Destination : International Student Insurance

Emergency Hospital & Medical Policy

INTERNATIONAL STUDENT
INSURANCE Updated November 2023
Underwritten by: The Manufacturers Life Insurance Company (Manulife).
Claims Administration and Assistance Services provided by: Active Care Management. Manulife has appointed Active Claims
Management (2018) Inc., operating as “Active Care Management”, “ACM” “Global Excel Management” and/or “Global Excel” as the provider
of all assistance and claims services under the policy.
Managed by: The Destination: Travel Group Inc.
NOTICE REQUIRED BY PROVINCIAL LEGISLATION
This policy contains a provision removing or restricting the right of the insured to designate persons to
whom or for whose benefit insurance money is to be payable.
Important Notice - Read Carefully Before You Travel • This insurance may not cover claims related to pre-existing medical conditions,
You have purchased a travel insurance policy - what’s next? We want you to understand whether disclosed or not at time of policy purchase.
(and it is in your best interest to know) what your policy includes, what it excludes, and what • Contact the Assistance Centre before seeking treatment or your benefits may be
is limited (payable but with limits). Please take time to read through your policy of insurance limited.
before you travel. Italicized terms are defined in your policy. • In the event of a claim your prior medical history may be reviewed.
• If you have been asked to complete a medical questionnaire and any of your
• Travel insurance covers claims arising from sudden and unexpected situations answers are not accurate or complete, your policy will be voidable.
(i.e. accidents and emergencies).
• To qualify for this insurance, you must meet all of the eligibility requirements. It is your responsibility to understand your coverage.
• This insurance contains limitations and exclusions (i.e. medical conditions that are not If you have questions, call your broker or 1 855-337-3532.
stable, pregnancy, child born on trip, excessive use of alcohol, high risk activities).

IMPORTANT INFORMATION
Travel insurance is designed to cover losses arising from sudden and unforeseeable HOW DO I MAKE A CLAIM?
circumstances. This policy also contains exclusions which apply to injury, sickness and/or
medical conditions that existed prior to and/or during your trip. Check to see how this To apply for benefits under this policy, you will need to send a completed claim form
applies in your policy and how it relates to your date of purchase, departure date and policy (with all original bills and receipts from commercial organizations attached) to the
effective date. Assistance Centre. Please take care in filling out the form, as any missing information
may cause delay. Failure to comply with the claims procedures set out on Page 6 of this
WHAT IF I HAVE AN EMERGENCY? policy will result in loss of rights to or reduction of, benefits conferred under this policy.
You, or someone acting on your behalf, must notify the Assistance Centre at
I WANT TO STAY LONGER. CAN I PURCHASE ADDITIONAL
+ 1 (519) 945-1070 (collect) or 1-833-886-1070 toll free within 24 hours of any emergency COVERAGE?
medical treatment and before any medical consultation or prior to your admission to a
hospital or surgery is performed. Failure to do so will result in you being responsible for 20% Yes, you can, subject to policy terms and conditions. Just call your broker or
of any eligible expenses incurred unless your emergency prevents you from calling. The Destination: Travel Group Inc. (1-855-337-3532) during business hours before
coverage under your policy expires. You must be in good health, not know of any
The Assistance Centre provides services 24 hours per day, reason to seek medical attention and not have incurred any losses during the first
7 days a week.
period of coverage.
IMPORTANT: ASSISTANCE
Your satisfaction is our priority. If you are not completely satisfied with this policy, you may
The Assistance Centre will use its best efforts to provide assistance for a sickness or
cancel it within 10 days of purchase for a full refund, provided you have not left on your trip
injury arising anywhere in the world. However, the Assistance Centre, the insurer, or
and have not experienced an event that would cause you to submit a claim.
The Destination: Travel Group Inc. and their brokers will not be responsible for the
Terms used in this policy that have been italicized have specific meanings and are defined availability, quantity, quality, or results of any medical treatment or service received, or
in the Definitions section of this policy. Please be sure to refer to them while reviewing this for failure of any person to provide or obtain medical treatment or services.
policy.
MANDATORY STATEMENT OF HEALTH AND CONSENT
You may not have coverage for costs incurred due to pre-existing medical conditions or
symptoms that began before the effective date of your policy. You should review this and all In the event of an emergency your medical history will be reviewed when a claim is
other exclusions that apply to your plan. reported. We may require you to complete and sign an application, which may include
a statement on your state of health with a consent to access your medical history when
LIMITS ON COVERAGE necessary.
If you fail to notify the Assistance Centre without reasonable cause, then we may reduce the
benefits payable to you under this policy.

ELIGIBILITY Effective Date

When an application has been made and the premium has been paid, coverage begins on the
Applicable to International Students studying in Canada:
latest of the date:
To be eligible for coverage a person must, as of the effective date: a) the completed application is accepted by us or its representative; or
a) be a student enrolled in a school in Canada; or b) indicated as the effective date on the application; or
b) be an accompanying dependent* under the age of 59 of an eligible student; and c) you depart from your country of origin.
c) be currently in good health; and
d) be less than 69 years of age at the time of application; and Expiry Date
e) not be insured under a Canadian government health insurance plan. Coverage ends on the earliest of the date:
*Coverage for dependents is only available to International Students age 59 or younger. a) indicated as the expiry date on your confirmation of coverage; or
b) 365 days after the effective date for this policy; or
c) you no longer meet this policy’s definition of student; or
Applicable to Canadian Students studying abroad: d) 60 days after you are no longer enrolled in a school; or
To be eligible for coverage a person must, as of the effective date: e) if you have purchased inbound coverage, the date you become insured under a govern-
a) be a student age 40 or younger at the time of application enrolled in a school outside ment health insurance plan; or
Canada; or f) if you are a Canadian, the date you are no longer covered by a government health
b) be an accompanying dependent under age 40 of an eligible student; and insurance plan; or
c) be currently in good health; and g) the date you cease to be a dependent as defined in this policy.
d) be insured under the government health insurance plan of the province or territory in which
you reside, for the entire duration of your trip.

