MAWISTA Student Classic: die Bedingungen im Volltext

[Seite 1] Versicherungen für Auslandsaufenthalte Informationsblatt zu Versicherungsprodukten Produkt: MAWISTA Student Unternehmen: AWP P&C S.A., Niederlassung für Deutschland Classic Dieses Informationsblatt gibt Ihnen einen kurzen Überblick über die wesentlichen Inhalte unseres Versicherungsproduktes. Vollständig dargestellt ist der Versicherungsschutz in Ihren Versicherungsunterlagen. Damit Sie umfassend informiert sind, lesen Sie bitte alle Unterlagen durch. Um welche Art von Versicherung handelt es sich? MAWISTA Student Classic ist ein Versicherungs-Paket und beinhaltet folgende Leistungen: Krankenversicherung und Notruf-Versicherung. Was ist versichert? Was ist nicht versichert? Kranken- und Notruf-Versicherung Kranken- und Notruf-Versicherung Welche Ereignisse sind versichert? x Heilbehandlungen und andere ärztlich angeordnete Maßnahmen, die ein Anlass für den ✓ Krankheit oder Unfall Aufenthalt sind oder deren Notwendigkeit Ihnen vor Antritt oder zur Zeit des Versiche- ✓ Schwangerschaft und Entbindung (nach einer Wartezeit von drei bzw. acht Monaten) rungsabschlusses bekannt war oder mit denen Sie nach den Ihnen bekannten Umständen Was wird ersetzt? rechnen mussten ✓ Kosten für ambulante Behandlung durch einen Arzt x Behandlungen von Schwangerschaften, die bereits vor Versicherungsbeginn eingetreten ✓ Kosten ärztlich verordneter Arzneimittel und Heilbehandlungen sind ✓ Kosten für stationäre Behandlung im Krankenhaus x Behandlung von Schwangerschaften innerhalb der Wartezeit nach Versicherungsbeginn ✓ Kosten für schmerzstillende Zahnbehandlung x Psychoanalytische und psychotherapeutische Behandlung sowie Hypnose ✓ Kosten für den medizinisch sinnvollen und vertretbaren Rücktransport in das Ihrem Wohn- x Vorsorgeuntersuchungen ort nächstgelegene, geeignete Krankenhaus sowie im Todesfall die Überführungskosten x Zahnersatz x Unfallbedingte Sehhilfen Im Rahmen der Notruf-Versicherung: Hilfe bei persönlichen Notfällen (Krankheit, Unfall und Tod) und Organisation des Kranken-Rücktransports mit medizinisch adäquaten Mitteln, sobald dies medizinisch sinnvoll und vertretbar ist Selbstbeteiligung: € 50,- pro Versicherungsfall für ambulante Behandlungen und Zahnbe- handlungen, max. € 5.000,- pro Kalenderjahr Gibt es Deckungsbeschränkungen? Kranken- und Notruf-Versicherung ! Schmerzstillende Zahnbehandlung: höchstens € 500,- ! Heilmittel (z. B. Massage- und Fango-Behandlungen sowie Lymphdrainagen): höchstens 6 Behandlungen ! Unfallbedingte Hilfsmittel: € 250,- ! Überführungskosten maximal € 25.000,- Wo bin ich versichert? ✓ Für Personen mit Heimatland Deutschland gilt der Versicherungsschutz für den vorübergehenden Aufenthalt außerhalb Deutschlands. ✓ Für Personen mit Heimatland außerhalb Deutschlands gilt der Versicherungsschutz für den vorübergehenden Aufenthalt in Deutschland, der EU sowie der Schweiz, Liechtenstein, Norwegen, dem Vereinigten Königreich und Island. ✓ Generell sind Reisen in Gebiete, für die zum Zeitpunkt der Einreise eine Reisewarnung des Auswärtigen Amtes der Bundesrepublik Deutschland besteht, vom Versicherungsschutz ausgenommen. Welche Verpflichtungen habe ich? - Sie sind verpflichtet, uns Schadenfälle unverzüglich anzuzeigen. Kranken- und Notruf-Versicherung - Bei schweren Verletzungen oder Krankheiten, insbesondere vor Klinikaufenthalten müssen Sie sich unverzüglich an uns wenden. Wann und wie zahle ich? Die Prämie ist erstmalig mit Beginn des Versicherungsvertrages fällig und monatlich im Voraus zu zahlen. Die Prämienzahlung kann mittels eines der angebotenen Zahlungsmittel (z. B. SEPA- Lastschrift oder Kreditkarte) erfolgen. Bei Vertragslaufzeiten von mehr als einem Monat sind die Folgeprämien jeweils zum 1. des neuen Monats fällig. Wann beginnt und endet die Deckung? Der Versicherungsschutz beginnt mit dem im Versicherungsschein bezeichneten Zeitpunkt (Versicherungsbeginn), jedoch nicht vor Antragsstellung, nicht vor Grenzübertritt und nicht vor Ablauf evtl. Wartezeiten. Der Versicherungsschutz endet mit dem vereinbarten Zeitpunkt, spätestens mit der Beendigung des versicherten Aufenthalts. Der Versicherungsvertrag kann für jeweils volle Monate vereinbart werden, maximal für 48 Monate. Wie kann ich den Vertrag kündigen? Sie können den Versicherungsvertrag täglich zum Monatsende kündigen. 2020-1072 AVB 20 -1- [Seite 2] Insurance Cover for stays abroad Insurance Product Information Document Product: MAWISTA Student Company: AWP P&C S.A., Germany Branch Classic This information sheet provides you with a brief overview of the essential contents of our insurance product. The insurance cover is exhaustively described in the General Policy Conditions. To be fully informed, please read all documents. What is this type of insurance? MAWISTA Student Classic is a comprehensive Insurance and includes the following benefits: Health Insurance and Emergency Call Insurance. What is insured? What is not insured? Health Insurance and Emergency Call Insurance Health Insurance and Emergency Call Insurance Which events are insured? x Medical treatment and other measures ordered by a physician that the insured person ✓ Illness or accident knew were necessary prior to inception of insurance cover or at the time of taking out the ✓ Pregnancy and childbirth (after the expiry of a waiting period of three or eight months insurance or which he or she could have expected in the circumstances of which he or she respectively) was aware. What will be reimbursed? x Treatment of pregnancies which occurred before the commencement of insurance ✓ Costs for outpatient treatment by a physician x Treatment of pregnancies within the waiting period after the commencement of insurance ✓ Costs for medical treatment and medication prescribed by a physician x Psychoanalytical and psychotherapeutic treatment and hypnosis ✓ Costs for inpatient treatment in a hospital x Prophylactic examinations and check-ups ✓ Costs for Pain-killing dental treatment x Dentures ✓ Costs of the medically advisable and appropriate return transportation to the nearest x Visual aids required as a result of an accident suitable hospital to the place of residence and, in the event of death, the repatriation of mortal remains As part of the Emergency Call Insurance: Assistance for personal emergencies (illness, accident, death) and organisation of repatriation with medically adequate means, Are there any restrictions on cover? as soon as this is medically advisable and reasonable. Health Insurance and Emergency Call Insurance Deductible: € 50 for outpatient and dental treatments for each insured event, max. € 5,000 per ! Pain-killing dental treatment: up to € 500 calender year ! Medically prescribed treatment (e.g. massages, fango or lymph drainage treatments): up to six (medical) applications ! Aids required as a result of an accident: up to € 250 ! Repatriation costs: up to € 25,000 Where am I covered? ✓ Insurance cover is valid for insured persons with Germany as home country for the temporary stay outside Germany. ✓ Insurance cover is valid for insured persons with home country outside Germany for the temporary stays within Germany and the rest of the EU, as well as in Switzerland, Liechtenstein, Norway, United Kingdom and Iceland. ✓ In general, no coverage exists in areas for which the Federal Foreign Office of Germany has issued a travel warning at the time of your entry into this area. What are my obligations? - You are obliged to report the damage or loss to us promptly. Health Insurance and Emergency Call Insurance - In case of severe injuries or serious illnesses, particularly prior to hospitalisation, you have to contact us immediately. When and how do I pay? The premium is due for the first time on commencement of the insurance contract and is payable each month in advance. The payment of the premium can be made by using one of the available payment methods (e.g. SEPA direct debit or credit card). If a contract is valid for a term of longer than one month, the renewal premium is payable on the 1st day of the new month respectively. When does the cover start and end? Insurance cover begins at the time stated in the insurance policy (start of insurance), however not before applying for insurance, not before crossing the border and not before the expiry of any waiting periods. Waiting periods are calculated from the commencement of insurance. Insurance cover ends at the agreed time, at the latest at the end of the insured stay in the agreed area of validity. The insurance contract can be agreed for full months in each case and for a maximum term of 48 months. How do I cancel the contract? You may cancel your policy at any time. It will then expire at the end of that month. 