Terms and Coverage Types Flashcards

Question

Package Policy | Commercial Property Insurance ## Footnote Section 10.7 Page 370

Answer 1

Package policy coverages are not standardized, but they generall include: * Property insurance * Business interruption insurance * Liability insurance * Criminal insurance

Answer 2

Seven characteristics of surety bond: 1. There are 3 parties to the contract - **principal, obligee, surety** 2. No losses are expected. 3. The **principal** is liable to the **surety**. 4. Bond premium (service fee to underwrite the risk). 5. Bond limit or penalty - the **surety** will pay to the **obligee** if the **principal** defaults. 6. A **surety** is of indeterminate length and non-cancellable. 7. It is a written contract and excecuted under seal of the **surety** and **principal**. | Oral contract are not binding on the surety.

Answer 3

For loss or damage by an insured peril. 5% additional is available for debris removal (Coverage A for homeowner, Coverage C for Condo owner) | Extensions of Coverage: All Risk Coverage

Answer 4

Under the comprehensive policy form, the policy provides coverage for property removed up to 30 days, or until the policy expires. (This extends the basic fire policy limits from 7 days to 30 days.) | Extensions of Coverage: All Risk Coverage

Answer 5

If the fire department charges for a legitimate call (i.e. a fire), up to $1,000 is provided, with no deductible. | Extensions of Coverage: All Risk Coverage

Answer 6

Up to $2,000 for loss or damage to food due to a power failure, with no deductible. | Extensions of Coverage: All Risk Coverage

Answer 7

For example, if you had your home keys stolen, up to $500 is provided to replace the home locks, with no deductible. | Extensions of Coverage: All Risk Coverage

Answer 8

Theft or other types of losses attributed to forgery and receipt of counterfeit money are covered up to $2,000, without a deductible.

Answer 9

In personal lines insurance, the application process determines the value of the property, and those values are often system generated. However, the cost of materials is vulnerable to inflation. This extension is in the contract so that, for policies that automatically renew, the limit of insurance remains current (i.e. against inflationary changes). | Extensions of Coverage: All Risk Coverage

Answer 10

A Comprehensive, or All Risk policy, provides coverage against all risk of direct physical loss or damage, subject to policy conditions and exclusions.

Answer 11

Do not insure buildings or structures, in whole or in part, for business or farming purposes. (Unless consented to by the insurer!) | Exclusion

Answer 12

Damage to outdoor radio or TV antennae, including satellite receivers, or their attachements, caused by windstorm or hail, ice, snow, sleet, or collapse. | Exclusion

Answer 13

Occurring after your dwelling has, to your knowledge, has been vacant for more than 30 consecutive days. What is vacant? This can get into grey areas, however, the key is; the intent by the insured to return to the dwelling. If the insured goes on a ski trip, there is intent to return. i.e. Not Vacant. If the insured leaves the country, buys a new house & lands a job in that other country, the intent to return is not likely. i.e. Vacant. | Exclusion

Answer 14

To personal property undergoing any process or while being worked on, where the damage results from that process or work, the resulting damage to other property is insured. The policy does not provide coverage for faulty workmanship. For example, if a table is being refinished and while working on that table it is destroyed. The table would not be covered. | Exclusion

Answer 15

Caused by continuous seepage or leakage of water (i.e. a tap keeps running and overflows). Caused by backup or escape of water by a sewer, sub-pump, or septic tank. | Exclusion

Answer 16

Caused by rust or corrosion, wet or dry rot, fungi or spores. | Exclusion

Answer 17

Resulting from the release, discharge, or dispersal of fuel oil. For example, many houses in rural areas need fuel oil for heating. If there is a release, the owner is liable for the cleanup. This liability is unlimited (i.e. it can go on for years without limit to what can be charged) | Exclusion

Answer 18

This is a separate dwelling. It may be rented for investment purposes. On the application, it is to be listed as Location 2 to the primary dwelling policy. This property must be listed on the Declarations page. It carries its own property limits, but liability coverage is extended from Section II of the primary policy. Coverage is on a Specified Perils Coverage basis. Payments are paid on, 1. Building ACV or RC. 1. Contents ACV.

Answer 19

This is a property owned by the insured for use on an intermittent or seasonal basis, i.e. a cottage. The seasonal residence is not their primary and they do not spend most of the year living there. Like the Secondary, it is added to the Primary Policy as Location 2. As with the Secondary, this property must be listed on the Declarations page. It carries its own property limits, but liability coverage is extended from Section II of the primary policy. The Basis of Claim payment for building and contents is; ACV only.