INTERNATIONAL STUDENTS PLAN / DISI_1123

 9. Transportation of Family
DESCRIPTION OF COVERAGE We agree to reimburse up to a maximum of $5,000 for the cost to transport one member
1. We agree to pay up to $2,000,000 for reasonable and customary costs incurred of your family by round-trip economy class (using the most direct route), and $150 per
unexpectedly as a result of your sickness or injury occurring as a result of an emergency day up to a maximum of $1,500 for the reasonable and customary costs incurred by the
during the period of coverage. Costs are paid for emergency hospitalization, emergency member of your family after arrival if:
medical, or other covered costs as provided in the Benefits section, due to sickness or a) the attending physician advises the necessary attendance by such a person; or
injury occurring during the period of coverage.
b) the local authorities legally require the attendance of a member of your family to
2. We will pay for eligible costs incurred, up to the sum insured, for acute emergency identify your remains in the event of your death due to a covered sickness or injury.
sickness or injury incurred during the period of coverage:
10. Non-Emergency Treatment
a) for International Students studying in Canada while you are travelling world- When required as a result of a covered emergency sickness or injury, up to $3,000 will be
wide, other than your country of origin, provided you spend at least 51% of the paid to continue medical treatment.
period of coverage within Canada.
Must be pre-approved by The Assistance Centre.
b) for Canadian Students studying abroad while you are travelling worldwide,
provided you spend at least 51% of the period of coverage in your country of study. 11. Accidental Dental
Coverage will be provided during school breaks as long as the insurance is in We agree to reimburse you up to $5,000 for emergency treatment or services to
effect during these periods. repair or replace your natural or permanently attached artificial teeth (including capped or
crowned teeth) caused by an accidental blow to the face.
3. Your dependents are insured only when dependent coverage is selected and paid
for at the time of application. Newborns will be covered from 15 days of age, provided Treatment relating to any dental claim must be completed no later than 90 days after
they meet the eligibility requirements, following written approval by us. treatment began and must be completed prior to your return to your country of origin.
12. Dental Emergencies
BENEFITS We agree to reimburse you up to $600 for the immediate relief of acute dental pain
caused by other than a blow to the face.
Benefits are payable for the following costs:
Treatment relating to any dental claim must be completed no later than 90 days after
1. Emergency Hospital treatment began and must be completed prior to your return to your country of origin.
We agree to pay for semi-private hospital accommodation and for reasonable and
customary costs for services and supplies for your emergency care during confinement 13. Wisdom Teeth
as a resident in-patient. We agree to reimburse you up to $150 per tooth for dental and/or oral surgical proce-
dures which are necessary for the extraction of impacted wisdom teeth.
2. Emergency Medical
We agree to pay for: 14. Return of Deceased
In the event of your death due to a covered sickness or injury, we will pay up to $15,000
a) The reasonable and customary costs for services of a legally licensed physician, for the return of your remains in a standard transportation container to your country of
surgeon or anaesthetist. origin; or up to $5,000 for the cremation or burial of your remains at the place of death.
b) Diagnostics, lab tests and/or x-ray examinations as ordered by a physician for the The cost of a coffin, urn or funeral service, is not covered.
purpose of diagnosis.
15. Mental Health Care
c) The use of a licensed local land or sea ambulance to the nearest hospital. If an We agree to reimburse the expenses incurred for treatment of mental, nervous or
ambulance is unavailable, we will reimburse up to $150 for taxi expenses. emotional disorders, as follows; :
d) Private duty services of a registered graduate nurse (who is not related to you by a) inpatient hospitalization, up to a lifetime maximum of $25,000; and
blood or marriage), up to $15,000.*
b) outpatient services, up to a maximum of $1,000 in any 12 consecutive months
e) Rental of crutches, wheelchair or hospital-type bed (standard non-electric model of coverage.
only), not exceeding the purchase price; the cost of splints, trusses, braces or other
approved prosthetic appliances; initial purchase of casts; artificial limbs, eyes or 16. Prescription Glasses, Contact Lenses, and Hearing Aids
other approved prosthetic or medical appliances.* We will pay up to a maximum of $200 for prescription glasses, contact lenses and hearing
aids required as a result of accidental injury. This benefit does not cover the
f) Oxygen and rental of equipment for its administration.* repair or replacement of prescription glasses, contact lenses and/or hearing aids.
g) Blood and blood plasma, except when donated. 17. Tutorial Services
* Must be pre-approved by the Assistance Centre. We will pay up to $20/hour to a maximum of $400 for the costs of a qualified private tuto-
rial service in the event you are hospitalized for 30 consecutive days or more.
3. Professional Services
The services of a legally licensed physiotherapist, chiropractor, chiropodist, osteopath, 18. Trauma Counselling
podiatrist, acupuncturist, naturopath and speech therapist (all of whom are not related to We will pay up to a maximum of $500 for trauma counselling within 90 days from the date
you by blood or marriage). A referral from a physician is required for acupuncturist and of your emergency covered under this policy. Our maximum liability is $5,000 per event
naturopath. Not to exceed $600 per practitioner per calendar year. under this policy and all other policies issued by the company within one calendar year.
Where the aggregate eligible claims within a calendar year exceed this limit, the eligible
4. Drugs or Medications claims will be reduced on a pro-rata basis and will be paid at the end of the year.
Prescription drugs or medications that require a physician’s written prescription, up to a
maximum of $10,000 not exceeding a one-month supply. 19. Tuberculosis Testing and Vaccination
We will pay up to a maximum of $100 for tuberculosis testing and vaccination or
5. Maternity Benefit immunization during 12 consecutive months of coverage, provided the minimum term
We agree to reimburse up to $25,000 for the costs, provided that the pregnancy of insurance purchased is 180 days with no lapse in coverage. Coverage for tuberculosis
commenced during the period of coverage and the costs are incurred in the country testing is not payable if testing is mandated by the school board or school as a
of study, for: requirement for program enrolment.
a) pre-natal care (including but not limited to tests and prescribed medication), and 20. Accidental Death & Dismemberment
b) involuntary termination of pregnancy or resulting complications. The insurer agrees to pay up to a maximum sum insured of $10,000, for loss of life, limb
or sight occurring during the period of coverage resulting directly from accidental injury.
No benefits will be payable for expenses incurred for childbirth, voluntary termination of The total aggregate limit for all losses under Accidental Death & Dismemberment is
pregnancy, or post-natal care. $10 million.
6. Eye Examination a) Flight Accident and Common Carrier
When a minimum of 12 consecutive months of coverage has been purchased, we agree as a result of an accident sustained during the period of coverage while riding as
to reimburse the services of a registered optometrist for diagnostic procedures a fare-ticket passenger or while entering or leaving a lawfully operated licensed
to determine the presence of any observed abnormality in the visual system. common carrier; or
Limited to one visit in any 12 consecutive months of coverage. b) 24-Hour Accident
as a result of an accident during the period of coverage in any other situation not
7. Physical Examination specifically mentioned under a) above.
When a minimum of 12 consecutive months of coverage has been purchased, we agree
to reimburse the cost of one routine physical examination or one consultation and Benefits are payable according to the following schedule. Only one amount is payable
prescription for the “morning-after pill” in any 12 consecutive months of coverage, to a (the largest) if the insured suffers more than one of these losses.
maximum of $150. a) 100% of sum insured resulting from the same accidental injury for loss of:
8. Emergency Air Transportation / Return to Country of Origin ii. life; or
If a covered sickness or injury necessitates your immediate transportation or return to iii. entire sight of both eyes; or
your country of origin, we agree to pay the cost of one-way transportation by the most iv. both hands; or
appropriate means, including the use of an air ambulance or stretcher accom- v. both feet; or
modation and medical escort if deemed medically necessary by the Assistance Centre, vi. one hand and entire sight of one eye; or
to the nearest appropriate medical facility or to your country of origin. To be eligible for vii. one foot and entire sight of one eye.
reimbursement, the Assistance Centre must pre-approve these costs. b) 50% of sum insured resulting from the same accidental injury for loss of:
i. entire sight of one eye; or
ii. one hand; or
iii. one foot.

