Trip Cancellation and Interruption
Terms and Conditions
Effective 4/1/17
Sometimes the unexpected happens and Your travel arrangements don’t go as planned. You’ve done a
great job preparing for Your Trip. But what if You have to cancel Your trip because of the death of an
Immediate Family Member? What if the airline You booked Your flight through declares bankruptcy?
Fortunately, Trip Cancellation and Interruption benefits are available to help You with these unforeseen
circumstances that could disrupt Your travel plans.
Trip Cancellation and Interruption benefits pay up to two thousand dollars ($2,000.00) per Insured
Person for the non-refundable Common Carrier ticket(s) that You paid for with Your covered Account
and/or rewards programs associated with Your covered Account. You, Your spouse (or Domestic Partner)
and Your Dependent Children are eligible for coverage if You charge the entire cost of the Trip using Your
Account, less redeemable certificates, vouchers, or coupons, or rewards program associated with Your
covered Account.
The Trip Cancellation or Interruption must be caused by or result from:
1. The death, Accidental Bodily Injury, disease or physical illness of You or an Immediate Family
Member of the Insured person; or
2. Default of the Common Carrier resulting from financial insolvency.
The death, Accidental injury, disease or physical illness must be verified by a Physician and must prevent
You from traveling on the trip.
Note: Common Carriers may issue a credit voucher for the value of the unused ticket. A fee may be
associated with changing or cancelling the ticket. Reimbursement of fee may be eligible at time of Loss.
Most Common Carrier credit vouchers expire in one year. Proof of unused credit voucher can be
submitted for reimbursement after expiration. Payment will not exceed either the actual Non-
Refundable amount paid by the Insured Person for a Common Carrier passenger(s) fare(s), or up to
two thousand dollars ($2,000.00).
The following exclusions apply to financial services Common Carrier Trip
Cancellation/Trip Interruption only
No Trip Cancellation or Interruption benefits will be paid for Loss caused by or resulting from:
• A Pre-existing Condition
• Accidental Bodily Injuries arising from participation in interscholastic or professional sports
events, racing or speed contests, or uncertified scuba diving
• Cosmetic surgery, unless such cosmetic surgery is rendered necessary as a result of a Loss covered
under this policy
• The Insured Person or an Immediate Family Member being under the influence of drugs (except
those prescribed and used as directed by a Physician) or alcohol
• The Insured Person or an Immediate Family Member: a) traveling against the advice of a
Physician; or b) traveling while on a waiting list for specified medical treatment; or c) traveling for
the purpose of obtaining medical treatment; or d) traveling in the third trimester (seventh month
or after) of pregnancy
• Suicide, attempted suicide, or intentionally self-inflicted injuries
• Declared or undeclared war, but war does not include acts of terrorism
• An Insured Person's emotional trauma, mental or physical illness, disease, pregnancy, childbirth
or miscarriage, bacterial or viral infection or bodily malfunctions, except physical illness or
disease which prevent the Insured Person from traveling on a Covered Trip. This Exclusion
does not apply to Loss resulting from an Insured Person's bacterial infection caused by an
Accident or from Accidental consumption of a substance contaminated by bacteria.
How to file a Trip Cancellation or Interruption claim
Within twenty (20) days of the Trip Cancellation or interruption or as soon as reasonably possible, You
must provide (written) claim notice to the Plan Administrator. The Plan Administrator will ask You for
some preliminary information and send You the appropriate claim forms. Failure to give notice
within twenty (20) days will not invalidate or reduce any otherwise valid claim, if notice is
given as soon as reasonably possible.
When the Plan Administrator receives notice of a claim, the Plan Administrator will send You forms for
giving proof of Loss within fifteen (15) days. If You do not receive the forms, You should send the Plan
Administrator a written description of the Loss.
Answers to specific questions can be obtained by writing to the Plan Administrator. To make a claim,
please contact the Plan Administrator:
cbsi Card Benefit Services
550 Mamaroneck Avenue, Suite 309
Harrison, NY 10528
For faster filing, to check the status of the claim and securely upload documents visit
www.myclaimsagent.com/cbs
Please return Your completed and signed claim form and the documents listed below as
soon as possible to the Plan Administrator:
• A copy of Your monthly billing statement or the travel itinerary (showing the last four [4] digits of
the Account number) confirming the Common Carrier ticket was purchased using the covered
Account and/or rewards programs associated with Your covered Account.