Answer 20

**Named Perils Policy** Vandalism is included in the Secondary but is not in the Seasonal. **Coverage A:** Dwelling and attached structures. *Does not unclude trees or shrubs.*Detached structures at *Seasonal Dwelling* are included under Coverage A. *Extensions do not increase limit of Coverage A - only extends to be covered.* **Coverage B:**Up to 10% of Coverage A limit for optional extensions, including outbuildings (Coverage B), fixures temporarily removed or fair rental value. It is a pool of funds divided equally amongst all properties. **Coverage C:**Only personal property of insured, **not tenant**. Upt to 10% of Coverage C for optional extensions of coverage: * Uninsured property of others * Personal property temporarily removed * Additional living expenses (Coverage D) **Extensions that do not increase limit are:** * Debris removal * Property removed (30 days_ * Fire departments ($1,000, no deductible)

Answer 21

1. Notice to Authorities. 2. No Benefit to Bailee. 3. Pair & Set. 4. Parts. 5. Sue and Labour. 6. Basis of settlement. 7. Subrogation.

Answer 22

People may enter one's property by invitation, such as guests, work, or delivery, or they may be uninvited. There is a difference in the standard duty of care expected of the owner in these situations. There are three situations for this; * Trespassing * Visitors (in Ontario) * Children

Answer 23

Neighbours or passers-by.

Answer 24

Animal bites or attacks.

Answer 25

Children are often responsible for their own actions, unless parental supervision was proven to be a reasonable expectation. Children are attracted to ...

Answer 26

This gets tricky. Most landlords are exempt from liability, however, it all depends on the lease agreement and how a landlord sets up their rental unit to be used. As always, there are exceptions (See Section 8.4.3.5).

Answer 27

Subject to interpretation and are for such items as pain and suffering, loss of limbs, damage to reputation, or mental anguish. The amount the court believes is necessary to compensate the aggreved party fairly.

Answer 28

Quanitfiable and can be accurately measured. Specific to medical, rehabiliation, and other like damages. | E.g. Doctor's bill

Answer 29

Personal injuries such as libel and slander.

Answer 30

These are damages intended to punish a defendent for their actions and serve to deter others from similar behavious in the future. Payments for these damages are borne by the insured themselves.

Answer 31

To insure the legal liability of insureds anywhere in the world. Accidental injury or damage caused by insureds is included. The base limit is set at $1,000,000. (higher limits can be purchased) Covers: * Legal liability of insureds in their role as private citizens while anywhere in the world. * Injury or damage arising out of the ownership, use, or occupancy of all listed premises by this Section.

Answer 32

1.Only who is contracted with is able to apply for coverage. 2.Damaged to property owned by the insured. 3.Property damage to property of others used, occupied, leased/rented, or in the care & custody of the insured, except for unintentional damage caused by fire, explosion, water, and smoke. 4.Damage to personal property or fixtures as a result of work being done on them. 5.Bodily injury to the person residing in the household other than a resident employee. 6.The personal actions of a named insured who does not reside on the premises as described on the Coverage Summary page.

Answer 33

All liability policies have the insurer agree to pay all costs associated with the defence and settlement of claims (including the following supplemental payments). This is described in three ways; * The insurer agrees to pay all costs associated with defence and settlement of claims including supplemental payments, even if the claim made against the insured is groundless or without merit. * The insurer agrees to investigate, negotiate and settle any claim they decide appropriate, and only pay for legal counsel the insurer selects. * The Supplemental payments are in excess of the limit of insurance purchased is under Section E.

Answer 34

Payment for reasonable medical expenses when the insured, unintentionally, injures another person or if they are accidentally injured while on the insured’s premises. The limit is set a $5,000. * The insurer agrees to voluntarily make such payment on the insured’s behalf. * Coverage includes surgical, dental hospital, nursing, and ambulance service or other transportation services expenses. * Payments **not made** to injured persons when covered by provincial workers compensation plan (WSIB), a hospitalization plan, or other private insurance plans.

Answer 35

This section responds to unintentional damages the insured may do at another person's residence. Personal Liability policies include coverage for this act of the insured. The limit is set a $1,000. * Insurer makes a voluntary payment for property damage unintentionally caused and where the insured would not be legally liable. * Reimburses others for direct property damage caused intentionally by an insured 12 years of age or under. * No coverage for damage to the insured's own property or their tenant's property.