2020-1072 AVB 20 -1- [Seite 3] Dokumente zur Versicherungspolice Die Leistungen im Überblick Inhaltsverzeichnis MAWISTA Student - Tarif Classic Datenschutzhinweise und Hinweise für den Schadenfall 2 • Krankenversicherung Versicherungsbedingungen 3  Selbstbehalt: € 50,- pro Versicherungsfall für ambulante Behandlungen und Allgemeine Bestimmungen 3 Zahnbehandlungen, max. € 5.000,- pro Kalenderjahr Krankenversicherung 3 • Notruf-Versicherung Notruf-Versicherung 4 MAWISTA Student – Versicherungsleistungen auf einen Blick / Tariftabelle 5 Wir sind für Sie da Bitte beachten Sie folgende wichtige Hinweise Hilfe im Notfall Bei Notfällen ist die Assistance für Sie da. Unser 24-Stunden-Notfall-Service bietet Geltungsbereich: siehe §2 VB AB-CLA 20 MST Ihnen rund um die Uhr schnelle und fachkundige Hilfe weltweit! Maximale Versicherungsdauer: Die Versicherungen gelten für den vereinbarten Zeitraum, maximal sind 48 Monate möglich. Telefon: +49.89.6 24 24-496 Versicherungsfähige Personen: siehe § 1 Nr. 1 VB AB-CLA 20 MST Abschlusshinweise: Der Vertrag kann jederzeit zum 1. eines Monats abgeschlossen werden. Der Versicherungsschutz beginnt mit dem in der Versicherungspolice Wichtig für Hilfe im Notfall: bezeichneten Datum, jedoch nicht vor Antragstellung, Grenzübertritt und nicht • Halten Sie die genaue Anschrift und Telefonnummer Ihres derzeitigen Aufenthalts- vor Ablauf evtl. Wartezeiten. orts bereit. • Notieren Sie sich die Namen Ihrer Ansprechpartner wie z. B. Arzt, Krankenhaus, Polizei. Versicherungsschutz besteht nur für die namentlich auf der Versicherungspolice • Schildern Sie möglichst genau den Sachverhalt und halten Sie alle notwendigen An- aufgeführte Person. Die Prämie ist erstmalig mit Beginn des Versicherungsvertrages gaben bereit. fällig und monatlich im Voraus zu zahlen. Die Prämienzahlung kann mittels eines der angebotenen Zahlungsmittel (z. B. SEPA-Lastschrift oder Kreditkarte) erfolgen. Falls Schadenmeldung der Versicherer ermächtigt wurde, die Prämie dem gewählten Zahlungsmittel zu be- Schnell, bequem und rund um die Uhr melden Sie uns Ihren Schaden unter: lasten, gilt die Zahlung als erfolgt, wenn zum Zeitpunkt des Prämieneinzugs Deckung www.mawista.com/schaden-melden auf dem vom Versicherungsnehmer genannten Zahlungsmittel besteht. Die Höhe alternativ auch per Post an die Schadenabteilung MAWISTA (Adresse siehe rechts) der Prämie richtet sich in der Regel nach dem ausgewählten Versicherungsschutz und der Laufzeit des Vertrages. Tritt der Versicherungsfall ein, müssen wir nur leisten, wenn die Prämie bezahlt ist oder wenn Sie als Versicherungsnehmer kein Verschulden daran trifft, dass die Prämie nicht gezahlt wurde. Dies müssen Sie uns nachweisen. Beschwerde, anwendbares Recht, Widerruf Die vertraglich vereinbarten Versicherungsleistungen werden von AWP P&C S.A. Beschwerdehinweis: (Allianz Partners) nach Maßgabe der nachstehenden Versicherungsbedingungen Unser Ziel ist es, erstklassige Leistungen zu bieten. Ebenso ist es uns wichtig, auf Ihre Anliegen einzuge- geboten. Mündliche Vereinbarungen sind unwirksam. Die Versicherungssteuer ist hen. Sollten Sie einmal mit unseren Produkten oder unserem Service nicht zufrieden sein, teilen Sie uns in den Prämien enthalten. Gebühren werden nicht erhoben. Maßgebend für den dies bitte direkt mit. Versicherungsumfang sind die in der Versicherungspolice dokumentierten Prämien Sie können uns Ihre Beschwerden zu Vertrags- oder Schadenfragen auf jedem Kommunikationsweg und Leistungsbeschreibungen. zukommen lassen. Telefonisch erreichen Sie uns unter +49.89.6 24 24-460, schriftlich per E-Mail an beschwerde-reise@allianz.com bzw. per Post an AWP P&C S.A.,Beschwerdemanagement, Bahnhofstraße AWP P&C S.A. Hauptbevollmächtigter: Jacob Fuest 16, D - 85609 Aschheim (bei München). Nähere Informationen zu unserem Beschwerdeprozess finden Niederlassung für Deutschland Registergericht: München HRB 4605 Sie unter www.allianz-reiseversicherung.de/beschwerde. An Streitbeilegungsverfahren vor einer Ver- braucherschlichtungsstelle nehmen wir nicht teil. Bahnhofstraße 16 USt.-IdNr.: DE 129274528 D - 85609 Aschheim (bei München) Für Beschwerden aus allen Versicherungssparten können Sie sich an die zuständige Aufsichtsbehör- de Bundesanstalt für Finanzdienstleistungsaufsicht (BaFin), Graurheindorfer Straße 108, D - 53117 Bonn, AWP P&C S.A. wenden (www.bafin.de). Aktiengesellschaft französischen Rechts Das Vertragsverhältnis unterliegt deutschem Recht, soweit internationales Recht nicht entgegensteht. Sitz der Gesellschaft: Saint-Ouen (Frankreich) Klagen aus dem Versicherungsvertrag können vom Versicherungsnehmer oder der versicherten Person Handelsregister: R.C.S. Bobigny 519 490 080 bei dem Gericht des Geschäftssitzes oder der Niederlassung des Versicherers erhoben werden. Ist der Vorstandsvorsitzende: Sirma Boshnakova Versicherungsnehmer oder die versicherte Person eine natürliche Person, so können Klagen auch vor dem Gericht erhoben werden, in dessen Bezirk der Versicherungsnehmer oder die ver-sicherte Person zur Zeit der Klageerhebung seinen Wohnsitz oder, falls kein Wohnsitz besteht, seinen gewöhnlichen Aufenthalt hat. Widerrufsrecht für Verträge mit einer Laufzeit von einem Monat oder mehr: Widerrufsfolgen: Sie können Ihre Vertragserklärung innerhalb von 14 Tagen ohne Angabe von Gründen in Textform (z. B. Im Falle eines wirksamen Widerrufs endet der Versicherungsschutz und wir erstatten Ihnen den auf Brief, Fax, E-Mail) widerrufen. Die Frist beginnt, nachdem Sie den Versicherungsschein, die Vertragsbe- die Zeit nach Zugang des Widerrufs entfallenden Teil der Prämien, wenn Sie zugestimmt haben, dass stimmungen einschließlich der Allgemeinen Versicherungsbedingungen, die weiteren Informationen der Versicherungsschutz vor dem Ende der Widerrufsfrist beginnt. Den Teil der Prämie, der auf die Zeit nach § 7 Abs. 1 und 2 des Versicherungsvertragsgesetzes in Verbindung mit den §§ 1 bis 4 der VVG- bis zum Zugang des Widerrufs entfällt, dürfen wir in diesem Fall einbehalten. Dabei handelt es sich Informationspflichtenverordnung unddiese Belehrung jeweils in Textform erhalten haben. Bei Verträ- um den anteilig nach Tagen berechneten Betrag. Die Erstattung zurückzuzahlender Beträge erfolgt gen im elektronischen Geschäftsverkehr (§ 312i Abs. 1 Satz 1 des Bürgerlichen Gesetzbuchs) beginnt unverzüglich, spätestens 30 Tage nach Zugang des Widerrufs. Beginnt der Versicherungsschutz nicht die Frist jedoch nicht vor Erfüllung unserer Pflichten gemäß § 312i Abs. 1 Satz 1 des Bürgerlichen vor dem Ende der Widerrufsfrist, hat der wirksame Widerruf zur Folge, dass empfangene Leistungen Gesetzbuchs in Verbindung mit Artikel 246c des Einführungsgesetzes zum Bürgerlichen Gesetzbuch. zurückzugewähren und gezogene Nutzungen (z. B. Zinsen) herauszugeben sind. Zur Wahrung der Widerrufsfrist genügt die rechtzeitige Absendung des Widerrufs. Der Widerruf ist zu richten an: Besondere Hinweise: AWP P&C S.A., Bahnhofstraße 16, D - 85609 Aschheim (bei München), Telefax + 49.89.6 24 24-244, Ihr Widerrufsrecht erlischt, wenn der Vertrag auf Ihren ausdrücklichen Wunsch sowohl von Ihnen als E-Mail: service-reise@allianz.com auch von uns vollständig erfüllt ist, bevor Sie Ihr Widerrufsrecht ausgeübt haben. Ihre AWP P&C S.A., Niederlassung für Deutschland -1- [Seite 4] Datenschutzhinweise Entsprechend Art. 13 und 14 der Datenschutz-Grundverordnung Wir können Ihre Daten gemäß Art 6 Abs. 1 d) DSGVO auch verarbei- III An welche Empfänger leiten wir Ihre Daten weiter? (DSGVO) informieren wir Sie über die Verarbeitung Ihrer per- ten, um Ihre lebenswichtigen Interessen zu schützen oder wenn Sie Empfänger Ihrer personenbezogenen Daten können sein: sonenbezogenen Daten durch AWP P&C S.A., Niederlassung in die Verarbeitung einwilligen, Art. 6 Abs. 1 a) DSGVO. ausgewählte externe Dienstleister (z. B. Assistance-Dienstleister, für Deutschland und die Ihnen nach dem Datenschutzrecht zu- Leistungsbearbeiter, Transportleistungserbringer, technische stehenden Rechte. Bitte geben Sie diese Hinweise allen mitver- Sollten wir Ihre personenbezogenen Daten für einen oben nicht ge- Dienstleister usw.) sowie andere Versicherer (z. B. bei Vorliegen sicherten Personen (z. B. Ehepartner) zur Kenntnis. nannten Zweck verarbeiten wollen, werden wir Sie im Rahmen der einer Mehrfachversicherung). gesetzlichen Bestimmungen darüber zuvor informieren. I Wer ist für die Verarbeitung Ihrer personenbezogenen Daten Von uns übernommene Risiken versichern wir bei speziellen Ver- verantwortlich? 