risk pregnancy
Means:

• Multiple pregnancy
• Pregnancy resulting from in vitro fertilization
• Pregnancy requiring follow-ups in a clinic specializing in high-risk pregnancies
• Pregrancy for which a medical leave of absence was prescribed to you for a reason other than preventive withdrawal due to the nature of your work
• Pregnancy for which the physician established one the following diagnoses: preeclampsia, eclampsia, gestational hypertension, placenta previa, cervical incompetence
   

High-risk sport, activity, or behaviour
Means:

1. All sports or activities for which the safety instructions, warning signs or prohibited areas are not observed.
2. All extreme sports or activities involving stunts, aerobatics, or improvised installations.
3. All motor sports in the context of competition or training, including on an approved circuit or elsewhere.
4. All sports practiced as a paid professional.
5. All high-level sports competitions, including the Olympics and national and international championships.
6. All aerial sports, including:
   - Hang-gliding
   - Parasailing
   - Bungee jumping
   - Skydiving or free fall
7. All combat sports, including:
   - Boxing
   - Judo
   - Karate
8. All sports authorizing tackling or body checking, including:
   - American football
   - Hockey
   - Rugby
9. All high-risk water sports, including:
   - Canoeing, kayaking or rafting on rapids of grades 4 to 6 according to the International Scale of River Difficulty
   - Canyoning
   - Kitesurfing
   - Scuba diving practiced:
   - Without adequate certification (except for an initiation activity supervised by a certified person), or
   - At a depth of over 30 meters, or
   - In an environment with a high degree of risk (wreck, cave, under ice, at night, etc.)
10. All high-risk mountain or climbing sports, including:
    - Climbing
    - Mountaineering of grades 4 and 5 according to the scale of the Yosemite Decimal System - YDS
    - Off-track snow sports or with jumps or acrobatics
    - Snow sports using an airfoil
    - Off-track mountain biking or with jumps or acrobatics

Hospital
Means an institution that is licensed as an accredited hospital that is staffed and operated for the care and treatment of in-patients and out-patients. Treatment must be supervised by physicians and there must be registered nurses on duty 24 hours a day. Diagnostic and surgical capabilities must also exist on the premises or in facilities controlled by the establishment.
A hospital is not an establishment used mainly as a clinic, extended or palliative care facility, rehabilitation facility, addiction treatment centre, convalescent, rest or nursing home, home for the aged or health spa.

Hospitalization
Means admission and stay in a hospital as a bedridden patient to receive acute care for a minimum period of 18 hours. Day surgery will always be considered a hospitalization, regardless of its duration. Hospitalization under no circumstance means convalescent care or physical or mental health rehabilitation.

Illness
Indicates a deterioration of health or a disorder of the organism observed by a physician.

Immediate family member
Means the spouse, father, mother, and children (not just dependent) of the insured person, the spouse or both.

Insurance certificate
Means the document certifying the existence of a contract and which specifies among other things: the insured persons, the contract number, the chosen product, the dates of coverage, the deductible, the selected coverages, and their associated amounts.

Insured person(s)
Means any person indicated as an insured on the insurance certificate.

Insurer
Means:

1. In Ontario and Quebec:

• Canassurance Insurance Company (non-profit mutual benefit society) for the Emergency Medical Care coverage
• Canassurance Insurance Company for all other coverages

2. Elsewhere in Canada:

• Canassurance Insurance Company
   

Maximum stay
Under the Annual, means the number of days covered per trip. The maximum stay includes the departure date and the return date.

Medical condition
Means a health issue, illness, or injury (including symptoms of undiagnosed conditions).

Medical emergency/Urgent
Means a sudden and unforseen medical condition requiring immediate treatment. An emergency no longer exists when the evidence reviewed by Blue Cross Travel Assistance indicates that no further treatment is required at destination or that you are able to return to your province of residence for further treatment.

Minor ailment
Means means a non-chronic medical condition, which ends at least 30 consecutive days before the effective date of the coverage, and which does not require:

• Consumption of medication for a period of more than 15 days (consecutive or not), or
• More than one follow-up visit to the physician, or
• Hospitalization, or
• Surgery, or
• Consultation with a medical specialist
   

Physician
Means a person without any relation to the insured person who is a medical graduate authorized to prescribe and administer medical treatment in the jurisdiction where the services are provided.

Pre-existing medical condition
Means any existing medical condition when the coverage comes into effect.

Prepayment
Means a non-refundable amount paid for travel expenses in connection with planning a trip and to secure, before the departure date, the availability of a product or service.

Public transportation
Refers to any means of public transportation (air, sea, land) operated by an authorized transporter holding a valid permit issued by the competent authorities and for which a transportation tariff is requested.

Spouse
Means the person to whom the contract holder is married or with whom the contract holder has lived permanently for at least one year. Dissolution of marriage by divorce or annulment as well as de facto separation of more than 3 months cancels this status.

Stable
Means a pre-existing medical condition that has remained unchanged for several months prior to the effective date of insurance.
For a pre-existing medical condition to be considered stable, it must meet all the following criteria:

1. No new medical diagnosis has been made
2. No new symptoms appeared and there was no worsening or increase in the frequency of existing symptoms
3. No hospitalization has taken place
4. No new medication was prescribed or recommended
5. No change of dosage¹ was made to a medication already prescribed or recommended (dose increased or decreased, or consumption stopped)
6. No new treatment or medical test is pending or has been prescribed, ongoing or recommended
7. No ongoing treatment has been changed or discontinued
8. No prescribed or recommended treatment, nor medical advice has been ignored

¹ We do not consider the following elements as a change of dosage of existing medication:

• Routine insulin or Coumadin^® adjustment
• Replacement of a medication by an equivalent generic brand if its dosage remains unchanged
• Decrease in dosage of cholesterol medication
• Change to hormone replacement therapy treatment
• Change in consumption of non-prescribed medication such as: Aspirin^®, vitamins, minerals, etc.
• Use of cream or ointment prescribed for skin irritation
   

Terminal stage
Means the period when death seems inevitable, in the near future, when there is no treatment to fight the illness or when the illness resists any curative treatment.

Travel expenses
Means the following expenses, when made for the purpose of planning and carrying out a trip:

• Public transportation ticket
• Accommodation at destination (when subject to the conditions of a rental contract)
• All inclusive travel package
• Guided tours, excursions, and other similar activities
• Theater or concert tickets and other recreational activities
• Car rental from a rental agency
• Convention, conference, or seminar registration fee
• Any other expense made in relation to your trip and deemed relevant by the insurer
   

Travel provider
Means a package tour operator, a travel wholesaler, an airline, a cruise line, or a hotel. When two or more travel providers are owned by a single person or corporation, they are considered as a single travel provider under the terms of this policy.

Travelling companion
Means an immediate family member and up to 6 other people. To qualify as such, a travelling companion must:

• Have planned the trip with you
• Have the same travel dates as you
• Have the same trip departure and return points as you
   

Treatment
Means a medical procedure prescribed, performed, or recommended by a physician for a medical condition. Without being limited to the following, here are a few examples: prescribed medication, investigative testing, surgery, etc.

Trip
Generally means temporarily being away from your province or your territory of residence. Trip also means temporarily being away from your usual place of residence inside of your province of residence if it includes at least a 2-night stay in a commercial accommodation establishment located more than 100 kilometres from your usual place of residence. For the Trip Cancellation or Interruption coverage, the trip begins when you leave your usual place of residence and ends when you return to it. The Annual covers trips made only outside the province or the territory of residence