The Complete
International Student Health Insurance Plan
Protecting Students around The World
Wherever they are travelling, it’s important that students are protected from unforeseen circumstances. One simple step, taken when
planning for the fun of learning abroad, can make all the difference in how their future may turn out.
The Caledon Insurance Group, with its extensive experience in identifying the right plan for
the right situation or custom-creating the right one, is affiliated with some of Canada’s largest
plan providers. Take a moment to review the following information.
Why Student Coverage when you are studying in Canada
An accident or illness can happen to anyone, anywhere, anytime. If you are planning to study in Canada, you need extended health
insurance coverage. Bear in mind that a single night in a hospital can cost in excess of $10,000!
Inbound Student Medical Insurance
Insurance coverage managed by: The Destination: Travel Group Inc.
Insurance is underwritten by Industrial Alliance Pacific Insurance and Financial Services Inc.
Claims and Assistance services provided by OneWorld Assist Inc.
Plan Highlights for the Student Medical Insurance
• $2,000,000 of emergency health coverage
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Hospital confinement up to semi-private room
Medical treatment by a physician
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Non emergency treatment up to a maximum of $3,000
X-ray and diagnostic laboratory procedures
Ambulance services including mountain and sea rescue
Psychiatric/Psychological treatment: Up to $1,000 for outpatient care and $25,000 for in-patient hospitalization
• Tuberculosis testing and Vaccination up to $100
Key Features
• 24/7 Worldwide Assistance
• No co-insurance, 100% payment
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Prescription drugs up to a maximum of $10,000 to a limit
of 30-day supply
Private duty nursing up to a maximum of $15,000
Paramedical services up to a maximum of $600 per
profession
Emergency Air Transportation
Treatment of Dental Accident up to $5,000
Relief of dental pain up to a maximum of $600
Family Transportation up to $5,000 ($150 per day up to
$1,500 for meals and accommodation)
Accidental Death and Dismemberment up to $10,000
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No Deductible
Pre-existing conditions covered if stable 90 days prior to
departure date
Travel worldwide during the period of coverage is valid as long as the majority of the period of coverage is spent in Canada.
Medical Expenses will not be covered in your home country.
Rate: $ 1.55/day - $500/year - $472.50/10 months
** Certain exclusions, limitation and conditions may apply. For complete details, refer to the policy wording which is available upon request.
Contact us at:
Caledon Insurance Group
Brian Tuohy
Tel: 519-853-5012 or 1-888-806-7866
Fax: 519-853-0383
[email protected]
RESET FORM
STUDENT MEDICAL INSURANCE - APPLICATION
Section I – Applicant Information
Last Name
First Name
Date of Birth (dd/mm/yy)
Gender
F
Section II – Parent Information
Parent Name:
Student Address in Canada (if not Appleby College) :
City:
Province:
Postal Code:
Phone #:
Parent’s e-mail address:
Section II – Trip Information
Effective Date (dd/mm/yy):
Expiry Date (dd/mm/yy):
Date of application (dd/mm/yy):
Rate:
$ 1.55 per day
$500/year
$472.50/10 months
Section III – Payment Type
Visa
Master Card
Card Number:
Amex
Expiry (mm/yy):
Cardholder’s Name:
Cardholder’s signature (if mail or fax):
You can submit your application once completed
by fax, mail or email to:
Caledon Insurance Group
67 Church Street West
Acton, ON
L7J 1K1
Tel: 519-853-5012 or 1-888-806-7866
Fax: 519-853-0383
[email protected]
M