FAMILY TRAVEL INSURANCE FOR CITI ČSA CREDIT CARD AND FAMILY TRAVEL INSURANCE

Transcription

1 FAMILY TRAVEL INSURANCE FOR CITI ČSA CREDIT CARD AND FAMILY TRAVEL INSURANCE

2

3 TABLE OF CONTENTS General Insurance Policy no. CIT 1/ General Terms and Conditions concerning Travel Insurance No. 2/ Appraisal table concerning permanent physical impairments caused by injury 23 GENERAL INSURANCE POLICY NO. CIT 1/2009 This Insurance Policy is concluded by and between: Citibank Europe plc, hereinafter referred to as the Policyholder, a company established and existing under the laws of Ireland, with its registered office at Dublin, North Wall Quay 1, Ireland, registered in the Company Register in the Irish Republic under No , conducting its business in the Czech Republic through Citibank Europe plc, organizational constituent Registered office: Praha 6, Vokovice, Evropská 423/178, Postcode , Id. No.: , Tax Id. No.: CZ , incorporated in the Commercial Register kept by the Municipal Court in Prague, file no. A Represented by Mr. Rizwan S. Qazi and Mr. Ladislav Kročák, both acting under a power of attorney, as one Party hereto, and POJIŠŤOVNA CARDIF PRO VITA, a. s., hereinafter referred to as the Insurer, Registered office: Praha 2, Nové Město, Na Rybníčku 1329/5, Id. No.: , Tax Id. No.: CZ , Bank: ABN Amro Bank Praha, Account number: 79273/5400, incorporated in the Commercial Register kept by the Municipal Court in Prague, file No. B 4327, represented by Mr. Zdeněk Jaroš, Chairman, as the other Party hereto. TABLE OF CONTENTS Article 3 Article 4 Article 5 Article 6 Article 7 Article 8 Article Introductory Provisions Definitions Duration of Validity of Policy Insurance Coverage Insurance Terms and Conditions, Inception of Insurance Insurance Period, Commencement and End of Insurance Insurance Premium Claim Process Terms and Conditions s and Insurance Benefits Obligations of the Policyholder Obligations of the Insurer Expiry and Termination of Individual Insurance Confidentiality, Commercial Secrets, and Sharing Personal Data Personal Data Protection Final Provisions ANNEXES Annex I. General Terms and Conditions Concerning Travel Insurance No. 2/2009 3

4 Introductory Provisions The insurance established herein by the Insurer and the Policyholder (hereinafter also referred to as the Insurance Policy or the General Insurance Policy ) shall be governed by Czech law and shall be subject to the applicable provisions of Act No. 37/2004 Coll., on insurance policies as amended (hereinafter referred to as the Insurance Policy Act or the Act ), the General Insurance Terms and Conditions for Travel Insurance No. 2/2009, which form Annex I hereto (hereinafter also referred to as the General Insurance Terms and Conditions or VPP ), the provisions of this Insurance Policy concluded by and between the Insurer and the Policyholder, the provisions of Act No. 101/2000 Coll., on personal data protection, as amended (hereinafter also referred to as the Personal Data Protection Act ), and other applicable general laws and regulations of the Czech Republic. Definitions For the purposes of this Insurance Policy, the following terms shall have the following meaning: 2.1 Policyholder Citibank Europe plc, being the person who has concluded this General Insurance Policy with the Insurer. 2.2 Insurer POJIŠŤOVNA CARDIF PRO VITA, a. s., being the person who has concluded this General Insurance Policy with the Policyholder. 2.3 Policyholder s Client an individual who concluded the Contract for Card Release and Use with the Policyholder, and is a holder of the Card. 2.4 Insured a Policyholder s Client who has met the terms and conditions specified in Article 5 hereof and the Co travelling Family Member. 2.5 Co travelling Family Member spouse, registered partner, or companion sharing the same household and any number of children under 18 years who are residents of the same country as the Policyholder s Client (insured client and all his/her Co travelling Family Members, hereinafter referred to as the Family ) 2.6 Insurance Benefit (also as Benefit ) a payment provided by the Insurer to the Authorized Person subject to the terms and conditions specified in Article 9 hereof. 2.7 Commencement of Insurance as defined in Article 6 hereof. 2.8 End of Insurance as defined in Article 6 hereof. 2.9 an occurrence that involves the establishment of the obligation of the Insurer to provide Insurance Benefits according to Article 9 hereof Authorized Person a person entitled to the insurance benefit arising from the insurance claim (in principle, the Authorized Person is the Insured; in the event of an involving death, the Authorized Person is the one so determined according to the Insurance Policy Act.) 2.11 Beneficiary a person determined in the process according to Section 51 of the Insurance Policy Act Capitalized Insurance insurance in the event of death and permanent disability as a result of injury and insurance of provision for daily needs in the event of hospitalization abroad Damage Insurance insurance of luggage and belongings, medical expenses abroad and assistance services, liability insurance, emergency reunion coverage, staff replacement coverage, legal assistance insurance and accident caution money insurance while abroad, insurance against luggage delays in air transport, flight delay insurance Insurance Risk injury, disease or any other occurrence related to a change in the personal status of the Insured which may cause an Duration of Validity of Insurance a period for which the Insurance has been arranged (The Duration of Validity of Insurance is different for each Insured; it starts upon the Commencement of Insurance and ends upon the End of Insurance.) 2.16 Card shall mean the following: a) any of the main Citi credit cards, issued by Citibank, with the international registered trademark MasterCard or VISA, held by an individual, through which the Client makes use of credit (hereinafter also referred to as the Credit Card ), and b) employee charge cards (hereinafter the Employee Card ) as well as any debit card, issued by Citibank (hereinafter the Debit Card ), with the international registered trademark MasterCard or VISA, held by an individual, through which the Client makes use of credit or resources deposited in the Card account, irrespective of whether the holder of the Card account is: the Client him/herself, in the case of a Credit or Debit Card, or the Client s employer, in the case of an Employee Card. The insurance may only be arranged for the main credit card, not for the additional cards Contract contract for the release and use of a Credit Card, concluded between the Policyholder and the Policyholder s Client, on the basis of which a Card Account is established and a Credit Card released, or a contract for the release and use of a Credit Card, concluded between the Policyholder and the Policyholder s Client, on the basis of which a Citibank account is established and a Debit Card released, or concluded between the Policyholder and the Policyholder s Client s employer, on the basis of which a Citibank account is established and an Employee Card released. 4

