Eligibility – Ingle Assurance Travel Insurance

“Ingle Assurance believes in providing clear and dependable coverage to those who qualify.
To be eligible for emergency medical insurance under this plan as of the effective date, a
person must meet all of the following conditions:

  1. Not be eligible for benefits under any Canadian Government Health Insurance Plan (GHIP).
  2. Be either:
    • a) A visitor to Canada, or
    • b) A Canadian citizen or permanent resident returning to reside in Canada.
  3. Be at least 15 days old and less than 90 years of age.
  4. Be the policyowner, unless the only insured person is under age 18 (in Quebec) or under 16 (in other provinces and territories), in which case a parent or legal guardian must be the policyowner.
  5. If not the policyowner, be the spouse or dependent of the policyowner.
  6. Be insurable based on Ingle Assurance’s current underwriting rules.

A person is not eligible for coverage if, as of the effective date, any of the following apply — even if disclosed in the application:

  1. Traveling to Canada against the advice of a physician.
  2. A terminal prognosis has been received.
  3. New or undiagnosed signs or symptoms of a medical condition are present that could reasonably require treatment while the policy is in effect, or there is a foreseeable need for treatment.
  4. Within the past 3 years, the person has received treatment for:
    1. Aplastic anemia,
    2. Hemolytic anemia,
    3. Sickle cell anemia,
    4. Anemia requiring blood transfusions or bone marrow transplants,
    5. Or was hospitalized for anemia treated with iron supplements.
  5. A bone marrow, stem cell, or organ transplant (excluding cornea transplants)
    has been received.
  6. Within the past 6 months, there has been hospitalization due to sickness.
  7. The person is currently residing in a nursing home, rest home, rehabilitation
    centre, convalescent home, or home for the aged.
  8. Except for minors due to their age, the person requires assistance with activities of daily living such as bathing, eating, using the toilet, taking medications, or
    moving in and out of bed or a chair.
  9. Within the past 12 months, the person has:
    • a) Been prescribed home oxygen (including an oxygen concentrator) or
      prednisone for a lung or heart condition,
    • b) Had pulmonary fibrosis or cystic fibrosis,
    • c) Used nitroglycerin (spray, patch, or pill) for a heart condition or had a heart
      condition with ejection fraction below 40%,
    • d) Had an aneurysm that is not surgically repaired

If it is determined that the person insured was not eligible on the effective date, the
contract will be considered null and void — no benefits will be paid, and premiums may
not be refunded in cases of fraud.”

ELIGIBILITY

To be eligible for any coverage under the contract, as of the Effective Date, a Person Insured must:

  1. Not be eligible for benefits under a Government Health Insurance Plan;
  2. Be either:
    • a) A visitor to Canada; or
    • b) A Canadian citizen or permanent resident returning to reside in Canada;
  3. Be at least 15 days old and less than 90 years of age;
  4. Be the Policyowner, unless the sole Person Insured is under the age of 18 (if in Quebec) or age 16 (all other Canadian provinces or territories), in which case the Policyowner must be the Person Insured’s parent or legal guardian;
  5. If not the Policyowner, be a Spouse or Dependent of the Policyowner;
  6. Be insurable in accordance with Our then-current underwriting rules.

A Person Insured is not eligible for any coverage under the contract if, as of the Effective Date, any of the following apply to a Person Insured, even if disclosed on the Application:

  1. They are travelling or planning to travel to Canada against the advice of a Physician;
  2. They have received a Terminal Prognosis;
  3. They are experiencing new or undiagnosed signs or symptoms of a Sickness for which they reasonably expect may require Treatment while the contract is in force, or otherwise have a reasonably foreseeable need for Treatment while the contract is in force;
  4. In the 3 years prior to the Effective Date, they have received Treatment for:
    • Aplastic anemia, hemolytic anemia, sickle cell anemia, or anemia requiring blood transfusions or bone marrow transplants;
    • Or have received Treatment in a Hospital for anemia through iron supplements;
  5. They have had a bone marrow transplant, stem cell transplant or an organ transplant (but excluding cornea transplants);
  6. In the 6 months prior to the Effective Date, they have been Hospitalized for a Sickness;
  7. They are residing in a nursing home, rest home, convalescent home, rehabilitation centre or home for the aged;
  8. Except as required by minors due to their age, they require assistance with any activities of daily living (i.e., bathing, eating, using a toilet, taking medication(s) or getting into or out of a chair or bed);
  9. In the 12 months prior to the Effective Date, they have:
    • a) Been prescribed home oxygen (including an oxygen concentrator) or prednisone for a lung condition or heart condition;
    • b) Had pulmonary fibrosis or cystic fibrosis;
    • c) Used nitroglycerine in any form (spray, patch, or pill) for a heart condition for the relief of angina or chest pain, or had heart condition with an ejection fraction of less than 40%;
    • d) Had any aneurysm that is not surgically repaired.