2) Was gilt für besondere Kategorien von personenbezogenen sicherungsunternehmen (Rückversicherer). Dafür kann es erforder- Für die Verarbeitung Ihrer personenbezogenen Daten Daten, insbesondere Gesundheitsdaten? lich sein, Ihre Vertrags- und ggf. Schadendaten an einen Rückver- verantwortlich ist Die Verarbeitung von besonderen Kategorien personenbezogener sicherer zu übermitteln, damit dieser sich ein eigenes Bild über das Daten, zu denen auch Gesundheitsdaten gehören, unterliegt be- Risiko oder den Versicherungsfall machen kann. AWP P&C S.A., Niederlassung für Deutschland sonderem Schutz. Die Verarbeitung ist in der Regel nur zulässig, Bahnhofstraße 16 wenn Sie gemäß Art. 9 Abs. 2 a) DSGVO in die Verarbeitung einwil- Treten Sie als versicherte Person einem Gruppenversicherungsvertrag D - 85609 Aschheim (bei München). ligen oder eine der übrigen gesetzlich vorgesehenen Möglichkeiten bei (z. B. im Rahmen eines Kreditkarten-Erwerbs), können wir Ihre vorliegt, Art. 9 Abs. 2 b) – j) DSGVO. personenbezogenen Daten an den Versicherungsnehmer (z. B. Kre- Der Datenschutzbeauftragte ist per Post zu erreichen unter der oben- ditinstitut) weiterleiten, wenn dieser ein berechtigtes Interesse hat. stehenden Anschrift mit dem Zusatz – Datenschutzbeauftragter – a) Verarbeitung Ihrer personenbezogenen Daten besonderer oder per E-Mail unter datenschutz-azpde@allianz.com. Kategorien Darüber hinaus können wir Ihre personenbezogenen Daten an In vielen Fällen benötigen wir zur Prüfung des Leistungs- weitere Empfänger übermitteln, wie etwa an Behörden zur Erfül- II Für welche Zwecke und auf welcher Rechtsgrundlage werden anspruchs personenbezogene Daten, die einer besonderen lung gesetzlicher Mitteilungspflichten (z. B. Finanzbehörden oder Ihre Daten verarbeitet? Kategorie angehören (sensible Daten). Dies sind z. B. Ge- Strafverfolgungsbehörden). 1.) Was gilt für alle Kategorien von personenbezogenen Daten? sundheitsdaten. Indem Sie uns anlässlich eines konkreten Wir verarbeiten Ihre personenbezogenen Daten unter Beachtung Versicherungsfalles solche Daten verbunden mit der Bitte Die Weiterleitung der Daten ist eine Form der Verarbeitung und der EU-Datenschutz-Grundverordnung (DSGVO), des Bundes- um Prüfung und Schadenbearbeitung mitteilen, willigen Sie erfolgt ebenfalls im Rahmen der in Art. 6 Abs. 1 und Art. 9 Abs. 2 datenschutzgesetzes (BDSG), der datenschutzrechtlich relevanten ausdrücklich ein, dass wir Ihre für die Bearbeitung des Ver- DSGVO genannten Grundlagen. Bestimmungen des Versicherungsvertragsgesetzes (VVG) sowie sicherungsfalles erforderlichen sensiblen Daten verarbeiten. aller weiteren maßgeblichen Gesetze. Hierauf weisen wir Sie nochmals und gesondert im Formular IV Wie lange speichern wir Ihre Daten? zur Schadenmeldung hin. Wir bewahren Ihre Daten für die Zeit auf, in der Ansprüche gegen Stellen Sie einen Antrag auf Versicherungsschutz, benötigen wir unser Unternehmen gemacht werden können (gesetzliche Ver- die von Ihnen hierbei gemachten Angaben für den Abschluss des Die Einwilligung kann jederzeit mit Wirkung für die Zukunft jährungsfrist von drei bis zu 30 Jahren). Zudem speichern wir Ihre Vertrages und zur Einschätzung des von uns zu übernehmenden widerrufen werden. Wir weisen jedoch ausdrücklich darauf Daten, soweit wir gesetzlich dazu verpflichtet sind, z. B. nach den Risikos. Kommt der Versicherungsvertrag zustande, verarbeiten hin, dass dann die Leistungspflicht aus dem Versicherungsfall Vorschriften des Handelsgesetzbuches, der Abgabenordnung oder wir diese Daten zur Durchführung des Vertragsverhältnisses, evtl. nicht geprüft werden kann. Ist die Prüfung des Scha- des Geldwäschegesetzes. Die Speicherfristen betragen danach bis z. B. zur Rechnungsstellung. Angaben zum Schaden benötigen wir denfalles bereits abgeschlossen, können z. B. gesetzliche zu zehn Jahre. etwa, um prüfen zu können, ob ein Versicherungsfall eingetreten Aufbewahrungspflichten dazu führen, dass die Daten nicht und wie hoch der Schaden ist. gelöscht werden. V Wo werden Ihre Daten verarbeitet? Sollten wir Daten an Dienstleister außerhalb des Europäischen Wirt- Der Abschluss und die Durchführung des Versicherungsvertrages Ihre sensiblen Daten dürfen wir auch dann verarbeiten, wenn schaftsraums (EWR) übermitteln, erfolgt die Übermittlung inner- sind ohne die Verarbeitung Ihrer personenbezogenen Daten dies zum Schutz Ihrer lebenswichtigen Interessen erforder- halb des Allianz-Konzerns auf Grundlage von verbindlichen Unter- nicht möglich. lich ist und Sie aus körperlichen oder rechtlichen Gründen au- nehmensvorschriften, der sogenannten „Binding Corporate Rules“, ßerstande sind, Ihre Einwilligung abzugeben, Art. 9 Abs. 2 c) die von den Datenschutzbehörden genehmigt wurden. Diese sind Rechtsgrundlage für diese Verarbeitungen personenbezogener DSGVO. Das kann zum Beispiel bei schweren Unfällen wäh- Teil des „Allianz Privacy Standard“. Diese Unternehmensvorschrif- Daten für vorvertragliche und vertragliche Zwecke ist Art. 6 Abs. 1 b) rend der Reise der Fall sein. ten sind für alle Unternehmen der Allianz Gruppe verbindlich und DSGVO. stellen einen angemessenen Schutz von persönlichen Daten sicher. Werden wir bei Vorliegen einer Mehrfachversicherung von Der „Allianz Privacy Standard“ sowie die Liste der Unternehmen der Daneben gibt es in Art. 6 Abs. 1 a) und c) – f) DSGVO weitere einem anderen Versicherer in Anspruch genommen oder Allianz Gruppe, die diesen einhalten, kann hier aufgerufen werden: gesetzlich vorgesehene Möglichkeiten, die uns zur Verarbeitung nehmen wir einen anderen Versicherer in Anspruch, dürfen https://www.allianz-partners.com/allianz-partners---binding- berechtigen. wir Ihre sensiblen Daten zur Geltendmachung und zur Vertei- corporate-rules-.html. digung des gesetzlichen Ausgleichsanspruches verarbeiten, Wir verarbeiten Ihre Daten zur Erfüllung einer rechtlichen Verpflich- Art. 9 Abs. 2 f) DSGVO. In den Fällen, in denen der „Allianz Privacy Standard“ nicht anwend- tung gemäß Art 6 Abs. 1 c) DSGVO, z. B. zur Prüfung von Ausgleich- bar ist, erfolgt die Übermittlung in Drittländer entsprechend der ansprüchen, wenn wir von einem anderen Versicherer aufgrund b) Abfrage von Gesundheitsdaten bei Dritten zur Prüfung der Art. 44 – 50 DSGVO. einer bestehenden Mehrfachversicherung in Anspruch genommen Leistungspflicht werden. Zur Prüfung der Leistungspflicht kann es erforderlich sein, VI Welche Rechte haben Sie? dass wir Angaben über Ihre gesundheitlichen Verhältnisse Sie haben das Recht über die bei uns gespeicherten Daten Auskunft Ihre Daten verarbeiten wir auch, um berechtigte Interessen von uns prüfen müssen, die Sie zur Begründung von Ansprüchen zu erhalten sowie unrichtige Daten berichtigen zu lassen. Unter oder von Dritten zu wahren, Art. 6 Abs. 1 f) DSGVO. Dies kann insbe- gemacht haben oder die sich aus eingereichten Unterlagen bestimmten Voraussetzungen haben Sie außerdem das Recht auf sondere erforderlich sein: (z. B. Rechnungen, Verordnungen, Gutachten) oder Mit- Löschung, das Recht auf Widerspruch gegen die Verarbeitung, • zur Gewährleistung der IT-Sicherheit und des IT-Betriebs, teilungen z. B. eines Arztes oder sonstiger Angehöriger eines das Recht auf Einschränkung der Verarbeitung und das Recht auf • zur Werbung für unsere eigenen Versicherungsprodukte sowie Heilberufs ergeben. Datenübertragbarkeit. für Markt- und Meinungsumfragen, • zur Verhinderung und Aufklärung von Straftaten, insbesondere Hierfür benötigen wir Ihre Einwilligung einschließlich einer Widerspruchsrecht nutzen wir Datenanalysen zur Erkennung von Hinweisen, die auf Schweigepflichtentbindung für uns sowie für alle Stellen, die Sie können einer Verarbeitung Ihrer Daten zu Zwecken der Versicherungsmissbrauch hindeuten können. der Schweigepflicht unterliegen und Angaben zur Prüfung Direktwerbung widersprechen. Verarbeiten wir Ihre Daten zur Wir verarbeiten in der Regel nur Daten, die wir direkt von Ihnen der Leistungspflicht machen müssen. Wahrung berechtigter Interessen, können Sie dieser Verar- erhalten haben. In Einzelfällen (z. B. wenn uns ein anderer Versiche- beitung aus Gründen, die sich aus Ihrer besonderen Situation rer bei Vorliegen einer Mehrfachversicherung in Anspruch nimmt) Wir werden Sie in jedem Einzelfall informieren, von welchen er-geben, widersprechen. erhalten wir diese von Dritten. Personen oder Einrichtungen zu welchem Zweck eine Aus- kunft benötigt wird. Sie können dann jeweils entscheiden, ob Darüber hinaus verarbeiten wir Ihre personenbezogenen Daten Sie in die Erhebung und Verwendung Ihrer Gesundheitsdaten Wenn Sie sich über den Umgang mit Ihren Daten beschweren zur Erfüllung gesetzlicher Verpflichtungen, wie z. B. aufsichts- durch uns einwilligen, die genannten Personen oder Einrich- möchten, können Sie sich an den oben genannten Datenschutz- rechtlicher Vorgaben, handels- und steuerrechtlicher Aufbe- tungen sowie deren Mitarbeiter von ihrer Schweigepflicht beauftragten wenden. Für Sie besteht außerdem ein Beschwerde- wahrungspflichten. Als Rechtsgrundlage für die Verarbeitung entbinden und in die Übermittlung Ihrer Gesundheitsdaten recht bei einer Datenschutzaufsichtsbehörde. dienen in diesem Fall die jeweiligen gesetzlichen Regelungen an uns einwilligen oder die erforderlichen Unterlagen selbst in Verbindung mit Art. 6 Abs. 1 c) DSGVO. beibringen. Allgemeine Hinweise für den Schadenfall Was ist in jedem Schadenfall zu tun? Wichtig: Aus den Rechnungen müssen der Name der behandelten Der Versicherte hat den Schaden möglichst gering zu halten und Person, die Bezeichnung der Erkrankung, die Behandlungsdaten und nachzuweisen. Sichern Sie deshalb in jedem Fall bitte geeignete die einzelnen