5 Article 3 Duration of Validity of Policy 3.1 This Insurance Policy becomes valid on the day it is signed by the authorized representatives of both Contracting Parties; it becomes effective on 1 May The validity of this Insurance Policy ends on 31 December 2012, unless otherwise agreed. Unless one contracting party informs the other party in writing of its intention to terminate the effectiveness of this General Insurance Policy, the effectiveness thereof is automatically extended by another one year. The notification of the termination of the General Insurance Policy must be delivered to the other party in writing via a registered letter at least two calendar months before the prescribed termination of the validity and effectiveness of this General Insurance Policy. If the notification has been delivered to the other party, it cannot be revoked without the prior consent of the same. 3.2 Each Party may withdraw herefrom in the event of a material breach by the other Party of the provisions of this Policy. The withdrawal shall become effective on the date following the date of the service of the relevant notice in writing upon the other Party. The period for the closing and settlement of all the mutual obligations shall be 30 days from the withdrawal herefrom. The provisions of Section 345 of Act No. 513/1991 Coll., the Commercial Code, as amended, shall apply to the determination of whether or not the breach was material. 3.3 The termination of this General Insurance Policy under Paragraph 3.1. and/or 3.2. is without any prejudice to the rights and obligations of the contracting parties arising from the insurance of the Policyholder s Clients whose insurance as per Article 5 (5.1) herein commenced at the latest on the last day of the effectiveness of this General Insurance Policy, and lasts until the stipulated termination of the insurance subject to the provisions of 2 herein, where such insurance is still governed by this General Insurance Policy. 3.4 The termination or expiry of the individual insurance(s) arising hereunder shall not affect the validity of this Policy or that of such other insurances as are based hereon. Article 4 Insurance Coverage 4.1 On the basis of this Insurance Policy, the travel insurance of the Insured is established within the scope of the following insurances: Family Travel Insurance for credit, debit and employee cards, coming with the following types of insurance: insurance of medical expenses abroad and of assistance services insurance of provision for daily needs in the event of hospitalization abroad insurance in the event of death or permanent disability caused by injury liability insurance insurance of luggage and personal belongings insurance against luggage delays in air transport insurance against flight delays emergency reunion coverage staff replacement coverage coverage of legal assistance and of bail in the event of a road accident Article 5 Insurance Terms and Conditions, Inception of Insurance 5.1 Family Travel Insurance for Citi ČSA Credit Card and Family Travel Insurance are established in association with a Card whose holder is an individual stipulated herein, younger than 70 on the date of signing this Policy. Article 6 Insurance Period, Commencement and End of Insurance 6.1 Unless otherwise specified hereinafter, the Insurance Period shall be equal to a calendar month. The first Insurance Period shall commence on the date of the Commencement of Insurance, and end on the last day of the calendar month in which the Card was approved. The last Insurance Period shall commence on the first day of the calendar month in which the End of this Insurance occurs in accordance with this Policy or the law, and end on the date on which the End of Insurance occurs. 6.2 The insurance starts at on the day after the day on which the Card has been approved. The insurance coverage is effective from the moment of crossing the frontier of the Czech Republic. 6.3 The insurance coverage ends when the Insured re enters the Czech Republic on their return. 6.4 The duration of the Insurance Period shall not affect the amount of the premium agreed in Article 7 hereof. Article 7 Insurance premium 7.1 Forms a part of the commercial secret. 7.2 The Policyholder shall pay the current premium for each Insurance Period for each individual insurance (i.e. for each Insured) into the account of the Insurer no later than on the 18th day of the calendar month following the end of the Insurance Period for which the premium is being paid. 7.3 The Insurer is entitled by virtue of the Insurance Policy Act to modify the amount of the current 5

6 premium for the following Insurance Period in connection with any changes in the conditions pertinent to the determination of the amount of premium except changes in age and health condition. If the Policyholder or the individual Policyholder s Client does not agree with the modified amount of the premium and makes his/her disapproval known within 2 months of the date on which he/she became aware of the proposed modification, the Insurance, or only the individual insurance of the Policyholder s Client who expressed his/her disapproval, shall expire upon the expiry of the Insurance Period for which the premium has been paid. Article 8 Claim Process Terms and Conditions 8.1 In the event of an, the Policyholder shall provide the Insurer with data only about its Clients involved in the. In the event of an, the Insured, or the Beneficiary in the event of the death of the Insured is obliged without undue delay to advise the Insurer through the Notification Form about the, giving a true explanation of how the emerged and how severe it is, and to produce the following