2 INTERNATIONAL STUDENTS PLAN / DISI_1123

 Loss of hand or hands, or foot or feet means severance through or above the wrist joint •  any skiing or snowboarding out of bounds, heliskiing, ski jumping;
or ankle joint, respectively. Loss of eye or eyes means total and irrecoverable loss of the •  white water rafting (except grades 1 to 4);
entire sight. •  street luge or skeleton activity;
21. Terrorism Coverage (only for Canadians) •  any rodeo activity;
When an act of terrorism directly or indirectly causes an eligible loss under the terms and •  skydiving and sky-surfing;
conditions of this policy, coverage is available for up to two (2) acts of terrorism within a •  any form of BASE jumping (ie: wingsuit flying);
calendar year and up to a maximum aggregate payable limit of $35 million for all eligible
emergency medical in-force policies issued and administered by us. The amount payable •  any speed event or other high-risk activity involving the use of a motor vehicle on
for each eligible claim is in excess of all other sources of recovery including alternative or land, water or air, whether on approved tracks or elsewhere;
replacement travel options and other insurance coverage. The amount paid for all such •  a professional sport, if that sport is your main paid occupation; or
claims shall be reduced on a pro rata basis so as to not exceed the respective maximum •  scuba diving (except if certified by internationally recognized and accepted program
aggregate limit which will be paid after the end of the calendar year and after completing such as NAUI or PADI, or if diving depth does not exceed 30 meters).
the adjudication of all claims relating to the act(s) of terrorism. 17. Any loss incurred as a result of pregnancy, abortion, miscarriage, childbirth, or com-
plications thereof, except as specifically provided under the Maternity Benefit (Benefit 5).
SPECIFIC CONDITIONS 18. Medical expenses incurred by an infant 14 days old or less.
Limits on Coverage 19. Sickness or injury resulting from a motor vehicle accident where you are entitled to
You or someone on your behalf must notify the Assistance Centre within 24 hours of admission receive benefits pursuant to any policy or legislative plan of motor vehicle insurance.
to a hospital or before any medical consultation or any surgery is performed. 20. Cosmetic surgery, including any expenses for directly or indirectly related complications
If you fail to do so without reasonable cause, we may reduce the benefits payable to you under unless such cosmetic surgery is a result of a covered sickness or injury.
this policy. You will be responsible for any expenses that are not payable by us. 21. Any medical consultation that is elective or related to a prior elective procedure.
22. Dental care, services or supplies, except as specifically provided under Accidental Dental
We reserve the right, as reasonably required, to transfer you to any hospital or to transport you (Benefit 11), Dental Emergencies (Benefit 12) or Wisdom Teeth (Benefit 13).
to your country of origin if you are unable to continue your studies due to a covered sickness
or injury. If you refuse to be transferred or transported when declared medically fit to travel, any 23. Treatment or services that contravene, or are prohibited by, legislation under a provincial
continuing costs incurred after your refusal will not be covered and the payment of such costs or territorial hospital/medical plan.
becomes your sole responsibility. Coverage ceases upon your refusal and no coverage will be 24. Costs that exceed the reasonable and customary rate for the area where the treatment or
provided to you for the remainder of the period of coverage. services are being performed.
25. Loss or repair of or damage to eye glasses, contact lenses, hearing aids and/or prescrip-
General Provisions of this policy apply. Refer to page 4 tions for any of these items.
EXCLUSIONS 26. Any learning or educational assessments for Attention Deficit Hyperactivity Disorder
(ADHD) or similar conditions or diagnosis.
Benefits are not payable for costs incurred due to: 27. General assessments or checkups, or any services requested by a third party.
1. Any pre-existing medical condition that was not stable within the 90 days immediately 28. Air travel other than as a passenger in a commercial aircraft licensed to carry passengers
before your effective date. for hire, except while being transported under the terms of the Emergency Air Transporta-
2. Any pre-existing medical condition or any related conditions for which, prior to your tion /Return to Country of origin benefit.
arrival date in Canada or country of study, you had, were scheduled or recommended for 29. The purchase of:
a medical consultation for the purpose of establishing a diagnosis, and for which results a) medications or drugs not approved for use by the appropriate government authority; or
had not yet been received at the time of departure from your country of origin. b) patent or proprietary medications; or
3. Test and investigative consultation including, but not limited to biopsies, except when c) vitamins or vitamin preparations; or
performed at time of an emergency sickness or injury; except as specified under the
Non-Emergency Treatment (Benefit 10). d) drugs or medications which can be purchased without a prescription; or
4. Losses incurred due to: e) acne medications; or
f) nicotine resin products; or
(i) any loss resulting from your minor mental or emotional disorder; and/or
g) dietary supplements or weight loss products; or
(ii) your self-inflicted injuries, unless medical evidence establishes that the injuries are
h) quantities of any drug or medication which exceed a 30-day supply within one
related to a mental health illness.
month prior to the policy expiry date; or
Except as provided under Medical Health Care (Benefit 15). i) contraceptives prescribed for any purpose, with the exception of the “morning-after
5. Medical treatment and expenses incurred while in your country of origin. pill”, which is limited to one per period of coverage; or
6. A medical condition which originated while visiting your country of origin during the period j) contraceptive consultation or testing, except as specifically provided under
of coverage or any condition wholly or partly, directly or indirectly, related thereto. Physical Exam (Benefit 7); or
7. If you are Canadian, any act of terrorism directly or indirectly caused by, resulting from, k) fertility drugs or testing; or
arising out of or that is in connection with biological, chemical, nuclear or radioactive l) drugs, medications, or other costs paid for by any other agency; or
means. m) experimental drugs, preventative medications or vaccines (except as specifically
8. For inbound insured, an act of terrorism. stated in Benefit 19).
9. An act of war. 30. Any loss incurred outside of your country of study, except for loss due to acute
10. Losses incurred due to your participation in: emergency hospital and other covered emergency costs due to sickness or injury
occurring during the period of coverage while you are travelling, other than your country
•  protests; or of origin, provided you spend the majority of the period of coverage within your country
•  armed forces activities; or of study.
•  a commercial sexual transaction; or 31. Any act of terrorism or medical condition you suffer or contract when:
•  the commission or attempted commission of any criminal offence or illegal act; or •  the Government of Canada issues a travel advisory to Avoid all travel or Avoid all
•  the contravention of any statutory law or regulation in the area where the loss non-essential travel to the region, city, or country of your destination; and
