euro corporate travel insurance

Transcription

1 euro corporate travel insurance General insurance terms and conditions and general terms of contract Valid as of 1 January

2 contents euro corporate travel insurance PURPOSE OF INSURANCE CONTENT OF INSURANCE GENERAL PROVISIONS Those insured and beneficiaries Validity Claims settlement expenses Deductible TRAVELLER S INSURANCE Travel-time illness Accident Costs of treatment of illness or injury Costs of treatment of dental injury and acute toothache Medical handicap due to an accident Daily benefit in the event of disability due to an accident Death Losses incurred from cancellation or interruption of a trip LUGGAGE INSURANCE Object of insurance Coverable loss events and related restrictions Safety regulations Sum insured and extent of indemnity TRAVEL LIABILITY INSURANCE Loss or damage caused to a third party Loss or damage falling outside the scope of coverage Indemnification regulations Assessment of loss and liability to pay damages...6 GENERAL TERMS OF CONTRACT KEY CONCEPTS DISCLOSURE OF INFORMATION PRIOR TO CONCLUDING AN INSURANCE CONTRACT Insurance company s obligation to disclose.information Policyholder s and insured party s obligation to disclose information Failure to disclose information COMMENCEMENT OF THE INSURANCE COMPANY S LIABILITY AND VALIDITY OF THE INSURANCE CONTRACT Commencement of the insurance company s liability Grounds for granting insurance Validity of the insurance contract INSURANCE PREMIUM Premium payment Delayed premium Reinstatement of terminated insurance of the person Payment of a delayed non-life insurance premium Returning of premium at the termination of a contract Setoff against premiums to be returned DISCLOSURE OF INFORMATION DURING VALIDITY OF CONTRACT Insurance company s obligation to disclose information Policyholder s obligation to disclose information about any increase in risk Decrease in risk of loss Provision of information on termination of group insurance OBLIGATION TO PREVENT AND MITIGATE LOSS OR DAMAGE UNDER NON-LIFE INSURANCE Obligation to observe safety regulations Obligation to prevent and mitigate loss or damage Failure to observe the safety regulations and the duty of salvage under liability insurance CAUSING AN INSURANCE EVENT Insurance of the person Non-life insurance Causing an insurance event under liability insurance IDENTIFICATION WITH ANOTHER PERSON UNDER NON-LIFE INSURANCE IRRESPONSIBILITY AND EMERGENCY Insurance of the person Non-life insurance BENEFICIARY CLAUSE UNDER INSURANCE OF THE PERSON Beneficiary Form of the beneficiary clause CLAIMS SETTLEMENT PROCEDURE Duties of claimant Time limitation on claims The insurance company s obligations Setoff against compensation LODGING AN APPEAL AGAINST A DECISION TAKEN BY THE INSURANCE COMPANY Right to correct Finnish Financial Ombudsman Bureau and boards issuing recommendations District court INSURANCE COMPANY S RIGHT OF RECOVERY Insurance company s right of recovery vis-à-vis a third party Other cases of right of recovery under non-life insurance ALTERING AN INSURANCE CONTRACT Altering the terms of contract during the insurance period Altering the terms of contract of a continuous policy at the end of an insurance period TERMINATION OF INSURANCE CONTRACT Policyholder s right to terminate the insurance The insurance company s right to terminate the insurance during the insurance period The insurance company s right to terminate the insurance at end of the insurance period RIGHTS OF A THIRD PARTY UNDER NON-LIFE INSURANCE Right to compensation under liability insurance of a person who has suffered injury, loss or damage Right of appeal under liability insurance of a person who has suffered injury, loss or damage APPLICABLE LAW AND CALCULATION BASES OTHER MATTERS COVERED BY THE INSURANCE CONTRACTS ACT...12 This is a translation of the original Finnish terms and conditions, which take precedence should there be any differences between the original and the translation. 2

3 euro corporate travel insurance 1 PURPOSE OF INSURANCE The purpose of travel insurance is to indemnify the insured for the cancellation of a trip and for any loss or damage incurred during a trip caused by a loss event mentioned in these insurance terms and conditions as stated in the policy or a separate contract and in accordance with the terms and conditions of the insurance. 2 CONTENT OF INSURANCE The insurance comprises, as agreed, either - traveller s insurance or - luggage insurance and related travel liability insurance or - all the above. These terms apply to insurance which is either a fixed-period or a continuous group insurance. The insurance policy or contract also defines whether the insurance covers all travel or only business travel. The term business travel is used to refer to a trip for the travel expenses of which the policyholder as employer is responsible and/or for which the employer pays his/her insured employee a daily allowance. 3 GENERAL PROVISIONS 3.1 Those insured and beneficiaries Those insured The insured persons are the following mentioned in the policy: - persons who have their actual home and residence in Finland and who primarily reside here, and - persons domiciled in Finland who temporarily live abroad Beneficiary The next of kin of the insured are the beneficiary in the case of death, unless the policyholder has notified Eurooppalainen in writing of another beneficiary. 3.2 Validity Territorial scope and period of validity The insurance is valid on trips abroad anywhere in the world unless otherwise stated in the insurance policy or contract. In Finland, the insurance is valid for trips made over a minimum distance of 50 kilometres, measured direct from the residence, place of work or study, or holiday home of the insured. The insurance is not, however, valid on trips between the places mentioned herein Flight In the event of injury or death occurring in connection with an aviation accident, the insurance does not cover persons who are members of the flight crew or persons carrying out duties related to the flight. The insurance is valid during a flight if the insured is traveling as a passenger on board an aircraft provided with nationality markings. If the insured has concurrently valid traveller s, travel accident or private accident insurance policies with one or several insurance companies, these policies, with the exception of aviation accident policies, are valid during a flight up to an aggregate maximum amount of EUR 255, Competitive sports, special types of sport and special trips Traveller s insurance is not valid in competitive sports and training for such sports. Traveller s insurance is not valid in the following