necessary documents: in the event of an insurance claim pertaining to the insurance of medical expenses: original copy of the medical report original copy of the travel contract (if any); original copies of bills for drugs and/or medical treatment, and/or original copies of other relevant bills, including the payment documents; in the event of a road accident with the police patrol called to the site of the accident, a copy of the police report with a translation into Czech; in the event of a luggage delay during air transport: original copy of the freight forwarder certificate (P.I.R.); original copy of the flight ticket and luggage claim ticket; original copy of the luggage delivery note; original copies of documents certifying the amount of the cost incurred for the purchase of basic necessities resulting from the luggage delay, and/or a certificate of payment for these basic necessities; in the event of a flight delay: original copy of the delayed flight certificate, issued by the freight forwarder; original copies of documents certifying the justifiable and necessary costs incurred as a result of the delayed flight and/or a certificate of payment for these costs; in the event of replacement staff: original copy of the certificate issued by the health care facility confirming the hospitalization of the Insured, medical report; original copy of the certificate issued by the employer sending the Insured on the business trip, if the Insured is an employee; original copy of the certificate issued by the employer sending the replacement staff substituting for the Insured on the business trip; in the event of damage to luggage and/or belongings: original copy of the flight ticket and luggage claim ticket; original copy of the freight forwarder certificate (P.I.R.); original copy of the luggage delivery note; original copy of certificates of purchase of the basic necessities and original copies of relevant bills; in the event of the theft of luggage carried in a vehicle: an original copy of the document certifying the repair of the damaged part of the vehicle in the event of other insurance claims: relevant documents certifying the insurance claim in question, and/or documents requested by the Insurer to assess the claim for the insurance benefit. 8.2 The Insurer may and shall conduct any further investigation itself, approaching the Insured or his/ her counsel directly or, if applicable, the persons determined in accordance with Section 51 of the Insurance Policy Act, i.e. persons who are entitled to the insurance benefit in the event of the death of the Insured. 8.3 The Insurer reserves the right to request from the Insured such additional documents as it considers necessary, examine facts or request that the Insured undergoes such medical examination as the Insurer deems necessary in order to determine its obligation to pay. The Insurer acknowledges that any such medical examinations or inspections, as well as submissions of documents or additional documents, shall be made at the exclusive expense of the Insurer. 8.4 The Insured shall provide the Insurer with cooperation according to this Policy if the Insurer exercises its right to examine and review facts material to the determination of whether or not the Insurance Claim is justified and of the amount of Insurance Benefits. 8.5 The Insured shall provide the Insurer with documents in the Czech language. Should such documents be provided in a foreign language, the Insured shall submit a translation of such a document into Czech, in which case the Insurer may request a certified translation into Czech. 6

7 Article 9 s and Insurance Benefits 9.1 a) In the event of entitlement to Insurance Benefits according to this Insurance Policy and the General Insurance Terms and Conditions and after the Insurer has received from the Insured (or from the persons specified in Article 8.1 hereof) the documents specified in Article 8 hereof, the Insurer shall pay the Insurance Benefits to the Authorized Person or to the Beneficiary, as applicable, within 15 days of the date on which the Insurer has completed all the necessary investigations regarding the in question. The investigation is deemed completed upon the Authorized Person or the Beneficiary, as applicable, being informed by the Insurer in writing about the results of the investigation. b) If the investigation cannot be completed within three months following the date on which the was reported, the Insurer shall inform the Authorized Person or the Beneficiary, as applicable, about the reasons for which the investigation cannot be completed. c) The period of three months shall not run if the investigation is prevented or hindered by the Authorized Person/Beneficiary, the Policyholder or the Insured. d) The expiry of the insurance shall be without prejudice to the right to tinsurance Benefits if the insurance expires after the occurrence of the and if the right to the Insurance Benefits has been exercised at the Insurer within the period specified by law. 9.2 Family Travel Insurance for Citi ČSA Credit Cards and Family Travel Insurance The is the occurrence of a claim for an Insurance Benefit as a result of one or more events as defined in the General Terms and Conditions for Travel Insurance No. 2/2009, provided that the journey abroad from the Czech Republic was not longer than 45 consecutive days. The Insurance Benefit Limits, depending on the insurance risks for the travel insurance (limits indicated in CZK, conversion from other currencies to CZK will use the exchange rate issued by ČNB (Czech National Bank) as of the day of the relevant ): Insurance of medical expenses abroad and of assistance services 3,000,000 Urgent dental treatment 10,000 Lost, theft or damage to luggage 50,000 Limit per one piece of luggage 25,000 Limit per one item 12,500 Legal assistance (road accident) 150,000 Emergency reunion coverage 75,000 Daily limit 2000 Staff replacement coverage 250,000 Death as a result of injury 1,000,000 Permanent disability as a result of injury 2,000,000 Cumulative limit per family in the event of death or permanent disability resulting from injury 4,000,000 Delay of luggage during air transport 10,000 Limit per hour of delay 2500 Coinsurance 6 hours Flight delay 10,000 Limit per hour of delay 2500 Coinsurance 6 hours Liability insurance 2,000,000 Insurance of provision for daily needs in the event of hospitalization abroad Apart from the exclusions defined in the General Terms and Conditions, the insurance claim and insurance shall not apply to an event which occurs during or in relation to a flight included in the ČSA special offer for ČSA Citibank Card holders. 