If the Company determines at any time that a Person Insured was not eligible on the Effective Date, the contract is null and void and is deemed to have never taken effect, no benefits will be payable and premiums may not be refunded in cases of fraud.

Limitations & Exclusions – Ingle Assurance Travel Insurance

“Ingle Assurance travel insurance provides essential coverage for emergencies — but like all insurance, certain conditions and situations are excluded. No coverage is available, and no payments will be made for any expenses that result directly or indirectly from the following limitations and exclusions:

  • Pre-Existing Conditions, unless specifically covered and declared, and if stable for the required time period prior to the effective date (90 or 365 days, depending on coverage purchased).
  • Any pre-existing condition that was not stable within the required stability period.
  • If the person insured has diabetes, treatment of any cardiovascular or cerebrovascular conditions is excluded.
  • Any loss, sickness, or injury occurring outside of Canada, unless in direct transit to or from Canada during an emergency.
  • Conditions or injuries that began before the policy’s effective date or during any applicable waiting period.
  • Any claims related to HIV/AIDS or other sexually transmitted diseases.
  • Travel to Canada for the purpose of seeking treatment, or with prior knowledge that treatment or surgery is required.
  • Non-emergency or elective treatment, including routine check-ups, chronic care, cosmetic procedures, and rehabilitation.
  • Travel against medical advice, or after receiving a terminal diagnosis.
  • Medication refills or replacements for prescriptions made prior to the policy start, and non-prescription drugs or unapproved medications.
  • Continuing or rehabilitative care after the emergency has been resolved
  • Pregnancy-related care, childbirth, or complications thereof.
  • For children under age 2: illnesses related to birth defects.
  • Mental health disorders, substance abuse, and related treatments, including injuries from excessive alcohol or drug use.
  • Suicide or self-inflicted injuries, regardless of mental state.
  • Losses due to war, civil unrest, or deliberate exposure to danger (unless saving a life).
  • Injuries or losses from illegal activity
  • Injuries from air travel other than as a fare-paying passenger on licensed commercial aircraft.
  • Injuries covered by automobile insurance policies or provincial no-fault plans.
  • Participation in high-risk or extreme sports or professional sports (e.g., skydiving, scuba diving without certification, racing, etc.).
  • Treatment for any pre-existing condition where travel was advised against by a physician.
  • Illness contracted in a region under a Canadian government travel advisory in effect before the policy start.
  • Failure to follow prescribed medical treatment.
  • Major medical or surgical procedures (e.g., MRIs, biopsies, angioplasty) unless pre-approved by the medical director or deemed emergency.
  • Vision or hearing correction surgery, unless caused by an injury.
  • Care provided by naturopaths, or in rehabilitation centers, spas, or similar facilities.
  • Loss or damage related to hearing aids, eyeglasses, contact lenses, prosthetic limbs/teeth, and related services.
  • Air ambulance or emergency air transport, unless approved by the medical director.
  • Expenses not normally charged in absence of insurance or above reasonable and customary rates, or any incurred in the person’s country of residence.
  • Fraudulent claims or claims involving false statements or omissions.

đź“ŚAdditional Limitations:

  1. No benefit is payable if the person insured is imprisoned or under house arrest during the policy period.
  2. Coverage is void if it results in violation of trade or economic sanctions or non-compliance with Canadian law.
  3. The maximum combined coverage across all Ingle Assurance policies is $200,000 per person — any excess coverage will be void and premiums refunded.
  4. Ingle Assurance reserves the right, through Trident Global Assistance, to transfer the person insured to another hospital or repatriate them once medically fit. Refusing such transfer may result in coverage termination for ongoing expenses.

