Special terms of NSA Garantie type "Elite", policy number 469,271, hereinafter "Elite 1". Excess: % 5) SPECIMEN.
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1 :06:15 Special terms of NSA Garantie type "Elite", policy number 469,271, hereinafter "Elite 1". Guarantee Details Policy nb: 469,271 Guarantee type: Elite 4x4 surcharge: Covered components Guarantee name: Elite 1 Turbo or supercharger surcharge: Covered components Guarantee start date: 23/07/2015 Maximum cover: 6, EUR 3) Guarantee end date: 22/07/2016 Maximum for engine failure: 6, EUR 4) Excess: % 5) Waiting period: 30 days 1) Minimum excess: EUR 5) Labour excluded: Labour Included 2) 1) In case a waiting period has been agreed all failures or defects of the vehicle occurring after the start of guarantee are not covered during this defined period. 2) If labour has been excluded, the insurer shall only cover the costs of spare parts. Any labour is excluded. 3) The limit of coverage is the vehicle's time value at the time of occurrence of the insured event not exceeding the maximum sum insured (settlement ceiling includes VAT). 4) Applies only if the engine is beyond repair and has to be replaced as a whole unit. 5) For each insured event the determined settlement amount is reduced by a settlement amount excess. This shall be deducted from the maximum cover even if the settlement ceiling has been exceeded. Beneficiary (Vehicle Owner) Name / Company: MUSTER Telephone Nb: Address: Musterstrasse Mobile: Post code / Town: Vehicle D-0000 Musterstadt Assignability: Non-assignable guarantee Make: Muster Initial registration date: 01/01/2015 Model: Mustermodell Kilometer reading a start: 10,000 km Chassis Nb: XXX Engine displacement: 1,200 cm2 Transmission: Automatic / Tiptronic Weight category: 3,500 kg 6) Fuel type: Unleaded Replacement value category: 100,000 EUR 7) Licence number: 6) The insurance is applicable to cars up to the contractually agreed weight category. 7) The insurer does not indemnify damages of vehicles with a replacement value exceeding the replacement value category. Breakdown Service - Replacement Vehicle Cover Coverage: Yes Replacement vehicle/day: EUR 9) Repatriation: Europe-wide 8) Maximum per event: EUR 9) Towing: EUR 10) 8) Repatriation of the vehicle organised by the insurer if it cannot be repaired within 48 hours. These costs shall only be taken over up to the time value of the vehicle to be repatriated. 9) Rented car of the same class or passengers' cost of return journey to the domicile if the vehicle breaks down and cannot be repaired within 48 hours. The maximum indemnity per event is limited. Entitled to benefits are the car owner or the authorised drivers and passengers (the respective first applicant). Hitchhikers are generally excluded. Guarantee types LKW Tuning and LKW are not covered. 10)Towing to the seller of the vehicle, to a concessionaire or an official authorised vehicle brand dealer.
