Travel Medical Insurance Information

Travel Medical Insurance

Global Village Program

A portion of your work trip fee established by your team leader covers the cost of insurance coverage. Through paying your fee, you will automatically be insured against accidental loss of life, limb, sight, speech or hearing while participating in volunteer activities sponsored and supervised by Habitat for Humanity. This mandatory insurance coverage is consistent with policies recommended by Habitat for Humanity International’s Legal department and ratified by the HFHI board of directors on Feb. 10, 1994. The coverage is designed to ensure a comprehensive risk management program and to provide protection to Habitat’s Global Village trip volunteers. We have a serious commitment to risk management and assume everyone is willing to comply.

Note: Covered medical expenses incurred for treatment of a pre-existing condition are limited to a maximum of $50,000. “Pre-existing condition” means any injury or illness that was contracted or that manifested itself, or for which treatment or medication was prescribed, prior to the effective date of this insurance.

Claims

To file a claim, consult with the team leader immediately and request a claim form. See “Quick Tips for Filing a Claim” (below) for proper procedures and assistance in filing a claim.

Specifications, Provisions and Exclusions

Coverage is sold on a per-day basis and commences at the actual start of the trip from the insured’s residence or designated departure point. Coverage terminates immediately upon return to the insured’s residence or designated return point, or at the end of the published itinerary.

Note: Anyone traveling five days before or five days after their official team dates is offered (automatically) the same coverage at no additional cost. Unfortunately, no other extensions of this coverage are available. You must be sure to properly insure yourself for all other personal travel.

The policy does not cover loss caused by or resulting from any of the following: intentionally self-inflicted injuries; suicide while sane; attempted suicide while sane; pregnancy, childbirth or miscarriage; accident occurring while a passenger on, operating or learning to operate, or serving as a crew member of any aircraft. Injuries or sickness sustained while under the influence of drugs (other than prescribed) or alcohol are not covered. Injuries or illness sustained while racing or committing or attempting to commit a felony are not covered. This is a general summary, but it is still subject to the policy terms, conditions and exclusions.

Medical Assistance

Medical assistance for Global Village team members is available 24 hours a day, seven days a week. It includes the following:

• Medical evacuation and repatriation benefit. Your expenses up to $150,000 will be covered in the case that accidental bodily injury, disease or illness requires your medical evacuation or repatriation while on a covered trip.

• Multilingual MEDEX assistance specialists.

• Assistance in locating the nearest, most appropriate medical care.

• International MEDEX preferred provider networks.

• MEDEX program medical advisors (physician) consultative and advisory services, including review of appropriateness and analysis of medical care.

• Assistance in establishing contact with family, personal physician and employer, as appropriate.

• Monitoring progress during treatment and recovery.

• Emergency message transmittal services.

• Translation services and referrals to local interpreters, as necessary.

• Verification of insurance coverage facilitating entry and admissions to hospitals and other medical care providers.

• Special assistance regarding the coordination of direct claims payment.

• Emergency funds transfers.

• Coordination of embassy and consulate services.

• Management, arrangement and coordination of emergency medical transportation, as necessary.

• Management, arrangement and coordination of repatriation of remains.

• Knowledgeable legal referral assistance. • Coordination of securing bail bonds and other legal documents.

• Special assistance in replacing lost or stolen travel documents,including passport.

• Courtesy assistance in securing incidental aid and othertravel-related services.

• Special assistance in making arrangements for interrupted or disrupted travel plans resulting from emergency situations, including:

1. The return of unaccompanied travel companions.

2. Travel to the bedside of a stranded person.

3. Rearrangement of ticketing due to accident or illnessand other travel-related emergencies.

4. The return of stranded motor vehicles and relatedpersonal items.

Covered Services Per Volunteer Benefits

Medical Accident or Sickness. . . . . . . $250,000 Max.

Deductible. . . . . . . . . . . . . . . . . . . . . . None

Coverage (%) . . . . . . . . . . . . . . . . . . . . . 100%

Permanent Total Disability . . . . . . . . . . . . $250,000

Emergency Medical Evacuation . . . . . . . . $150,000

Accidental Death & Dismemberment. . . . . . $250,000

Repatriation of Remains . . . . . . . . . . . . . $150,000

Medical Assistance Services . . . . . . . . . . . MEDEX

Quick Tips for Filing a Claim

Policy 6404-54-47

MEDEX Code CHB

1. Notify your Global Village team leader of any accident or need for medical attention as soon as possible.

2. Your team leader will supply you with an accident claim form that needs to be completed and sent to Habitat Claims Unit c/o Chubb Group of Insurance Co. Details are on the form.