Note: This is a summary only. For full details, refer to the official policy wording and your policy receipt.

Limitations & Exclusions

The contract will not provide any coverage, and no payments will be made for any expenses that result, either entirely or in part, from or are contributed to by, or naturally and predictably stem from, any of the following excluded risks:

  1. Any Pre-Existing Condition, unless the most recent Policy Receipt from the Company confirms the Person Insured has Pre-Existing Condition coverage and the Person Insured, or the Person Insured’s behalf, accurately and fully disclosed all of the Person Insured’s Pre-Existing Condition(s) material to the insurance applied for in the Application and such Pre-Existing Condition is not expressly excluded in the most recent Policy Receipt.
  2. a) Any Pre-Existing Condition that was not Stable at any time during the 90 days immediately before the Effective Date.
    b) If the 365-day stability coverage is purchased, any Pre-Existing Condition that was not Stable at any time during the 365 days immediately before the Effective Date.
    c) Any condition listed under “Exclusions” on the most recent Policy Receipt.
    d) Any condition listed under “Notes” on the most recent Policy Receipt as an excluded condition.
    e) Any loss, Sickness, or Injury related to a Pre-Existing Condition that is not excluded by exclusion #1 above if the Person Insured does not inform the Company of a change in such Pre-Existing Condition before the Effective Date and the Company did not agree in writing to cover such change in the Pre-Existing Condition.
  3. If the Person Insured has diabetes as a Pre-Existing Condition, treatment of any cardiovascular or cerebrovascular conditions.
  4. Any loss, Sickness or Injury which occurred outside of Canada, unless the Person Insured experiences an Emergency while in direct transit to or from Canada (including layovers) and the contract is in effect.
  5. Any loss, Sickness or Injury that occurred before the Effective Date or during the Waiting Period, if applicable.
  6. Any loss, Sickness or Injury resulting from asymptomatic or symptomatic HIV infection, Acquired Immune Deficiency Syndrome (AIDS), AIDS-related conditions (ARC), or the presence of HIV, including any related diagnostic tests, charges, or other sexually transmitted diseases.
  7. Any loss, Sickness or Injury that occurs during the Person Insured’s visit to Canada, when it is reasonable to expect the Person Insured will need or seek Treatment or surgery for that Sickness, Injury, or medical condition, or for the purpose of obtaining Treatment or surgery for such a condition.
  8. Any loss relating to conditions from Non-Emergency Treatment, check-ups, general health examinations, cosmetic care or surgery, routine care for chronic conditions, rehabilitation, or any related complications, whether directly…
  9. Any loss, Sickness or Injury when travel is arranged or initiated against medical advice and either with prior awareness of an Unstable Condition or following the diagnosis of a Terminal Prognosis.
  10. a) The replacement or refill of a medication prescribed to the Person Insured before the Effective Date, whether due to loss, renewal, or insufficient supply, unless expressly provided as a benefit herein.
    b) The purchase of drugs and medications, including vitamins, that are commonly available without a prescription or those that are not legally registered and approved in Canada.
  11. Except as otherwise expressly provided herein:
    a) Treatment, investigation, or Hospitalization for a Recurrence.
    b) Continuing Treatment or rehabilitative care of a Sickness or Injury after the Medical Director has determined that the Emergency has ended.
  12. Childbirth, miscarriage, deliberate termination of pregnancy, routine prenatal care, or any complications related to pregnancy or childbirth.
  13. For Persons Insured under 2 years of age on the Effective Date, any Sickness related to a birth defect.
  14. Any psychiatric, psychological, mental, nervous, or emotional disorders; the misuse of medication; drug abuse; or intoxication; any Sickness related to and/or induced by alcohol, medication, drug, or toxic substance abuse; any Injury related to and/or induced by excessive alcohol consumption (determined by a blood-alcohol level in excess of 80 milligrams per 100 milliliters of blood); or the Treatment thereof.
  15. Suicide or attempted suicide, or self-inflicted Injury, regardless of the Person Insured’s state of mind.
  16. Any loss, Sickness or Injury arising from civil disorders, war or acts of war, whether declared or not, or willful exposure to peril, except in cases where the exposure was in an attempt to save human life.
  17. Any loss, Sickness or Injury arising from or in connection with the Person Insured committing or attempting to commit any illegal activity under any applicable law, whether or not charged or convicted of such offence.
  18. Any loss, Sickness or Injury arising from or in connection with air travel, except when the Person Insured is a passenger in a commercial aircraft with a seating capacity of six people or more that is licensed to carry passengers for hire.
  19. Any loss, Sickness or Injury arising from or in connection with an automobile accident if You or the Person Insured is entitled to benefits under an automobile insurance policy, including but not limited to no-fault benefits, or under an applicable Insurance Act, in accordance with the “Coordination of Benefits” provision in the General Terms & Conditions of this Policy.
  20. Any loss, Sickness or Injury arising from or in connection with a Person Insured participating in sanctioned competitive sports, professional sports, aerobatic or stunt flying, hang gliding, mountaineering, skydiving, parachuting, bungee jumping, scuba diving without proper certification, extreme fighting, and any racing or speed contests.
  21. Treatment or surgery for a Pre-Existing Condition for which a Physician had advised the Person Insured not to travel.
  22. Treatment for any Sickness contracted in a country before the Effective Date when a written formal notice was issued by the Canadian government advising Canadians not to travel to that country, region, or city.
  23. Any loss, Sickness or Injury arising from the Person Insured not complying with prescribed medical therapy or Treatment.
  24. Major medical or surgical procedures unless they are approved in advance by the Medical Director. This includes, without limitation:
    • Cardiac catheterization, angioplasty, and/or cardiovascular surgery, including associated diagnostic tests or charges.
    • Magnetic resonance imaging (MRIs), computerized axial tomography (CAT) scans, sonograms, ultrasounds, or biopsies.