2 :06:15 Covered components and parts Engine Pistons, Cylinder liners, Bolts, Rings, Connecting rods, Crankshaft, Crankshaft gear, Layshaft gear, Oil pump, Driving wheel, Cylinder head gasket, Cylinder block, Camshaft, Tappet, Rocker arm, Camshaft sprocket, Induction manifold, Exhaust manifold, Cylinder head, Valves, Valve stem guides, Carburettor, Crankcase, Oil cooler, Oil sump, Oil pressure switch, Air flow sensor, Air mass sensor, Knocking sensor, Sensors, Bearings, Idle control motor Not insured components and parts Engine Distribution system including timing belt and chain Turbo / Supercharger (Option) Turbo, Compressor, Intercooler, Assumption of the damage up to 100'000 km max. 4x4 (Option) Transfer gear-box, Viscous coupling, Differential lock Mechanical Transmission Pinion, Gearshift forks, Sliding sleeve, Axle drive shaft, Transmission main shaft Automatic Transmission Shafts, Planet wheel kits, Discs, Belts, Valves, Oil pump, Control unit, Safety valves, Assumption of the damage up to 100'000 km max. Fuel System Fuel pump, Fuel injection pump, Fuel pressure regulator Limited-slip Differential Differential, Pinion, Wheel bearing Axle Drive Cardan shafts, Cardan shaft bearings, Axle drive shafts, Electronic control devices Steering System Power steering pump, Mechanical steering, Power steering Brakes Servobrake, Master cylinder, Vacuum pump, Brake pressure regulator, Brake pressure reducer, ABS, ABS control unit, ASR Suspension Lower and upper rocker bars, Suspension arm rings, Axles and suspensions, Steering swivel pins and rings, Transverse links, Track rods Electrical System Alternator, Starter, Windscreen wiper motor, Sunroof motor, Central locking system motor of the doors, Ignition coil, Electronic control unit Cooling System Water pump, Cooler, Thermostat, Electric fan motor, Visco-static cooling fan, Heating fan Air Conditioning Compressor, Vaporizer, Condenser Chassis MacPherson strut unit, Strut mounting, Height control, Stabiliser Electronics Alarm system, Digital engine electronics, Car computer, ESP, Multi-functional display Comfort options Speed control, Seat adjuster, Seat heater, Heatable exterior mirrors, Airbag, Immobiliser Mechanical Transmission Body, Synchroniser discs Brakes ABS sensors Suspension Ball pins, Silentbloc Comfort options Stereo equipment (radio, cassette and CD player), CD changer, TV equipment, Satellite control, Loudspeakers, Amplifier, Antennas
3 Exhaust Catalyser, Lambda sensor Accessoires :06:15 Seals, Sealing studs, Hoses, Feed lines, Metal or rubber lines, Electric lines, Oil seal, Insulating rubber Additional general exclusions can be taken from the NSA Garantie "Helvetia" General Terms and Conditions of Insurance for NSA Guarantees. Contract basis: Application dated 23/07/2015 and General Conditions of Insurance for NSA guarantees Elite 1. Execution and delivery date: 23/07/2015. Insurance premiums are exempt from sales tax: Sales tax identification number DE Note: Please see instructions and explanations in the insurance policy on the back of the insurance policy and in the Appendices. These are part of the contract. "Helvetia" Versicherungs-Aktiengesellschaft in Deutschland
4 NSA Garantie "Helvetia " (hereinafter "the Insurer") General Terms and Conditions of Insurance for NSA Guarantees. 1. Insured objects and risks 2. Non-insured objects / Exclusions 3. Extent of indemnity, excess 4. Payment of the indemnity, deadlines 5. Term and Termination 6. Incidental obligations of the insured 7. Release from obligation to perform in case of non-observance of an incidental obligation 8. No obligation to pay for particular reasons 9. Place of jurisdiction 10. Final provisions 1 Insured objects and risks 1. Insured objects Insured are the standard parts exhaustively listed in the special terms of the respective policy (hereinafter "tariff terms") of the motor vehicle detailed in the application registered in Switzerland, a neighbouring country or a member state of the European Union (incl. Liechtenstein, enclaves of Büsingen and Campione d'italia) and provided with a valid operating licence. 2. Obligation to pay, definition of claim The insurer shall indemnify if one of the insured parts directly loses its correct operation within the insured period (damage). There is no obligation to pay if the failure to function properly has been caused by a part Non-insured. durch ein nicht versichertes Teil verursacht worden ist. 2 Non-insured objects / Exclusions 1. Non-insured risks The insurer will not indemnify damages without taking into consideration other concurrent causes a) to vehicles used even temporarily during the insured period commercially or as official vehicles. b) caused to the car by all kinds of external hazards such as I. accidents (an event suddenly acting directly from the exterior with mechanical force) and all kinds of undue force; II. misappropriation (in particular theft, unauthorised use, robbery, embezzlement), events such as storm, hail, lightning, animals, earthquakes or floods as well as water, frost, scorching, fire and explosion; III. all kinds of wartime events, civil war, civil commotion, vandalism, terrorism, confiscation or sovereign