sports and activities: - combat and contact sports, including boxing, wrestling, judo and karate - strength sports, including weight and power lifting - motor sports - airborne sports, including parachuting, gliding, hot-air ballooning, bungee jumping, hang-gliding and flying in an ultra-light or amateur-built aircraft - climbing sports, including mountain, rock and wall climbing - speed and downhill skiing or the equivalent - scuba diving and whitewater canoeing - research expeditions and treks to mountains, the jungle, deserts or wilds abroad or other uninhabited areas anywhere - ocean boating. Insurance covering these sports can be taken out only through a supplementary agreement at an additional premium, subject to Eurooppalainen s approval Nuclear accident and war The insurance does not cover any loss or damage caused by - the sudden effect of a weapon or device based on nuclear reaction, destroying people in large numbers; - war or armed conflict. The exclusion laid down in this section will not be applied within 14 days following the commencement of armed operations, except where a major war is concerned, provided that the insured has begun his/ her trip prior to the said operations and has not participated in them. Insurance covering the risk of war can be taken out only through a supplementary agreement at an additional premium, subject to Eurooppalainen s approval Manual labour In paid manual labour the insurance is valid only through a supplementary agreement at an additional premium. 3.3 Claims settlement expenses The insurance will indemnify for the cost of the following documents required by Eurooppalainen: - medical statement - records of police investigations - certificates from the authorities - repair cost estimate, as well as the cost of an emergency or claims service approved by Eurooppalainen in advance. 3.4 Deductible In all loss events the insured is responsible for a certain amount of the loss. This deductible is recorded in the policy. 4 TRAVELLER S INSURANCE 4.1 Travel-time illness Travel-time illness is indemnified if it is an illness requiring treatment by a doctor and if it started, or if its first symptoms appeared, during the trip. A sudden worsening of an existing illness or a change in the state of the illness is also indemnified as a travel-time illness insofar as such a change was not likely or expected on the basis of medical experience. In these cases acute, emergency type treatment given during the trip is indemnified. The insurance indemnifies for the illness only if medical treatment was started during the trip or within 14 days of the end of the trip, unless the illness in question is a contagious disease with a longer incubation period. The insurance does not indemnify for an illness which was caused by the use of alcohol or drugs or the misuse of medicine. 4.2 Accident The concept accident, as covered by insurance is a sudden external occurrence which is beyond the control of the insured and which causes bodily injury during the trip. The concept accident includes an injury caused, through no fault of the insured, by sudden exertion and movement, for which medical treatment has been given within 14 days of occurrence of the injury. The concept accident also includes unintentional drowning, heat-stroke, sunstroke, hypothermia, injury caused by considerable variation in atmospheric pressure and gas poisoning sustained by the insured, as well as poisoning caused by a substance taken inadvertently The concept accident does not include an injury caused by - a loss event arising from an illness or physical defect of the insured; - an operation, treatment or other medical procedure undertaken in order to treat an illness or physical defect, except where the procedure in question is undertaken in order to treat an injury covered by this insurance; - poisoning due to medicine, alcohol or drugs used by the insured or to the toxic effect of a substance taken as food or - biting on a tooth or dentures, even though an external factor has contributed to the loss (cf. section 4.4.) Nor does the concept accident cover - an infectious disease caused by an insect bite or sting - psychic consequences of an accident Injury caused by illness or defect Where an illness or defect not related to the accident has materially contributed to the injury caused by the accident, indemnity will be paid only insofar as the injury can be considered a consequence of the accident in question. 4.3 Costs of treatment of illness or injury Treatment expenses incurred from traveltime illness are indemnified for a maximum of 90 days from the outset of treatment, and treatment expenses incurred from an accident for a maximum of three years after the accident. Treatment expenses are Please pay special attention to the restrictions printed in italics. 3

4 indemnified on the basis of an original invoice or receipt insofar as they are not indemnified under some law Treatment expenses comprise - any necessary expenses arising from treatment or examination carried out or prescribed by a doctor, together with reasonable local travel expenses; expenses incurred from physiotherapy are covered for a maximum of ten treatment sessions per accident provided the therapy is carried out at an institution and prescribed by a doctor; - necessary costs of repairing or replacing spectacles, a hearing aid or dentures in use and broken when the accident occurred; spectacles are indemnified insofar as they have been acquired within two months of the occurrence of the accident, at the latest; - expenses other than the above, approved by Eurooppalainen in advance, if the measures taken by the insured have reduced the occurrence of a subsequent loss and helped avoid alternative costs Treatment expenses do not include - cost of staying at a rehabilitation institution, spa or naturopathic centre, or the travel expenses there and back - purchasing of medical equipment other than items mentioned under section loss of earnings owing to the treatment, or other indirect losses Subject to Eurooppalainen s advance approval, indemnity is paid for - expenses for the repatriation of the patient, and for an escort where necessary. 