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PRE-EXISTING CONDITION EXCLUSIONS
TEN and On Call shall not be responsible for the cost of evacuation, repatriation, remains return and/or any Special Services as defined in the Membership Handbook, whenever the provisions of these services arise from or are due to a Pre-Existing Condition. A Pre-Existing Condition is an injury, sickness or other medical condition that manifested itself or worsens within ninety (90) days preceding the date that membership became effective. This exclusion applies where medical treatment is received or recommended or where a prudent person would have sought diagnostic care or treatment. The other membership services, including medical referral, shall not be excluded because of pre-existing conditions.

No services shall be available for any Member if such services are required as a result of:
  • Mild lesions, simple fractures, or mild diseases which can be treated by local doctors and do not prevent the Member from continuing his or her trip or returning home;
  • Infections under treatment not yet healed;
  • Traveling for the purpose of obtaining medical treatment;
  • Routine physical examination:
  • Cosmetic or plastic surgery, chiropractic care except as a result of an accident;
  • Any nervous, emotional or mental disorder;
  • Dental care, except as the result of injury to natural teeth caused by an accident;
  • Eye refractions or eye examinations for the purpose of prescribing corrective lenses for eye glasses or for the fitting thereof, unless caused by accidental bodily injury incurred during TEN Membership;
  • Treatment by a family member;
  • Terminal illness.
  • The failure of medical appliances, monitors, or any other pieces of medical equipment that a Member requires.
  • Pregnancy, childbirth, or complications of pregnancy.
  • Active treatment of any condition within the last 90 days.
  • Services are not provided for injuries or illness due to or arising from:
  • Sickness when traveling against the advice of a physician;
  • Air travel in aircraft used for experimental purposes;
  • Commissions of, or attempt to commit an illegal act;
  • Service in the military or police service for the purpose of taking part in any police or peacekeeping action, conflict, combat, declared or undeclared war;
  • Participation in professional, intercollegiate, or hazardous sports;
  • A Member’s suicide, attempted suicide, or willfully self-inflicted injury, sexually transmittable diseases, including AIDS, or the abuse of legal or illegal drugs or alcoholic drink;
  • Services, supplies, or treatment, including any period of hospital confinement, which were not recommended, approved and certified as necessary and reasonable by a physician; or expenses which are non-medical in nature.
  • Claims for individuals who have non-group memberships who are age 80 or older prior to their membership date.
  • War, invasion, acts of foreign enemies, hostilities between nations (whether declared or not), civil war, rebellion, revolution, insurrection, military or usurped power.
  • Limitations: Traveler Emergency Network does not provide protection caused by or resulting from: Applying for membership while hospitalized; being under the influence of drugs or intoxicants unless prescribed by a physician; participating in bodily contact sports, skydiving, hang gliding, parachuting, mountaineering, mountain climbing, rock climbing, bungee cord jumping, any race, and speed contest; Traveling in any country for which the U.S. State Department issued travel restrictions: Services provided for a Member for which no charge is normally made: Services provided to an injured person where the member is entitled to receive reimbursement for such expenses under any group insurance program maintained by the Member’s employer; travel within 100 miles of your permanent land based residence, unless in a foreign country; Maximum duration any one trip 90 consecutive days.

TEN and On Call reserve the right to suspend, curtail or limit Member Services in any area in the event of rebellion, riot, military uprising, war, labor disturbances and strikes, nuclear accidents, acts of God, or refusal of the authorities in the country of assistance to permit On Call to fully provide services. On Call will, however, endeavor to provide services during any such occurrence. It is the responsibility of the Member to inquire with On Call’s Assistance Center whether a country is “open” for assistance prior to his or her departure. Should you require assistance service from any “closed” country, On Call will attempt to help, but cannot guarantee provision of its services.

The medical professionals, medical facilities, and/or attorneys suggested and/or designated by On Call and/or providing services on behalf of On Call are not employees of On Call (or TEN), and, therefore, On Call (and TEN) are not responsible or liable for their actions or omissions. On Call shall not be responsible for providing medical diagnosis or treatment. The final selection of the medical provider is the right and responsibility of the Member. All decisions as to the medical necessity for evacuation, the means and timing of any evacuation, the medical equipment and personnel to be used, and the final destination are medical decisions which will be made by physicians designated by On Call in consultation with a local attending physician based on medical factors. Their decisions shall be conclusive in determining the need for such services.