occurred. •  the travel advisory is issued before your effective date.
11. Any medical condition: You can read all travel advisories on the Government of Canada Official Global Travel
•  when you knew, or for which it was reasonable to expect, before you left your Advisory website.
country of origin, that you would need or be required to seek treatment for that
medical condition; and/or Note: This exclusion does not apply to claims for an emergency or medical condition that
•  when the purpose of your trip was to seek medical treatment for that medical is not related to the travel advisory.
condition.
DEFINITIONS
12. Loss, death or injury, if at the time of the loss, death or injury, evidence supports you were
affected by, or the medical condition causing the loss was in any way contributed to by: Accident(al) means a sudden, unexpected, unforeseeable, unavoidable external event and
•  your use of alcohol, prohibited drugs or any other intoxicant; or excludes disease or infections.
•  you not following treatment as prescribed to you, including prescribed or over-the- Act(s) of terrorism means any activity that involves a threat to use or the actual use of
counter medication; or violence or any dangerous or threatening act, or the use of force. Such act is directed
•  your non-compliance with medical therapy before or after the effective date; or against the general public, governments, organizations, properties or infrastructures,
•  your use of medication or drugs that have not been approved by the appropriate orelectronic systems.
government authority. The intention of such activity is to:
13. Any treatment, investigation or hospitalization which is a continuation of, or subsequent
to, an emergency, except as specified under the Non-Emergency Treatment (Benefit 10). •  instill fear in the general public;
14. Any treatment, investigation or hospitalization which exceeds 30 days following the •  disrupt the economy;
initial day that outpatient treatment began, unless approved in advance by the Assistance •  intimidate, coerce or overthrow a sitting government or occupying power; and/or
Centre. •  promote political, social, religious or economic objectives
15. Travelling against the advice of a physician or any loss resulting from a sickness or Act of war means hostile or warlike action, whether declared or not, in a time of peace or
medical condition that was diagnosed by a physician as terminal prior to the effective date war, whether initiated by a local government, foreign government or foreign group, civil unrest,
of this policy. insurrection, rebellion or civil war.
16. Injury resulting from training for, competing or participating in:
•  mountain climbing which involves the ascent or descent of a mountain requiring Change in medication means the medication dosage, frequency or type has been reduced,
the use of specialized equipment, including crampons, pickaxes, anchors, bolts, increased or stopped, and/or new medication(s) has/have been prescribed. Exceptions: the
carabiners and lead or top-rope anchoring equipment; routine adjustment of Coumadin, warfarin or insulin (as long as they are not newly prescribed
3 INTERNATIONAL STUDENTS PLAN / DISI_1123
or stopped) to test your blood levels; and a change from a brand name medication to a generic Student means a person:
brand medication of the same dosage. a) who regularly attends school, college, university, or other accredited educational
Common carrier means a licensed carrier offering its transportation services to paying institution; and
passengers at published rates and scheduled times. b) who is enrolled in a minimum of 60% of the usual course requirements for the program in
Country of origin means : which they are enrolled; or
c) who remains in their country of study for up to 60 days immediately after completion of
a) For International Students studying in Canada: the country in which you maintained a studies as described under a) and b) of this definition.
permanent residence prior to entry into Canada or, if different, the country which issued
your passport. Terminal means a sickness or medical condition for which a physician gave a prognosis of
eventual death or for which palliative care was received, prior to the effective date.
b) For Canadian Students studying abroad: means Canada if you hold a Canadian passport.
Treatment means hospitalization, a procedure prescribed, performed or recommended by a
If you have more than one passport, country of origin will be the country you indicated as such physician for a medical condition. This includes but is not limited to:
when applying for this insurance.
i) prescribed medication,
Dependent means:
ii) surgery,
your legally married spouse or a person with whom you have been cohabitating in a common-law iii) investigative testing that results in a diagnosis of a specific medical condition.
relationship for at least 12 consecutive months prior to the date of application; and
Important: Any reference to testing, tests, test results, or investigations excludes genetic tests.
a) any unmarried children residing with you, who are more than 15 days of age and age 25 or
“Genetic test” means a test that analyzes DNA, RNA or chromosomes for purposes such as the
under and dependent upon you for their sole means of support; and
prediction of disease or vertical transmission risks, or monitoring, diagnosis or prognosis.
b) your parent, stepparent, legal guardian, brother, sister, stepbrother, or stepsister who are
living with the student while in the country of study. Trip means the time beginning with your effective date and ending with your expiry date, as
shown on your application.
Dependents are covered only when dependent coverage is selected and paid for at the time
of application. We, us, our means Manulife.
Effective date means the date coverage begins as indicated in the Eligibility section titled You or Your means an eligible person named on the application, who has been accepted by the
Effective Date. insurer or its authorized representative, and has paid the required premium for a specific plan
of insurance.
Emergency means a sudden and unforeseen medical condition that requires immediate
treatment. An emergency no longer exists when the evidence reviewed by Assistance Centre
indicates that no further treatment is required and that you are able to continue your trip or return GENERAL PROVISIONS
to your place of ordinary residence or country of origin. Assignment
Expiry date means the date coverage ends as indicated in the Eligibility section titled Expiry Date. Any benefits payable or which may become payable under this policy cannot be assigned by
Hospital means an institution that is licensed as an accredited hospital that is staffed and you and we are not responsible for and will not be bound by any assignment entered into
operated for the care and treatment of in-patients and out-patients. Treatment must be supervised by you.
by physicians and there must be registered nurses on duty 24 hours a day. Diagnostic and Despite any other provisions of this contract, this contract is subject to the statutory conditions
surgical capabilities must also exist on the premises or in facilities controlled by the establishment. contained in the Insurance Act as applicable in your province or territory of residence respecting
A hospital is not an establishment used mainly as a clinic, extended or palliative care facility, contracts of sickness and accident insurance.
rehabilitation facility, addiction treatment centre, convalescent, rest or nursing home, home for the Automatic Extension of Coverage
aged or health spa.
Coverage will be automatically extended for up to 72 hours in the event of a delay during the