4.4 Costs of treatment of dental injury and acute toothache The insurance covers the necessary expenses for the treatment or examination of an injury if given or prescribed by a dentist, including reasonable local travel expenses. The insurance covers expenses for treatment of injury caused by biting on a tooth or dentures, including reasonable local travel expenses, up to a maximum of EUR 85. The insurance covers expenses for necessary treatment of acute toothache, including reasonable local travel expenses, up to a maximum of EUR 85, provided the toothache began and treatment was given during the trip. 4.5 Medical handicap due to an accident Handicap Handicap (disability) refers to a medicallyassessed general handicap caused to the insured by an injury. In the determination of handicap, only the nature of the injury is taken into account, and not the individual circumstances of the injured person, such as his/her profession or leisure-time pursuits. The degree of handicap is determined in accordance with a handicap classification decision made by the Ministry of Social Affairs and Health on the basis of the Workers Compensation Insurance Act. The degree of handicap is determined according to the handicap classification valid at the time of the accident. Injuries are divided into handicap classes 1-20, with class 20 corresponding to full handicap Payment of handicap indemnity The sum insured valid at the time of accident is paid for full permanent handicap. For partial permanent handicap, the indemnity equals as many one-twentieths of the sum insured as indicated by the handicap class. A lump-sum indemnity is paid when the handicap has become permanent. Permanent handicap is determined according to the state of injury caused by the accident within three years of the incident, at the latest. If the degree of handicap changes by at least two handicap classes before three years have elapsed following payment of the lump-sum indemnity, the amount of the indemnity must be revised accordingly. No indemnity paid, however, shall be recovered. The amount of the indemnity is not reviewed because of a change in handicap class after the period mentioned Temporary handicap If one year has elapsed since the accident occurred and the injury has not healed or the handicap class has not become permanent, the injured will receive an annual continuous indemnity of 10 per cent of the portion of the sum insured corresponding to the handicap class at any given time. This handicap indemnity is not paid after three years have elapsed since the accident. 4.6 Daily benefit in the event of disability due to an accident Where an insured between 18 and 64 years of age has become disabled owing to an accident, he/she is paid the daily benefit valid at the time the accident occurred or that part of the daily benefit which corresponds to the disability. Disability is total if the insured is wholly unable to carry out his/her normal functions, and partial if the insured is partially unable to carry out these functions. Payment of daily benefits begins, at the earliest, on the day medical treatment commences, and is terminated, at the latest, when one year has elapsed since the accident. If the accident causes permanent injury and the handicap becomes permanent before one year has elapsed since the accident, payment of daily benefits will cease. 4.7 Death If the insured dies during the trip, the insurance will cover reasonable expenses of repatriation or reasonable funeral expenses abroad. These expenses will be paid on the basis of an original invoice or receipt, and even if the death of the insured was not caused by a loss event otherwise coverable under this insurance. The sum insured valid at the time of an accident is paid for accidental death of the insured. An indemnity for a permanent handicap paid because of the same accident is deducted from this indemnity. An indemnity is not, however, paid if the insured dies after three years have elapsed since the accident. The sum insured valid at the onset of an illness is paid for the death of the insured when the essential cause thereof is an infectious disease constituting a public hazard, as defined in the Decree on Infectious Diseases, and contracted on the trip. However, indemnity will not be paid if the insured dies after one year has elapsed since diagnosis of the said disease. 4.8 Losses incurred from cancellation or interruption of a trip Cancellation of a trip The insurance indemnifies for cancellation of a trip, i.e. prevention of the insured s departure for the following compelling reasons: - sudden illness of the insured - an accident sustained by the insured - death of the insured or - loss of or material damage to the insured s property in Finland. In the event of cancellation, the insurance covers costs for which the insured is liable in view of the tour operator s travel conditions The insurance does not cover cancellation of a trip if - the insurance has been paid later than three days prior to the beginning of the trip, - the reason for the cancellation has become apparent before the conclusion of the insurance contract or - the reason for the cancellation has become apparent before the reservation and payment of the trip Interruption of a trip The insurance indemnifies the interruption of a trip, i.e. a change in a trip already begun, due to a compelling reason occurring while the insured was on the trip, such as - sudden illness of the insured - an accident sustained by the insured or - loss of or material damage to the insured s property in Finland. Where a trip is interrupted, the insurance covers - unavoidable additional travel and accommodation expenses incurred by the insured; - reasonable travel expenses approved by Eurooppalainen for a new trip to the destination if such a trip is necessary because of work or continuing studies Hospital treatment and untimely return The insured is indemnified at EUR 43 per day for travel days lost on a holiday trip owing to hospital treatment or untimely return for reasons mentioned under section If the insured hospitalized during a holiday trip is under 15 years of age and treatment of the illness or injury requires, on the doctor s order, a guardian s assistance, one guardian is correspondingly indemnified for travel days lost. Indemnity for the same period is paid for only one reason, i.e. either for hospitalization or for untimely return. Indemnity is paid for a maximum of 45 days, but not above and beyond the price of the trip. Indemnity is not paid if the trip has lasted over 90 days at the time the loss occurs. The number of travel days is calculated in full 24-hour periods as of the moment the trip begins. The lost travel days are calculated correspondingly, as of the commencement of hospital treatment or of interruption of the trip until hospital treatment ceased, but not beyond the date the trip was scheduled to end. If the last full period calculated in this manner is exceeded by 12 hours, the latter is considered a full day. 4