0 Obligations of the Policyholder The Policyholder shall: 10.1 pay the premium in a proper and timely manner according to Article 7 hereof to the Insurer; 10.2 answer truly and completely all the written inquiries of the Insurer regarding the insurances, and pass on to the Insurer any and all information regarding the insurances hereunder which the Policyholder may learn or obtain from the Policyholder s Client; this shall also apply to any changes in the insurances; 10.3 provide due cooperation to ensure that all the documents requested by the Insurer from the Insured are duly completed and signed by the Insured; 10.4 provide the Insurer, upon its request in writing, with any such additional information, summaries, and reports not specified herein as relate to the insurance, are readily available to the Policyholder and do not breach any commercial or banking secrets of the Policyholder or its confidentiality obligations or legal requirements regarding data protection; 10.5 provide the Insurer with information about the agreements or amendments in the scope of which this Insurance herein has been arranged; 7

8 10.6 acquaint the Insured with the terms and conditions of this General Insurance Policy; 10.7 agree with the Insurer on any marketing materials concerning insurance according to this General Insurance Policy, as well as any documents making reference to the Insurer. 1 Obligations of the Insurer 11.1 The Insurer shall investigate any s it becomes aware of, and inform the Authorized Person or the Beneficiary, as applicable, in writing about the results of an investigation according to Article 9 hereof The Insurer shall immediately inform the Policyholder about any reported by an Insured, his/her counsel or a person determined according to Section 51 of the Insurance Policy Act The Insurer shall immediately inform the Policyholder about any written communications from the Insured, his/her counsel or a person determined according to Section 51 of the Insurance Policy Act The Insurer shall provide free training for the Policyholder or such persons as are authorized by the Policyholder and as enter into contact with an actual or prospective Insured as per Paragraph 5.1 herein. 2 Expiry and Termination of Individual Insurance Insurance (meaning the individual insurance of an individual Insured) shall cease to exist: 12.1 on the day on which the Policyholder s Client reaches the age of 75; 12.2 upon the death of the Policyholder s Client; 12.3 the insurance against permanent disability resulting from injury expires on the day when the insured person obtains the status of a 3rd class disabled person; 12.4 at 00:00 o clock on the day following the date on which the Insured requested the termination of insurance using the CitiPhone customer support line, 12.5 upon the termination of the Card account or Citibank account in accordance with the Business Terms and Conditions of the Policyholder, 12.6 for an Employee Card, upon the termination of the employment relationship between the Card holder and the Citibank account holder. 3 Confidentiality, Commercial Secrets, and Sharing Personal Data 13.1 The Insurer and the Policyholder shall keep confidential the commercial secrets of the other Party hereto and any other facts, the knowledge of which they gained in the performance of the activities under this Policy and which may be detrimental to either Party hereto. In particular, they shall protect information and data regarding the customers, business terms and conditions, and know how of the other Party. This obligation shall survive the contractual relationship established hereby The Policyholder and the Insurer shall share media and data the personal (incl. sensitive) data of the Insured in an encrypted or otherwise secure form in order to prevent unauthorized access to such media or data or their misuse by an unauthorized person. The Policyholder and the Insurer shall also ensure the highest standards of technical and organizational security and data transfer as may be reasonably required with regard to the subject matter hereof and to the position of the Parties The Policyholder declares that it is authorized, by virtue of agreement or according to special legal provisions and in accordance with Act No. 101/2000 Coll., on data protection, to share with the Insurer the third party personal data specified in the Insurance Policy, account statements, and other documents for the purposes of insurance administration and performance by the Insurer of the obligations arising herefrom, for the period of the legal relations arising from the Insurance Policy and for the period necessary to settle the mutual claims arising from the termination of such legal relations. 4 Personal Data Protection 14.1 By giving its consent to the General Insurance Policy and/or the Contract, the Policyholder s Client also gives his/her consent to the Insurer according to Act No. 101/2000 Coll. on personal data protection and amendment to certain acts, as amended (hereinafter the Personal Data Protection Act ), that the Policyholder s Client s personal data, including sensitive information as per Section 4 (b) of the Act, may be processed by the Insurer within the framework of the insurance services and operations related to the insurance services as per Act No. 363/1999 Coll., on the insurance industry, as amended, for the purpose of the insurance (or claim process) for the period that is necessary to arrange for all the rights and obligations arising herefrom. The Policyholder s Client declares that he/she has been properly informed about the processing of his/her personal data, his/her rights and the obligations of personal data processors and administrators in compliance with the provisions of Section 11 of the Personal Data Protection Act. The Policyholder s Client hereby gives his/her consent to the transfer of his/her personal data to other countries as per Section 27 of the Personal Data Protection Act. All the data provided hereunder will be processed by the Insurer or a processor appointed by the former in compliance with Section 6 of the Personal Data Protection Act. If the personal data are to be processed by a processor appointed by the Insurer, the Insurer bears the same responsibility as if the data were processed by itself. 8