Injury means bodily harm which is directly caused by or resulting from an accident, being a period of coverage of the conveyance in which you are riding or are scheduled to ride as a
sudden and unforeseen event, excluding bodily harm that results from deliberate or voluntary passenger. This delay must be due to circumstances beyond your control and the conveyance
action and independent of sickness and all other causes. must be scheduled to arrive during the period of coverage.
Insurer means The Manufacturers Life Insurance Company (Manulife). Coverage will be automatically extended for up to 5 days, if you are hospitalized due to a
Medical condition means any disease, sickness or injury (including symptoms of undiagnosed covered sickness or injury on or before the coverage expiry date.
conditions). Benefit Payments
Medical consultation means any medical services obtained from a licensed medical practitioner Unless otherwise stated, all provisions in this policy apply to you during one period of coverage.
for any medical condition, including but not limited to any or all of: history taking, medical Benefits are only payable to you under one policy during the period of coverage. If more than
examination, investigative testing, advice or treatment, and for which a diagnosis of the condition one policy issued by us is in effect at the same time, benefits will only be paid under one
need not have been definitively made. This does not include regular medical check-ups where no insurance policy, the one with the highest amount of insurance. Benefits are only payable for the
medical signs or symptoms existed or were found during the check-up. plans and the specific amount of insurance selected, paid for and accepted by the Assistance
Centre on our behalf at the time of application. Any benefits payable do not include interest
Minor mental or emotional disorder means: charges. Benefits payable as a result of your death will be payable to your Estate.
•  having anxiety or panic attacks, or Conformity with Law
•  being in an emotional state or in a stressful situation. Any policy provision in conflict with any law to which this policy is subject is hereby deemed to
A minor mental or emotional disorder is one where your treatment includes only minor be amended to conform thereto.
tranquilizers or minor anti-anxiety medication (anxiolytics) or no prescribed medication at all. Coordination of Benefits
Period of coverage means the period from the effective date to the expiry date as indicated in Amounts payable under this plan are in excess of any amounts available or collectible under
this policy and for which premium has been paid. any existing coverage concurrently in force held by or available to you.
Other coverage includes but is not limited to:
Physician means a person:
•  homeowners insurance;
• who is not you or an immediate family member or your travel companion; •  tenants insurance;
• licensed in the jurisdiction where the services are provided, to prescribe and •  multi-risk insurance;
administer medical treatment. •  any credit card, third-party liability, group or individual basic or extended
Pre-existing medical condition means any medical condition that exists prior to your effective health insurance;
date. •  any private or legislative plan of motor vehicle insurance providing hospital,
Reasonable and customary means charges incurred for goods and services that are medical or therapeutic coverage.
comparable to what other providers charge for similar goods and services in the same The Assistance Centre, on our behalf, will coordinate all benefits in accordance with the
geographical area. Canadian Life and Health Insurance Association guidelines.
School means a school, university, college or other recognized institution of learning that is Reimbursement will not be made for any costs, services or supplies that are payable to you
accredited by the local authorities. under a motor vehicle insurance policy or legislative plan pursuant to the no-fault benefits
schedule under any Insurance Act, or for which you receive benefits from any other party under
Sickness means illness, disease, or any symptom related to that illness and/or disease. any policy or legislative plan of motor vehicle insurance, until such benefits are exhausted.
Stable means a medical condition is considered stable when all of the following statements You may not claim or receive in total more than 100% of the loss caused by the insured event.
are true: If you are retired with an extended health plan provided by a former employer, with a lifetime
1) there has not been any new treatment prescribed or recommended, or change(s) to limit of up to $100,000, the Assistance Centre will not coordinate benefits with that provider on
existing treatment (including a stoppage in treatment), and our behalf, except in the event of your death.
2) there has not been any change in medication, or any recommendation or starting of a Currency
new prescription drug, and All amounts stated in the policy, including premium, are in Canadian dollars. At the option of the
3) the medical condition has not become worse, and Assistance Centre, benefits may be paid in the currency of the country where the loss occurred.
If currency conversion is necessary, the exchange rate on the date the service was rendered to
4) there has not been any new, more frequent or more severe symptoms, and you will be used.
5) there has been no hospitalization or referral to a specialist, and
6) there have not been any tests, investigation or treatment recommended, but not yet
complete, nor any outstanding test results, and
7) there is no planned or pending treatment.
All of the above conditions must be met for a medical condition to be considered stable.
4 INTERNATIONAL STUDENTS PLAN / DISI_1123
Emergency Assistance Sanctions
The Assistance Centre will use its best efforts to provide assistance for a medical emergency Benefits are not payable under this policy for any losses or expenses incurred due to or as a
arising anywhere in the world. However, the Assistance Centre, the insurer, nor result of your travel to a sanctioned country for any business or activity that would violate any
The Destination: Travel Group Inc. and their brokers will not be responsible for the availability, Canadian or any other applicable national economic or trade sanction law or regulation.
quantity, quality, or results of any medical treatment received, or for the failure of any person to
provide or obtain medical services. Time
Extending Your Trip Applicable to International Students studying in Canada: This policy will be governed by the
local time of the Canadian province or territory in which your policy was issued.
Applicable to International Students studying in Canada:
Applicable to Canadian Students studying abroad: This policy will be governed by the local time of
If you decide to apply for additional coverage before you have left your country of origin, contact the Canadian province or territory in which you normally reside.
your broker or The Destination: Travel Group Inc. at 1-855-337-3532.
If you decide to apply for additional coverage after you have left your country of origin, you may STATUTORY CONDITIONS
apply for a new term of coverage if you: Contract
a) purchase additional coverage before the expiry date; and The application, this policy, any document (including but not limited to the completed medical
b) are in good health; and questionnaire, Confirmation of Coverage) attached to this policy when issued and any
c) have no reason to seek treatment during the new term of coverage. amendment to the contract agreed on in writing after this policy is issued, constitute the entire
If you have incurred a claim, the Assistance Centre and the insurer will review your file before contract, and no agent has the authority to change the contract or waive any of its provisions.