5 4.8.5 The insured is also entitled to an indemnity as defined under sections if the cancellation of or untimely return from the trip is caused by a compelling reason such as sudden illness, accident or death suffered by the insured s spouse or common-law spouse, child, adopted or foster child, child of spouse or common-law spouse, grandchild, parents, parents-in-law or siblings. 5 LUGGAGE INSURANCE 5.1 Object of insurance The object of insurance is luggage, which means property of the insured taken along on or acquired during a trip Luggage insurance does not cover - motorized vehicles, caravans or other trailers, watercraft or aircraft, or any parts or accessories thereof - surfboards or sailboards - merchandise, samples of goods, advertising material, commercial or educational films or tapes, photographs or drawings, or program diskettes - manuscripts, collections and their parts - securities, credit cards and money - removal goods - animals or plants. 5.2 Coverable loss events and related restrictions The insurance indemnifies for any direct material damage produced by some unforeseen sudden occurrence The insurance does not indemnify for - any loss arising from the loss of goods or from leaving them behind; - any loss arising from the ordinary use of goods, or damage to goods caused by chafing, scratching or insufficient covering; - any loss of or damage to bicycles, skis or other sports equipment occurring while the equipment is being used for its intended purpose - any loss arising from an action taken by the authorities; - any loss which is indemnified under some special law, guarantee or other insurance. 5.3 Safety regulations Public places The insured must not leave his/her luggage without continuous supervision in public transport stations, squares, restaurants, shops, lobbies of hotels or other accommodation establishments, public conveyances or popular tourist sites. If bicycles, skis or other sports equipment have to be left outside or in public areas without supervision, they must be locked to a stand intended for this purpose or other suitable corresponding fixture Interior areas or storage space If an object or equipment which exceeds EUR 340 in value is kept in a hotel room or equivalent space, or in a vehicle, caravan or boat, such object or equipment must be stored in a fixed and separately locked space, provided its use, size and conditions so allow. Ski boxes, panniers and container bags etc. and trailers do not qualify as such storage spaces. No object or equipment worth over EUR 170 may be kept in a tent, shared accommodation or outside storage space forming a vehicle accessory unless a continuous watch on this is separately arranged Corrosive and staining substances Corrosive and staining substances and bottles and packages containing liquids must be packed safely and separately from other luggage Notification to the transport company If an object has been damaged or lost in transit or while stored, the damage or loss must be duly reported to and a claim filed with a representative of the haulage or transport company. 5.4 Sum insured and extent of indemnity The upper limit of Eurooppalainen s liability shall be the sum insured for property as recorded in the policy, irrespective of the total value of the luggage. As a result of a claim, the sum insured will be reduced by the amount of indemnity paid. This section does not apply to continuous insurance Regardless of the sum insured, the insurance covers - any reasonable expenses incurred in searching for lost luggage, provided the luggage had been entrusted to a hotel, service station, haulage or transport company, tour operator or similar; - any reasonable expenses incurred in rescuing the luggage and in efforts to minimize loss or damage; - expenses caused by acquiring necessities when luggage handed in for transportation is delayed at least six hours after the insured has reached the destination of his/ her outward or return trip. The maximum amount of indemnity is EUR Amount of indemnity and indemnification method For property in good condition and less than one year old, the amount of indemnity is based on the replacement value, i.e. on the price of purchasing new, similar property. Otherwise, the amount of indemnity is based on the value of the property at the time of loss, in which case the effect of age, use and other corresponding factors on the value of the property is taken into account. If damaged property can be repaired, the repair costs will be covered. Instead of paying indemnity in cash, Eurooppalainen has the right to have a damaged object repaired or replaced by another corresponding object Remaining property Any damaged or remaining undamaged property will remain in the policyholder s or the insured s possession. However, Eurooppalainen is entitled to redeem damaged property or part thereof, assessed in accordance with the principles applied prior to the loss event. If lost property is recovered following payment of indemnity, the policyholder or the insured must immediately hand the recovered property over to Eurooppalainen or return the corresponding amount of indemnity paid Multiple insurance If the insured has several insurance policies providing the same benefit, the aggregate amount of indemnity must not exceed the amount of the loss less the deductible. 6 TRAVEL LIABILITY INSURANCE 6.1 Loss or damage caused to a third party The insurance covers any bodily injury or material damage that the insured, in the capacity of a private individual, causes to a third party in the course of a trip, and for which the insured is liable according to existing legislation, provided the liability derives from an act or negligence that has taken place during the insurance period Loss or damage caused by a child Loss or damage caused by a child is covered even when the child is not liable to pay damages because of his/her age. The insurance also covers loss or damage deliberately caused by a child under 12 years of age Damage caused by a pet Regardless of any fault of the insured, the insurance covers bodily injury caused by a dog kept as an ordinary pet in the insured s family and any loss or damage caused by the family s dog in a direct collision with a motor vehicle. This regulation does not apply to - any loss or damage for which another party is liable - a traffic or other accident caused by avoiding a dog. 6.2 Loss or damage falling outside the scope of coverage 1) Loss or damage caused - to the policyholder him/herself or to another insured - to an employee of the policyholder or the equivalent, insofar as the person concerned is entitled to indemnity under statutory workers compensation insurance or motor third party liability insurance. 