General Terms and Conditions of Insurance

Transcription

1 Policy no Insurer: AGA International Tour Gallieni II 36, avenue du Général de Gaulle Bagnolet Cedex General Terms and Conditions of Insurance Activity covered: we cover board sports accidents recognised by the French Ski Federation: alpine ski, cross country skiing, speed skiing, grass skiing, pelle, freestyle, roller ski, biathlon, ski -jumping, Nordic combined, snowboarding, telemark, as well as sledging, amateur skating on the ski area for the whole duration of your insured stay. In the case of off-piste activities you will be covered as long as the off-piste activity is practised within the skiing area. Methods of subscribing: the cover is acquired once the policyholder has settled the insurance premium. The items of cover apply in mainland France and adjacent countries, as part of a leisure activity limited to 60 consecutive days. This contract is governed by the French Insurance Code. THE COVER ASSISTANCE TO PERSONS In the event of a covered accident 1 - Reimbursement of search and rescue costs and urgent medical transport: Refund of operations carried out by rescuers or rescue bodies active specially with the aim of searching for the insured party in a place lacking all means of organised aid and/or similar (real costs in mainland France, up to 15,000 per insured person per loss in a neighbouring country). 2 - When repatriation is necessary, after approval by our medical advisor: a) if medical care cannot be carried out on site, organisation of and payment for repatriation to the medical centre suitable for your state of health or to your home. b) organisation of and payment for the return home of children under the age of 15 who were accompanying you if no adult is on site helping them and if your repatriation takes place more than 24 hours before the initial date of return. 3 - Additional refund of medical expenses up to 15,000 per insured person and period: After payment by your basic health insurance body, your health insurance company or any other insurance or provident organisation. Only care provided in the context of medical organisations closest to the site of the accident and the most suitable for your state of health, or care on your return home, prescribed and begun within 15 days following the accident covered will be reimbursed. (Absolute excess: 46 per claim) 4 - We make a driver available for your return home if your state of health does not allow you to drive your car to return to your home, and none of the passengers accompanying you can take your place. Version 09/12/2011 Page 1 of 5

2 5 - in the event of the decease of an insured person: following a covered accident, payment for: a) costs of transporting the body from the place to which the body has been taken following the decease to the burial place in France or a neighbouring country b) funeral expenses required for transport (up to 1,525 per insured person ). c) additional costs for transport for insured persons accompanying you insofar as the means of transport originally planned for their return can no longer be used because of this repatriation. Services which have not been requested in advance and which have not been organised by us do not entitle you to a refund or a compensation payment. INSURANCE COVER 1 - Refund of ski lift passes and courses: - In the event of an accident covered with hospitalisation or medical repatriation by Mondial Assistance or of temporary disability with medical evidence preventing the practise of the activity. - In the event of closure of more than 80% of the skiing area * as a result of lack or excess of snow or of an unusual climactic event (storm, hurricane, cyclone) preventing the activity. 2 - Reimbursement of hiring of replacement equipment : - In the event of damage to board sport equipment hired from SKIMIUM, while practicing the activity. You must be able to present the invoice for the hire of the damaged equipment, the damage report drawn up by SKIMIUM, and the invoice for hire of the replacement equipment. Cover amounts Indemnity in proportion to the period not enjoyed up to 300 per insured person and insurance period. * An excess of one day will be deducted from your indemnity in the event of closure of the skiing area. EXCLUSIONS COMMON EXCLUSIONS TO ALL TYPES OF COVER 1. civil or foreign wars, riots, popular movements, strikes, hostage taking. 2. effects of a nuclear origin or caused by any source of ionising radiation. 3. intentional acts and wilful misconduct on the part of the insured person. 4. handling of weapons. 5. all forms of natural disaster (avalanche). 6. the consequences of your consumption of alcohol, or any narcotic substance, listed in the French Public Health Code, not medically prescribed. 7. conscious failure to comply with official prohibitions and failure to respect recognised safety rules. 8. ILLNESS otherwise provided for, including epidemics and pandemics. 9. Use by the insured person of a motorised engine. 10. the practise of a sport as a professional, participation in competitions or preparatory training subject to prior regulatory authorisation or to legally required insurance obligation. 11. unstabilised previous pathologies under treatment which have led to hospitalisation within 6 months previous to the subscription. Version 09/12/2011 Page 2 of 5