impacts. c) caused by the insured's or the driver's fault, in particular, neglect of the operating manual or non-observance of the indicating instruments (temperature indicator, oil pressure gauge, warning light, boost pressure indicator), improper malicious or wilful treatment (consequences can e.g. be damages caused by overheating or oil deficiency). d) caused by neglect of the maintenance instructions for the vehicle or use of inadequate lubricants or lubricants not approved by the vehicle manufacturer. e) caused by the installation of foreign or accessory parts not approved by the vehicle manufacturer or not professionally installed. f) caused by excessive wear and tear of the vehicle or of parts of the vehicle. g) caused by widespread failure, design failure and manufacturing imperfections or for which a third party is liable as a manufacturer, supplier or contractor. h) for which a third party (even insurances) is liable for different guarantee, insurance or assumption of costs promises or is not liable because of the insured's fault. i) caused by changes of the vehicle control or computer systems regardless of the transmission path. (does not apply to the Tuning guarantee class) j) caused by participation in driving events with a competitive character or by the associated driving classes or because the admissible axle or trailing load or total weight fixed by the vehicle manufacturer were exceeded. k) caused by the operation of an object visibly needing repair unless the damage is proven not to be related to the repair requirement or the object was repaired if only provisionally at the time of the damage with the insurer's consent. l) caused by a crack of a hose or a seal of the oil or cooling system (subsequent damages). m) where somebody - the insured or somebody else with the insured's knowledge - tried to deceive with regard to facts important for the amount and cause of the damage. n) which occurred already prior to concluding, entering and legal validity of the guarantee agreement. 2. Non-insured objects Non-insured are a) The components and parts excluded in the tariff terms. b) Parts not approved by the vehicle manufacturer, in particular, components without a manufacturer part number. c) Parts subject to wear, i.e., vehicle parts which are subject to wear when correctly operating, in particular, brake pads, discs, tires, shock absorbers, drum brakes, luminaires, ball joints, flywheel and couplings. d) Operating supplies, in particular, fuel, chemicals, oils, greases and other lubricants, coolants and antifreeze, hydraulic and windscreen wiper fluids. e) Components of the car body incl. hardtop, convertible soft top, wings, windows, windscreen, headlamps and headlamp lenses, windscreen wipers, mirrors, rims and hub caps. f) Parts belonging to the vehicle interior decoration, in particular, the controls and instruments, seats, seat upholstery. g) Non-motorised vehicles which are attached to or towed by the insured vehicle. 3. Non-insured damages and work Not replaced are
5 a) Direct or indirect or subsequent damages (e.g. overnight accommodation expenses, indemnity for lost use e.g. in case of delayed spare part procurement or external repair, subsequent damages of components Non-insured) unless expressly covered separately. b) Isolated defect and test analyses as well as adjustments. c) Damages due to lack of hardened valve seats / valve seat rings or valves not hardened (armoured). (Only applies to the gas guarantee class) d) Damages to the automatic transmission as far as they are a result of the omission to install an additional oil cooler. 3 Extent of indemnity, excess 1. Principle a) The insurer shall pay damages exclusively within the frame of these terms and conditions for technically necessary and actually accrued repair costs including all necessary insured modules. There will be no payment of estimated repair costs without actually carrying out the repair. b) The insurer reserves the right to deduct betterment owing to the repair measures. The amount of betterment has to be determined by an independent expert s office. c) Unless entirely waived in the tariff terms, labour costs are only reimbursed within the frame of this insurance according to the vehicle manufacturer's labour time reference values for removal and installation or in compliance with Eurotax 2. Time value repair The insurer always reserves the right to a time value repair. This comprises the installation of replacement and/or identical parts and also used parts instead of new original parts from the vehicle manufacturer. 3. Extent of indemnity, excess The extent of indemnification (maximum cover) and a possible excess can be taken from the tariff terms. 4. Service station In principle, the insured has to have the repair carried out in a qualified service station. However, the insurer reserves the right to have the repair carried out in a garage determined by him. 4 Payment of the indemnity, deadlines 1. Principle The indemnity becomes due when the insurer's findings regarding the reason and the amount of the claim have been finalized. In this connection, the principle mentioned in 3 (1) has to be considered. In particular, the indemnity cannot become due before the repair has actually been carried out. Maturity cannot occur either as long the indemnity cannot be determined with regard to the reason and the amount through the fault of the insured. 