Answer 36

Coverage in the event of the injury or death to a resident employee. Covers: * Loss of life including funeral expenses. * Temporary total disability. * Permanent total disability. * Injury benefits (weekly indemnity). * Medical expenses. Each claim is assessed individually by the insurer. The claim can be paid according to the schedule. But, 1. No obligation on the insurer to make payment in the following instances: * When the residence employee or their representative refuses to accept these benefits. * When the residence employee sues the insured. 2. Insurer has the right to subrogate against anyone other than the insured who is responsible for the residence employee’s injury or death. ## Footnote Resident employees can be caretakers, nurses, gardeners, or housekeepers. There is a schedule for coverages, limits, and exceptions.

Answer 37

As the Master Policy first responds to property claims, so it is with liability. If there is a deficiency, then the insured's own liability coverage will respond, under Coverage I. This is comparable to the insured's policy responding to a claim involving Coverage A1. **The limit is 250% of Coverage A1.** The insurer will pay a special assessment if: 1. Assessment is valid under the Condominium Corporation’s governing rules, 2. Assessment is made necessary by occurrence(s) to which Coverage E applies.

Answer 38

* Watercraft & Motorized Vehicles (Lawn mowers) * Trailers * Business & Business Property

Answer 39

**Watercraft** is covered under **Section E, Policy limit**: ***Owned*** watercraft is limited by engine size or length: * 16 HP Outboard motor * 50 HP Inboard motor * 26 Feet sailboat length *Anything larger must be specified on the policy & endorsed. ***Non-Owned*** - The use of any boat of any size, not owned by insured, is covered. For example, borrowing a boat from a friend, or being at the wheel of a boat while on a lake. **Motorized Vehicles (Lawn mowers)** ***Owned*** is limited by engine size: 25 HP *Anything larger must be specified on the policy & endorsed. * **Section E, Policy limit.** ***Non-Owned*** is **not covered**.

Answer 40

Trailers are attachments to any vehicle that can carry or transport items. When these are attached to a vehicle, the liability of the vehicle flows back to the trailer. An **unhitched** **and parked** trailer becomes a **premises liability**. It can be a small open cart to a large closed container to a housing trailer. Coverage for injury or damage by ownership, use, or operation of any trailer or its equipment, provided trailer not attached to, carried, or towed by motorized vehicle subject to motor vehicle registration. *For example, injury or damage caused by children playing in a parked trailer at the side of a house.* Damage caused to others or as a result of it being** in motion**, either while being mobile and becoming disconnected from a towing vehicle would come under the **automobile policy**.

Answer 41

* The business may totally operate out of the home. If the home policy is endorsed with a Home Business extension then the liability of the activities are covered under that extension, or under a commercial liability policy, except those listed below. * Liability for any business pursuits or business use of the premises excluded under Section II: Liability Coverages, would not be covered. The insurer does agree to provide coverage for liabilities relating to the following business activity related scenarios: **1.** Personal actions during trade, profession, or occupation not related directly to trade, profession, or occupation. *For example, a client visits and is bitten by your dog.* **2.** Occasional rental to others of the portion of the dwelling usually occupied by you as a private residence. **3.** Rental to others of a family dwelling usually occupied as a residence. **4.** Rental of space in residence to others for incidental office, school or studio. **5.** Rental to others, or the holding for rent, of not more than 3 car spaces or stalls in garages or stables. **6.** Temporary or part-time business pursuits of an Insured person under the age of 21. | (i.e.freelance graphic designer)

Answer 42

“any continuous or regular pursuit undertaken for financial gain including a trade, profession or occupation.”

Answer 43

**1. Product Liability** - Some businesses make things i.e. clothing. When the use of a product results in injury or damage, consumers have a right to take legal action against the party that made or sold the defective product. **2. Completed Operations Liability** - Some businesses "make" things, i.e. building a back deck. When completed work is put to its intended use and injury or damage results, the party responsible for the work may be sued for damages. **3. Personal & Advertising Injury Liability** - Where public perception matters. Injury, including consequential bodily injury from; libel & slander, malicious persecution, unauthorized use of another’s advertising idea, etc.

Answer 44

The insurance company that was on the risk **at the time of the loss** **occurred** willl respond to the claim. A claim that occurred in the past is responded to by the insurer at that time. *E.g. Fires on customer's end resulting of cables sold, claim goes back to date of production.* | Determinate time loss started

Answer 45

The insurance company that is on risk **at the time the claim was made** will respond. Claim | Indeterminate of time loss started, despite occurring in the past. ## Footnote Claims Made policies are under a Professional Liability policy.