• If more than one method of payment was used, please provide documentation as to additional
currency, voucher, points or any other payment method utilized.
• Confirmation of the non-refundable amounts for the unused Common Carrier tickets and/or
travel vouchers
• Confirmation that the tickets were cancelled with the Common Carrier
• A copy of the travel itinerary showing the passenger names and ticket cost
• Confirmation of the reason for the Trip Cancellation; (completed attached physician statement,
confirmation of death of Immediate Family Member or documentation confirming any other
cause of Loss)
• A copy of the cancellation or refund policies of the Common Carrier, Tour Operator or Travel
Supplier
Additional Travel Accident benefit
As a cardholder, You, Your spouse (or Domestic Partner), and unmarried Dependent Children will be
automatically insured up to one thousand dollars ($1,000) for Accidental Loss of life, limb, sight, speech,
or hearing. This benefit applies while:
1. Riding as a passenger in or entering or exiting any Common Carrier; or
2. Riding as a passenger in, entering, or exiting any conveyance licensed to carry the public for a
fee and while traveling to or from the airport:
a. Immediately preceding the departure of a Common Carrier on which the Insured
Person has purchased passage; and
b. Immediately following the arrival of a Common Carrier on which the Insured Person
was a passenger; or
3. At the airport, terminal or station, at the beginning or end of the Common Carrier Covered
Trip.
Covered Loss
Benefit Maximum
Accidental Loss of Life, two or more Members, sight of both
eyes, speech and hearing or any combination thereof
$1,000.00
Accidental Loss of one Member, sight of one eye, speech or
hearing
$500.00
Accidental Loss of the thumb and index finger of the same
hand
$250.00
Loss means, with respect to a hand, complete severance through or above the knuckle joints of at least
four (4) fingers on the same hand or at least three (3) fingers and the thumb on the same hand; with
respect to a foot, complete severance through or above the ankle joint. The Company will consider it a
Loss of hand or foot even if the fingers, thumb, or foot is later reattached.
In order to be eligible for this additional coverage, the entire cost of the Common Carrier passenger
fare(s), less redeemable certificates, vouchers, or coupons, must be charged to Your covered Account
and/or rewards programs associated with Your covered Account during the policy period. If the purchase
is not made prior to the Insured Person’s arrival at the airport, coverage begins at the time the entire cost
of the Common Carrier passenger fare is purchased.
This travel accident benefit is provided to eligible cardholders. Your financial institution pays the
cardholder’s premium as a benefit of the card membership.
The Loss must occur within one year of the Accident. The Company will pay the single largest applicable
Benefit Amount. In the event of multiple Accidental deaths per Account arising from any one Accident,
the Company’s liability for all such Losses will be subject to a maximum limit of insurance equal to two
times the Benefit Amount for Loss of life. Benefits will be proportionately divided among the Insured
Persons up to the maximum limit of insurance.
The Loss of Life benefit will be paid to the Beneficiary designated by You. If no such designation has been
made, that benefit will be paid to the first surviving Beneficiary in the following order: a) Your spouse, b)
Your Children, c) Your parents, d) Your brothers and sisters, e) Your estate. All other indemnities will be
paid to You.
The following exclusions apply to the Travel Accident benefit
Loss caused by or resulting from:
• An Insured Person's emotional trauma, mental or physical illness, disease, normal pregnancy,
normal childbirth or elective abortion, bacterial or viral infection, or bodily malfunctions. This
exclusion does not apply to Loss resulting from an Insured Person's bacterial infection caused
by an Accident or from Accidental consumption of a substance contaminated by bacteria
• Suicide, attempted suicide, or intentionally self-inflicted injuries
• Declared or undeclared war, but war does not include acts of terrorism
• An Accident occurring while You are in, entering, or exiting any aircraft while acting or training as
a pilot or crew member (does not apply if You temporarily perform pilot or crew functions in a
life-threatening emergency)
How to file a Travel Accident benefit claim
Within twenty (20) days of the accident or as soon as reasonably possible, You must provide (written)
claim notice to the Plan Administrator. The Plan Administrator will ask You for some preliminary
information and send You the appropriate claim forms. Failure to give notice within twenty (20)
days will not invalidate or reduce any otherwise valid claim, if notice is given as soon as
reasonably possible.