ärztlichen Leistungen mit den entsprechenden Kosten Nachweise zum Schadeneintritt (z. B. Schadenbestätigung, Attest) hervorgehen. Rezepte müssen Angaben über die verordneten Medi- und zum Umfang des Schadens (z. B. Rechnungen, Belege). kamente, die Preise und den Stempel der Apotheke enthalten. Wie verhalten Sie sich bei Krankheit, Verletzung oder anderen Not- fällen während des Aufenthalts im vereinbarten Geltungsbereich? (Krankenversicherung, Notruf-Versicherung) Wenden Sie sich bei schweren Verletzungen oder Krankheiten, insbesondere vor Klinikaufenthalten, bitte unverzüglich an die Assi- stance, damit adäquate Behandlung sichergestellt und notfalls der Rücktransport veranlasst werden kann. Für die Erstattung Ihrer vor Ort verauslagten Kosten reichen Sie bitte Originalrechnungen und / oder -rezepte ein. -2- [Seite 5] Bedingungen der AWP P&C S.A., Niederlassung für Deutschland Allgemeine Bestimmungen tritt wieder in Kraft. Für Versicherungsfälle, die nach Ablauf der Versicherungsbedingungen VB AB-CLA 20 MST Zahlungsfrist eingetreten sind, besteht jedoch kein Versiche- rungsschutz. zur Krankenversicherung VB K-CLA 20 MST Die nachstehenden Regelungen unter §§ 1 bis 11 gelten für alle MAWISTA Student Versicherungsprodukte. Die nachfolgend abge- § 5 In welchen Fällen besteht kein Versicherungsschutz? § 1 Was ist versichert? druckten Versicherungsbedingungen gelten für die jeweilige Ver- Nicht versichert sind 1. Versichert sind die Kosten sicherung. Versicherungsschutz besteht, wenn Sie die betreffende 1. Schäden durch Streik, Kernenergie, Beschlagnahme und son- a) der Heilbehandlung Versicherung vertraglich vereinbart haben. stige Eingriffe von hoher Hand sowie Schäden in Gebieten, für b) des Krankentransports welche das Auswärtige Amt eine Reisewarnung ausgesprochen c) der Überführung bei Tod § 1 Wer ist versicherungsfähig? hat. Befindet sich eine versicherte Person zum Zeitpunkt der bei im vereinbarten Geltungsbereich und versicherten Zeitraum 1. Versicherungsfähig sind Bekanntgabe einer Reisewarnung vor Ort, endet der Versiche- akut eintretenden Krankheiten und Unfällen. a) Personen mit Wohnsitz in Deutschland für Reisen ins Aus- rungsschutz 14 Tage nach Bekanntgabe der Reisewarnung; der 2. Für die Kosten der ärztlichen Behandlung der Schwangerschaft land als Sprachschüler, Studenten, Stipendiaten, Doktoran- Versicherungsschutz dauert trotz der Reisewarnung fort, wenn und Entbindung besteht nur dann im vereinbarten Geltungsbe- den, Gastwissenschaftler, Praktikanten oder im Rahmen von sich die Beendigung der Reise aus Gründen verzögert, welche reich Versicherungsschutz, wenn die Schwangerschaft (Emp- „Work- & Holiday“-Programmen sowie deren begleitende die versicherte Person nicht zu vertreten hat; fängnis) nach Versicherungsbeginn eingetreten ist. Ungeachtet Familienangehörige. 2. Schäden durch Krieg oder kriegsähnliche Ereignisse. Versiche- des Zeitpunktes des Eintrittes der Schwangerschaft und der b Personen, die aufgrund eines Aufenthaltstitels (Aufenthalts- rungsschutz besteht jedoch, wenn der Schaden sich in den Wartezeit erstattet der Versicherer die Kosten der ärztlichen erlaubnis) zu Ausbildungszwecken in Deutschland befinden, ersten 14 Tagen nach Beginn der Ereignisse ereignet; der Ver- Heilbehandlung bei akut auftretenden Schwangerschaftskom- und deren begleitende Familienangehörige. sicherungsschutz dauert jedoch fort, wenn sich die Beendigung plikationen einschließlich Fehl- und Frühgeburt. c) Personen mit einem sonstigen befristeten Aufenthaltstitel für der Reise aus Gründen verzögert, welche die versicherte Person 3. Pauschaler Spesensatz bei stationärer Unterbringung Deutschland. nicht zu vertreten hat. Dies gilt nicht bei Aufenthalten in Staaten, Werden die Kosten bei medizinisch notwendiger vollstationärer Voraussetzung ist, dass die Personen bei Versicherungsbeginn auf deren Gebiet bereits Krieg oder Bürgerkrieg herrscht oder Heilbehandlung im vereinbarten Geltungsbereich von einer drit- das 55. Lebensjahr noch nicht vollendet haben. der Ausbruch vorhersehbar war. Schäden durch die aktive Teil- ten Stelle getragen, so zahlt der Versicherer einen pauschalen 2. Versichert ist die in der Police namentlich genannte Person für nahme an Krieg, an Bürgerkrieg oder an kriegsähnlichen Ereig- Spesensatz (Telefon, TV, zusätzliche Verpflegung auch der Besu- den vorübergehenden Aufenthalt im vereinbarten Geltungs- nissen sind nicht versichert. cher etc.) in Höhe von maximal € 30,- je Tag, höchstens bis zu 45 bereich. 3. Schäden, welche die versicherte Person vorsätzlich herbeiführt. Tagen ab Beginn der stationären Behandlung. § 2 Welchen Geltungsbereich hat die Versicherung? § 6 Was muss die versicherte Person im Schadenfall unbedingt § 2 Welche Kosten werden bei Heilbehandlung erstattet? Der Versicherungsschutz gilt für versicherte Personen unternehmen (Obliegenheiten)? 1. Der Versicherer ersetzt die Aufwendungen für im vereinbarten 1. mit Heimatland Deutschland für den vorübergehenden Aufent- Die versicherte Person ist verpflichtet, Geltungsbereich notwendige ärztliche Heilbehandlung. Dazu halt außerhalb Deutschlands. Für den Aufenthalt in Deutschland 1. den Schaden möglichst gering zu halten und unnötige Kosten zu gehören die Kosten für besteht kein Versicherungsschutz. vermeiden; a) ambulante Behandlung durch einen Arzt; 2. mit befristetem Aufenthaltstitel für Deutschland für den vorü- 2. den Schaden unverzüglich dem Versicherer anzuzeigen; b) Heilbehandlungen und Arzneimittel, die der versicherten Per- bergehenden Aufenthalt in Deutschland sowie urlaubs- und 3. dem Versicherer jede sachdienliche Auskunft wahrheitsgemäß son ärztlich verordnet wurden; ausbildungsbedingte Aufenthalte in der EU sowie der Schweiz, zu erteilen. Zum Nachweis hat die versicherte Person Original- c) stationäre Behandlung im Krankenhaus einschließlich unauf- Liechtenstein, Norwegen, dem Vereinigten Königreich und Is- Rechnungen und -Belege einzureichen, gegebenenfalls die schiebbarer Operationen. Bei einer Frühgeburt werden (in land. Außerhalb der genannten Länder besteht kein Versiche- Ärzte – einschließlich der Ärzte der Assistance – von der Schwei- Abweichung von § 1 VB AB-CLA 20 MST) auch die Kosten der rungsschutz. gepflicht zu entbinden und es dem Versicherer zu gestatten, im vereinbarten Geltungsbereich notwendigen Heilbehand- Ursache und Höhe des geltend gemachten Anspruchs in zumu- lungen des neugeborenen Kindes bis zu einem Betrag von § 3 Wann beginnt und wann endet die Versicherung? tbarer Weise zu prüfen. € 100.000,- übernommen. Der Versicherungsschutz Für stationäre Behandlungen und Entbindungen in Deutsch- 1. beginnt mit dem im Versicherungsschein bezeichneten Zeit- § 7 Wann zahlt der Versicherer die Entschädigung? land gilt: Es werden allgemeine Krankenhausleistungen punkt (Versicherungsbeginn), jedoch nicht vor Antragsstellung, Hat der Versicherer die Leistungspflicht dem Grund und der Höhe (Mehrbettzimmer) gemäß der Bundespflegesatzverordnung nicht vor Grenzübertritt und nicht vor Ablauf evtl. Wartezeiten. nach festgestellt, wird die Entschädigung innerhalb von zwei bzw. dem Krankenhausentgeltgesetz erstattet; Aufwendun- Wartezeiten rechnen ab Versicherungsbeginn. Wochen ausgezahlt. gen für Wahlleistungen (privatärztliche Behandlung) sind 2. endet mit dem vereinbarten Zeitpunkt, spätestens mit der Been- nicht Gegenstand des Versicherungsschutzes. digung des versicherten Aufenthalts im vereinbarten Geltungs- § 8 Was gilt, wenn die versicherte Person Ersatzansprüche d) den medizinisch notwendigen Krankentransport zur statio- bereich. gegen Dritte hat? nären Behandlung in das nächst erreichbare und geeignete 3. kann auf Antrag vor Ablauf der ursprünglichen Vertragslaufzeit 1. Ersatzansprüche gegen Dritte gehen entsprechend der gesetz- Krankenhaus im vereinbarten Geltungsbereich und zurück in bis zu insgesamt max. 48 Monaten (= tarifliche Höchstver- lichen Regelung bis zur Höhe der geleisteten Zahlung auf den die Unterkunft; sicherungsdauer) verlängert werden, sofern der vorüber- Versicherer über, soweit der versicherten Person daraus kein e) schmerzstillende Zahnbehandlung und Reparaturen von gehende Aufenthalt andauert und der Versicherungsnehmer Nachteil entsteht. Zahnprothesen und Provisorien bis € 500,- pro Versiche- bereit ist, die im Zeitpunkt der Verlängerung gültigen Prämien 2. Die versicherte Person ist verpflichtet, in diesem Rahmen den rungsjahr; zu zahlen. Ist die tarifliche Höchstversicherungsdauer von Rechtsübergang auf Wunsch des Versicherers schriftlich zu be- f) die ärztliche Betreuung und Behandlung von Schwanger- 48 Monaten erreicht, kann unter Berücksichtigung der nachfol- stätigen. schaften, die nach Versicherungsbeginn eingetreten sind, genden Ziffer 4 ein neuer Vertrag beantragt werden. 