Travel Insurance Policy Conditions

Understand the conditions of your Cover-More travel insurance policy

When you find a suitable travel insurance plan for your trip, it’s important to understand what it does – and doesn’t – cover.

The Product Disclosure Statement (PDS) contains all the details our customers need to know about their travel insurance policy. This includes our Policy Conditions, which are listed below.

If you are considering covering your trip with Cover-More, please make sure you read and understand our Policy Conditions. If you’d like to speak to our team about the below or any of the details in our PDS, please call 1300 72 88 22 during business hours.

Our policy conditions:

1. Excess

The excess is the first amount of a claim that We will not pay for. It is deducted from Your claim if it is approved by Us. The excess applies per event i.e. If You fall over and need medical treatment, and smashed Your smart phone in the fall, the excess will be deducted once.

The excess, if applicable, applies to any claim arising from a separate event in respect of Sections 1, 2, 4, 5, 6, 10, 11, 12, 19, Additional Cruise Benefits (i)-(iv), and for Sections 20, 22 and 23 where relevant. The excess amount will be shown on Your Certificate of Insurance.

Claim example: You have a $250 excess on Your policy. If You made a claim for $2,500 under Section 1: Overseas Medical Expenses, You already paid the expenses and We approve Your claim, We would deduct the $250 excess from the claim before We paid You. If, via Our emergency assistance team, We approved a claim directly with an overseas medical provider, We may ask You to pay the $250 excess directly to the provider at the time or request You to pay it to Us before We can finalise Your claim with the provider. In any event, the total claim We pay is $2,250.

In some circumstances, prior to Your entry into the policy or when You apply for cover for Your Existing Medical Conditions, whichever occurs later, We may impose an extra or increased excess for claims arising from Existing Medical Conditions. We will inform You in writing if this applies: These will be set out in Your Certificate of Insurance or in a letter from Our medical assessment team.

2. Limits of liability

The limits of Our liability for each Section of the policy are the amounts shown in the relevant table for the plan purchased as shown on pages 3-8 except:

1. where the policy limit for SECTION 4: Amendment or Cancellation Costs applies on a per policy basis and will be shown on Your Certificate of Insurance;
2. the maximum liability collectively for Sections 15, 16 and 17, shall not exceed $45,000 on the Comprehensive+ and $30,000 on the Comprehensive and Inbound plans;
3. where You have paid the additional premium to include Cruise Cover on the International or Inbound plans, the standard benefits apply as per the plan purchased and the Cruise Cover additional benefits and limits apply; or
4. where We have notified You in writing of different limits such as on Your Certificate of Insurance.

3. Claims

1. You must report any loss or theft of luggage, personal effects, travel documents or money to the police, the Transport Provider or accommodation provider as relevant within 7 days of You first becoming aware of the loss or theft. You should obtain a report confirming the incident to submit to Us with Your claim.
2. You must take all reasonable steps to prevent or minimise a claim.
3. You must not make any offer, promise of payment or admit any liability without Our consent.
4. You must advise Us of any claim or occurrence which may give rise to a claim as soon as possible and within 60 days of the return date shown on Your Certificate of Insurance by sending a completed claim form.
5. You must at Your own expense, supply any documents in support of Your claim which We may request, such as a police report, a Property Irregularity Report (PIR), receipts, valuations, a repair quote, a death certificate and/or medical certificate.
6. You must co-operate fully in the assessment or investigation of Your claim.
7. When making a claim, You are responsible for assisting Us and acting in an honest and truthful manner. If You make or try to make a false, exaggerated or fraudulent claim or use any false, exaggerated or fraudulent means in trying to make a claim, We will not pay Your claim, Your cover under this policy will be voided (without any return of the amount You have paid), We may report You to the appropriate authorities and You may be prosecuted.
8. Where You are a registered entity on one of the Domestic Plans You may be entitled to an input tax credit for Your Amount Payable and/or for things covered by this policy. You must disclose these entitlements to Us if You make a claim under Your policy.
9. If We agree to pay a claim under Your policy We will base any claim payment on the GST inclusive costs (up to the relevant limits of liability). However, We will reduce any claim payment by any input tax credit You are, or would be, entitled to for the repair or replacement of insured property or for other things covered by this policy.
10. We will be entitled, at Our expense, to have You medically examined or, in the event of death, a post-mortem examination carried out. We will give You or Your legal representative reasonable notice of the medical examination.

4. If You are able to claim from a statutory fund, compensation scheme or Transport Provider

If You are able to claim from a statutory fund, compensation scheme (for example a private health fund or workers compensation scheme) or Transport Provider for monies otherwise payable under this policy You must do so and the policy will only cover the remaining amount.