      This exclusion will not apply if the Person Insured’s condition prevents You or the Person Insured from seeking approval in advance by the Medical Director or if such procedures are Medically Necessary as part of an Emergency Treatment protocol determined by the attending Physician, and You or the Person Insured contact the Company as soon as it is medically possible.

  25. Surgery to correct vision or hearing, except when caused by an Injury.
  26. Services provided by a naturopath or services provided in a convalescent home, nursing home, rehabilitation centre, or health spa.
  27. Any loss relating to damage to or loss of hearing devices, optometrist services, eye examinations, eyeglasses, sunglasses, contact lenses, or prosthetic teeth or limbs, and the resulting prescriptions thereof.
  28. Emergency transportation by airplane (regular flight, private flight or air ambulance) and presence of a medical attendant, unless approved in advance by the Medical Director.
  29. Expenses for which no charge would typically be incurred in the absence of insurance, expenses that exceed the Reasonable and Customary charges for the region where the services were provided, or any loss, Sickness or Injury if the expense is incurred in the Person Insured’s Country of Residence.
  30. Any loss or expense for which a claim was made involving fraud or deliberate misstatement or concealment.


Except in respect of the Accidental Death Coverage, the contract will not provide any coverage, and no payments will be made, for any loss or expense insured by other existing insurance coverages, including but not limited to, a Government Health Insurance Plan or a private plan, as further described in the “Coordination of Benefits” section of the General Terms & Conditions of this Policy.

If a Person Insured is covered under more than one travel insurance contract underwritten by the Company and the total amount of insurance in respect of the Person Insured exceeds $200,000, the Company’s aggregate liability for all contracts with the Company under which the Person Insured is covered will not exceed $200,000 and any excess insurance will be void and the premiums paid for such excess insurance will be refunded.

Benefits are not payable under the contract and will terminate on the commencement of, any period during which You are or a Person Insured is serving a sentence for a criminal offence and are confined in a prison or other place of detention, including but not limited to, a mental institution, a halfway facility, or private residence (under house arrest).

This contract provides no coverage and the Company shall not be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such coverage, payment of such claim or provision of such benefit would expose the Company to any trade or economic sanctions, or cause the Company to be non-compliant with any applicable laws or regulations of Canada.

Trident Global Assistance has the authority to transfer the Person Insured to a different Hospital, provided they are medically fit for such a transfer, or to arrange transportation to return them to their Country of Residence following an Emergency. If the Person Insured chooses not to be transferred to another Hospital or return to their Country of Residence when deemed medically fit to travel by the Medical Director, any ongoing expenses for Sickness or Injury will not be covered.