|
(For Missionaries Only.
Individuals and families who are not missionaries, please visit www.overseashealth.com
)
Why Buy International Medical Insurance? and am I
eligible?
Who is the Plan Administrator?
Who
is the Insurer?
Which Plan is Right for Me?
Am I Eligible for
The International Citizen Series?
Is Coverage Under The International Citizen Series
Renewable?
How Do I File a Claim?
Hospital Pre-certification
What Are the Plan Features?
What Are the Benefits and Policy Limits?
What Are the Rates?
How Do I Apply for The International Citizen Series?
Apply
online
Why Buy International Medical
Insurance?
The answer is easy.
If you are a missionary living abroad, traditional sources of US
private health insurance will not meet your needs. Geographical
exclusions and provider limitations common to these policies will
restrict or even eliminate the coverage available to you while you are
outside the US. At the same time, you may not be eligible for
participation in the government sponsored plans in the country where
you reside. Or you may wish to have access to health care in other
countries, including the US, in the event you become seriously ill. If
you are a non-US citizen, you may need an international medical
insurance policy to supplement the coverage available to you through
your government sponsored plan, or to provide coverage while you are
outside your home country. If your ministry knows no geographic
limits, you need health insurance that knows no boundaries as
well. The International Citizen Series is designed to meet your
needs.
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Who is the Plan Administrator?
MultiNational Underwriters, Inc., headquartered in Indianapolis,
Indiana, is a full service organization, offering a comprehensive
portfolio of insurance products designed specifically to address the
insurance needs of international citizens. With over 40 years of
experience in the international insurance market, the staff of
MultiNational Underwriters, Inc. is ready to serve you. Our
international claims specialists, medical professionals and customer
service representatives are available 24 hours a day, 7 days a week to
answer your questions and respond to your needs. Whether you have a
question about your coverage, or are in need of emergency medical
evacuation, you will find our service team to be prompt,
compassionate, and of the highest professional quality.
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Which Plan is Right for Me?
If you desire worldwide coverage, including coverage in the US and
Canada, the Messenger plan is right for you. This plan is one of the
most comprehensive medical insurance products available, featuring a
$5,000,000 lifetime limit, worldwide medical coverage, maternity
benefits, mental and nervous benefits, wellness benefits. emergency
medical evacuation and US Furlough benefits. If you desire worldwide
coverage, excluding the US and Canada, either the Premier or Risk
Share plans will meet your needs, depending on your budget and your
appetite for risk.
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Am I Eligible for The
International Citizen Series?
The International Citizen Series is available to citizens of all
countries of the world who are at least age 14 days, and not older
than age 74. If you are a US citizen, you must reside outside the US,
or plan to depart the US within 30 days of the effective date, and
plan to reside abroad for at least 6 months. Citizens of other
countries may reside anywhere, including their country of citizenship.
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Is Coverage Under The
International Citizen Series Renewable?
Yes. The International Citizen Series products are annually renewable.
There are no medical questions at renewal. Renewal is only subject to
your continued eligibility and payment of premiums. Your renewal
premium will be the same as all persons of your same age and gender.
If you purchase coverage before you reach the age of 65, and maintain
coverage continuously for 10 years, subject to continued eligibility,
you will automatically be eligible to apply for the International
Citizen Senior Plan, with no medical questions.
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How Do I File a Claim?
Filing a claim is easy. Once your Application is accepted, you will
receive a kit which contains claimant's Statement and Authorization
forms. Just complete the claimant's Statement and Authorization forms,
attach original, itemized bills, and forward them to MultiNational
Underwriters, Inc. Be sure to complete your claim form, sign it, and
indicate a convenient time and location to contact you in the event
questions arise. If you have already paid certain expenses, attach a
copy of your paid receipt. You will be reimbursed for eligible medical
expenses. In many cases, MultiNational Underwriters, Inc. will make
payment directly to the hospital or physician who treated you.
Remember, you are responsible for the deductible, coinsurance, and any
ineligible charges.
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Hospital Pre-certification
All plans in The International Citizen Series contain hospital
pre-certification provisions. Pre-certification simply means that you
must contact MultiNational Underwriters, Inc. as soon as possible
before a planned hospitalization or surgical procedure, or within 48
hours of an emergency hospital admission, or within the first 90 days
of pregnancy. Pre-certification allows us to establish contact and
make payment arrangements with your providers, negotiate discounts
which will benefit both you and us, pre-arrange future care, and plan
for your claim. Pre-certification helps us help you.