3. Leistungsverpflichtungen aus anderen Versicherungsverträgen nach Ablauf einer Wartezeit von drei Monaten. Die besondere 4. Für Personen mit befristetem Aufenthaltstitel in Deutschland sowie der Sozialversicherungsträger gehen der Eintrittspflicht Wartezeit für Entbindung beträgt acht Monate; darf unter Berücksichtigung von gleichartigen Versicherungs- des Versicherers vor. Der Versicherer tritt in Vorleistung, sofern g) unfallbedingte Hilfsmittel bis € 250,- pro Versicherungsjahr; verträgen mit anderen Versicherern eine maximale Laufzeit von er unter Vorlage von Original-Belegen zunächst in Anspruch ge- h) ärztlich verordnete Heilmittel (z. B. Massagen- und Fango- 60 Monaten (= gesetzliche 60-Monatsgrenze) nicht überschrit- nommen wird. Behandlungen oder Lymphdrainagen), bis zu sechs Anwen- ten werden. dungen insgesamt je Versicherungsjahr; dies gilt auch dann, § 9 Wann verliert die versicherte Person den Anspruch auf wenn mehrere Anwendungen innerhalb eines Behandlungs- § 4 Welche Laufzeit hat der Vertrag und wann ist die Prämie Versicherungsleistung durch Obliegenheitsverletzung und termins durchgeführt werden; zu zahlen? Verjährung? i) medizinisch notwendige, ärztlich verordnete Rehabilitations- 1. Der Versicherungsvertrag kann für jeweils volle Monate verein- 1. Wird eine Obliegenheit vorsätzlich verletzt, ist der Versicherer maßnahmen als Anschlussheilbehandlung. bart werden, maximal für 48 Monate. von der Verpflichtung zur Leistung frei; bei grob fahrlässiger j) Der Versicherer leistet dabei im vertraglichen Umfang für 2. Der Versicherungsvertrag kann vom Versicherungsnehmer täg- Verletzung ist er berechtigt, die Leistung in einem der Schwere Untersuchungs- oder Behandlungsmethoden und Arznei- lich zum Monatsende gekündigt werden. des Verschuldens der versicherten Person entsprechenden Ver- mittel, die von der Schulmedizin überwiegend anerkannt 3. Die Prämie ist erstmalig mit Beginn des Versicherungsvertrages hältnis zu kürzen. sind. Der Versicherer leistet darüber hinaus für Metho- fällig und monatlich im Voraus zu zahlen. Die Prämienzahlung 2. Das Nichtvorliegen einer groben Fahrlässigkeit hat die versicher- den und Arzneimittel, die sich in der Praxis als ebenso kann mittels eines der angebotenen Zahlungsmittel (z. B. SEPA- te Person zu beweisen. Außer im Falle der Arglist ist der Ver- erfolgsversprechend bewährt haben und die angewen- Lastschrift oder Kreditkarte) erfolgen. sicherer zur Leistung verpflichtet, soweit die versicherte Person det werden, weil keine schulmedizinischen Methoden Ist die erste Prämie bei Eintritt des Versicherungsfalles nicht nachweist, dass die Verletzung der Obliegenheit weder für den oder Arzneimittel zur Verfügung stehen; der Versicherer gezahlt, ist der Versicherer nicht zur Leistung verpflichtet, es sei Eintritt noch für die Feststellung oder den Umfang der Leistungs- kann jedoch die Leistung auf die Höhe herabsetzen, die denn, der Versicherungsnehmer hat die Nichtzahlung nicht zu pflicht des Versicherers ursächlich ist. bei der Anwendung schulmedizinischer Methoden oder vertreten. 3. Der Anspruch auf Versicherungsleistung verjährt in drei Jahren, Arzneimittel angefallen wäre. Falls der Versicherer ermächtigt wurde, die Prämie dem ge- gerechnet ab Ende des Jahres, in welchem der Anspruch ent- 2. Der Versicherer erstattet im bedingungsgemäßen Rahmen die wählten Zahlungsmittel zu belasten, gilt die Zahlung als erfolgt, standen ist und die versicherte Person von den Umständen zur Kosten über die vereinbarte Laufzeit des Versicherungsvertrages wenn zum Zeitpunkt des Prämieneinzugs Deckung auf dem Geltendmachung des Anspruchs Kenntnis erlangt hat oder ohne hinaus bis zu 6 Wochen, maximal bis zum Tag der Transportfä- vom Versicherungsnehmer genannten Zahlungsmittel besteht. grobe Fahrlässigkeit hätte Kenntnis erlangen müssen. higkeit, sofern ein Rücktransport während der Vertragslaufzeit 4. Bei Vertragslaufzeiten von mehr als einem Monat sind die Folge- medizinisch nicht vertretbar war. prämien jeweils zum 1. des neuen Monats fällig. § 10 Welche Form gilt für die Abgabe von Willenserklärungen? Falls der Versicherer ermächtigt wurde, die Prämie dem ge- 1. Anzeigen und Willenserklärungen der versicherten Person und § 3 Welche Kosten erstattet der Versicherer bei Krankenrück- wählten Zahlungsmittel zu belasten, gilt die Zahlung als erfolgt, des Versicherers bedürfen der Textform (z. B. Brief, Fax, E-Mail). transport und Überführung? wenn zum Zeitpunkt des Prämieneinzugs Deckung auf dem 2. Versicherungsvermittler sind mit der Entgegennahme und Wei- Der Versicherer erstattet vom Versicherungsnehmer genannten Zahlungsmittel besteht. terleitung von Erklärungen an den Versicherer beauftragt. 1. die Kosten für den medizinisch sinnvollen und vertretbaren Ist die Folgeprämie zu diesem Termin nicht bezahlt, kann der Rücktransport der versicherten Person in das dem Wohnort der Versicherer in Textform eine Zahlungsfrist von mindestens zwei § 11 Welches Gericht in Deutschland ist für die Geltendma- versicherten Person im Heimatland nächstgelegene geeignete Wochen setzen. Tritt nach Ablauf der Frist ein Schadenfall ein chung der Ansprüche aus dem Versicherungsvertrag Krankenhaus. und ist der Versicherungsnehmer mit der Zahlung der Folgeprä- zuständig? Welches Recht findet Anwendung? Darüber hinaus werden auf Wunsch der versicherten Person mie noch in Verzug, ist der Versicherer von der Verpflichtung zur 1. Der Gerichtsstand ist nach Wahl der versicherten Person Mün- die Kosten des medizinisch sinnvollen und vertretbaren Rück- Leistung frei. Der Versicherer kann den Vertrag fristlos kündigen, chen oder der Ort in Deutschland, an welchem die versicherte transports erstattet, wenn nach der Prognose des behandelnden wenn der Versicherungsnehmer nach Ablauf der Frist noch mit Person zur Zeit der Klageerhebung ihren ständigen Wohnsitz Arztes die weitere Krankenhausbehandlung voraussichtlich 14 der Zahlung in Verzug ist. Wird die Zahlung innerhalb eines oder ihren ständigen Aufenthalt hat. Tage übersteigt. Monats nach der Kündigung oder dem Ablauf der Zahlungsfrist 2. Es gilt deutsches Recht, soweit internationales Recht nicht ent- nachgeholt, entfällt die Wirkung der Kündigung und der Vertrag gegensteht. -3- [Seite 6] Unabhängig hiervon werden die Kosten des Rücktransportes ins 2. Der Versicherer hat die Assistance damit beauftragt, für die ver- Heimatland übernommen, wenn diese im Rahmen der voraus- sicherte Person die nachstehend genannten Dienstleistungen sichtlichen Kosten der weiteren Heilbehandlung bleiben. im 24-Stunden-Service zu erbringen. 2. die unmittelbaren Kosten bis zu € 25.000,- für die Überführung 3. Die versicherte Person hat zur Inanspruchnahme der Dienstlei- des verstorbenen Versicherten zur Bestattung im Heimatland, stungen in Notfällen unverzüglich Kontakt zur Assistance aufzu- wahlweise die unmittelbaren Kosten der Bestattung vor Ort bis nehmen. maximal zur Höhe der Kosten der Überführung. 4. Soweit die versicherte Person weder vom Versicherer noch von einem anderen Kostenträger die Erstattung verauslagter Beträ- § 4 Welche Einschränkungen des Versicherungsschutzes sind ge beanspruchen kann, hat die versicherte Person die Beträge zu beachten? innerhalb eines Monats nach Rechnungsstellung an den Ver- Kein Versicherungsschutz besteht für sicherer zurückzuzahlen. 1. Heilbehandlungen und andere ärztlich angeordnete Maßnah- men, die ein Anlass für den Aufenthalt im vereinbarten Gel- § 2  Welche Hilfeleistung bietet die Assistance bei Krankheit tungsbereich sind; und Unfall? 2. Heilbehandlungen und andere ärztlich angeordnete Maßnah- 1. Ambulante Behandlung men, deren Notwendigkeit der versicherten Person vor dem Die Assistance informiert auf Anfrage über die Möglichkeiten Aufenthalt im vereinbarten Geltungsbereich oder zur Zeit des ärztlicher Versorgung und benennt, soweit möglich, einen Versicherungsabschlusses bekannt war oder mit denen sie nach Deutsch oder Englisch sprechenden Arzt. Die Assistance stellt den ihr bekannten Umständen rechnen musste; jedoch nicht den Kontakt zum Arzt her. 3. Nähr- und Stärkungsmittel; 2. Stationäre Behandlung 4. kieferorthopädische Behandlungen, Zahnbehandlungen, die Bei stationärer Behandlung der versicherten Person in einem über schmerzstillende Behandlungen, Reparaturen von Zahn- Krankenhaus erbringt die Assistance folgende Leistungen: prothesen und Provisorien hinausgehen; a) Betreuung 5. Heilmittel (z. B. Massagen- und Fango-Behandlungen sowie Die Assistance stellt bei Bedarf über ihren Vertragsarzt Kon- Lymphdrainagen), die sechs Behandlungen im Versicherungs- takt zum jeweiligen Hausarzt der versicherten Person und zu jahr übersteigen; den behandelnden Krankenhausärzten her; sie sorgt für die 6. die Anschaffung von Prothesen und Hilfsmitteln; für unfallbe- Übermittlung von Informationen zwischen den beteiligten dingte Hilfsmittel besteht in Abweichung hierzu Versicherungs- Ärzten. Auf Wunsch informiert die Assistance Angehörige der schutz bis € 250,- pro Versicherungsjahr; versicherten Person. 