2. Deferred payment The insurer may defer payment; a) As long as there are official, penal or petty offences procedures pending against the insured or the driver of the vehicle because of this insured event. b) As long as there are doubts regarding the insured's authority to take receipt. 3. Assignment Prior to maturity of the indemnity claim the latter can only be assigned with the insurer's consent, the consent having to be given if requested for good reason.. 5 Term and Termination 1. Beginning and duration of insurance cover The guarantee agreement is concluded with the acknowledgement of the insurance application. As a rule this takes place when the insured receives the policy. The insurance contract is concluded for the duration indicated in the tariff terms. The insurance cover starts; a) If the tariff terms do not stipulate a waiting period, with the start of the contract, otherwise at the end of the agreed waiting period. b) At the earliest, however, with the payment of the premium indicated in the policy. 2. Maturity of the premium Regardless of any right of withdrawal, the premium is due immediately after the date of invoicing, at the earliest, however, with the start of the contract. If the insured does not pay promptly after the date defined in Sentence 1, the insurance cover will only start after payment has been effected. 3. Insurer's right to withdrawal in case of default If the premium is not paid at the due date decisive according to No. 2, the insurer may rescind the contract as long as payment has not been effected. Rescission is excluded if the insured is not liable for nonpayment. 4. Insurer's release from the obligation to perform If the insured does not pay the premium at the due date decisive for No. 2 the insurer shall not be obliged to perform for an insured event that occurred prior to the payment of the premium. Release from obligation to perform does not occur if the insured is not liable for non-payment. 5. Right of termination in case of an insured event a) After an insured event has occurred each of the parties to the contract may terminate the insurance contract. The notice of termination has to be given in text form to the other party to the contract and must be received by this party at the latest four weeks after payment or refusal of the indemnity. Any notice of termination of the insured shall become effective immediately after its receipt by the insurer unless another date is stipulated in the notice of termination. Any notice of termination of the insurer shall become effective four weeks after its receipt by the insured. b) In case of termination of the insurance contract before the end of the insurance term the insurer shall only be entitled to that part of the premium which corresponds to the period during which the insurance cover existed. 6 Incidental obligations of the insured 1. Incidental obligations prior to the insured event The insured has to have the maintenance work on the vehicle carried out in time at a garage authorised by the manufacturer pursuant to the recommendations and regulations of the vehicle manufacturer. Maintenance at other authorised garages than the above-mentioned requires prior consultation with the insurer. The insured must obtain confirmation of the maintenance carried out and present the certificate in case of a claim or upon request.
6 2. Incidental obligations after the insured event The insured must a) Take care that the damage is notified promptly in writing to the insurer and always before the start of damage inspection or repair work. b) Obtain from the insurer a written damage release/confirmation of cost coverage including approval number and wait for its receipt prior to the start of damage inspection or repair work. c) Permit inspection of the damaged object by a representative of the insurer at any time. Upon request the parts required for ascertainment of the damage and the causes of damage have to be handed over to him or the insurer. For this purpose, all defective parts replaced must be available in any case two months after issuance of the approval number. d) Give the insurer all necessary information such as maintenance documents or loss report forms in writing. e) Reduce the damage as far as possible and follow all reasonable directions of the insurer. f) Present the repair invoice within four weeks from the invoice date to the insurer. The invoice must disclose separately and correctly the work performed the part numbers, the spare part prices and the labour costs as well as the VAT. Upon the insurer's request the delivery notes of the spare parts also have to be presented. 7 Release from obligation to perform in case of non-observance of an incidental obligation 1. In case of deliberate non-observance of an incidental obligation by the insured the insurer shall be exempt from the obligation to perform. In case of grossly negligent non-observance of an incidental obligation the insurer shall be entitled to reduce its performance in proportion to the seriousness of the insured's fault. The insured shall bear the burden of proof for the non-existence of gross negligence. 