When the Plan Administrator receives notice of a claim, the Plan Administrator will send You forms for
giving proof of Loss within fifteen (15) days. If You do not receive the forms, You should send the Plan
Administrator a written description of the Loss.
Answers to specific questions can be obtained by writing to the Plan Administrator. To make a claim,
please contact the Plan Administrator:
cbsi Card Benefit Services
550 Mamaroneck Avenue, Suite 309
Harrison, NY 10528
Please return Your completed and signed claim form and the documents listed below as
soon as possible to the Plan Administrator:
• A copy of the police report
• A completed medical authorization form for each treating medical facility
• Copy of the certificate of death, if applicable
• A copy of the travel itinerary
• A copy of the credit card statement reflecting the purchase, verification of the cardholder's name
and the first six digits of the credit card number.
To view the status of your claim and to securely upload documents, visit
www.myclaimsagent.com
Or mail the completed and signed claim form and all required documents to:
Claim Benefit Services
P.O. Box 459084
Sunrise, FL 33345
If You choose to mail Your documents, please send a copy of Your documents and retain
the originals for Your records. Claim Benefit Services is unable to return any submitted
documents. You will be contacted by a claim adjuster if additional information or
documentation is required.
Definitions for Trip Cancellation/Interruption and Travel Accident Benefits
Accident or Accidental means a sudden, unforeseen, and unexpected event which: happens by chance;
is independent of illness and disease and is the direct source of Loss.
Accidental Bodily Injury means Bodily Injury, which: 1) is Accidental; 2) is the direct cause of a Loss;
and 3) occurs while the Insured Person is insured under this policy, which is in force.
Account means Your credit or debit card Accounts.
Benefit Amount means the Loss amount at the time the entire cost of the passenger fare is purchased
with an eligible Account and/or rewards programs associated with Your covered Account.
Common Carrier means any licensed land, water or air conveyance operated by those whose
occupation or business is the transportation of persons or things without discrimination and for hire.
Covered Trip means travel on a Common Carrier when the entire cost of the passenger fare for such
transportation, less redeemable certificates, vouchers, or coupons, has been purchased with an Insured
Person’s covered card Account and/or rewards programs associated with Your covered Account issued by
the Policyholder.
Dependent Child or Children means those Children, including adopted Children and those Children
placed for adoption, who are primarily dependent upon the Insured Person for maintenance and support,
and who are: 1) under the age of nineteen (19), and reside with the Insured Person; 2) beyond the age of
nineteen (19), permanently mentally or physically challenged, and incapable of self-support; or 3) under
the age of twenty-five (25) and classified as full-time students at an institution of higher learning.
Domestic Partner means a person who is registered as a Domestic Partner or legal equivalent under
laws of the governing jurisdiction, or who: 1) is at least 18 years of age and competent to enter into a
contract; 2) is not related to the Primary Insured Person by blood; 3) has exclusively lived with the
Primary Insured Person for at least twelve (12) consecutive months. 4) is not legally married or
separated; and 5) has with the Primary Insured Person at least two (2) of the following financial
arrangements: a) a joint mortgage or lease; b) a joint bank account; c) joint title to or ownership of a
motor vehicle or status a joint lessee on a motor vehicle lease; or d) a joint credit card account with a
financial institution.
Immediate Family Member means the Insured Person's: 1) Spouse or Domestic Partner; 2) children
including adopted children or stepchildren; 3) legal guardians or wards; 4) siblings or siblings-in-law; 5)
parents or parents-in-law; 6) grandparents or grandchildren; 7) aunts or uncles; 8) nieces and nephews.