2) Loss of or damage to property that is or was in the insured s possession, hired by the insured or otherwise at his/her disposal when the act or negligence which caused the loss or damage took place. However, the insurance covers the liability to pay damages the insured has to assume for any sudden damage caused to the structures, equipment /appliances or furnishing of a hotel suite, rented or owner-occupied apartment used for the accommodation of the insured and his/her family, provided the loss or damage was not caused by poor maintenance or wear and tear. 3) Loss of or damage to property that was being manufactured, installed, repaired, stored or otherwise handled by the insured or by someone else on his/her behalf when the act or negligence which caused the loss or damage took place. 4) Loss or damage for which the insured is liable in the capacity of owner or possessor of real estate, unless most of the estate is used by the insured for residential purposes. 5) Loss or damage for which the insured is liable only by virtue of an agreement, engagement, promise or guarantee. 6) Loss or damage caused by the use of a motor vehicle or a motorized appliance on public roads in accordance with the Motor Liability Insurance Act or corresponding foreign legislation. 7) Loss or damage caused - by the use of a craft or boat subject to registration; 5

6 - by using an aircraft for aviation purposes, when the insured is liable to pay damages in the capacity of owner, possessor or user of the aircraft or a person carrying out duties on board the craft or in the capacity of employer of any such persons. 8) Loss or damage caused by the insured in the course of professional, business or wage-earning activity. 9) Loss or damage caused in connection with an assault or brawl. 10) A fine or any similar consequence. 11) Loss or damage insofar as this is covered by another valid liability insurance of the insured. 6.3 Indemnification regulations Sum insured The upper limit of Eurooppalainen s liability is EUR 85,000. All cases of loss or damage deriving from the same occurrence or the same circumstance are considered to constitute a single loss event Joint liability Where several parties are jointly liable to make good a case of loss or damage, the insurance will indemnify only for that part of the loss or damage which corresponds to the degree of culpability attributable to the insured and to any advantage he/she may have gained through the loss event. Where the above-mentioned circumstances have no other implications, the maximum amount of indemnity payable under the insurance shall equal the per capita share of the total loss. 6.4 Assessment of loss and liability to pay damages The insured shall endeavour to ensure that Eurooppalainen has the opportunity to assess the amount of loss or damage and to contribute to the achievement of an amicable settlement. Eurooppalainen will establish whether the insured is liable for any reported loss event covered by the insurance and will conduct negotiations with the claimant. If the insured pays damages, reaches an agreement on the amount of damages or accepts a claim, this will not be binding on Eurooppalainen unless it is obvious that the amount of damages and the basis for liability are correct. If the loss event leads to litigation, the insured must notify Eurooppalainen immediately. Eurooppalainen will undertake the handling of such litigation and meet the resulting legal expenses up to a maximum of EUR 8,500. If Eurooppalainen has informed the insured that the company is prepared to negotiate an agreement within the sum insured with the party who has suffered the loss or damage, in order to indemnify the latter for the loss or damage concerned, and the insured does not give his/her consent, Eurooppalainen will be under no obligation to pay indemnity for any subsequent costs or to carry out any further investigations. GENERAL TERMS OF CONTRACT These General Terms of Contract contain the relevant provisions of the Insurance Contracts Act (543/94). The symbol in brackets refers to the relevant sections of the Insurance Contracts Act in which the matters in question are dealt with. The insurance contract is also subject to certain provisions of the Insurance Contracts Act not appearing from these General Terms of Contract. The clauses below apply to group insurance unless otherwise agreed in respect of a matter stipulated in the group insurance contract or the terms and conditions. 1 KEY CONCEPTS ( 2, 6, 16, 17 and 31) Insurance of the person, or personal insurance, is insurance by which a natural person is covered, such as traveller s insurance. Non-life insurance is a policy taken out to cover a loss incurred due to material damage, an obligation to pay damages, or other financial loss. This insurance includes luggage, travel liability and legal expenses travel insurance. Consumer is a person who acquires consumer goods mainly for a purpose other than his/her business activity. An entrepreneur comparable to a consumer is an entrepreneur who, considering the type, extent and other circumstances of his/her business activity, is comparable to a consumer as a contracting party of the insurer. Group insurance ( 2) is insurance under which those insured are members of a group as defined in the insurance contract and the premium is paid in full by its policyholder. Safety regulation is the obligation to observe given regulations recorded in the insurance policy or insurance terms and conditions, or otherwise in written form, aimed at preventing or restricting the occurrence of a loss. The essential content of an insurance contract is defined in the insurance policy and the insurance terms and conditions. Policyholder is a party who has concluded an insurance contract with the insurer. In these terms and conditions, the insurers are referred to as the insurance company. The insurer under the contract is stated in the insurance policy. For travel insurance (traveller s, luggage, travel liability and legal expenses travel insurance), the insurer is Eurooppalainen Insurance Company Ltd. Insured is a party who is covered by personal insurance or for whose benefit non-life insurance is valid. Insurance period is the agreed period recorded in the insurance policy during which the insurance is valid. The insurance contract continues for one agreed insurance period at a time, unless either contracting party gives notice of termination. Premium period is the period for which a premium is paid at regular intervals as agreed. Insurance event is an event for which compensation is paid under the insurance. 