deciding on granting a new term of coverage. The Assistance Centre on the insurer’s behalf reserves the right to decline any application or any
Each policy or period of coverage is considered a separate contract and all limitations and request for new terms of coverage.
exclusions will apply. Waiver
The Assistance Centre on the insurer’s behalf reserves the right to decline any request for new
terms of coverage. The insurer shall be deemed not to have waived any condition of this contract, either in whole or
in part, unless the waiver is clearly expressed in writing signed by the insurer.
Applicable to Canadian Students studying abroad:
Copy of Application
If you decide to apply for additional coverage before you have left your province or territory of
residence, contact your broker or The Destination: Travel Group Inc. at 1-855-337-3532. The insurer shall, upon request, furnish you or a claimant under the contract a copy of the
If you decide to apply for additional coverage after you have left your province or territory of application.
residence, you may apply for a new term of coverage if you: Material Facts
a) purchase additional coverage before the expiry date; and No statement made by you or a person insured at the time of application for the contract shall be
b) are in good health; and used in defence of a claim under or to avoid the contract unless it is contained in the application
c) have no reason to seek treatment during the new term of coverage. or any other written statements or answers furnished as evidence of insurability.
If you have incurred a claim, the Assistance Centre on the insurer’s behalf will review your file Termination
before deciding on granting a new term of coverage. You may at any time request that this contract be terminated and the insurer shall, as soon as
Each policy or period of coverage is considered a separate contract and all limitations and practical after you make the request, refund the amount of premium actually paid by you that is
exclusions will apply. in excess of the short-rate premium calculated to the date of the request according to the table in
The Assistance Centre on the insurer’s behalf reserves the right to decline any request for new use by the insurer at the time of the termination.
terms of coverage. Refer to Refunds
General Terms
Notice and Proof of Claim
Insurance terms and conditions are subject to change with each new policy purchased, without
prior notice. Please refer to the Claims Procedures on page 6.
Governing Law If you do not provide the required supporting documentation, your claim will not be paid.
This policy will be governed by the laws of the Canadian province or territory where the Failure to Give Notice and Proof
policy was issued.
Failure to give notice of claim or furnish proof of claim within the time prescribed does not
Limit on Liability invalidate the claim if:
It is a condition precedent to liability under this policy that on the effective date, you are in good
health and know of no reason to seek medical attention. a) the notice or proof is given or furnished as soon as reasonably possible, and in no event
later than 1 year from the date of the accident or the date a claim arises under the contract
Limitation of Action on account of sickness or disability if it is shown that it was not reasonably possible to give
Every action or proceeding against an insurer for the recovery of insurance money payable notice or furnish proof within the time so prescribed; or
under the contract is absolutely barred unless commenced within the time set out in the b) in the case of your death, if a declaration of presumption of death is necessary,
Insurance Act or in the Limitations Act, 2002 in Ontario or other applicable legislation. the notice or proof is given or furnished no later than 1 year after the date a court makes
Misrepresentation or Nondisclosure the declaration.
We will not pay a claim if you, any person insured under this policy or anyone acting on your Insurer to Furnish Forms for Proof of Claim
behalf attempt to deceive us or makes a fraudulent, false or exaggerated statement or claim.
Claims forms are available by contacting the Assistance Centre Claims Department and shall
When completing the application (including the questionnaire if required), your answers must be be furnished to you upon request.
complete and accurate. In the event of a claim, we will review your medical history. If any of your
answers are found to be incomplete or inaccurate: Rights of Examination
•  your coverage will be void, The claimant shall provide the insurer with the opportunity to examine you when and so often as
•  which means your claim will not be paid. it reasonably requires while a claim is pending. In the case of your death, the insurer may require
You must be accurate and complete in your dealings with us at all times. an autopsy, subject to any laws of the applicable jurisdiction relating to autopsies.
Where there is an error as to your age, provided that your age is within the insurable limits of When Money Payable
this policy, the premiums will be adjusted according to your correct age. All money payable under this contract shall be paid by the insurer within 60 days after the insurer
Premiums has received proof of claim.
The total premium amount is due and payable at the time of application. REFUNDS
This policy is non-participating. You are not entitled to share in our divisible surplus.
Right to be Reimbursed (Subrogation) A full refund will be provided for policies which are returned within 10 days of purchase and
requested in writing prior to the effective date of coverage.
As a condition to receiving benefits under the policy, you agree to:
When submitting your refund request, please include:
a) reimburse the insurer for all emergency medical and hospital costs paid under the
policy from any amounts you receive from a third party responsible (in whole or in 1. a written request; and
part) for your injury or sickness whether such amounts are paid under a judgment or 2. a copy of your confirmation of coverage; and
settlement agreement; 3. confirmation of your early departure such as boarding pass or itinerary, or any other
b) whenever reasonable, initiate a legal action against the third party to recover your written proof of your early return to your country of origin; and
damages, which include emergency medical and hospital costs paid under the policy; 4. any other documentation to support your refund request.
c) include all emergency medical and hospital costs paid under the policy in any
settlement agreement you reach with the third party; Refunds are payable when:
d) act reasonably to preserve the insurer’s rights to be reimbursed for any emergency 1. The student fails to meet visa entry eligibility requirements.
medical or hospital costs paid under the policy; 2. You return your country of origin 30 days or more prior to the expiry date of coverage,
e) keep the insurer informed of the status of any legal action against the third party; and without intending to return to Canada.
f) advise your counsel of the insurer’s right to reimbursement under the policy. 3. The student is no longer enrolled in a school within Canada or the country of study.
Your obligations under this section of the policy in no way restrict the insurer’s right to bring 4. You become covered under a provincial or territorial health/medical plan.
a subrogated claim in your name against the third party and you agree to cooperate with the Premium refund requests, regardless of method of payment, should be submitted to
insurer fully should the insurer choose to exercise its right of subrogation. The Destination: Travel Group Inc.