Immediate Family Member also means a Spouse's or Domestic Partner's children, including adopted
children or step children; legal guardians or wards; siblings or siblings-in-law; parents or parents-in-law;
grandparents or grandchildren; aunts or uncles; nieces or nephews.
Insured Person means the individual or entity to whom the Policyholder has issued an Account, as well
as authorized users of the Account registered with the Policyholder. Insured Person also means the
Insured Person’s Spouse or Domestic Partner and Dependent Children.
Member means hand or foot.
Pre-existing Condition means Accidental Bodily Injury, disease, or illness of the Insured Person or
Immediate Family Member of the Insured Person which occurs or manifests itself during the sixty (60)
day period immediately prior to the purchase date of a Common Carrier passenger fare(s). Disease or
illness has manifested itself when either: 1) medical care or treatment has been given; or 2) there exists
symptoms which would cause a reasonably prudent person to seek medical diagnosis, care or treatment.
The taking of prescription drugs or medication for controlled (continued) condition throughout this sixty
(60) day period will not be considered to be a manifestation of illness or disease.
Trip Cancellation means the cancellation of Common Carrier travel arrangements when the Insured
Person is prevented from traveling on a Covered Trip on or before the Covered Trip departure.
Trip Interruption means the Insured Person’s Covered Trip is interrupted either on the way to the
Covered Trip point of departure or after the Covered Trip departure.
You or Yours means an Insured Person who purchase their trip to the Insured person’s covered Account
and/or rewards programs associated with the Insured Person’s covered Account.
Additional provisions for Trip Cancellation and Interruption
• As a handy reference guide, please read this and keep it in a safe place with Your other insurance
documents.
• This description of coverage is not a contract of insurance but is simply an informative statement
of the principal provisions of the insurance while in effect. Complete provisions pertaining to this
plan of insurance are contained in the master policy, on file with the Policyholder: BNY Midwest
Trust Company as trustee of the Chubb Financial Institution Group Insurance Trust for the
Account of participating financial institutions. Policy #: 6478-07-74
• Signed or pinned transactions are covered as long as You use Your eligible card to secure the
transaction.
• You shall do all things reasonable to avoid or diminish any Loss covered by this benefit. This
provision will not be unreasonably applied to avoid claims.
• If You make any claim knowing it to be false or fraudulent in any respect, no coverage shall exist
for such claim, and Your benefit may be cancelled. Each cardholder agrees that representations
regarding claims will be accurate and complete. Any and all relevant provisions shall be void in
any case of fraud, intentional concealment, or misrepresentation of material fact.
• No legal action for a claim may be brought against the Provider until sixty (60) days after the
Provider receives Proof of Loss. No legal action against the Provider may be brought more than
two (2) years after the time for giving Proof of Loss. Further, no legal action may be brought
against the Provider unless all the terms of the Guide to Benefits have been complied with fully.
• This benefit is provided to eligible cardholders at no additional cost. The terms and conditions
contained in this Guide to Benefits may be modified by subsequent endorsements. Modifications
to the terms and conditions may be provided via additional Guide to Benefits mailings, statement
inserts, statement messages or electronic notification. The benefits described in this Guide will
not apply to cardholders whose Accounts have been suspended or cancelled.
• Termination dates may vary by financial institutions. Your financial institution can cancel or non-
renew the benefits for cardholders, and if they do, they will notify You at least thirty (30) days in
advance. Federal Insurance Company (“Provider”) is the underwriter of these benefits and is
solely responsible for its administration and claims. The Plan Administrator provides services on
behalf of the Provider.
• After the Plan Administrator has paid Your claim, all Your rights and remedies against any party
in respect of this claim will be transferred to the Plan Administrator to the extent of the payment
made to You. You must give the Plan Administrator all assistance as may reasonably be required
to secure all rights and remedies.
• This benefit does not apply to the extent that trade or economic sanctions or other laws or
regulations prohibit the provision of insurance, including, but not limited to, the payment of
claims.
FORM #TRCAN – 2017 (04/17) TC-I
For more information about the benefit described in this guide, please contact the Plan
Administrator.