Answer 46

This Umbrella policy is designed to only respond **after** the underlying or **primary policy** has responded: **Personal**: 1. Not enough insurance under the primary policy. 2. No coverage. **Commercial**: 1. Inadequate limits where the primary insurer denies increased limits (reinsurance and capacity). 2. Inadequate coverage.

Answer 47

"the undertaking by one person to indemnify another person against loss or liability for loss in respect of a certain risk or peril to which the object of insurance may be exposed, or to pay a sum of money or other thing of value upon the happening of a certain event."

Answer 48

A basic rule og insurance stating that policyholders receive the actual amount of their loss, no more and no less.

Answer 49

A self-governing, self-funded organization of general insurance brokers of Ontario.

Answer 50

Any insurance product other than travel, health or life insurance.

Answer 51

The chance of financial loss occurring, or an object or activity that is insured or about to be insured.

Answer 52

The possibility of either financial loss or gain.

Answer 53

The chance of financial loss with no chance of financial gain.

Answer 54

Observable conditions relating to the object of insurance. | E.g. Building construction

Answer 55

Subjcetive characteristics of an insured or an applicant for insurance that increases the likelihood of loss. | E.g. Dishonesty

Answer 56

A form of insurance that can be purchased by an insurance company to limit the amount of los it might experience at any one time.

Answer 57

A conscious decision on the part of an organization to self-insure all or a portion of losses rather than purchasing insurance (that is, a planned acceptance of future losses,)

Answer 58

An insurance broker in Ontario who is governed by the Registered Insurance Brokers Act. They provide independent advice and sell general insurance products from a variety of insurance companies. They represent their client's best interest when negotiating a contract between the client and the insurance company.

Answer 59

aka General Insurance. Property - coverage for homes, business assets, equipment, etc. Casualty - coverage against a finding of legal responsibility for causing injury to another person or damage to their property.

Answer 60

The action of compensating an insured following a loss under their insurance policy.

Answer 61

The contractual obligation by one party (the insurer) to make good the losses suffered by another (the insured) by putting them back in the same financial position they were in at the time the loss occurred.

Answer 62

Any condition that increases the risk or chance of a loss occurring or increases the amount of damage that may happen if there were a loss.

Answer 63

The act of selling or issuing an insurance policy. Can be purchased through **Direct Writers** (insurance company) or through **Intermediaries** (Brokers/Agents).

Answer 64

Sells insurance products directly to customers, typically through call centres and online. | E.g. TD Bank, Belair Direct

Answer 65

A person or organization who acts as a mediator or link between two parties. Two types are agents and brokers.

Answer 66

Ownership: Shareholders Main goal: Cover costs and make profit for shareholders Operations come from private funds or through publicly traded stock. | Examples are Intact and AVIVA

Answer 67

Ownership: Policyholders Main goal: Collect sufficient premiums to cover costs of claims and operating the company Profits are kept in reserve, re-invested in the company, or distributed back to policyholders in the form of lower premiums (sometimes refunds.)

Answer 68

A group of insurance companies and individuals (underwriters) who assume risks for themselves to underwrite large, high-risk operations or unusual risks.

Answer 69

A marketplace for insurance companies and individuals who assume risks for themselves that form **syndicates** to underwrite large, high-risk operations or unusual risks. Goal: to make a profit for the members. Agent manages affairs of each syndicate-> appoints an expert underwriter fir each class of business written. | E.g. voices of singers, commercial aircraft, nuclear power plants, cance

Answer 70

A type of insurance brokerage that has been granted authority by one or more insurance companies to transact business on their behalf. Extend insurance company to write higher-risk operations without in-house expertise. AKA "broker for a broker" | E.g. Sports liability, professional liability, demolition contractors

Answer 71

Written or oral agreement giving temporary insurance protection, pending issuance of the insurance policy by the insurer.

Answer 72

The power given to a brokerage under a contractual agreement allowing the brokerage to immediately provide insurance coverage to an applicant up to a pre-agreed limit without first receiving an approval from an underwriter.

Answer 73

The person at the insurance company who anaylzes application forms submitted by brokers to ensure applicants; risks meet the insurance company's established eligibility criteria.

Answer 74

Someone who has undertaken to act for and on behalf of another person in a particular matter, in circumstances that give rise to a relationship of trust and confidence.

Answer 75

Considered to have never existed.

Answer 76

May be rendered void or unenforceable for one or more reasons discussed earlier.