7. Behandlung von Alkohol-, Drogen- und anderen Suchtkrankhei- b) Krankenbesuche ten sowie deren Folgen; Bei stationärer Behandlung der versicherten Person orga- 8. Behandlungen von Schwangerschaften, die bereits vor Ver- nisiert die Assistance auf Wunsch die Reise für eine der ver- sicherungsbeginn eingetreten sind, sowie für die Behandlung sicherten Person nahestehende Person zum Ort des Kranken- von Schwangerschaften innerhalb der Wartezeit nach Versiche- hausaufenthaltes und zurück zum Wohnort im Heimatland. rungsbeginn; Der Versicherer übernimmt die Kosten der Beförderung bei 9. durch Siechtum, Pflegebedürftigkeit oder Verwahrung bedingte lebensbedrohender Krankheit der versicherten Person oder Behandlung oder Unterbringung; bei stationärer Behandlungsdauer von mehr als 14 Tagen. 10. psychoanalytische und psychotherapeutische Behandlung so- c) Kostenübernahme-Erklärung wie Hypnose; Bei stationärer Krankenhausbehandlung gibt der Versicherer 11. für Honorare und Gebühren, die den in dem betreffenden Land der versicherten Person eine Kostenübernahme-Erklärung bis als allgemein üblich und angemessen betrachteten Umfang zu € 15.000,-. Diese Erklärung beinhaltet keine Anerkennung übersteigen sowie für Wahlleistungen wie z. B. Einbettzimmer der Leistungspflicht. Der Versicherer übernimmt im Namen oder Chefarztbehandlung. Die Erstattung kann ggf. auf die lan- der versicherten Person die Abrechnung mit dem zuständi- desüblichen Sätze gekürzt werden; gen Kostenträger. 12. Krankenrücktransport aus einem der unter Nr. 1, 2, 7 und 9 ge- 3. Krankenrücktransport nannten Gründe. Sobald es medizinisch sinnvoll und vertretbar ist bzw. wenn 13. Vorsorgeuntersuchungen zur Früherkennung von Krankheiten, nach der Prognose des behandelnden Arztes die voraussicht- Kinder- und Jugenduntersuchungen, Zahnvorsorgeuntersu- liche Dauer des Krankenaufenthalts 14 Tage übersteigt, organi- chungen und -prophylaxe, Schutzimpfungen sowie für Hono- siert die Assistance nach vorheriger Abstimmung des Vertrags- rare und Gebühren für Atteste, Befundberichte und (Arbeits- arztes mit den behandelnden Ärzten vor Ort den Rücktransport unfähigkeits-) Bescheinigungen, die nicht vom Versicherer mit medizinisch adäquaten Transportmitteln (einschließlich angefordert wurden. Ambulanz-Flugzeugen) in das dem Wohnort der versicherten Person im Heimatland nächstgelegene geeignete Krankenhaus. § 5  Was muss die versicherte Person im Schadenfall unbedingt unternehmen (Obliegenheiten)? § 3  Beschafft die Assistance für die versicherte Person notwen- Die versicherte Person ist verpflichtet, dige Arzneimittel? 1. im Falle stationärer Behandlung im Krankenhaus, vor Beginn Die Assistance übernimmt in Abstimmung mit dem Hausarzt der umfänglicher ambulanter oder stationärer diagnostischer und versicherten Person die Beschaffung ärztlich verordneter Arzneimit- therapeutischer Maßnahmen sowie vor Abgabe von Zahlungs- tel und den Versand an die versicherte Person, soweit dies möglich anerkenntnissen unverzüglich Kontakt zur Assistance aufzu- ist. Die Kosten der Präparate hat die versicherte Person innerhalb nehmen – die nachgewiesenen Kosten zur Kontaktaufnahme eines Monats nach Reiseende an die Assistance zu erstatten. erstattet der Versicherer bis zu € 25,-; 2. ihrem Rücktransport oder der Rückführung in ihr Heimatland bei § 4  Welche Dienste leistet die Assistance bei Tod der versicher- Bestehen der Transportfähigkeit und Vorliegen der Vorausset- ten Person? zungen nach § 3 Nr. 1 VB K-CLA 20 MST zuzustimmen, wenn die Stirbt die versicherte Person während des Aufenthalts im vereinbar- Assistance den Rücktransport nach Art der Krankheit und deren ten Geltungsbereich, organisiert die Assistance nach dem Wunsch Behandlungsbedürftigkeit genehmigt. der Angehörigen die Bestattung im vereinbarten Geltungsbereich 3. dem Versicherer die Rechnungsoriginale oder Zweitschriften oder die Überführung der verstorbenen Person zum Bestattungsort mit einem Originalerstattungsstempel eines anderen Versiche- im Heimatland. rungsträgers über die gewährten Leistungen vorzulegen; diese werden Eigentum des Versicherers. § 6 Welchen Selbstbehalt trägt die versicherte Person? Der Selbstbehalt beträgt € 50,- pro Versicherungsfall für ambulante Behandlungen und Zahnbehandlungen, maximal jedoch € 5.000,- pro Kalenderjahr. Versicherungsbedingungen zur Notruf-Versicherung VB N 20 MST Hinweis: Die Assistance ist mit der Durchführung der Leistungen aus der Notruf-Versicherung beauftragt. § 1 Welche Dienste bietet der Versicherer? 1. Der Versicherer bietet der versicherten Person während des Aufenthalts im vereinbarten Geltungsbereich in nachstehend genannten Notfällen Hilfe und Beistand und trägt die entstehen- den Kosten im jeweils bezeichneten Rahmen. Die Deckungs- prüfung bleibt dem Versicherer vorbehalten; Dienstleistungen und Kostenübernahme-Erklärungen der Assistance sowie die Beauftragung von Leistungsträgern beinhalten grundsätzlich keine Anerkenntnis der Eintrittspflicht des Versicherers aus dem Versicherungsvertrag gegenüber der versicherten Person. -4- [Seite 7] MAWISTA Student – Versicherungsleistungen auf einen Blick / Tarifvergleichstabelle Tariftabelle MAWISTA Student Classic ® MAWISTAStudent Classic ® plus MAWISTA Student Comfort ® Allgemeine Bestimmungen § 2 Nr. 1 Versicherungsschutz für Deutsche in Deutschland bei einer Unter- nicht versichert nicht versichert bis zu 6 Wochen je Versicherungsjahr brechung des Auslandsaufenthalts Krankenversicherung § 2 Nr. 1 Höhe der Kostenerstattung für … ambulante Behandlung unbegrenzt unbegrenzt unbegrenzt Heilbehandlungen und Arzneimittel unbegrenzt unbegrenzt unbegrenzt Stationäre Behandlung unbegrenzt unbegrenzt unbegrenzt Heilbehandlung eines Neugeborenen bei Frühgeburt max. € 100.000,- max. € 100.000,- max. € 100.000,- Medizinisch notwendigen Krankentransport ins Krankenhaus unbegrenzt unbegrenzt unbegrenzt Schmerzstillende Zahnbehandlung je Versicherungsjahr max. € 500,- max. € 500,- max. € 1.000,- Zahnersatz je Versicherungsjahr 60 % der Gesamtkosten, nicht versichert nicht versichert max. € 1.000,- Behandlung wegen Schwangerschaft nach Ablauf einer Wartezeit von 3 bzw. 8 nach Ablauf einer Wartezeit von 3 bzw. 8 unbegrenzt Monaten: unbegrenzt Monaten: unbegrenzt Unfallbedingte Hilfsmittel je Versicherungsjahr max. € 250,- max. € 250,- max. € 1.000,- Unfallbedingte Sehhilfen je Versicherungsjahr nicht versichert nicht versichert max. € 100,- Impfungen max. € 250,- für die nicht versichert nicht versichert gesamte Vertragslaufzeit Heilmittel (z. B. Massagen-, Fango-Behandlungen, Lymphdraina- max. 6 Behandlungen max. 8 Behandlungen max. 8 Behandlungen gen) je Versicherungsjahr Rehabilitationsmaßnahmen unbegrenzt unbegrenzt unbegrenzt § 2 Nr. 2 Nachleistung nach Ablauf des Versicherungsvertrages max. 6 Wochen max. 6 Wochen max. 8 Wochen bei Transportunfähigkeit § 3 Nr. 1 Kostenerstattung für den medizinisch sinnvollen und vertretbaren Krankenrücktransport in das nächstgelegene Krankenhaus im Heimat- Krankenrücktransport ins Heimatland land in unbegrenzter Höhe, außerdem auf Wunsch der versicherten Person bei Krankenhausbehandlungen länger als 14 Tage. § 3 Nr. 2 max. € 25.000,- max. € 25.000,- max. € 25.000,- Kostenerstattung für Überführung ins Heimatland § 3 Nr. 2 max. bis zur Höhe der Überführungskosten max. bis zur Höhe der Überführungskosten max. bis zur Höhe der Überführungskosten Kostenerstattung für Bestattung vor Ort §6 € 50,- pro Versicherungsfall bei ambulanter ohne Selbstbehalt ohne Selbstbehalt Selbstbehalt Behandlung und bei Zahnbehandlungen Notrufversicherung §1-§4 Bietet weltweite Soforthilfe bei Notfällen im vereinbarten Geltungsbereich § 2 Nr. 2 max. € 15.000,- max. € 15.000,- max. € 15.000,- Höhe der Kostenübernahmeerklärung bei stationärer Behandlung Unfallversicherung §3 nicht versichert € 10.000,- € 10.000,- Versicherungssumme für den Todesfall §4 nicht versichert max. € 140.000,- max. € 140.000,- Versicherungssumme für den Invaliditätsfall § 6 Nr. 1 nicht versichert max. € 5.000,- max. € 5.000,- Bergungskosten § 6 Nr. 2 nicht versichert max. € 1.500,- max. € 1.500,- Kurbeihilfe Haftpflichtversicherung §1 • max. € 1.000.000,- für Personen- und • max. € 1.000.000,- für Personen- und Versicherungssummen nicht versichert Sachschäden Sachschäden • max. € 250.000,- für Mietsachschäden • max. € 250.000,- für Mietsachschäden Monatsprämien bis 40 Jahre € 33,10 € 59,70 € 39,70 € 63,80 € 76,80 € 76,80 Versicherungsdauer in Monaten 1. bis 12. 13. bis 48. 1. bis 12. 13. bis 48. 1. bis 12. 13. bis 48. 41 bis 55 Jahre € 69,90 € 114,- € 74,90 € 119,- € 129,90 € 134,- Versicherungsdauer in Monaten 1. bis 12. 13. bis 48. 1. bis 12. 13. bis 48. 1. bis 12. 13. bis 48. 