All international assistance cases are coordinated by GEMS where our experience Customer Service team assesses the case and contacts the most appropriate assistance partner depending on the location.
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"Insurer" shall mean a licenced insurance company / health plan that contracts with GEMS for healthcare management services.
"Participant" shall mean an individual covered under the terms of an insurance policy issued by a company for whom GEMS is obligated to provide travel assistance services and for whom GEMS pays AML a fee as set forth herein.
Srvices To An Eligible Participant
In appropriate cases, AML shall arrange and pay for the following travel assistance services listed beiow within this paragraph for an Eligible Participant All services must be arranged and paid by AML; no claims for reimbursement are accepted:
(1) Medical Consultation. Evaluation and Referrals: Eligible Participants will have telephone access to operations center staffed twenty-four hours a day, every day of the year, with multilingual personnel for medical consultation, evaluation and referral to Western-trained physicians.
(2) Emergency Medical Evacuation: When an adequate medical facility is not available proximate to the Eligible Participant, as determined by the AML’s consulting physician and the Eligible Participant’s attending physician, AML will arrange transportation under appropriate medical supervision, by an appropriate mode of transport to the nearest medical facility capable of providing the required care.
(3) Medical Repatriation: AML will arrange for transportation under medical supervision to the Eligible Participant’s residence or to a medical or rehabilitation facility near the Eligible Participant’s residence when AML’s consulting physician and the Eligible Participant’s attending physician determines that transportation is medically necessary, at such time as the Eligible Participant is medically cleared for travel by AML's consulting physician and the attending physician,
(4) Hospital Admission Assistance: Assist America shall assist in either issuing a prompt financial guarantee to facilitate admittance to a foreign medical facility and/or validate Eligible Participant’s medical insurance; provided that the Eligible Participant commits in writing to repay all funds advanced for hospital admittance within forty-five (45) days of the date advanced.
(5) Medical Monitoring: Medical personnel will monitor Eligible Participant’s condition and will (i) stay in regular communication with the attending physician and/or hospital and (ii) relay necessary and legally permissible information to family members.
(6) Prescription Assistance: If an Eligible Participant needs replacement prescription medicine while traveling, AAAL helps with replacing the prescription, when possible and legally permissible and upon consulting with a treating physician; the Eligible Participant is responsible for the cost of the prescription and medicine.
(7) Emergency Message Transmission: AAAL will transmit and receive legally permitted emergency messages to and from family members and/or employer.
(8) Compassionate Visit: When an Eligible Participant will be hospitalized for more than five (5) consecutive days and is traveling without a companion, AAAL will arrange for a family member or personal friend to travel to visit the Eligible Participant by providing an appropriate means of transportation via economy carrier transportation as determined by AAAL. The family member or the personal friend is responsible to meet all visa and travel document requirements, if applicable.
(9) Care of Minor Childfren): One-way economy common carrier transportation, with attendants if required, will be provided to the place of residence of minor child(ren) when they are left unattended as a result of medical emergency or death of an Eligible Participant.
(10) Return of Mortal Remains: In the case of an Eligible Participant’s death, AAAL will arrange and pay for the return of mortal remains to an authorized funeral home proximate to the Eligible Participant’s legal residence.
(11) Interpreter and Legal Referrals: Upon request, provide referrals to interpreters, counselors or legal personnel.
(12) Lost Luggage or Document Assistance: AAAL helps Eligible Participant locate lost luggage, document, personal belongings or assist with the replacement of travel tickets.
(13) Pre-trip Information: AAAL offers Participants web-based and app-based country profiles that include visa requirements, immunization and inoculation recommendations, embassy and consulate information , country- specific details and security advisories as well other pertinent information for travel destinations.