International Citizens Series Insurance Terms

Acute Onset of Pre-existing Condition
A sudden and unexpected outbreak or recurrence of a Pre-existing Condition, which occurs spontaneously and without advance warning, either in the form of Physician recommendation or symptoms which would have caused a prudent person to seek medical attention prior to the outbreak or recurrence.

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Amateur Athletics

A sport or other athletic activity that is organized and/or sanctioned, involving regular or scheduled practices and/or regular or scheduled games. This definition does not include athletic activities that are non-contact and engaged in by a Member solely for recreational, entertainment or fitness purposes.

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Beneficiary

The individual named in the Member's Application to be the recipient of any Accidental Death or Common Carrier Accidental Death benefit.

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Certificate Period

The period of time beginning on the Certificate Effective Date and ending on the Certificate Termination Date, both days at 12:01am at the location of the Member.

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Coinsurance

The co-insurance is the co-payment that the policy holder will have to pay once they have satisfied their deductible. This co-insurance is only for claims made inside the USA and covers 80% of medical expenses up to $5,000 and 100% over $5,000. This is waived if you attend one of the network doctors.

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Citizen

An individual's specific legal citizenship designation. Permanent residency, visa status or intent of duration of residence has not consideration with regard to this definition.

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Deductible

The dollar amount of Eligible Expenses, specified in the Schedule of Benefits and Limits, that the Member must pay per Certificate Period.

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Health Care Provider network

While you are always free to visit any provider, anywhere, we do have a provider network available for your use in the U.S. You may search a listing of facilities and practitioners at the following web site: www.multiplan.com

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Non-renewable

An insurance plan which does not cover an illness or injury which develops in one certificate period on any subsequent purchase. The Atlas Travel insurance may be repurchased, but is not renewable.

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Pre-existing Condition

Any Injury, Illness or Mental or Nervous Disorder which existed at the initial Certificate Effective Date and/or any chronic or recurring Illness and/or chronic or recurring Mental or Nervous Disorder which existed at or prior to the initial Certificate Effective Date. Pre-existing Condition also includes any complications or consequences associated with these conditions.

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Usual, Reasonable, and Customary

The most common charge for similar services, medicines or supplies within the area in which the charge is incurred, so long as those charges are Reasonable. What is defined as Usual, Reasonable and Customary Charges will be determined by Underwriters. In determining whether a charge is Usual, Reasonable and Customary, Underwriters may consider one or more of the following factors: the level of skill, extent of training, and experience required to perform the procedure or service; the length of time required to perform the procedure or services as compared to the length of time required to perform other similar services; the severity or nature of the Illness or Injury being treated; the amount charged for the same or comparable services, medicines or supplies in the locality; the amount charged for the same or comparable services, medicines or supplies in other parts of the country; the cost to the provider of providing the service, medicine or supply; such other factors as Underwriters, in the reasonable exercise of discretion, determine are appropriate

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