3. Be certain the attending physician completes the “Physician’s Report” section of the claim form, including diagnostic/treatment, signature and date.

4. Obtain a copy of the hospital/clinic invoices and make copies of all prescriptions/invoices and submit same with the claim form.

5. Have your team leader sign the form.

6. Claims must be submitted within 90 days from the date of the accident/injury/illness.

Important: If assistance is needed in identifying an appropriate medical provider or facility, contact MEDEX at (800) 527-0218 or collect at (410) 453-6330. MEDEX code is CHB.

Urgent Care and Evaluation: If emergency evacuation and/or urgent care are needed, contact MEDEX immediately. MEDEX will make all the appropriate arrangements. See phone numbers above.

Note: Even if the claim amount is considered too small for submission, or it is determined by diagnostic evaluation that the condition may not be serious or requires no further medical treatment at the time, the Global Village program and its underwriter recommend completing all of the above steps in order to establish a basis for admission of a valid claim later. Toll free numbers are available in some countries as listed below. You should call collect if the toll free number is not accepted by the local telephone exchange.

International Toll Free Telephone Access Numbers

Australia and Tasmania. . . . . . 1-800-127-907

Austria . . . . . . . . . . 0-800-29-5810

Belgium. . . . . . . . . . 0800-1-7759

Brazil . . . . . . . . . . 0800-891-2734

China. . . . . . . 108888-800-527-0218 (North : Beijing, etc)

China. . . . . . . 10811-800-527-0218 (South : Shanghai, etc)

Egypt. . . . 510-0200-1-877-569-4151 (inside Cairo)

Egypt. . . 02-510-0200-1-877-569-4151 (outside of Cairo)

Finland. . . . . . . . . . 0800-114402

France and Monaco. . . 0800-90-8505

Germany. . . . . . . . 0800-1-811401

Greece . . . . . . . 00-800-4412-8821

Hong Kong . . . . . . . . 800-96-4421

Indonesia. . . . . . 001-803-1471-0621

Israel . . . . . . . . . . 1-800-941-0172 I

taly, Vatican City and San Marino . . 800-877-204

Japan . . . . . . . . . . 00531-11-4065

Mexico. . . . . . . . 001-800-101-0061

Netherlands. . . . . . . 0800-022-8662

New Zealand. . . . . . . 0800-44-4053

Philippines. . . . . . 1-800-1-111-0503

Portugal. . . . . . . . . . 0800-84-4266

Republic of Ireland (Eire) . . 1-800-409-529

Republic of South Africa . . . 0800-9-92379

Singapore. . . . . . . . . 800-1100-452

South Korea . . . . 00798-1-1-004-7101

Spain and Majorca. . . . 900-98-4467

Switzerland and Liechtenstein. . . . . 0800-55-6029

Thailand. . . . . . 001-800-11-471-0661

Turkey. . . . . . . . 00-800-4491-4834

UK and Northern Ireland, Isle of Jersey, the Channel Isles and Isle of Man. . . 0800-252-074

United States. . . . . . 1-800-527-0218

Canada, Puerto Rico, U.S. Virgin Islands, Bermuda MEDEX Assistance Coordination Centers United States. . . . . [1] 410-453-6330 Baltimore, Maryland

United Kingdom and England. . [44] 1-273-223000 Brighton,

Notes:

• When a toll free number is not available, travelers are encouraged to call MEDEX collect. The country code precedes the phone number in brackets. The toll free numbers listed are available only when physically calling from within the country.

• The toll free Israel line is not available from payphones and there is a local access charge.

• The toll free Italy, Vatican City and San Marinonumbers have a local charge for access.

• The toll free Japan line is available only from touch-tone phones (including pay phones) equippedfor international dialing.

• If calling from Mexico on a pay phone, the payphone must be a La Datel pay phone. Global Vilage department : P.O. Box 369 Americus, GA 31709-0369 USA phone: (229) 924-6935, Ext. 2549; (800) 422-4828 in the U.S. or Canada fax: (267) 295-8714 e-mail: gv@habitat.org www.habitat.org/gv 3405/2M/GV/12-06