Exclusions – Travelling for Work and Leisure

Before travelling, it is your responsibility to understand the level of coverage you have for a medical emergency, and any conditions and limits that apply including other coverage purchased privately and not outlined on this website.

The Emergency Medical Travel Benefit, Emergency Travel Assistance Services, Medi-Passport and Non-emergency Medical Expenses are provided for a period of 365 days of absence per trip. If you are hospitalized during this period as a result of a medical emergency, in-patient services are covered for up to 90 days.

Eligible emergency medical expenses and emergency services that are considered reasonable are covered at 100% less the deductible, up to your overall extended health lifetime maximum. The overall extended health lifetime maximum is $1,000,000 per covered person less any amounts reimbursed since joining the UBC extended health benefit plan.

Also, an emergency ends when you or your family member is medically stable to return to BC. If you choose not to do so, any further expenses would not be covered.

For complete details about the specific provisions of your plan, refer to the Sun Life group benefits booklet based on your employment group.

Extended Health Plan
Medi-Passport: Emergency Travel Assistance Services
Europ Assistance
Other Excluded Benefits
Additional Exclusions When Travelling for Work

The following provides highlights of those exclusions that may apply while travelling for work or leisure. Please see the appropriate links for further information.

Extended Health Plan

Any expenses related to the following situations are not covered by the UBC Extended Health Plan’s Out-of-Country Emergency Medical Travel Benefit:

• Services that are not immediately required or which could reasonably be delayed until you return to BC, unless your medical condition reasonably prevents you from returning to BC prior to receiving the medical services;
• Services relating to an illness or injury which caused the emergency, after such emergency ends;
• Continuing services, arising directly or indirectly out of the original emergency or any recurrence of it, after the date that Sun Life or Europ Assistance, based on available medical evidence, determines that you can be returned to the province where you live and you refuse to return;
• Services which are required for the same illness or injury for which you received emergency services, including any complications arising out of that illness or injury, if you had unreasonably refused or neglected to receive the recommended medical services;
• Where the trip was taken to obtain medical services for an illness or injury, services related to that illness or injury, including any complications or any emergency arising directly or indirectly out of that illness or injury;
• Illness resulting from the hostile action of any armed forces, insurrection or participation in a riot or civil commotion;
• Any work for which you were compensated that was not done for the employer (UBC) as the provider of this plan; and
• Participation in a criminal offence.

For complete details about the specific provisions of your plan, refer to the extended health benefits for your employment group.

Medi-Passport: Emergency Travel Assistance Services

Your Medi-Passport coverage may be subject to the following conditions, limitations and exclusions:

• Your out-of-province extended health coverage has time limit of 365 days from the date you leave BC and in-patient hospital stays due to medical emergencies are limited to up to 90 days unless transportation back to home would endanger the patient;
• Your coverage will be subject to a maximum limit. The overall extended health lifetime maximum is $1,000,000 per covered person less any amounts reimbursed since joining the UBC extended health benefit plan.
• No benefit is payable for expenses incurred on a non-emergency or referral basis; and
• In some situations, you may be required to reimburse Sun Life for expenses paid by Europ Assistance on your behalf (e.g., Amounts that were paid for services or supplies that are not covered by your plan, exceed the maximum amount of your coverage under your plan, or that you are responsible for, such as deductibles and the percentage of expenses you must pay under your plan).

For complete details about the specific provisions of your plan, refer to the Medi-Passport section of your employment group benefits.

Europ Assistance

Europ Assistance, Sun Life’s travel assistance provider, will not provide services in the province where you live, or during any trip taken to seek medical attention. As well, Europ Assistance reserves the right to suspend, curtail or limit its services in any area, without prior notice due to the following conditions:

• A rebellion, riot, military uprising, war, labour disturbance, strike, nuclear accident or an Act of God; and
• The refusal of the authorities to permit Europ Assistance to fully provide service to the best of its ability during any of the above occurrences.