2 DISCLOSURE OF INFORMATION PRIOR TO CONCLUDING AN INSURANCE CONTRACT 2.1 Insurance company s obligation to disclose information ( 5 and 9) (Not applicable to group insurance) Prior to concluding an insurance contract, the insurance company will provide the insurance applicant with relevant information on such matters as the insurance company s own types of insurance, premiums and insurance terms and conditions, so that the applicant can evaluate his/her insurance needs and choose the most suitable insurance cover. The insurance company will also bring the most relevant insurance exclusions to the applicant s attention. In distance selling of insurance products, the insurance company must also provide consumers with the advance information referred to in chapter 6 a of the Consumer Protection Act. Distance selling refers to selling insurance policies, for example, over the telephone or on the internet. If the insurance company or its representative has failed to provide the policyholder with any necessary information when marketing its insurance or has provided him/her with incorrect or misleading information, the insurance contract will be considered valid in the form that the policyholder has had reason to understand it in the light of the information he/she received. 2.2 Policyholder s and insured party s obligation to disclose information ( 22, 23 and 24) Prior to the insurance being granted, the policyholder and the insured party must provide full and correct answers to all questions presented by the insurance company that may be relevant to the assessment of the insurance company s liability. During the validity of the insurance period, the policyholder and the insured party must also correct without undue delay any information provided to the insurance company by him/her that he/she has found to be incorrect or insufficient. If the policyholder or the insured person has acted fraudulently with regard to the abovementioned obligation, the insurance contract is not binding on the insurance company. The insurance company has the right to withhold all premiums paid, even if the insurance is annulled. 2.3 Failure to disclose information Insurance of the person ( 24 and 34) If the policyholder or the insured person has wilfully or through negligence which cannot be deemed minor failed in his/her obligation to disclose information under personal insurance, and the insurance company would have refused to grant the insurance altogether had the full and correct information been provided, the 6

7 insurance company is released from liability. If the insurance company had granted the insurance only against a higher premium or otherwise on terms other than those agreed, the insurance company s liability is restricted to what corresponds to the agreed premium or the terms on which the insurance would have been granted. If the above-mentioned consequences of failure to disclose information lead to a result that is clearly unreasonable from the point of view of the policyholder or another party entitled to compensation, they may be adjusted Non-life insurance ( 23 and 34) If the policyholder or the insured person has wilfully or through negligence which cannot be deemed minor failed in his/her obligation to disclose information under non-life insurance, compensation payable under the insurance can be reduced or disallowed. The effect of the incorrect or insufficient information provided by the policyholder or the insured person on the occurrence of the loss or damage is taken into account in considering whether the compensation is to be reduced or disallowed. The policyholder s and the insured person s intent or the nature of negligence and other circumstances will also be taken into account. If, due to incorrect or insufficient information provided by the policyholder or the insured person, the agreed premium is smaller than it would have been had the insurance company been given the correct and full information, the ratio of the agreed premium to the premium that would have been charged had the information provided been correct and full is taken into account. If, however, the information provided differs only slightly from the correct and full information, the insurance company is not entitled to reducing compensation. 3 COMMENCEMENT OF THE INSURANCE COMPANY S LIABILITY AND VALIDITY OF THE INSURANCE CONTRACT 3.1 Commencement of the insurance company s liability ( 11) If the insurance company has not agreed on any other date individually with the policyholder, the insurance company s liability will commence from the time when the insurance company or the policyholder has submitted or sent an affirmative reply to the offer/bid of the other contracting party. Payment of the premium for the insurance period is a precondition for commencement of the insurance company s liability - if the insurance company has set the payment of the premium for the first insurance period as a precondition before continuous travel insurance can enter into force; or - if there are special reasons, for instance, because of the policyholder s earlier default of payment. The insurance bill contains a mention to this effect. If the policyholder has submitted or sent a written insurance application to the insurance company and if it is apparent that the insurance company would have approved the application, the insurance company will also assume liability for an insurance event occurring after the application was submitted or sent. An insurance application or an affirmative reply which the policyholder has submitted or sent to the insurance company s representative is considered to have been submitted or sent to the insurance company. If there is no indication of the time of the day when the reply or application was submitted or sent, it is considered to have taken place at midnight. 3.2 Grounds for granting insurance (Not applicable to group insurance) The insurance premium and other contract terms are determined in accordance with the policy anniversary. If new insurance is added to the contract, the premium and other terms of contract for this insurance are determined in accordance with the date of inception of the added insurance. Under insurance of the person, the insured person s state of health is assessed and his/ her age calculated on the basis of his/her state of health and age at the time he/she gave or submitted the insurance application. The insurance company will not reject an application for personal insurance on the grounds that an insurance event has occurred or that the state of health of the person for whom the application is made deteriorated after the application documents were submitted or sent to the insurance company. 