Guide to Benefits for MasterCard® Cardholders

Guide to Beneﬁts for

MasterCard

Cardholders

Trip Cancellation

Key Terms

Throughout this document, You and Your refer to the cardholder or authorized user of the covered

card. We, Us, and Our refer to New Hampshire Insurance Company, an AIG Company.

Administrator means Sedgwick Claims Management Services, Inc., You may contact the administrator

if You have questions regarding this coverage or would like to make a claim. The administrator can be

reached by phone at 1-800-MasterCard.

Authorized User means an individual who is authorized to make purchases on the covered card by

the cardholder and is recorded by the Participating Organization on its records as being an authorized

user.

Cardholder means the person who has been issued an account by the Participating Organization for the

covered card.

Charge means any non-refundable cancellation or change fee imposed by the common carrier.

Common carrier means an air, land or water motorized transportation carrier operating under a

regularly published schedule and current license as required by law for the conveyance of passengers.

Common carrier does not include helicopters, taxis, rental cars, hired cars and private and contract

carriers.

Covered card means the MasterCard card.

Destination means the place where You expect to travel on Your trip as indicated on Your common

carrier ticket.

Domestic partner means an unmarried person in an intimate, committed relationship of mutual caring.

They must share responsibility for basic living expenses with You. They must be at least eighteen (18)

years old and not currently married and/or committed to another person.

Evidence of Coverage (EOC) means the document describing the terms, conditions, and exclusions.

The EOC, Key Terms, and Legal Disclosures are the entire agreement between You and Us.

Representations or promises made by anyone that are not contained in the EOC, Key Terms, or Legal

Disclosures are not a part of Your coverage.

Family member means the spouse or domestic partner of You. It includes unmarried children of You

under nineteen (19) years of age. It also includes unmarried children under twenty-six (26) years of age if

a full-time student at an accredited college or university.

Injury means bodily injury caused by an accident that occurs while You are covered under this program,

and results directly and independently of all other causes of loss. The injury must be veriﬁed by a

physician.

Medically imposed restrictions means a restriction certiﬁed by Your physician prohibiting You from

traveling on a common carrier.

Physician means a licensed medical, surgical, or dental practitioner acting within the scope of his or

her license. The treating physician may not be You, Your family member, a traveling companion or

related to You by blood.

Pre-existing medical condition means any condition resulting from any injury or sickness affecting

You, a traveling companion, or a Family Member traveling with You within the sixty (60) day period

prior to the purchase date of Your trip. The condition must have (a) ﬁrst manifested itself or exhibited

symptoms which would have caused one to seek diagnosis, care, or treatment; (b) required taking

prescribed drugs or medicine; or (c) required medical treatment or treatment was recommended by

a physician. Taking maintenance medications for a condition that is considered stable shall not be

included as a pre-existing medical condition.

Return destination means the place to which You expect to return from Your trip as indicated on Your

common carrier ticket.

Sickness means an illness or disease that is diagnosed or treated by a physician.

Traveling companion means any individual(s) with whom You have arranged to travel on the same trip

with the same itinerary and for which the cost of trip was charged with Your covered card.

Trip means a scheduled period of travel with a destination and return destination away from Your

primary residence using a common carrier.

Trip departure date means the date on which You are originally scheduled to leave on Your trip.

United States Dollars (USD) means the currency of the United States of America.

Evidence of Coverage

Refer to Key Terms for the deﬁnitions of You, Your, We, Us, Our, and words that appear in bold and Legal

Disclosures.

A. To get coverage:

You must purchase the trip with Your covered card and/or accumulated points from Your covered card

for You, or Your family member, and Your traveling companions. Family member(s) do not need to

travel with the cardholder to receive coverage. If the trip is not purchased entirely with Your covered

card, We will only pay for the percentage of the eligible claim based on the percentage of the trip

purchased on the covered card.

If redeemable certiﬁcates, vouchers, coupons, or discounts awarded from frequent ﬂier programs are

used to purchase the trip, any remaining charge for the trip must be purchased entirely with Your

covered card.

B. Covered Reasons:

1. Sickness, injury, or death of You, Your family member, or Your traveling companion, booked to

travel with You which results in medically imposed restrictions. A physician must advise cancellation

of Your trip on or before the trip departure date.