9 14.2 Subject to all applicable provisions of the Personal Data Protection Act, the Insurer undertakes to arrange for adequate technical and organizational protection of personal data and to adopt measures to prevent any unauthorized or inadvertent access to personal data or any changes, destruction, loss, unauthorized transmission and processing thereof, as well as any other misuse of those personal data. The Insurer also undertakes to ensure the confidentiality of its employees, or the appointed processor s employees, who in the course of their duties come into contact with the personal data provided hereunder. 5 Final Provisions 15.1 This Policy shall include, as an integral part, the General Insurance Terms and Conditions for Travel Insurance No. 2/2009, which form Annex I hereto. The Contracting Parties explicitly state that if the Insurer terminates its operations, primarily as a result of a change in the person of the Insurer or in the event of receiving an order concerning the Insurer s assets, the Policyholder bears no responsibility for any obligations of the Insurer towards the Insured In the event of a discrepancy between this Policy and the General Insurance Terms and Conditions, this Policy shall prevail Should any provision of this General Insurance Policy become invalid or unenforceable, the validity and enforceability of the remaining provisions of this General Insurance Policy shall not be affected The legal relations arising from this General Insurance Policy shall be governed by the laws of the Czech Republic and any disputes arising herefrom shall be decided by Czech courts of law The Parties have agreed that the Insurer shall inform the Policyholder about all such material changes in the position of the Insurer as may affect the performance of the subject matter hereof (in particular, about any administrative or judicial proceedings initiated, etc.) The Insurer declares that it meets all the technical, legal, personnel, and organizational requirements to duly perform the subject matter hereof, in particular to ensure the continued performance of the subject matter hereof in the event of any non standard situation which may realistically occur in the place of performance of this General Insurance Policy The Parties shall not assign their rights and obligations hereunder to any third party without the prior written consent of the other Party hereto. This provision shall not apply to the Policyholder within the meaning of the transfer of its rights and obligations hereunder, also without the prior consent of the Insurer, to any person within the Citi Group, i.e. to any person directly or indirectly controlled by Citigroup Inc. In addition, this provision shall also not apply to the transfer of the insurance portfolio in accordance with Section 32 of Act No. 363/1999 Coll., the Insurance Act. This provision shall not apply to the Insurer with respect to the transfer of its rights and obligations hereunder, also without the prior consent of the Policyholder, to any person within the BNP PARIBAS ASSURANCE Group and all the corporate entities directly or indirectly controlled by this company This Policy may be altered and amended subject to agreement between the Contracting Parties. No amendments hereto shall be effective unless executed in writing, numbered and signed by the authorized representatives of both Parties hereto The Parties hereto declare that they are capable of entering into legal acts, that they have perused and understand the content of this Policy, including its annexes, and that they agree with the same; in addition, the Parties hereto declare that the present Policy was executed on the basis of true data and their true and free will, that it has not been signed under duress or under otherwise unilaterally disadvantageous conditions, and that they are unaware of any circumstances applicable at the time of the signing hereof that could restrict the content and validity of the same This General Insurance Policy has been prepared in two original copies, each of which shall be submitted to either Party hereto. GENERAL TERMS AND CONDITIONS CONCERNING TRAVEL INSURANCE NO. 2/2009 A) GENERAL PART Introductory Provisions 1.1 The travel insurance arranged by POJIŠŤOVNA CARDIF PRO VITA, a. s., with its registered office in Praha 2 Nové Město, Na Rybníčku 1329/5, ID No (hereinafter referred to as the Insurer ) shall be governed by the provisions of the Insurance Policy concluded by and between the Insurer and the Policyholder, an integral part of which is formed by these General Terms and Conditions Concerning Travel Insurance No. 2/2009 (hereinafter the Insurance Terms and Conditions ), and shall be subject to the applicable provisions of Act No. 37/2004 Coll., on insurance policies as amended (hereinafter referred to as the Insurance Policy Act ), the applicable provisions of Act No. 101/2000 Coll., on personal data protection, as amended, and the other applicable generally recognized laws and regulations of the Czech Republic. Definitions 2.1 Policyholder an individual or a corporate entity who/which has concluded an Insurance Policy with the Insurer and is obliged to pay the premium. 9

10 2.2 Insured an individual whose health or other qualities of relevance to the insurance are covered by the travel insurance. The Insured is the Policyholder, unless otherwise provided for by the Act or the Insurance Policy. 2.3 Authorized Person an individual or a corporate entity, a person entitled to Insurance Benefits as a result of an (the Authorized Person is the Insured, unless otherwise provided for by the Act or the Insurance Policy.) 2.4 Insurance Benefit an amount which is paid out according to the Insurance Policy if an insurance claim is raised. 2.5 a contingency that involves the emergence of the Insurer s obligation to provide Insurance Benefits according to the Insurance Policy 2.6 Term of Insurance a period of time for which the Travel Insurance has been arranged. 