5. You must help Us to make any recoveries

We have the right to recover from any other party in Your name, money payable under the policy or to choose to defend any action brought against You. You must provide reasonable assistance to Us.

6. Claims payable in Australian dollars

All amounts payable and claims are payable in Australian dollars at the rate of exchange applicable at the time the expenses were incurred.

7. Policy interpretation

The policy shall be interpreted in accordance with the law of the Australian State or Territory in which it is issued.

8. Emergency assistance

1. Where Your claim is excluded or falls outside the policy coverage, the giving of emergency assistance will not in itself be an admission of liability.
2. The medical standards, sanitary conditions, reliability of telephone systems and facilities for urgent medical evacuations differ from country to country. Responsibility for any loss, medical complication or death resulting from any factor reasonably beyond Our control cannot be accepted by Our emergency assistance, Cover-More or Us.

9. Free extension of insurance

Where Your Journey is necessarily extended due to an unforeseeable circumstance outside Your control, Your Period of Insurance will be extended until You are physically able to travel Home by the quickest and most direct route. The Period of Insurance will not be extended for any other reason.

10. Special conditions, limitations, excesses and Amounts Payable

If You:

1. want cover for an Existing Medical Condition or pregnancy which does not satisfy the provisions set out in the PDS You will need to complete a health assessment. We will notify You of the outcome. If We are able to approve cover for the condition(s) or pregnancy You must pay an extra premium to Us. Cover may be subject to special conditions, limitations, limits, and excesses.
2. in the last 5 years have:
   1. made 3 or more travel insurance claims;
   2. had insurance declined or cancelled or had a renewal refused or claim rejected; or
   3. been in prison or had any criminal conviction (other than driving offences)
   4. cover must be separately applied for and accepted by Us, and it may be subject to special conditions, limitations, excesses and amounts payable.
   We will notify You in writing of these before We issue the policy.

11. Automatic reinstatement of sums insured

If You purchase the Annual Multi-Trip Policy the limits of liability under each Section of the policy are automatically reinstated on completion of each Journey and in respect of SECTION 5: Luggage and Travel Documents, also once on each Journey.

12. Policy conditions applying to SECTION 1: Overseas Medical and Dental (including emergency repatriation/evacuation) and SECTION 2: Additional Expenses

1. We have the option of returning You to Australia if the cost of medical and/or Additional expenses overseas are likely to exceed the cost of returning You to Australia subject always to medical advice. We also have the option of evacuating You to another country.
2. In all cases the cost of evacuation or to bring You back to Australia will only be met if Your claim is approved by Us and it was arranged by and deemed necessary by Our emergency assistance network.
3. If We request that You be moved to another hospital, return to Australia or be evacuated to another country and You refuse, We will only consider:
   1. Your costs and expenses per Sections 1 and 2 (as applicable) incurred up to the time of Our request; and
   2. the lesser of:
      • an amount equivalent to the costs and expenses per Sections 1 and 2 (as applicable) that You would have incurred after Our request had You moved to another hospital, returned to Australia or been evacuated to another country as requested; or
      • Your costs and expenses actually incurred after Our request.
4. If You are hospitalised We will pay for a share room. If a share room is not available We will pay to upgrade You to a single room.
5. If You do not hold a return airline ticket an amount equal to the cost of an economy class one way ticket will be deducted from Your claim for repatriation expenses.

13. Policy conditions applying to SECTION 15: Loss of Income, SECTION 16: Disability and SECTION 17: Accidental Death

1. If the conveyance You are travelling in disappears, sinks or crashes and Your body has not been found after 12 months You will be presumed to have died.

You must obtain and follow advice and treatment given by a qualified doctor as soon as possible after suffering a disabling injury, during the Period of Insurance.

14. Non-Australian residents travelling to Australia – Inbound

This policy condition applies if You have paid the Inbound Amount Payable and You are a non-Australian resident.

In this policy wording (other than in this policy condition, the second bullet point under Policy wording on page 22, SECTION 1: Overseas Medical and Dental Expenses including emergency repatriation/evacuation, SECTION 19: Medical and Dental Expenses in Australia (Inbound plan) and the General exclusions):

1. the word “Australia” should be replaced with Your country of residence; and
2. the word “overseas” should be interpreted to mean a place outside Your country of residence.

15. Already travelling

Not available on the Inbound plan

If You purchase this policy on Your trip after leaving Home, this cover is subject to a 3 day no-cover period. This means there is no cover under any section of the policy for any event that has occurred already or that arises within the first 3 days of buying the policy.

16. Sanctions regulation

Notwithstanding any other terms or conditions under this policy, We shall not be deemed to provide coverage and will not make any payments nor provide any service or benefit to You or any other party to the extent that such cover, payment, service, benefit and/or activity of Yours would violate any applicable trade or economic sanctions, law or regulation.

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