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What Are the Benefits and Policy
Limits?
Messenger
|
Benefit
|
Messenger
|
|
Coverage Area
|
Worldwide
|
|
Overall Policy Maximum
|
$5,000,000 Lifetime
|
|
Deductibles Available
|
$250, $500, $1,000 or $2,500 per
Certificate Period.
|
|
Coinsurance -- Claims incurred in US or
Canada
|
80% of the next $5,000 of Eligible Medical
Expenses after the
Deductible, then 100% to the Overall Policy
Maximum. The
Coinsurance will be waived if expenses are
incurred within the PPO.
|
|
Coinsurance -- claims incurred outside US
or Canada
|
100% of Eligible Medical Expenses after the
Deductible to the Overall
Policy Maximum.
|
|
Hospital Room and Board -- In US or Canada
|
Average Semi-private room rate.
|
|
Hospital Room and Board -- Outside US or
Canada
|
Average Private room rate.
|
|
Intensive Care Unit -- In US or Canada
|
Usual, Reasonable and Customary.
|
|
Intensive Care Unit -- Outside US or Canada
|
Usual, Reasonable and Customary.
|
|
Mental or Nervous Disorders
|
$10,000 per Certificate Period (after 12
months of continuous coverage); $25,000 Lifetime Maximum.
|
|
Maternity -- Normal Delivery
|
Same as any other Illness (after 12 months
of continuous coverage) including pre-natal, Delivery and
post-natal care.
|
|
Maternity -- Complicated Delivery
|
Same as any other Illness (after 12 months
of continuous coverage).
|
|
Maximum for Maternity
|
$50,000 Lifetime
|
|
Newborn Care
|
$25,000 Maximum Limit for maximum of 31
days.
|
|
Pre-existing Conditions
|
Same as any other Injury or Illness if
disclosed on Application and
not excluded or limited by Rider.
|
|
Local Ambulance
|
Usual, Reasonable and Customary.
|
|
Physical Therapy
|
$50 Maximum per visit.
|
|
Wellness
|
$50 per visit(including immunizations),
maximum of 3 visits per year
for children under the age of
19(after 12 months of continuous
coverage). $150 per
Certificate Period (after 12 months of continuous coverage)
for Members age 35 or older. Not subject to Deductible.
|
|
Human Organ/Tissue Transplants
|
Same as any other Illness for Covered
Transplants.
|
|
All Other Eligible Expenses
|
Usual, Reasonable and Customary.
|
|
Emergency Medical Evacuation
|
$50,000 Lifetime Maximum.
|
|
Repatriation of Remains
|
$25,000 Limit
|
|
Emergency Reunion
|
$10,000 Lifetime Maximum.
|
|
Pre-certification Penalty
|
50%
|
|
Prescription Drugs
|
Usual, reasonable and customary (subject to
deductible and
co-insurance)
|
Premier
|
Benefit
|
Premier
|
|
Coverage Area
|
Worldwide, except US and Canada
|
|
Overall Policy Maximum
|
$1,000,000 Lifetime
|
|
Deductibles Available
|
$250, $500, $1,000 or $2,500 per
Certificate Period.
|
|
Coinsurance–Claims incurred in US or
Canada
|
No coverage in US or Canada.
|
|
Coinsurance–claims incurred outside US or
Canada
|
100% of Eligible Medical Expenses after the
Deductible to the Overall Policy Maximum.
|
|
Hospital Room and Board–In US or Canada
|
No coverage in US or Canada.
|
|
Hospital Room and Board–Outside US or
Canada
|
Average Private room rate.
|
|
Intensive Care Unit–In US or Canada
|
No coverage in US or Canada.
|
|
Intensive Care Unit–Outside US or Canada
|
3 times the Average Private room rate.
|
|
Mental or Nervous Disorders
|
$5,000 per Certificate Period (after 24
months of continuous coverage);
$10,000 Lifetime Maximum.
|
|
Maternity–Normal Delivery
|
$3,500 per Pregnancy (after 24 months of
continuous coverage) including
pre-natal, Delivery and
post-natal care.
|
|
Maternity–Complicated Delivery
|
$6,000 per Pregnancy (after 24 months of
continuous coverage) including
pre-natal, Delivery and
post-natal care.
|
|
Maximum for Maternity
|
$10,000 Lifetime
|
|
Newborn Care
|
$5,000 Maximum Limit for maximum of 31
days.