2. Except for malicious non-observance of an incidental obligation the insurer shall be obliged to perform in derogation of No. 1 as far as the non-observance of the incidental obligation is neither a cause of the occurrence or ascertainment of the insured event nor of the ascertainment or extent of the insurer's obligation to perform. 3. If the insured does not observe an incidental obligation to inform or explain after the insured event has occurred the insurer shall only be released from the obligation to perform in full or in part if it indicated this legal consequence to the insured in text form by separate notice. 8 No obligation to pay for particular reasons 1. Deliberate or grossly negligent causation of the insured event If the insured causes the insured event deliberately the insurer shall be exempt from the duty to indemnify. If the causation of damage has been established by a valid sentence for intent in the person of the insured the deliberate causation of damage is deemed to be proven. If the insured causes the damage with gross negligence the insurer shall be entitled to reduce its performance in proportion to the seriousness of the insured's fault. 2. Malicious deceit after occurrence of the insured event The insurer shall be exempt from the duty to indemnify if the insured maliciously deceives or tries to deceive the insurer about facts which are important for the reason or for the amount of indemnity. If the deceit or attempted deceit has been ascertained by a valid sentence against the insured for fraud or attempt to defraud, the deceit or attempt to deceive is deemed to be proven. 9 Place of Jurisdiction The place of jurisdiction for actions of the insured is Frankfurt am Main. 10 Final Provisions This contract is subject to German law. Unless otherwise specified in these terms and conditions or the tariff terms, the legal provisions shall apply. Should any provision of these terms and conditions or the tariff regulations be or become invalid it shall not affect the validity of the remaining provisions.
7 A breakdown? Follow this simple fast and efficient procedure. First check the validity of your insurance policy. A breakdown in Gemany? Take your car to a local repair shop. If your car needs to be towed, call: +49 (0) (24 hour service, including Sundays and weekends) A breakdown outside Germany (Europe)? In all cases first call +41 (0) (24 hour service, including Sundays and weekends) Before carrying out any repairs the repair shop will fill out the claim form and fax it to NSA. Tel : +49 (0) Fax : +49 (0) The same day NSA will provide an approval number covering the repair costs. The vehicle is repaired. The repair shop sends the invoice for the agreed amount to NSA. The invoice is paid within 30 days. The following documents must be included with the caim form : Copy of vehicle registration document Copy of the service history If required, photos of the damaged parts The next steps will be explained by our operator, either on-site or in a repair shop Before carrying out any repairs the repair shop will fill out the claim form and fax it to NSA. Fax : +41 (0)848 (0) The same day NSA will provide an approval number covering the repair costs. The vehicle is repaired. The following information must be provided to the breakdown service : Beneficiary s full name Vehicle number plates Vehicle make and model Guarantee policy number Phone number The repair shop sends the invoice for the agreed amount to NSA. The invoice is paid within 30 days. Do not make any repairs before receiving an authorisation number from NSA.
8 Claim Form! Fax to NSA Garantie Repairs that have been started without obtaining a prior authorisation number will not be covered by the Insurer. This claim form is only valid if accompanied by a copy of the vehicle s service history and registration documents (essential). A photo of the damaged parts may be required. Warning Guarantee Guarantee type: Guarantee start date: Guarantee end date: 469,271 / Elite 1 23/07/ /07/2016 Beneficiary (Vehicle Owner) Name / Company: Address: Mobile: MUSTER Musterstrasse D-0000 Musterstadt Vehicle Make: Muster Model: Mustermodell Engine displacement: 1,200 Initial registration date: 01/01/2015 Transmission: Automatic / Tiptronic Fuel type: Unleaded Chassis Nb: XXX Licence number: Kilometer reading a star10,000 To be filled out by the repairing workshop Repairing workshop: Contact person: Telephone Nb: Address: Fax: Event date: Current kilometre reading: Actual damage to the vehicle If possible attach a detailed cost estimate -> total repair cost Date: Signature Stamp The repair shop responsible for the repairs hereby certifies to the accuracy of the above facts, and that no payments or other benefits in kind have been received from the vehicle manufacturer or any other third party. If any payment or benefit is received from the vehicle manufacturer or other third party, the repair shop undertakes to inform NSA Garantie immediately.
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