5 INTERNATIONAL STUDENTS PLAN / DISI_1123

Under no condition will a refund be made if a claim has been incurred or paid, or is pending. We need the following information if submitting an accidental death or
Premiums which are 100% refundable are subject to a $10 administration fee, except when dismemberment claim:
cancelled during the 10 day examination period.
a) report from the police, coroner, or autopsy
Partial cancellations are charged a $25 administration fee. These fees are deducted from the
net premium to be refunded. Refunds will not be provided for amounts less than the b) medical records
minimum required premium for the plan purchased. c) death certificate, if applicable
Refunds are calculated as follows: d) any other documents requested by the Assistance Centre after initial review of the claim.
• From the date of permanent return to your country of origin; or
Note: If your body is not found within 12 months of the flight or travel accident, we presume you
• If you become eligible for coverage under a provincial or territorial government health/ died from your injuries.
medical plan, we will consider your cancellation request from the date we receive
acceptable proof of your provincial or territorial government health care coverage Questions?
(inbound students only). Such requests cannot be backdated because this insurance If you have any questions or concerns about our products or services, or your policy or claim
policy provides insured services and other benefits that are not provided by provincial or please feel free to contact the Assistance Centre anytime:
territorial government health care; or
• The day you are no longer enrolled in a school within Canada or your country of study. Toll-Free
1-833-886-1070
CLAIMS PROCEDURES Collect
Travel assistance and CLAIM SUBMISSION, anywhere in the world + 1 (519) 945-1070
Before you travel, download the Manulife TravelAid™ mobile app through the Emergency Medical Assistance and Claims Administration
Google Play™ store or the Apple App Store®. provided by:
The Assistance Centre (Active Care Management)
Features of Manulife TravelAid include: PO Box 1237, Station A
Windsor, ON N9A 6P8
• Start a Claim – begin the process to file a claim and track your claim status
Managed and Distributed by:
• Contact Us – a direct link to the Assistance Centre for immediate medical The Destination: Travel Group Inc.
assistance 24/7 304-155 Gordon Baker Road
Toronto, Ontario, Canada M2H 3N5
• International 911 – search emergency phone numbers in other countries (GPS Tel: 1-855-337-3532
enabled)
Underwritten by:
• Find Medical Facility – find directions to the closest medical facility (GPS enabled) The Manufacturers Life Insurance Company (Manulife).
P.O. Box 670, Stn. Waterloo,
• Travel Tips – pre- and post-departure Waterloo, ON N2J 4B8
• Travel Advisories EMERGENCY PROCEDURES
In the event of an injury or sickness, you or someone acting on your behalf must notify
To download the app, visit http://www.active-care.ca/en/travelaid/ the Assistance Centre (toll free 1-833-886-1070 or worldwide collect +1 (519) 945-1070
before any medical consultation or any surgery is performed.
Online Claims Submission is also available, visit https://manulife.acmtravel.ca to
submit your claim online. For faster and easier submissions, have all your documents The Assistance Centre is here to help with service available 24 hours a day, 7 days a week.
available in electronic format,such as a PDF or a JPEG. The Assistance Centre also provides support and recommendations for non-medical
emergencies, providing you with access to resources to help resolve any unexpected difficulties
You may call the Claims Centre directly for specific information on how to make a claim you encounter during your period of coverage.
or to enquire about your claim status at: 1 833-886-1070 or +1 (519) 945-1070.
MEDICAL CONCIERGE SERVICES
SEND YOUR CLAIMS TO: The Destination: Travel Group Inc. is pleased to provide you with value‑added medical
Active Care Management concierge services.
P.O. Box 1237, Stn. A
Windsor, ON N9A 6P8 What services are available?
Collect worldwide: + 1 (519) 945-1070 StandbyMD has an international network of medical providers and partners who can provide
Toll free Canada/USA: 1-833-886-1070 quick and streamlined services and access to healthcare, 24 hours a day, every day of the year.
1. Claims must be reported within 30 days of occurrence. StandbyMD offers access to personalized care including:
2. Written proof of claim must be submitted within 90 days of occurrence. • telephone or video chat with a qualified physician who can assess symptoms and provide
3. Any costs incurred for documentation or required reports are your or the claimant’s treatment options (for eligible cases)
responsibility. • a network of physicians who make house call visits in 141 countries and over 4,500 cities
4. To submit your claim, fill out the claim form completely. Incomplete information will cause delay.
• in-network clinics and emergency rooms when necessary
5. Failure to comply with the claims procedures will result in loss of rights to or reduction of,
benefits available under this policy. • coordination and delivery of lost or forgotten prescription medications, eyeglasses or
contact lenses, and medical supplies when you travel within Canada and the US
We need the following information if you are submitting a medical claim:
How does this service work?
a) original, itemized bills and invoices StandbyMD triages you according to your symptoms, profile, and location and then refers you to