Due to conditions such as war, political unrest, epidemics and geographical inaccessibility, travel assistance services may not be available in certain countries. For an up-to-date list of countries where travel assistance services may not be available, please contact Europ Assistance (1-800-511-4610) prior to leaving on your trip. If conditions in the country, region, or city you are travelling to change while travelling – contact Europ Assistance to determine if there are any changes to their ability to provide services.

For complete details about the specific provisions of your plan, refer to the benefits for your employment group.

Other Excluded Benefits

Dental benefit claims will not be paid for services as the result of the hostile action of any armed forces, insurrection or participation in a riot or civil commotion or a participation in a criminal offence.

For complete details about the specific provisions of your plan, refer to the dental benefits for your employment group.

Basic Group Life and Optional Employee and Spousal Life benefits remain in place with no exclusions.

Optional Accidental Death and Dismemberment benefit claims will not be paid if caused by the following:

• Suicide or attempted suicide;
• Self-inflicted injury by firearm or otherwise;
• Drug overdose;
• Carbon monoxide inhalation;
• Flying in, descending from, or being exposed to any hazard incident with any kind of aircraft, if you:
  • were receiving aeronautical instruction;
  • had any duties to perform in connection with the aircraft;
  • were being flown for a parachute descent; or,
  • were a member of any armed forces and the aircraft was under the control or charter of the forces; or,
• the hostile action of any armed forces, insurrection, or participation in a riot or civil commotion.

For complete details about the specific provisions of your plan, refer to the benefits for your employment group.

Income Replacement Plan benefits will not be paid for any total disability resulting from:

• the hostile action of any armed forces, insurrection or participation in a riot or civil commotion;
• intentionally self-inflicted injuries or attempted suicide, while sane or insane;
• participation in a criminal offence.
• bodily injury that are sustained while you are doing any act or thing pertaining to any occupation or employment for wage or profit, outside of your duties and responsibilities with the University.

For complete details about the specific provisions of your plan, refer to the benefits for your employment group.

Europ Assistance: Liability

Neither Sun Life Assurance Company of Canada nor Europ Assistance is responsible for the availability, quality or results of the medical treatment you or your insured dependents receive, nor if you fail to obtain medical treatment.

Any physician or other health care professional who provides direct services to a covered person will be acting on the person’s behalf only and will not be considered acting on behalf of Sun Life Assurance Company of Canada or Europ Assistance.

Neither Sun Life Assurance Company of Canada nor Europ Assistance assumes any responsibility or liability for:

• Any medical advice given by any physician or other health care professional, and
• The negligence or other wrongful acts or omissions of any physician or other health care professional providing services under your plan.

No person will have any recourse against Sun Life Assurance Company of Canada or Europ Assistance because Europ Assistance suggested, or contracted with, a physician or other health care professional.

Decisions by a physician or other health care professional as to the need for providing any of the services covered by this benefit are medical decisions based on medical factors, and as such will be conclusive in determining the need for these services.

For complete details about the specific provisions of your plan, refer to the extended health benefits for your employment group.

Additional Exclusions When Travelling for Work

UBC faculty and staff should note the following exclusions when travelling for work:

UBC’s accidental death and dismemberment business travel insurance plan does not cover any loss, fatal, or non-fatal, caused or contributed to by:

• Suicide or intentionally self-inflicted injury;
• War, whether declared or not;
• Participation in a riot, insurrection, civil commotion or disturbance
• Active, full-time, part-time or temporary service in the armed forces of any country;
• Riding as a passenger or otherwise in any vehicle or device for aerial navigation other than as provided in the paragraph entitled “Aircraft Coverage.”
• Medical treatment or surgery, except if the medical treatment or surgery was needed because of an Accident

For a copy of the policy, please contact the UBC Treasury (http://www.treasury.ubc.ca).

WorkSafe BC, Out-of-Province/Country Coverage

WorkSafe BC coverage is provided to a faculty or staff member who sustains an injury arising out of and in the course of their employment. Coverage, however, does not extend to all activities that the staff/faculty member might participate in while travelling.