2020-1072 -5- [Seite 8] Documents to Insurance Policy Overview of Benefits Table of contents MAWISTA Student - Tariff Classic Data Protection and General Information in the Event of Claim 2 • Health Insurance Terms and Conditions 3  Deductible: € 50 for outpatient and dental treatments for each insured event, General Provisions 3 max. € 5,000 per calender year Health Insurance 3 • Emergency Call Insurance Emergency Call Insurance 4 MAWISTA Student – Insurance Benefits at a Glance / Tariff Table 5 We are there for you Please note the following important information Assistance in an emergency Area of validity: see §2 VB AB-CLA 20 MST If you require help in an emergency the Assistance is there for you. Our 24-hour Maximum insured travel duration: The insurances are valid for the agreed term, emergency service guarantees rapid and expert assistance all over the world! maximum 48 months. Insurable persons: see §1 No. 1 VB AB-CLA 20 MST Phone: +49.89.6 24 24-496 Guidelines on taking out insurance: The policy can be purchased at any time, effective on the first day of any month. Insurance cover commences at the time specified in the insurance policy, but not before applying for insurance, not Important for help in an emergency: before crossing the border and not before the expiry of any waiting periods. • Please hold the exact address and phone number of your current whereabouts ready to hand. Insurance cover is provided only for the person named on the insurance policy. • Note down the name of your contacts, e.g. physician, hospital or police. The premium is due for the first time at the beginning of the insurance contract • Describe as exactly as possible the facts of the case and have the necessary infor- and is payable monthly in advance. The payment of the premium can be made by mation at hand. using one of the available payment methods (e.g. SEPA direct debit or credit card). If the insurer has been authorized to debit the premium from the selected payment Notification of claim method, the payment shall be deemed to have been made, if there is sufficient cover The simplest and quickest way of notifying us of your claim is via on the stated payment method at the time of debiting. The amount of the premiums https://www.mawista.com/en/file-a-claim/ is usually based on the selected insurance cover and the term of the contract. or alternatively by post to our MAWISTA Claims Department (see adress on the right). If the insured event occurs, we will only be obliged to provide indem- nity if the premium has been paid, or if you, as the policyholder, are not at fault for the non-payment of the premium. You are required to prove this to us. AWP P&C S.A. General Representative: Jacob Fuest Niederlassung für Deutschland Registration court: Munich HRB 4605 Complaints, Applicable Law and Withdrawal (Germany Branch) Bahnhofstraße 16 VAT ID No. DE 129274528 Complaint Notice: D - 85609 Aschheim (near Munich) Our goal is to offer first-class services. It is equally important to us to respond to your concerns. If you are Germany not satisfied with any of our products or our service, please notify us directly. AWP P&C S.A. You can send us your complaints relating to contract or claim issues using any means of com- Public Limited Company incorporated under French law munication. You can reach us by telephone at +49.89.6 24 24-460, in writing by e-mail to beschwerde-reise@allianz.com, or by regular mail to AWP P&C S.A., Beschwerdemanagement, Registered Office: Saint-Ouen (France) Bahnhofstrasse 16, D - 85609 Aschheim (bei München), Germany. Additional information on our com- Commercial register: R.C.S. Bobigny 519 490 080 plaint process can be found at www.allianz-reiseversicherung.de/beschwerde. We will not participate in Chairman of the Board of Management: Sirma Boshnakova dispute settlement proceedings before a consumer arbitration board. In the event of complaints relating to all types of insurance, please contact the responsible superviso- ry authority, Bundesanstalt für Finanzdienstleistungsaufsicht (BaFin - the German Federal Financial Supervisory Authority), Graurheindorfer Strasse 108, D - 53117 Bonn, Germany (www.bafin.de). This translation is for information purposes only. In the event of any The contract is governed by the laws of the Federal Republic of Germany, unless this conflicts with in- conflict or inconsistency between the German and the English versi- ternational law. Legal action based on the insurance contract can be brought by the policyholder or the ons, the German original shall prevail. insured person before the court with jurisdiction over the principal place of business or the branch of the insurer. If the policyholder or the insured person is a natural person, legal action can also be brought before the court in the district of which the policyholder or the insured person has his place of residence when the legal action is brought or, if he does not have a place of residence, his habitual place of abode. Right to revoke contracts valid for a term of one month or more: Consequences of revocation: You can revoke your contractual declaration within 14 days in writing (e.g., letter, fax, e-mail) without When revocation is effective, insurance cover ceases and we shall refund to you that portion of the stating reasons. The period begins after you have received the insurance certificate, the terms of the premium allocated to the period after receipt of the revocation if you consented to insurance cover contract including the Terms and Conditions of Insurance, the additional information pursuant to § 7 beginning prior to the end of the revocation period. We are entitled in this case to retain that portion (1) and (2) of the Insurance Contracts Act (VVG) in conjunction with §§ 1 through 4 of the VVG Decree of the premium that is allocated to the period until receipt of the revocation. This is a sum calculated on Information Duties - each of these notifications in written form. In case of contracts in electronic proportionally by days. Amounts to be refunded will be remitted without undue delay, no later than commerce (§ 312i (1)(1) of the German Civil Code (BGB), this period shall not commence prior to 30 days after receipt of the revocation. If insurance cover does not commence prior to the end of the our performance of our duties pursuant to § 312i (1)(1) of the German Civil Code in conjunction with revocation period, then effective revocation means that payments received must be refunded and uses Article 246c of the Introductory Law to the German Civil Code (EGBGB). made thereof (e.g., interest) must be disbursed. The deadline for revocation is deemed met if the revocation is dispatched in good time. It must be sent to: Special notes: AWP P&C S.A., Bahnhofstraße 16, D - 85609 Aschheim (bei München), Telefax + 49.89.6 24 24-244, Your right of revocation lapses when the contract is completely performed both by you and also by us E-Mail: service-reise@allianz.com. at your express request before you have exercised your right of revocation. Your AWP P&C S.A., Germany Branch -1- [Seite 9] Data Protection In accordance with Art. 13 and 14 of the General Data Protec- In these cases, the legal basis of the data processing is provided III To what recipients will we communicate your data? tion Regulation (GDPR), we are informing you about how your by the relevant statutory regulations in conjunction with Art 6 Recipients of your personal data may include: selected external ser- personal data is processed by AWP P&C S.A., Niederlassung für (1) c) GDPR. vice providers (e.g. assistance service providers, benefit processors, Deutschland (Germany Branch), and about the rights to which transport service providers, technical service providers, etc.), other you are entitled under data protection law. Please make all co- We may also process your data in accordance with Art 6 (1) d) insurers (e.g. in the case of multiple insurance coverage). insured individuals (e. g. your spouse) aware of this policy. GDPR in order to protect your vital interests, or if you have con- sented to the data processing, Art. 6 (1) a) GDPR. We also insure some of the risks that we cover with specialist in- I Who is responsible for processing your personal data? surance companies (re-insurers). To this end, it may be necessary Responsibility for processing your personal data rests with If we wish to process your data for any purpose other than those to send your contract and, where relevant, your claims information specified above, we will notify you in advance within the frame- to a re-insurer, to enable it to form its own opinion of the risk or the AWP P&C S.A., Niederlassung für Deutschland work of the statutory regulations. insured event. Bahnhofstraße 16 D - 85609 Aschheim (near Munich). 