|
|
Pre-existing Conditions
|
$25,000 Lifetime Maximum (after 24 months
of continuous coverage).
|
|
Local Ambulance
|
$1,000 Lifetime Maximum.
|
|
Physical Therapy
|
No coverage.
|
|
Wellness
|
No coverage.
|
|
Human Organ/Tissue Transplants
|
Same as any other Illness for Covered
Transplants.
|
|
All Other Eligible Expenses
|
Usual, Reasonable and Customary.
|
|
Emergency Medical Evacuation
|
No coverage.
|
|
Pre-certification Penalty
|
50%
|
Optional Term Life Insurance and Accidental
Death and Dismemberment
|
Age
|
Basic Life Principal Sum
|
Supplemental Life Principal Sum
|
|
19 to 59
|
$50,000
|
$50,000
|
|
60 to 64
|
$25,000
|
$25,000
|
|
65 to 69
|
$10,000
|
Not Available
|
|
Dependent Child
|
$5,000
|
Not Available
|
|
Accidental Death
|
Principal Sum
|
|
Accidental Loss of Two Members
|
Principal Sum
|
|
Accidental Loss of One Member
|
50% of Principal Sum
|
The Benefit is based on your age at time of Death or Dismemberment.
"Member" means hand, foot or eye.
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What Are the Plan Features?
Pre-existing Conditions:
If you are insured under the Platinum plan, and your pre-existing
conditions have been fully disclosed on your application and not
excluded or restricted by a rider or any other provision of your
certificate, your pre-existing conditions are covered the same as any
other illness or injury as of your effective date. If you are insured
under the Premier plan, your pre-existing conditions are covered up to
a lifetime limit of $25,000 after you have been insured continuously
for 24 months. If you are insured under the Risk-Share plan, your
pre-existing conditions are not covered.
Pre-existing conditions include any injury or illness or
mental/nervous condition that existed at or prior to your initial
effective date, including chronic, recurring and congenital
conditions.
What Are the Exclusions and Limitations?
The following charges, treatments, care, services, supplies and/or
conditions are excluded from coverage:
- Charges not incurred during the certificate period
- Services or treatment payable by another insurance or government
- Substance abuse
- Charges which exceed reasonable and customary
- Investigational or experimental surgeries or treatment
- Custodial, educational or rehabilitative care
- Weight modification
- Cosmetic surgery, unless reconstructive following covered
surgery
- Individuals HIV+ at effective date
- Drugs or treatment for sexual dysfunction
- Drugs or treatment to promote or prevent conception
- Dental treatment, except emergency treatment following covered
accident
- Devices or procedures to correct sight or hearing
- Self inflicted injury or illness
- Foot care, unless related to a covered accidental injury
- Treatment or supplies not ordered by a physician or not
medically necessary
- Organ transplants, except for covered transplants
- Speech or acupuncture therapy
This is a summary of the exclusions contained in the Master Policy.
See the Master Policy for a complete list of exclusions.
Waiting Period for Certain Illnesses:
The following conditions which manifest themselves within the first
180 days of coverage are excluded: any condition of the breast,
prostate, tonsils, adenoids, disease of sebaceous glands, acne, other
acne, sebaceous cyst, seborrhea, unspecified disease of the sebaceous
glands, moles, skin tags, hypertrophic and atrophic conditions of the
skin, nervous, hemorrhoids, the reproductive system, hernia,
gallstones or kidney stones. If you are insured under the Risk Share
Plan, all illnesses are excluded for the first 90 days of coverage.
Wellness:
If you are insured under the Platinum plan, after 12 months of
continuous coverage, and if you are at least 35 years old, you will be
entitled to the following Wellness benefits: the benefit provides $150
per Certificate Period for a routine physical exam, including mamogram
and OB/GYN visits for females. If you are under the age of 19, this
benefit provides $50 per visit (including immunziations) with a
maxmium of 3 visits per Certificate Period.
Emergency Medical Evacuation:
If you are insured under the Platinum plan, you are covered for
emergency medical evacuation to the nearest medical facility qualified
to treat your life threatening condition. All emergency medical
evacuations must be approved in advance and coordinated by
MultiNational Underwriters, Inc. MultiNational Underwriters, Inc. is
available 24 hours a day, 7 days a week, to approve and coordinate
emergency medical evacuations. Emergency medical evacuations provide
you with access to care when you need it most.