Answer 77

An independent regulatory agency created to improve **consumer protection** in regulated professions in Ontario, including insurance. They are responsible for all : * Automobile forms/underwriting approvals, rates and claims forms, * Licensing of both life and general insurance agents and insurers, * Monitoring insurer solvency, and * Ensuring fair marketing practices. They enforce the **provincial Insurance Act** and the Compulsory Automobile Insurance Act.

Answer 78

An independent agency of the Government of Canada **to contribute to the safety and soundness of the Canadian financial system. **

Answer 79

Industry-funded organization that protexts eligible policyholders from undue financial loss in the event that a member insurer becomes insolvent. Membership is required for P&C insurers.

Answer 80

* **Business Property except as shown under Special Limits** * **Samples and goods held for sale** * **Evidence of debt or title** * **Sporting equipment - loss due to use** * **Property in any fairground, exhibition or exposition for the purpose of exhibition or sale** * **Property illegally acquired, kept, stored or property subject to forfeiture** * **Any property lawfully seized or confiscated, unless destroyed to prevent spread of fire** * **Camper units, truck caps or their equipment** * **Aircraft including UAV or drones and their equipment** *equipment as in audio, visual, recording or transmitting equipment powered by the electrical system of a motor vehicle or aircraft - not included in Spare Automobile parts* * **Motorized vehicles and their equipment except:** * Wheelchairs or scooters with 2+ wheels specifically for physical disability * e-bikes * watercraft * golf carts including attachments and accessories * lawn mowers * garden tractors including attachments and accessories * snowblowers *Other than those used for compensation or hire*

Answer 81

Direct result of damage to a neighbouring premises by an insured peril. Covers Additional Living Expenses and Fair Rental Value loss for a maximum period of 2 weeks. Does not insure cancellation of a lease or agreement.

Answer 82

* Change of Temperature * Debris Removal - additional 5% for removal if loss equals insurable amount * Credit, Debit or Automated Teller Cards, Depositors Forgery and Counterfeit Paper Money -$10,000 in all, no deductible, not covered for entrusted persons * Fire Department Charges - $1,000, no deductible

Answer 83

*"Loss under any items on this form shall not reduce the applicable amount of insurance."* The limits of insurance provided bythe policy remain unchanged for the entire policy period, regardless of the number and amounts of claims paid

Answer 84

*"The insurer, upon making any payment or assuming liability therefore under this form, shall be subrogated to all rights of recovery of the insured against others and may bring action to enforce such rights. Nothwithstanding the foregoing, all rights of subrogation are hereby waived against any corporation, firm, individual, or other interest with respect to which insurance is provided by this policy."* The insurer agrees not to exercise the right of subrogation against any party having insurable interset in the property insured such as, payees, business partners, and subsidiary firms.

Answer 85

Start: Time of loss End: Reinstatement of the lost or damaged property Goal: To return insured to the competitive position they were in immediately prior to the loss.

Answer 86

Start: Time of the loss End: Income is restored to the level that would have been earned if the loss had not occurred, subject to the indemnity period selected at inception. Business may be open but has not been restored to its former competitive position. Higher premium due to longer coverage period.

Answer 87

Direct result of damage to a neighbouring premises by an insured peril. Covers Additional Living Expenses and Fair Rental Value loss for a maximum period of 2 weeks. Does not insure cancellation of a lease or agreement.

Answer 88

* Change of Temperature * Debris Removal - additional 5% for removal if loss equals insurable amount * Credit, Debit or Automated Teller Cards, Depositors Forgery and Counterfeit Paper Money -$10,000 in all, no deductible, not covered for entrusted persons * Fire Department Charges - $1,000, no deductible

Answer 89

Insures extra expenses incurred after a loss to continue normal business operations. Limited to over and above normal expenses including: -Renting temporary premises -Renting temporary equipment -Paying overtime salaries Single limit and spread over defined period.

Answer 90

* Medical Risks * Non-Medial Risks Faced by Travellers with a Medical Emergency * Destination Risks

Answer 91

An insurance product designed to cover unexpected medical and related costs due to a medical emergency occurring while a resident is travelling outside of their home province or territory.

Answer 92

Any illness, accident, injury or symptoms for which the insured consulted a physician, was hospitalized, was prescribed or received a new treatment or medication, or received a change in existing treatment or medication.

Answer 93

Sources of benefits available to an injured person. These can incude a group or private income replacement, rehabilitation benefit, and more.