C. The kind of coverage You receive:

Trip Cancellation

We will reimburse You for any incurred charge if You are required to cancel Your trip, prior to Your trip

departure date, due to a covered reason. You must cancel Your trip with Your common carrier as

soon as the covered reason arises. You must also advise the administrator immediately, as We will

not pay beneﬁts for any additional charges incurred that would not been charged had You notiﬁed the

common carrier and the claim administrator as soon as reasonably possible.

Term of Coverage:

Coverage begins on the date the trip was purchased and ends on the trip departure date.

Coverage Limitations:

Coverage is limited to the lesser of the following:

• $1,500 per trip; or

• $5,000 per 12 month period; or

• The original cost of the common carrier ticket for the trip.

Coverage is secondary to any other applicable insurance or beneﬁt available to You including beneﬁts

provided by the common carrier (including, but not limited to, exchanged tickets, drop in ticket prices,

goodwill payments, refunds, credits, or vouchers).

D. What is NOT covered:

• Pre-existing medical conditions.

• Intentionally self-inﬂicted injuries, including suicide or attempted suicide.

• War, invasion, acts of foreign enemies, hostilities between nations (whether declared or not) civil war.

• Participation in any military maneuver or training exercise.

• Piloting or learning to pilot or acting as a member of the crew of any aircraft.

• Mental or emotional disorders, unless hospitalized.

• Participation in professional athletics or underwater activities.

• Being under the inﬂuence of drugs or intoxicants.

• Commission of or the attempt to commit a criminal act.

• Participating in bodily contact sports (ex. boxing); skydiving; hang gliding; parachuting; mountaineering;

any race; bungee cord jumping; or speed contest.

• Dental treatment except as a result of accidental injury to sound, natural teeth.

• Any non-emergency treatment or surgery, routine physical examinations.

• Hearing aids, eye glasses or contact lenses.

• Curtailment or delayed return for other than a covered reason.

• One-way travel that does not have a return destination.

Guide to Beneﬁts for

MasterCard

Cardholders

Trip Cancellation

E. How to ﬁle a claim:

• Call the 1-800-MasterCard to request a claim form. You must report the claim within sixty (60) days of

the failure or the claim may not be honored.

• Submit the following documentation within one hundred and eighty (180) days from the date of failure

or the claim may not be honored:

- Completed and signed claim form.

- Covered card billing statement showing the charge for the covered trip.

- Proof of a covered reason. Examples, orders to report for active duty, subpoena to appear in court,

etc.

- For sickness, injury or death, a completed physician’s form.

- Copy of the cancellation policy of the common carrier.

- Any other documentation that may be reasonably requested by Us or Our designated representative

to validate a claim.

Legal Disclosure

This Guide to Beneﬁts is not, by itself, a policy or contract of insurance or other contract.

Beneﬁts are provided to you, the accountholder, at no additional charge. Non-insurance services may

have associated costs, which will be your responsibility (for example, legal referrals are free, but the

lawyer’s fee is your responsibility).

The insurance beneﬁts are provided under a group policy issued by New Hampshire Insurance Company,

an AIG company. This Guide to Beneﬁts is a summary of beneﬁts provided to you. The attached Key

Terms and EOC is governed by the Group Policy.

Effective date of beneﬁts: Effective February 1, 2015, this Guide to Beneﬁts replaces all prior

disclosures, program descriptions, advertising, and brochures by any party. The Policyholder and the

insurer reserve the right to change the beneﬁts and features of these programs at anytime. Notice will be

provided for any changes.

Cancellation: The Policyholder can cancel these beneﬁts at any time or choose not to renew the

insurance coverage for all cardholders. If the Policyholder does cancel these beneﬁts, you will be notiﬁed

in advance. If the insurance company terminates, cancels, or chooses not to renew the coverage to

the Policyholder, you will be notiﬁed as soon as is practicable. Insurance beneﬁts will still apply for any

beneﬁts you were eligible for prior to the date of such terminations, cancellation, or non-renewal, subject

to the terms and conditions of coverage.

Beneﬁts to you: These beneﬁts apply only to the cardholder whose cards are issued by U.S. ﬁnancial

institutions. The United States is deﬁned as the ﬁfty (50) United States, the District of Columbia, American

Samoa, Puerto Rico, Guam, and the U.S. Virgin Islands. No person or entity other than the cardholder

shall have any legal or equitable right, remedy, or claim for beneﬁts, insurance proceeds and damages

under or arising out of these programs. These beneﬁts do not apply if your card privileges have been

cancelled. However, insurance beneﬁts will still apply for any beneﬁt you were eligible for prior to the date

that your account is suspended or cancelled, subject to the terms and conditions of coverage.