b) proof of payment by you (receipts) the most appropriate level of care for your situation.
c) proof of payment from any other insurance plan or benefit plan The worldwide network offers preferred rates and direct billing options to help reduce your
d) applicable medical records, including: out-of-pocket expenses. The StandbyMD program also helps coordinate payment for eligible
- complete diagnosis by the attending physician expenses according to the terms and conditions of this policy.
- documentation from the hospital that the treatment was appropriate and consistent with To use this service, contact the Assistance Centre at the number provided in this policy.
your diagnosis
- documentation that states the treatment could not be delayed until you returned home Disclaimer, waiver, and limitation of liability
without adversely affecting your condition and quality of medical care StandbyMD is not intended as a substitute for professional medical advice. The program is
provided to assist you in finding medical providers.
e) under the Professional Services benefit, a letter from the referring physician
recommending treatment by an acupuncturist and naturopath. The advice StandbyMD provides is a recommendation only and entirely voluntary. You retain the
f) under Drugs benefit, original pharmacist, physician or hospital receipts indicating total right to choose your own level of care, regardless of the recommendation StandbyMD makes.
drug cost, prescription number, name of medication, quantity, date and prescribing Medical providers within the StandbyMD network are not employees or agents and are not
physician name affiliated with StandbyMD in any way beyond accepting referrals. StandbyMD has no control –
g) proof of the accident if you submit a claim for dental expenses that result from an accident real or implied – over the medical judgment, actions, or inactions of the medical providers and
does not assume any responsibility for:
h) proof of travel, including your departure date and return date
• availability of the medical providers
i) your historical medical records, if we ask for them
• quality of the medical providers
j) proof of your school enrolment
• the results or outcome of any treatment or service.
You waive any and all rights to proceed legally against StandbyMD or anyone related
to StandbyMD. Related people include principals, parents, successors, and assigns of
StandbyMD.

6 INTERNATIONAL STUDENTS PLAN / DISI_1123

 Waiving these rights to proceed legally includes the following that relate in any way to the
medical concierge services offered by StandbyMD:
• any and all claims
• demands
• actions and causes of action
• suits of any kind, nature, or amount
StandbyMD’s liability, if any, is limited solely to the amount of payment made to participating
medical providers for services you received after obtaining a referral from StandbyMD.

ACTIVE CARE MANAGEMENT

Toll free Canada/USA:
1-833-886-1070
If unable to contact us through the
toll-free number, call collect
+ 1 (519) 945-1070

PRIVACY INFORMATION NOTICE

At the Manufacturers Life Insurance Company (Manulife), your privacy matters. We are
committed to protecting the privacy of the information we receive about you in the course
of providing the insurance you have chosen. While our employees need to have access
to that information, we have taken measures to protect your privacy. We ensure that other
professionals, with whom we work in giving you the services you need under your insurance,
have done so as well. To find out more about how we protect your privacy, please read our
Notice on Privacy and Confidentiality.
Notice on Privacy and Confidentiality. The specific and detailed information requested on
the application form is required to process the application. To protect the confidentiality of this
information, Manulife will establish a “financial services file” from which this information will be
used to process the application, offer and administer services and process claims. Access to
this file will be restricted to those Manulife employees, mandataries, administrators or agents
who are responsible for the assessment of risk (underwriting), marketing and administration of
services and the investigation of claims, and to any other person you authorize or as authorized
by law. These people, organizations and service providers may be in jurisdictions outside
Canada, and subject to the laws of those foreign jurisdictions. Your file is secured in our offices
or those of our administrator or agent. You may request to review the personal information it
contains and make corrections by writing to: Privacy Officer, Manulife, P.O. Box 1602, Waterloo,
Ontario N2J 4C6.
For further details about our Privacy Policy, you may also visit Manulife at
https://www.manulife.ca/privacy-policies.html.
Accessible formats and communication supports are available upon request.
Visit Manulife.ca/accessibility for more information.

Manulife, Manulife & Stylized M Design, and Stylized M Design are trademarks of
The Manufacturers Life Insurance Company and are used by it, and by its affiliates under license.
© 2023 The Manufacturers Life Insurance Company. All rights reserved
TravelAid ™ is a trademark of Active Claims Management (2018) Inc. and is used by Manulife and its affiliates
under license.
StandbyMD ™ is a trademark of Healthcare Concierge Services Inc, owned by Global Excel Management Inc.
App Store is a trademark of Apple Inc.
Google Play is a trademark of Google LLC.

7 INTERNATIONAL STUDENTS PLAN / DISI_1123