Emergency Reunion:
In the event of a covered Emergency Evacuation, the platinum plan will
provide the following benefits:the cost of an economy round trip air
or ground transportation ticket for one of your relatives (parent,
spouse, sibling or child age 18 years or older) for transportation to
the area where you are hospitalized following Emergency Evacuation,
and reasonable expenses for lodging and meals for your relative for a
period not to exceed 10 days.
Repatriation of Remains:
In the event of a covered injury or illness resulting in your death,
the platinum plan will provide the following benefit: air or ground
transporation of bodily remains or ashes to the area of your Principal
Residence and reasonable cost of preparation of your remains necessary
for transporation.
International Citizen Assistance Services:
The following Assistance Services are available to you 24 hours a day,
7 days a week whie your International Citizen Plan is in effect.
Pre-Trip Health and Safety Advisories (available after your
purchase of the International Citizen Series, and before your
departure) - call us for current passport, visa, inoculation and
vaccine requirements, as well as up-to-date travel safety advisories.
Livetravel Services - we will make emergency travel and
itinerary changes for you including rebooking flights, hotel
reservations and ground transportation arrangements.
BagTrak - we are the industry leaders in tracking lost checked
baggage. We will help you locate your lost checked baggage, and
deliver it to you anywhere in the world.
Emergency Message Relay - we will relay messages to your
family, friends and co-workers, helping you to maintain contact during
an emergency.
Emergency Cash Transfers - we will assist you in arranging and
obtaining cash transfers anywhere in the world.
Other International Citizen Assistance Services include:
- Medical referrals
- Up-to-the-minute travel medical advisories
- Assistance with prescription drug replacement
- Dispatch of a doctor or specialist
- Emergency travel arrangements for family members
- Lost passport or travel documents assistance
- Embassy and consulate referrals
- Legal and accounting referrals
- Bail bond assistance
- Translation and interpretation assistance
International Citizen Assistance Services are not insurance benefits
and provision of any International Citizen Assistance Services is not
a guarantee of any other benefit under the International Citizen
Series.
Other services provided by MultiNational Underwriters, Inc:
Hospital/Physician Referral: MultiNational Underwriters, Inc.
maintains relationships with hospitals and physicians throughout the
world, and this network is growing daily. If you need a referral, just
contact MultiNational Underwriters, Inc. and one of our Customer
Service Representatives will assist you.
Patient Advocacy Services: If you are faced with a complex or
severe medical condition, you will be assigned to one of
MultiNational's Patient Advocates. Your Patient Advocate is your
personal assistant at MultiNational Underwriters on all matters
relating to your treatment and claim, with the goal of securing the
best possible care for you in a convenient and cost effective setting.
General Customer Service:
You've lost your ID card or your Certificate. Or, you have a question
about your insurance. Or, you have filed a claim and you want to know
the status of payment. These and many more questions may arise from
time to time. MultiNational Underwriters, Inc. Customer Service Team
is ready to respond. If you do not speak English, your Customer
Service Representative will arrange for a telephone translator to
monitor your call and assist in providing the answers you need.
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What Are the Rates?
Annual Premium -- For Insurance Effective
Through 7/31/2005
| |
$250
Deductible |
$500
Deductible |
$1,000
Deductible |
$2,500
Deductible |
$5,000
Deductible |
| Age |
Male |
Female |
Male |
Female |
Male |
Female |
Male |
Female |
Male |