3 12. any expenses incurred without the approval of the Mondial Assistance Assistance Department. The exclusions specific to the cover expenses: Additional reimbursement of medical 13. Complications in pregnancy. 14. cost of private rooms and ancillary hospitalisation costs. 15. The costs of prosthetics, optical, dental and dental implant costs. 16. services, care, treatment or operations not medically prescribed not resulting from a medical urgency and not recognised by Social Security. WHAT YOU MUST DO IN THE EVENT OF A CLAIM 1. DO YOU NEED ASSISTANCE? Contact us by telephoning (+33) so that our doctors can access the medical information. 2. TO DECLARE AN INSURED LOSS? Contact us by telephone on from Monday to Friday, from to or by to reglement.assistance@mondial-assistance.fr within five working days (48 hours in the event of theft) following the occurrence of the loss or accident, unless in the event of act of God, failing which you will not be covered. reglement.assistance@mondial-assistance.fr If you fail to observe this deadline and we incur a loss because of your late declaration, you lose all rights to indemnity. In the event of theft: report the crime within 48 hours, to the nearest police authorities to the crime location. The insured person must send Mondial Assistance the evidence requested which enables us to establish that your claim is well founded. Version 09/12/2011 Page 3 of 5

4 DEFINITIONS THE INSURED PERSON: persons residing in the European Union or Switzerland and referred to in the policy by the word you. SKIING AREA: an area of mountain accessible from mechanical ski lifts with ski slopes and authorised off-piste skiing zones. SPORTS ACCIDENT: any unintentional bodily injury to the insured person caused by the sudden action of an external cause. Cardiovascular and respiratory pathologies are treatable as accidents. CONSOLIDATION: stabilisation of wounds which can leave definite after effects, certified by a medical authority. MEDICAL COSTS: consultation fees, medically prescribed pharmaceutical, surgical, practitioner's and hospital costs following a covered accident, and which are necessary for the diagnosis and treatment of a pathology justifying intervention by Mondial Assistance. EXCESS: the share in the damage payable by yourself when the claim is settled. CLAIM: all harmful consequences of an event leading to the application of one of the types of cover. All damages arising from the same initial cause constitute one and the same loss. SUBSCRIBER: the signatory of the policy for the cover insured, who thereby undertakes to pay the insurance premium. Version 09/12/2011 Page 4 of 5

5 ADMINISTRATIVE PROVISIONS Procedures for taking out cover, taking effect and its termination: the policy must be purchased on the le site web site. Cover takes effect from the first day of the stay covered by the policy, and declared on the site. Cover ceases as of right on the final day of the stay declared on the site. Regulatory framework within which our assistance services are provided: we act in compliance with national and international laws and regulations and our services are subject to approval obtained from the competent authorities whose rules locally apply. We cannot be held liable for delays or hindrance to the performance of the agreed services following a case of force majeure or any other act of God such as strikes, riots, popular movements, restrictions on free circulation, sabotage, terrorism, civil or foreign wars, the consequential effects of a radioactive source. Cumulative insurance: if you are covered for the same risks with other insurance companies, you must inform us of this, providing us with their details and their cover, cf. Article L of the French insurance code. You can obtain compensation for your damage by contacting the insurance company of your choice. Subrogation in your rights and actions: in consideration for the payment of indemnity and, up to its limit amount, we become beneficiaries of the rights and actions that you own against anyone liable for the loss, cf. Article of the French Insurance Code). Penalties if you make a false declaration when taking out the policy: any non-disclosure or false statement, any omission or inaccuracy in the statement of the risk is penalised by Articles L and L of the French Insurance Code. Penalties if you make an intentionally false statement at the time of the claim: any fraud, nondisclosure or intentional false statement by you about the circumstances or consequences of an incident will result in the loss of all entitlement to services or compensation for this incident. Time limitation: any legal action arising from the policy is subject to a time limitation period of 2 years from the event, cf. the provisions of Articles L and L of the French Insurance Code. Complaints handling procedures: In the event of a claim the Insured may write to: MONDIAL ASSISTANCE FRANCE SAS - Service Traitement des Réclamations- TSA (F) Paris cedex 08. A response will be provided within 2 months of the date of receipt of the claim. In the event of a persistent disagreement the Insured may submit the case to a mediator: Médiateur de la Fédération Française des Sociétés d Assurance (F FSA) - BP Paris cedex 09. Insurance policy n taken out by SKI BREAK SAS capital 250, RCS Annecy B avenue Joseph Thoret PASSY-MON BLANC,with MONDIAL ASSISTANCE FRANCE SAS, capital 7,584, RCS Paris , rue de Londres Paris - Orias n ( MONDIAL ASSISTANCE is subject to control by the Autorité de Contrôle Prudentiel (French insurance industry regulatory authority) - 61 rue Taitbout (F) Paris Cedex 09. Version 09/12/2011 Page 5 of 5