3.3 Validity of the insurance contract Insurance of the person ( 17) After the first premium period, the insurance contract is valid for one agreed premium period at a time, unless the policyholder or the insurance company terminates the contract. The insurance contract may also terminate for other reasons referred to in clauses 4.2 and 15 below Non-life insurance ( 16) After the first insurance period, the insurance contract is valid for one agreed insurance period at a time, unless the policyholder or the insurance company terminates the contract. The insurance contract may also terminate for other reasons referred to in clauses 4.2 and 15 below Fixed-period insurance A fixed-period insurance contract is valid for the agreed insurance period. However, the insurance may terminate during the insurance period on grounds specified in clauses 4.2, 15.1 and 15.2 below. In fixed-period travel insurance, if the journey back to the insured person s country of residence is delayed for reasons beyond his/ her control, the validity period of the insurance will be extended by 48 hours. 4 INSURANCE PREMIUM 4.1 Premium payment ( 38) The insurance premium must be paid within one month of the date on which the bill for the premium was sent by the insurance company to the policyholder. However, the initial premium need not be paid before the commencement of the insurance company s liability, nor the subsequent premiums before the beginning of the agreed premium period or insurance period, except in circumstances described in clause 3.1 above, whereby the insurance company s liability will not commence until the premium has been paid. If some of the insurance company s liability commences at a later date, the related premium will not need to be paid before said liability commences. The premiums of individual insurance policies included in the same insurance contract are combined into a single premium to be invoiced in one or several instalments as agreed. If a premium resulting from an alteration made to the insurance contract has not been combined with the instalments agreed previously, this premium will be invoiced separately. The insurance premium paid for this insurance contract is divided among all individual policies in proportion to the ratio of the premium paid to the billed amount in such a way that all continuous insurance policies are valid until the same date. If payment by the policyholder is not sufficient to cover all the insurance company s insurance premium receivables, the policyholder has the right to decide for which of the outstanding premiums he/she wishes to use the money. However, the payment is used for the insurance contract to which the bill refers and to pay for the oldest outstanding amount under this contract, unless the policyholder has specified otherwise in writing. 4.2 Delayed premium ( 39) If the policyholder has neglected to pay the premium in part or in full by the due date as referred to in clause 4.1 above, the insurance company has the right to terminate the insurance contract in 14 days time after sending a notice of termination. However, if the policyholder pays the outstanding premium in full before the end of the notice period, the insurance will not cease to be effective at the end of the notice period. The insurance company will state this option in its notice of termination. If the delay in payment is caused by the policyholder s financial difficulties resulting from illness, unemployment or other special reason primarily beyond the policyholder s control, then, despite the notice given, the insurance will not expire until 14 days after the obstacle in question has ceased to exist. However, the insurance will expire in three months after the end of the notice period, at the latest. The notice of termination states this option to continue the insurance for a fixed period. The policyholder must notify the insurance company in writing of the financial difficulties referred hereto during the notice period at the latest. If the premium is not paid by the due date referred to in clause 4.1 above, penalty interest shall be paid for the period of delay in accordance with the Interest Act. The insurance company is entitled to compensation for costs incurred due to collection of insurance premiums under the Act on the Collection of Debts. If the insurance company has to collect an unpaid insurance premium through legal action, it is also entitled to being recompensed for the statutory fees and charges incurred due to the legal proceedings. The insurance company may transfer outstanding amounts for collection by a third party. 7

8 4.3 Reinstatement of terminated insurance of the person ( 43) (Not applicable to group insurance) If a contract of insurance of the person has terminated as a result of non-payment of other than the initial premium, the insurance regains its validity if the policyholder pays the outstanding premium within six months of termination of the insurance. The insurance company will state this option in its notice of termination. If the insurance regains its validity, the insurance company s liability will commence on the day following payment. 4.4 Payment of a delayed non-life insurance premium ( 42) If the policyholder pays a non-life insurance premium in full after the insurance has terminated, the insurance company s liability will commence on the day following payment. In such a case, the insurance is valid from the date of its reinstatement until the end of the insurance period originally agreed. However, if the insurance company does not wish to reinstate the insurance, the insurance company will, within 14 days of payment of the premium, notify the policyholder that it will not accept the payment. 4.5 Returning of premium at the termination of a contract ( 45) If the insurance terminates before the date agreed, the insurance company is entitled only to the premium for the period during which it was liable. The rest of the premium paid will be returned to the policyholder. The amount of premium refund is calculated by subtracting from the total premium for the insurance period in question that part which corresponds to the actual period of validity, as shown in the formula below: Premium for actual validity in days premium for X insurance period insurance period in days insurance period = premium to be refunded _ ( ) However, the premium is not returnable in cases stated below in this clause or if the policyholder or the insured person has acted fraudulently in the circumstances referred to in clause 2.2 above. However, the premium will not be returned separately if the returnable euro amount is smaller than that mentioned in the Insurance Contracts Act. The insurance company charges a nonreturnable minimum premium for travel insurance as stated in the insurance policy. 