Female |
| 14
days to 9* |
$475 |
$475 |
$429 |
$429 |
$326 |
$326 |
$293 |
$293 |
$282 |
$282 |
| 10
to 18* |
$500 |
$500 |
$452 |
$452 |
$350 |
$350 |
$316 |
$316 |
$304 |
$304 |
| 19-24 |
$1,180 |
$1,905 |
$1,048 |
$1,796 |
$814 |
$1,291 |
$718 |
$1,144 |
$588 |
$940 |
| 25-29 |
$1,300 |
$2,110 |
$1,162 |
$1,983 |
$901 |
$1,428 |
$793 |
$1,263 |
$652 |
$1,031 |
| 30-34 |
$1,394 |
$2,359 |
$1,224 |
$2,199 |
$951 |
$1,638 |
$844 |
$1,451 |
$691 |
$1,190 |
| 35-39 |
$1,525 |
$2,595 |
$1,355 |
$2,368 |
$1,049 |
$1,813 |
$929 |
$1,603 |
$759 |
$1,285 |
| 40-44 |
$1,705 |
$2,125 |
$1,507 |
$1,898 |
$1,166 |
$1,472 |
$1,036 |
$1,308 |
$843 |
$1,070 |
| 45-49 |
$1,865 |
$2,319 |
$1,666 |
$2,092 |
$1,292 |
$1,626 |
$1,145 |
$1,439 |
$935 |
$1,111 |
| 50-54 |
$2,266 |
$2,516 |
$2,040 |
$2,289 |
$1,586 |
$1,785 |
$1,445 |
$1,620 |
$1,184 |
$1,325 |
| 55-59 |
$2,800 |
$2,800 |
$2,630 |
$2,630 |
$2,000 |
$2,000 |
$1,863 |
$1,863 |
$1,524 |
$1,524 |
| 60-64 |
$3,960 |
$3,733 |
$3,662 |
$3,435 |
$3,066 |
$2,839 |
$2,798 |
$2,588 |
$2,321 |
$2,053 |
| 65-69 |
$8,180 |
$7,134 |
$7,882 |
$6,835 |
$7,287 |
$6,237 |
$5,666 |
$4,715 |
$4,915 |
$4,150 |
| 70 |
$9,645 |
$8,339 |
$9,343 |
$8,046 |
$8,739 |
$7,443 |
$6,891 |
$5,594 |
$5,977 |
$4,835 |
| 71 |
$10,097 |
$8,738 |
$9,795 |
$8,438 |
$9,192 |
$7,834 |
$7,257 |
$5,898 |
$6,295 |
$5,098 |
| 72 |
$10,484 |
$9,070 |
$10,185 |
$8,771 |
$9,588 |
$8,174 |
$7,573 |
$6,160 |
$6,569 |
$5,324 |
| 73 |
$10,882 |
$9,404 |
$10,586 |
$9,108 |
$9,994 |
$8,517 |
$7,900 |
$6,421 |
$6,853 |
$5,550 |
| 74 |
$11,412 |
$9,854 |
$11,115 |
$9,558 |
$10,524 |
$8,966 |
$8,321 |
$6,762 |
$7,218 |
$5,845 |
| *First 2 children age 14 days to
9 years are free only when both parents are insured under the
Platinum Plan. The Dependent Child rate is only available when
parent (guardian) is insured under the Platinum Plan.
Dependent children alone must pay the age 19 to 24 rate. |
|
A one-time, non-refundable Policy Fee of
$50 is required with each Application for the Messenger plan.
|
Print an Application
| |
$250
Deductible |
$500
Deductible |
$1,000
Deductible |
$2,500
Deductible |
$5,000
Deductible |
| Age |
Male |
Female |
Male |
Female |
Male |
Female |
Male |
Female |
Male |
Female |
| 14
days to 9* |
$326 |
$326 |
$280 |
$280 |
$218 |
$218 |
$190 |
$190 |
$174 |
$174 |
| 10
to 18* |
$350 |
$350 |
$300 |
$300 |
$245 |
$245 |
$220 |
$220 |
$205 |
$205 |
| 19-24 |
$624 |
$863 |
$553 |
$797 |
$435 |
$588 |
$385 |
$520 |
$335 |
$452 |
| 25-29 |
$687 |
$950 |
$621 |
$883 |
$481 |
$650 |
$424 |
$575 |
$369 |
$500 |
| 30-34 |
$737 |
$1,050 |
$654 |
$966 |
$508 |
$728 |
$450 |
$645 |
$391 |
$561 |
| 35-39 |
$858 |
$1,183 |
$722 |
$1,049 |
$560 |
$804 |
$497 |
$712 |
$432 |
$620 |
| 40-44 |
$953 |
$1,162 |
$804 |
$1,014 |
$623 |
$787 |
$554 |
$700 |
$482 |
$609 |
| 45-49 |
$1,044 |
$1,271 |
$890 |
$1,116 |
$690 |
$868 |
$611 |
$769 |
$532 |
$669 |
| 50-54 |
$1,244 |
$1,376 |
$1,083 |
$1,216 |
$843 |
$948 |
$767 |
$861 |
$667 |
$749 |
| 55-59 |
$1,497 |
$1,497 |
$1,330 |
$1,330 |
$996 |
$996 |
$942 |
$942 |
$820 |
$820 |
| 60-64 |
$2,488 |
$2,368 |
$2,196 |
$2,076 |
$1,612 |
$1,492 |
$1,486 |
$1,366 |
$1,293 |
$1,188 |
| 65-69 |
$4,726 |
$4,157 |
$4,434 |
$3,865 |
$3,850 |
$3,281 |
$3,008 |
$2,437 |
$2,617 |
$2,121 |
| 70 |
$5,753 |
$5,031 |
$5,459 |
$4,735 |
$4,869 |
$4,146 |
$3,100 |
$2,495 |
$2,697 |
$2,170 |
| 71 |
$6,005 |
$5,248 |
$5,709 |
$4,953 |
$5,120 |
$4,363 |
$3,263 |
$2,506 |
$2,839 |
$2,180 |
| 72 |
$6,216 |
$5,428 |
$5,924 |
$5,136 |
$5,340 |
$4,552 |
$3,471 |
$2,684 |
$3,020 |
$2,335 |
| 73 |
$6,433 |
$5,610 |
$6,143 |
$5,320 |
$5,565 |
$4,742 |
$3,686 |
$2,863 |
$3,207 |
$2,491 |
| 74 |
$6,727 |
$5,861 |
$6,439 |
$5,571 |
$5,861 |
$4,993 |
$3,952 |
$3,085 |
$3,438 |
$2,684 |
|
*First child age 14 days to 9 years is free
only when both parents are insured under the Premier Plan. The
Dependent Child rate is only available when parent (guardian)
is insured under the Premier Plan. Dependent children alone
must pay the age 19 to 24 rate.