Transfer of rights or beneﬁts: No rights or beneﬁts provided under these insurance beneﬁts may be

assigned without the prior written consent of the claim administrator for these beneﬁts.

Misrepresentation and Fraud: Beneﬁts shall be void if the cardholder has concealed or

misrepresented any material facts concerning this coverage.

Dispute Resolution – Arbitration: This EOC requires binding arbitration if there is an unresolved

dispute concerning this EOC (including the cost of, lack of or actual repair or replacement arising from a

loss or breakdown). Under this Arbitration provision, You give up your right to resolve any dispute arising

from this EOC by a judge and/or a jury. You also agree not to participate as a class representative or class

member in any class action litigation, any class arbitration or any consolidation of individual arbitrations.

In arbitration, a group of three (3) arbitrators (each of whom is an independent, neutral third party) will

give a decision after hearing the parties’ positions. The decision of a majority of the arbitrators will

determine the outcome of the arbitration and the decision of the arbitrators shall be ﬁnal and binding and

cannot be reviewed or changed by, or appealed to, a court of law.

To start arbitration, the disputing party must make a written demand to the other party for arbitration.

This demand must be made within one (1) year of the earlier of the date the loss occurred or the dispute

arose. The parties will each separately select an arbitrator. The two (2) arbitrators will select a third

arbitrator called an “umpire.” Each party will each pay the expense of the arbitrator selected by that

party. The expense of the umpire will be shared equally by the parties. Unless otherwise agreed to by

the parties, the arbitration will take place in the county and state in which You live. The arbitration shall

be governed by the Federal Arbitration Act (9 U.S.C.A. § 1 et. seq.) and not by any state law concerning

arbitration. The rules of the American Arbitration Association (www.adr.org) will apply to any arbitration

under this EOC. The laws of the state of New York (without giving effect to its conﬂict of law principles)

govern all matters arising out of or relating to this EOC and all transactions contemplated by this EOC,

including, without limitation, the validity, interpretation, construction, performance and enforcement of

this EOC.

Due Diligence: All parties are expected to exercise due diligence to avoid or diminish any theft, loss or

damage to the property insured under these programs. “Due diligence” means the performance of all

vigilant activity, attentiveness, and care that would be taken by a reasonable and prudent person in the

same or similar circumstances in order to guard and protect the item.

Subrogation: If payment is made under these beneﬁts, the insurance company is entitled to recover

such amounts from other parties or persons. Any party or cardholder who receives payment under

these beneﬁts must transfer to the insurance company his or her rights to recovery against any other

party or person and must do everything necessary to secure these rights and must do nothing that would

jeopardize them, or these rights will be recovered from the cardholder.

Salvage: If an item is not repairable, the claim administrator may request that the cardholder or gift

recipient send the item to the administrator for salvage at the cardholder’s or gift recipient’s expense.

Failure to remit the requested item for salvage to the claim administrator may result in denial of the claim.

Other Insurance: Coverage is secondary to and in excess of any other applicable insurance or

indemnity available to You. Coverage is limited to only those amounts not covered by any other insurance

or indemnity. It is subject to the conditions, limitations, and exclusions described in this document. In no

event will this coverage apply as contributing insurance. This Other Insurance clause will take precedence

over a similar clause found in other insurance or indemnity language.

In no event will these insurance beneﬁts apply as contributing insurance. The non-contribution insurance

clause will take precedence over the non-contribution clause found in any other insurance policies.

Severability of Provisions: If in the future any one or more of the provisions of this Guide to Beneﬁts

is, to any extent and for any reason, held to be invalid or unenforceable, then such provision(s) shall be

deemed “severable” from the remaining provisions of the Guide. In that event, all other provisions of this

Guide shall remain valid and enforceable.

Beneﬁts listed in this Guide to Beneﬁts are subject to the conditions, limitations, and exclusions described

in each beneﬁt section. Receipt and/or possession of this Guide to Beneﬁts does not guarantee

coverage or coverage availability.

This Guide is intended as a summary of services, beneﬁts, and coverages and, in case of a conﬂict

between the Guide and the master insurance policies, or an issuer’s, or the MasterCard actual offerings,

such master policies or actual offering shall control. Provision of services is subject to availability and

applicable legal restrictions.