2.7 Injury is the unexpected and sudden action of an outside agent or force, or inner physical force acting independently of the will of the Insured, which emerged during the Duration of Validity of the Travel Insurance and which caused harm to the health of the Insured or caused the death of the same the action of an outside force also includes drowning, a lightning strike or electric shock, the effect of high or low ambient temperatures, or gas, vapors and toxic substances, as long as these fulfill the aforementioned conditions; the Insurance excludes the bodily harms caused by previously suffered injuries or diseases, and any other diseases, including their demonstration or deterioration of previously existing diseases as a result of injury, seizures, mental disorders and changes in mental condition, irrespective of their root cause 2.8 Permanent disability permanent bodily harm or impairment resulting from injury, irrespective of the ability of the Insured to exercise their profession or any other gainful employment the condition for the provision of the insurance benefit in the event of permanent disability is the submission of a medical certificate of permanent bodily harm and stabilized consequences of the injury 2.9 Appraisal tables tables on the basis of which the amount of insurance benefit is determined for the individual consequences of insurance claims; these tables form an integral part of these General Terms and Conditions 2.10 Disease accidental disorder affecting the physical or mental health of the Insured which emerged during the Duration of Validity of the Travel Insurance and which has no causal connection with any previous physical or mental disorder of the Insured, which has already been recommended for medical care or treated by a physician, provided that the Insured has evidently sought medical assistance during the Duration of Validity of the Travel Insurance Administrator corporate entity appointed by the Insurer in writing to administer and attend to insurance claims, as well as other administrative tasks, e.g. organizing and providing assistance services (herein also referred to as the Assistance Service Provider or the Assistance Service ) Hospital health care facility licenced to practice medical services and providing outpatient and inpatient and basic and specialized medical care Material damage damage caused by physical loss, deterioration or destruction of tangible assets Luggage luggage with a solid lockable cover, which is used for transporting the belongings of the Insured or their fellow travelers 2.15 Family member parents, children, siblings, husband, wife, registered partner, companion sharing the same household who are residents of the same country as the Insured 2.16 Coinsurance an amount determined in the Insurance Policy, by which the Insurance Benefit is reduced in the event of an insurance claim (or a period determined in the Insurance Policy expressed in days or hours) to which the Insurance Benefit does not apply 2.17 Reasonable travel expenses costs incurred for the purchase of economy class flight tickets, first class railway tickets, bus tickets or costs of fuel for a passenger vehicle, where the decision on the method of transport is at the discretion of the Insurer or the Assistance Service Provider, taking into account all the relevant circumstances 2.18 Provider of public transport person/subject operating the paid transport of passengers, in the scope of the relevant licence 2.19 Hospitalization admission of the Insured to an in patient ward in hospital for a period of at least 24 hours for the purpose of urgent treatment 2.20 Medical expenses costs of medical material, treatment and other medical services which are necessary from the medical point of view for the treatment of the Insured and are reasonable and usual in the place and at the time of the insurance claim 2.21 Journey a trip abroad from the Czech Republic and subsequent stay outside the territory of the Czech Republic 2.22 Insurance Benefit Limit an amount set out in the Insurance Policy which represents the upper threshold of the Insurance Benefit 2.23 Justified and necessary expenses costs incurred for the purchase of the most necessary clothing and hygienic needs, costs of transport between the airport and the point of replacement accommodation provided by the airline company and costs of the necessary phone calls 2.24 Stabilized chronic disease a disease which existed as of the date of the Inception of the Insurance, but the development of which during the 12 months before the Insured took the journey did not reveal or indicate any need for medical assistance during the journey 10

11 2.25 Severe injury or disease injury or disease classified by a physician as life threatening 2.26 Loss with respect to limbs or organs, the physical loss or permanent loss of their functionality; the loss of an eye is deemed to be a total and unrecoverable loss of vision, i.e. a state after the convalescence when the degree of vision does not exceed 3/60 on the Snellen chart; a loss of hearing or speech shall mean a total or unrecoverable loss of hearing or speech. Article 3 Insurance categories 3.1 The Insurer, within the scope of the travel insurance, arranges all or some of the following types of insurance: insurance of medical expenses abroad and of assistance services (damage insurance), insurance of luggage and personal belongings (damage insurance), liability insurance, coverage of legal assistance and of bail in the event of a road accident (damage insurance), accompanying party insurance/reunion coverage (damage insurance) insurance in the event of death resulting from injury (capitalized insurance) insurance in the event of permanent disability resulting from injury (capitalized insurance), insurance against luggage delays in air transport (damage insurance), insurance against flight delays (damage insurance), staff replacement coverage (damage insurance), insurance against the cancellation of a journey (damage insurance), insurance against the interruption of a journey (damage insurance), insurance of provision for daily needs in the event of hospitalization resulting from injury or disease (capitalized insurance), insurance against loss or theft of travel documents. Article 4 Inception of Insurance 4.1 The insurance commences for each person under the terms and conditions set out in the Insurance Policy. Article 5 Alterations to insurance 5.1 If the Parties agree on modifying any insurance previously arranged and unless otherwise specified in the Insurance Policy, any such modification shall become effective on the date agreed and no earlier than at o clock on the date following the date on which the agreement regarding the modification is concluded. Article 6 Insurance Policy 6.1 The insurance policy must be executed in writing and should incorporate the terms and conditions for insurance. 