Answer 94

A policy clause intended to ensure that benefits payable under multiple policies do not exceed 100% of a person's eligible incurred expense. This clause upholds the principle of indemnity.

Answer 95

A delay due to an emergency, including severe weather conditions, mechanical breakdowns, or an accident involving land transportation to the insured's departure point.

Answer 96

The earlier of the date the applicant (1) boards the ticket transportation or (2) leaves Canada on an insured trip.

Answer 97

The marketing firm who sells (distributes) travel health products (for example, insurance brokers, travel agents, and credit card companies).

Answer 98

Health services given in connection with an acute, unexpected condition, illness, disease, or injury requiring immediate treatment.

Answer 99

A voluntary or involuntary extension of the policy expiration date beyond the original intended date of return.

Answer 100

An annual policy providing a frequent traveller with coverage for any number of short-trips in a one-year period.

Answer 101

Universal health care system in Canada, administered through provincial and territorial health insurance plans.

Answer 102

Travel health insurance for travellers arriving in Canada from another country who are not covered by a Canadian GHIP.

Answer 103

A trip where the applicant travels outside of their province/territory of residence, for which travel health insurance is in effect.

Answer 104

A policy which pays the reasonable and customary medical and non-medical charges for such costs incurred while the insured travels outside of their home province/territory or outside of Canada.

Answer 105

Provides benefits for a single trip for a fixed number of days of coverage, equal to the total length of the insured's trip, including the insured's departure date and return date.

Answer 106

An organization that is contracted to take over management of travel health insurance claims on behalf of the insurer (also known as the claims manager).

Answer 107

A sickness or injury that would cause an ordinarily prudent person to expect to need medical treatment or investigation following departure.

Answer 108

* Child care expenses if a parent must be hospitalized due to an unexpected health emergency while travelling. * Medical emergency of a travel companion, resulting in early or late return from a trip. * Return of insured to their residence via regular air or MedEvac service. * Automobile return to residence if medical emergency occurred while travelling within Canada or the United States. * Trip cancellation fees or penalties. * Pet return. * Return of deceased insured.

Answer 109

* Must hold a valid OHIP card. * Ontario is their primary home. * Physically be in Ontario for 153 days in any 12-month period. If the resident has been out of Ontario for more than 212 days in any 12-month period, their OHIP coverage is cancelled (unless applied for an exception). * Physicallly be in Ontairo for at least 153 days of the first 183 days immedicately after the person begain living in the province.

Answer 110

To obtain funding by OHIP, the treatment must meet all the following conditions: * Must be performed at a hospital or licensed health facility. * Is not experiemental or for research or for a survey. * Is generally accpeted in Ontario as appropriate treatment for a person in th same medical circumstances as the insured person. * Is either not performed in Ontario by an identical or equivalent procedure, or is performed in Ontario by the insured person must receive the services outside Canada to avoid a delay that would result in death or medically significant irreversible tissue damage. *Expenses incurred for non-medical services (e.g. travel, accommodation, meals unless patr of insured hospital services) are not covered by OHIP.*

Answer 111

OHIP will reimburse dialysis costs upto a maximum of $210 CAD per treatment with no maximum number of treatments. The applicaiton and approval for out-of-country- dialysis is administered for OHIP by the Ontario Renal Network (ORN). *Dialysis patient should carry THI to cover the cost of emergency health services beyond the actual dialysis, for health emergencies not related to the dialysis.*

Answer 112

* Credit Card Companies * Emplyee Benefit Group Plans * OAP1 Section 4: Accidents Benefits Coverage**

Answer 113

* Emergency medical services and extended health care benefits * Trip cancellation, interruption, or delay * Miscellaneous benefits

Answer 114

* Direct payment to the hospitals and doctors providing care * Local ambulance services * Hospital care and related drug and diagnostic services * Physician services * X-ray and labratory fees * Appliances and related services (e.g. wheelchair rental, crutches, boot cast) * Private duty nursing services by a registered nurse and paramedical practitioner services (e.g. chiro/physio). *A maximum dollar valuemay be stated for each practitioner.* * Assistance with bringing a family member to an isured person's bedside * Outpatient services * Out-of-pocket expense (daily and overall dollar max applies) *Reimbursement of additional out-of-pocket expenses (e.g.phone/tv rental charges) if the insured is hospitalized.* * Child care attendant (non-relative) *Reimbursement of costs for a child care attendant to care for children accompanying the insured, if the insured is hospitalized.* * Air ambulance or commercial repatriation home, where medically necessary.