|
|
A one-time, non-refundable Policy Fee of
$50 is required with each Application for the Premier Plan.
|
Go to the
Application Page
Optional
Term Life and AD&D Insurance - Rate Table
|
| Age |
Basic Premium |
Supplemental Premium |
| 19-29 |
$130 |
$100 |
| 30-39 |
$210 |
$160 |
| 40-44 |
$310 |
$235 |
| 45-49 |
$450 |
$340 |
| 50-54 |
$570 |
$430 |
| 55-59 |
$770 |
$580 |
| 60-64 |
$585 |
$440 |
| 65-69 |
$315 |
Not Available |
| Dependent Child |
$85 |
Not Available |
| RATES |
| Annual
Premium |
US
Citizen |
$348 |
|
All
Other |
$492 |
THIS MEDICAL AND LIFE INSURANCE IS
UNDERWRITTEN BY CERTAIN UNDERWRITERS AT LLOYD'S, LONDON, AND
IS AVAILABLE TO MEMBERS OF THE ATLAS/INTERNATIONAL CITIZEN
GROUP INSURANCE TRUST, HAMILTON, BERMUDA.
LLOYD'S IS AN APPROVED NON-ADMITTED INSURER IN ALL STATES OF
THE UNITED STATES, EXCEPT KENTUCKY AND ILLINOIS WHERE THEY ARE
ADMITTED. CLAIMS UNDER THIS INSURANCE MAY NOT BE MADE AGAINST
ANY STATE GUARANTY FUND. |
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How Do I Apply for The
International Citizen Series?
Just print the Application For Insurance and send it to Insurance Services of
America, Inc. along with your initial premium payment. Within 5
business days of receipt of your Application, the Underwriters will
inform you as to the acceptance of your application and your effective
date, or of any additional information required to continue
considering your application. Remember, your Application will become a
permanent part of your record, and will become a part of your
certificate of coverage. Answer each question thoroughly and legibly,
and attach additional sheets if necessary. If your application is not
accepted, the Underwriters, Inc. will promptly refund your premium. If
your application is accepted, you will receive a fulfillment kit
containing your certificate of coverage, an identification card, a
claim form, and instructions on how to use your insurance.
You can also
apply online, CLICK
HERE
Important Instructions For All Applicants
1. Review your answers to each question on this Application for
accuracy. Unanswered questions or incomplete information will delay
processing.
2. All Applications must be signed and dated. Full details,
including treatment dates, name, address and telephone number of
attending physician, diagnosis, prognosis and present course of
treatment must be provided for all yes answers in Part 2.
3. All family members must apply for the same plan and
Deductible.
4. Annual premiums may be paid by check, money order or credit card
authorization. Insurance Services of America will not accept checks
or money orders for quarterly or semi-annual payment modes. These
payment modes are only accepted with pre-authorization to debit your
credit card on the due date of your premium.
5. If you are a US citizen, or if you are in the US now, you must
provide your anticipated date of departure from the US and your
anticipated length of residence outside the US.
6. If you would like to have your Certificate overnighted to you
after approval, an additional delivery fee will be added to your
premium.
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Copyright © 2003, Multinational Underwriters, Inc. All
rights reserved.
If you have questions, please call
or email us |