6.2 The Policyholder and the Insured are obliged to truthfully and completely answer all written inquiries made by the Insurer concerning the travel insurance arranged. The same provision applies to alterations to the travel insurance. The Insurer has the same obligation towards the Policyholder and the Insured. Article 7 Processing personal data of the Insured 7.1 By giving his/her consent to the Insurance Policy, the Insured also gives his/her consent to the Insurer according to Act No. 101/2000 Coll. on personal data protection and amendment to certain acts, as amended (hereinafter the Personal Data Protection Act ), that the Policyholder s Client s personal data, including sensitive information as per Section 4 (b) of the Act, may be processed by the Insurer within the framework of insurance services and operations related to insurance services as per Act No. 363/1999 Coll., on the insurance industry, as amended, for the purpose of the insurance (or claim process) for the period that is necessary to arrange for all the rights and obligations arising herefrom. The Insured declares that he/she has been properly informed about the processing of his/her personal data, his/her rights, and the obligations of personal data processors and administrators in compliance with the provisions of Section 11 of the Personal Data Protection Act. The Insured hereby gives his/her consent to the transfer of his/her personal data to other countries as per Section 27 of the Personal Data Protection Act. All the data provided hereunder will be processed by the Insurer or a processor appointed by the former in compliance with Section 6 of the Personal Data Protection Act. This consent is also given by the Insured for the purpose of obtaining the data about his/her state of health through physicians contracted by the Insurer (appointed health care facilities) in compliance with Section 55 (2) (d) of Act 20/1996 Coll. on national health care, as amended, and the Insured thereby authorizes all the physicians, institutes, health care facilities and health insurance companies who are questioned to provide this information even after the death of the Insured to the Insurer, and empowers the competent social security administration office to provide the information to the Insurer. It is explicitly agreed that the Insurer may also disclose the data obtained in connection with the insurance to other entities operating in insurance, banking and other financial services and to associations of such entities. 11

12 7.2 The Insurer declares that it shall comply with all the obligations arising for the Insurer from the Personal Data Protection Act. 7.3 The Policyholder and the Insurer shall share media and data the personal data of the Insured in an encrypted or otherwise secure form in order to prevent unauthorized access to such media or data or their misuse by an unauthorized person. The Policyholder and the Insurer shall also ensure the highest standards of technical and organizational security and data transfer as may be reasonably required with regard to the subject matter hereof and to the position of the Parties. 7.4 If the telephone is used as an alternative means of communication by the Insured, the Policyholder, the Insurer or the Administrator, the Insured and the Policyholder agree that incoming and outgoing phone calls with the Administrator and the Insurer may be recorded and that such an audio recording may be used in connection with the contractual or any other legal relationship for the purposes of insurance and other activities defined by Act No. 363/1999 Coll. on insurance. The Administrator and the Insurer shall keep the recording of the telephone call for the entire duration of validity of the Insurance Policy. Following this period, the recording may only be used for protecting the rights of the Insurer and the Administrator, as the administrator and processor of the personal data of the Insured and of the Policyholder contained in the recording, in particular as evidence for judicial, administrative or other proceedings to which the Insurer, the Administrator, the Policyholder or the Insured is a party. The Insured and the Policyholder agree that their personal data which they disclose to the Administrator and which are contained in the audio recording of the telephone call may be kept as part of the recording for the period and for the purposes for which the recording is to be kept. Article 8 Insurance premium 8.1 The Insurance premium is an amount of money paid for the insurance policy. 8.2 The amount and due date of the premium are determined in accordance with the rates applicable to the individual types of insurance and specified in the Insurance Policy. 8.3 The insurance premium is paid as a lump sum for the entire term of the nsurance (single premium) or for the agreed insurance periods (regular insurance). 8.4 The Insurer shall be entitled to the insurance premium for the period until the termination or expiry of the insurance for each Insured in accordance with the provisions of Section 13 (1) and (2) of the Insurance Policy Act. Article The shall refer to all or some circumstances listed hereinbelow, which arise during the term of insurance and which establish the event of an insurance claim according to the provisions hereunder. 9.2 The insurance covers s which arise outside the territory of the Czech Republic and the country of citizenship or residence of the Insured. The Insurance Policy may specify certain territorial limitations, i.e. it may specify which territories are not covered by the insurance. 9.3 The Authorized Person or the Insured, if the latter is not the Authorized Person him/herself, shall notify the Insurer without undue delay of an, giving a true explanation as to the emergence and severity of the, produce the required relevant documents, and proceed in the manner agreed in the Insurance Policy. 