4.6 Setoff against premiums to be returned The insurance company may deduct any outstanding premiums overdue and other outstanding amounts from the premium to be returned. 5 DISCLOSURE OF INFORMATION DURING VALIDITY OF CONTRACT 5.1 Insurance company s obligation to disclose information ( 6, 7, 9 and 76) Upon entering into an insurance contract, the insurance company issues the policyholder with an insurance policy and the insurance terms and conditions, if these terms and conditions have not already been given to the policyholder. In distance selling of insurance products to consumers, however, the provisions of chapter 6 a, section 11 of the Consumer Protection Act shall apply. During the validity of the insurance, the insurance company will annually notify the policyholder of the sum insured and any other insurance-related matters of obvious relevance to the policyholder (annual bulletin). If, during the validity period of the insurance, the insurance company or its representative has provided insufficient, incorrect or misleading information on the insurance, the insurance contract will be considered valid in the form that the policyholder has had reason to understand it in the light of the information he/she was given, provided that such insufficient, incorrect or misleading information can be regarded as having influenced the policyholder s conduct. However, this does not apply to information provided by the insurance company or its representative on future compensation payable after an insurance event has occurred. If the terms and conditions of a group insurance contract include a provision to the effect that the insurer keeps a list of persons who are covered by the insurance, the insurer will, as soon as the contract takes effect and at reasonable intervals thereafter, provide those insured with information on the scope of the cover, major exclusions, obligations of the insured person under the contract and how the validity of cover depends on the fact that the insured person is a member of the group mentioned in the contract. If the insurance company does not keep a list of those insured, the above-mentioned information will be given to them in a suitable manner agreed in the group insurance contract, taking circumstances into account. 5.2 Policyholder s obligation to disclose information about any increase in risk Insurance of the person ( 27) The policyholder must notify the insurance company of any changes in factors increasing risk that were reported when the insurance contract was concluded and that are relevant in terms of assessment of the insurance company s liability, such as changes in profession/occupation, leisure time activities or place of residence, or the termination of any other insurance cover. A change resulting in increased risk may be, for instance, residence abroad of the insured person for over a year on a continuous basis. The insurance company must be notified of any such changes no later than one month of receipt of the annual bulletin following such a change. Notifying of changes in the state of health is not required. The insurance company reminds policyholders in the annual bulletin of their disclosure obligation. If, in the case of insurance of the person, the policyholder has wilfully or through negligence which cannot be deemed minor failed to notify the insurance company of increased risk as mentioned above, and the insurance company would not have kept the insurance in force as a result of the changed circumstances, the insurance company is released from liability. If, however, the insurance company had extended the validity of the insurance but only for a higher premium or on other terms, the insurance company s liability is limited to what corresponds to the insurance premium or the terms on which the insurance would have been extended. If the above-mentioned consequences of failure to disclose information lead to a result that is clearly unreasonable from the point of view of the policyholder or another party entitled to compensation, they may be adjusted Non-life insurance ( 26 and 34) The policyholder must notify the insurance company of any essential change occurring during the insurance period in the circumstances stated at the time of concluding the insurance contract or in the state of affairs recorded in the insurance policy which has increased the risk of loss or damage, and which the insurer cannot be deemed to have taken into account when concluding the contract. The policyholder must notify the insurance company of any such changes no later than one month of receipt of the annual bulletin following such a change. The insurance company will remind the policyholder of this obligation in the annual bulletin. If the holder of a non-life insurance policy has wilfully or through negligence which cannot be deemed minor failed to notify the insurance company of the increased risk, the insurance company may reduce or disallow compensation payable under the insurance. The effect of the changed, risk-increasing circumstance on the occurrence of the loss or damage is taken into account when considering whether to reduce or disallow the compensation. The policyholder s intent or the type of negligence and any other circumstances will also be taken into account. 5.3 Decrease in risk of loss If the risk of loss has decreased to such an extent that it has a bearing on the insurance contract, the company is responsible, having been informed thereof by the policyholder, for adjusting the premium and the insurance terms and conditions to correspond to the changed circumstances as of the date of the change, and at the earliest as of the beginning of the current insurance period. 5.4 Provision of information on termination of group insurance If a group insurance policy terminates as a result of action taken by the insurance company or the group insurance policyholder, the insurance company will notify the insured persons of such termination in the manner deemed appropriate in view of the circumstances. If the terms and conditions of a group insurance contract include a provision to the effect that the insurance company keeps a list of persons who are covered by the insurance, the insurance company will notify them of termination. If the insurance company does not keep a list of those insured, the notice of termination will be given in the manner agreed in the group insurance contract on providing the information specified in clause 5.2 above. In respect of the insured person, the insurance terminates in one month s time from the date the insurance company sent him/her a notice of termination or notified him/her of such termination as agreed in the group insurance. 8