9.4 The Insurer may require additional documents and conduct additional investigations to determine the extent of its obligation to pay. 9.5 Any documents submitted to the Insurer as proof for the shall be issued in accordance with Czech law. Any documents issued in accordance with foreign law may be recognized by the Insurer as proof for the if their content unquestionably indicates that the event under the did indeed occur. Unless the documents submitted to the Insurer as proof for the are issued in accordance with Czech law and are recognized by the Insurer as such, the event under the shall be considered as not having occurred. 9.6 Documents certifying the emergence and scope of the insurance claim must be presented in the Czech language. 0 Insurance Benefit scope and maturity period 10.1 In the event of an, the payment shall be made by the Insurer in accordance with the provisions of the Insurance Policy The Insurer may refuse to pay according to the Insurance Policy if: the grounds for the are a fact of which the Insurer has learnt only following the occurrence of the event under the and which it could not have had knowledge of when the insurance or an amendment thereto was agreed in consequence of deliberately or negligibly false or incomplete written answers, provided that the Insurer would not have arranged the insurance or would have arranged it under different terms and conditions if it had had knowledge of such a fact, the Insured suffered the injury in connection with an act for which the Insured was found guilty of committing a wilful criminal act or an act through which the Insured deliberately harmed his/ her own health, 12

13 when exercising his/her entitlement to payment under the insurance, the Authorized Person has knowingly provided false or grossly distorted information as to the extent of the event under the or concealed any material facts related to such an event Upon the receipt of a rejection notice of Insurance Benefit, the insurance will expire If the violation of the obligations, as specified in the Insurance Policy Act or in the Insurance Policy of in these Terms and Conditions, has materially affected the occurrence or course of the event under the, aggravated the consequences thereof, or affected the establishment or determination of the amount of the Insurance Benefit, the Insurer may reduce the Insurance Benefit in proportion to the impact of such a violation on the extent of the Insurer s obligation to pay The Insurance Benefit shall be due no later than on the 15th day following the completion of the investigation. The investigation is deemed completed upon the Authorized Person being informed by the Insurer about the results of the investigation The upper limit of the insurance benefit shall be defined as the Insurance Benefit Limit in the Insurance Policy The Insurance benefit is paid by the Insurer in Czech currency. Conversion from foreign currencies to CZK will use the exchange rate issued by the ČNB (Czech National Bank) as of the day of the relevant. 1 Insured Person s Obligations 11.1 The Insured, or the Authorized Person, if applicable, shall notify the Insurer without unreasonable delay about the, giving a true explanation as to the emergence and severity of the, fill in the Notification Form, produce the following required documents, and proceed in the manner agreed in the Insurance Policy When lodging their claim for the Insurance Benefit, the Insured, or the Authorized Person, if applicable, shall meet all their obligations specified in the Insurance Policy In the event of doubt on the part of the Insurer, the Insured, or the Authorized Person, if applicable, shall prove that the did indeed occur to the extent declared In the event of an insurance claim, the Insured is obliged without undue delay to contact an assistance service; in the event of injury or disease, the Insurer shall seek medical treatment, cure him/herself according to the instructions issued by the physician and if requested by the Insurer have him/herself examined at his/her own expense by a physician appointed by the Insurer. The Insurer may require the aforementioned examination by an appointed physician in the event of doubts as to whether the insurance claim actually happened or happened in the scope described by the Insured or the physician chosen by the Insured. In addition, the Insured is obliged to undergo all mandatory inoculations before a journey to exotic countries If the Insured requests a follow up examination, the Insured shall bear the costs thereof. If, on the grounds of this follow up examination, the Insurer provides another insurance benefit, the costs of the follow up examination shall be refunded to the Insured; however, this shall not apply if the follow up examination is requested or recommended by the attending physician. 2 The Insurer s authorization to examine and verify the state of health and information presented 12.1 The Insurer or the Assistance Service Provider is entitled to examine and verify the state of health of the Insured or the causes of his/her death, on the basis of the medical reports and documentation requested by the appointed health care facility from the attending physicians, without any restrictions as to the content, and, if necessary, through an examination and inspection carried out by a health care facility appointed by the Insurer. To this end, the Insured undertakes to relieve his/her attending physician of the duty of confidentiality about the facts concerning the former s state of health with respect to the Insurer s investigation of the. If the Insured fails to give or revoke the aforementioned consent, the Insurer shall cease to investigate the and to pay the Insurance Benefit The consent to the examination and verification of the state of health and the information presented shall be given by the Insured or his/her successor through accession to the insurance and expressing consent to the Insurance Policy and the Terms and Conditions thereof, on the basis of which the Insurance is arranged, and by appending his/her signature to the Notification Form In the event of death, the Insured relieves all the physicians who were or would be engaged in his/her state of health of the duty of confidentiality with respect to the Insurer s investigation of the Any information which the Insurer learns through examining the state of health of the Insured may only be used for its own use; otherwise the consent of the Insured must be sought. 3 General exclusions from the Insurance 13.1 The Insurer is not obliged to pay out the insurance benefits for all types of insurance under the following circumstances or as a result thereof: an intentional act committed by the Insured, 13