2. What applies to special categories of personal data, especially If you join a group insurance contract as an insured person, (e.g. health data? when acquiring a credit card), we may disclose your personal data to The Data Protection Officer can be contacted by standard mail at the There are special safeguards on the processing of special the policyholder (a bank for example), if it has a legitimate interest aforementioned address, using the suffix “Data Protection Officer“, categories of personal data, of which health data is one. As a rule, in knowing this information. or by email at datenschutz-azpde@allianz.com. processing is permitted only if you have consented to the pro- cessing in accordance with Art. 9 2) a) GDPR, or if this is a case of In addition, we may also communicate your personal data to other II F or what purpose is your data processed, and on what legal one of the other situations defined by law, Art. 9 (2) b) – j) GDPR. recipients, such as public authorities for the fulfilment of statutory basis does this take place? duties of notification (e.g. finance authorities or criminal investiga- 1. What applies to all categories of personal data? a) Processing of your special categories of personal data tion agencies). We process your personal data in compliance with the EU In many cases, in order to review the benefit entitlement, we General Data Protection Regulation (GDPR), the German Fe- require personal data belonging to a special category (sensi- The forwarding of data is a form of data processing, and is likewise deral Data Protection Act (BDSG), the provisions of the German tive data). This includes health data, for example. If, in connec- performed within the framework of the principles set out in Art. 6 Insurance Contract Act (VVG) relevant to data protection law, as tion with a specific insured event, you provide us with such (1) and Art. 9 (2) GDPR. well as all other applicable laws. data together with a request to review and process the claim, you are explicitly permitting us to process your sensitive data IV How long will we retain your data? When you apply for insurance cover, we will require the informa- necessary in order to process the insured event. We will again We will retain your data for the period during which claims may be tion provided by you at this point in order to arrange the contract remind you specifically of this fact in the claim form. made against our company (statutory limitation period of 3 to 30 years). and to estimate the risk assumed by us. If the insurance contract We will also retain your data if we are under a legal obligation to do so, comes into being, we will process this data for the implementati- You may withdraw your consent at any time, with future e.g. according to the provisions of the German Commercial Code, the on of the contractual relationship, such as for invoicing purposes. effect. However, we explicitly inform you that it may in that German Fiscal Code or the German Money Laundering Act. The relevant We require information about loss or damage in order to be able case no longer be possible to review our indemnity obligati- retention periods range up to ten years. to assess whether an insured event has occurred and determine on in connection with the insured event. If the review of the the extent of this loss or damage. claim is already concluded, there may be statutory retention V Where will your data be processed? obligations that mean the data cannot be erased. If we should transfer your data to service providers located outside It is not possible to arrange and implement the insurance of the European Economic Area (EEA), the transfer within the Allianz contract without processing your personal data. We may also process your sensitive data if this is necessary to Group will be performed on the basis of “Binding Corporate Rules“, protect your vital interests, and if you are physically or legally which have been approved by the data protection authorities. These Art. 6 (1) b) GDPR constitutes the legal basis for the processing incapable of giving consent, Art. 9 (2) c) GDPR. This may be the form part of the “Allianz Privacy Standard“. These Corporate Rules of personal data for pre-contractual and contractual purposes. case if you suffer a serious accident while travelling, for example. are binding on all companies within the Allianz Group, and they ensure an appropriate level of protection for personal data. The Alongside that, Art. 6 (1) a) and c) – f) GDPR contain other legally In the case of multiple insurance policies, if another insurer “Allianz Privacy Standard“ and the list of Allianz Group companies defined situations in which we are entitled to process personal seeks recourse from us or if we seek recourse from another bound by this standard, can be viewed here: https://www.allianz- data. insurer, we may process your sensitive data in order to assert partners.com/allianz-partners---binding-corporate-rules-.html. and defend the statutory claim for settlement, Art. 9 (2) f) GDPR. We will process your data in order to fulfil a legal obligation in In those cases in which the “Allianz Privacy Standard“ does not apply, accordance with Art 6 (1) c) GDPR, such as to review claims for b) Requesting health data from third parties for review of the transfer of data to third countries will take place in accordance settlement, if another insurer seeks recourse from us due to the the indemnity obligation with Art. 44 – 50 GDPR. existence of multiple insurance policies. In order to review our indemnity obligation, it may be ne- cessary for us to review information about the state of your VI What are your rights? We will also process your data in order to uphold our legitimate health, as provided by you for the substantiation of claims, or You have the right to be informed about all of the information re- interests or the legitimate interests of others, Art. 6 (1) f) GDPR. which is contained in the documents submitted (e.g. invoices, tained by us, and to demand that incorrect data be rectified. Under This may be the case particularly: prescriptions, medical reports) or statements, such as from a certain conditions, you also have the right to the erasure of data, the • for ensuring IT security and IT operations doctor or other member of the healthcare profession. right to object to processing, the right to the restriction of proces- • for marketing our own insurance products, and for conducting sing and the right to data portability. marketing surveys and opinion polls For this purpose, we will require your consent, including a • for the prevention and investigation of criminal activities (in par- confidentiality waiver covering us and all agencies subject to Right of objection ticular, we employ data analyses to detect possible indications of a duty of confidentiality, and which are required to provide You may object to the processing of your data for direct insurance fraud). information for review of the indemnity obligation. marketing purposes. If we process your data in order to protect legitimate interests, you may object to this processing for reasons As a rule, we only process that data that we have received directly We will notify you in each specific case about what persons pertaining to your particular situation. from you. In certain cases we may also receive such data from or institutions require information for what purpose. You may other sources (such as if another insurer seeks recourse from us then decide in each case whether you consent to us collecting If you have any objections concerning the handling of your data, due to the existence of multiple insurance policies). and using your health information, and whether to release the you may contact the aforementioned Data Protection Officer in this named persons or institutions and their duty of non-disclo- connection. You are also entitled to lodge an objection with a data We also process your personal data in order to fulfil other sure, and if you agree to the communication of your health protection supervisory authority statutory obligations, such as regulatory requirements, as well as data to us, or if you want to personally provide the necessary data retention obligations imposed by commercial and tax law. documentation. General Information in the Event of Claim What do you do in any case of damage? The insured person must minimise and document the damage as far as possible. For this reason, please ensure that you have suita- ble proof of the occurrence of the damage (e.g. confirmation of damage, medical certificate) and of the extent of damage (e.g. bills, receipts). What should you do if you fall ill, injure yourself or any other emergency occurs during your stay in the agreed area of validi- ty? (Health Insurance, Emergency Call Insurance) Please immediately contact the Assistance in case of severe injuries or serious illnesses, particularly prior to hospitalisation, so that adequa- te treatment can be ensured or repatriation transport arranged. For the reimbursement of the costs you have paid at the location, please submit original bills and/or prescriptions. Important: The bills must show the name of the person receiving treatment, the name of the illness, the treatment data and the in- dividual medical services provided and the costs of these. Prescrip- tions must provide information on the medications prescribed, the prices and bear the stamp of the pharmacy. -2- [Seite 10] Terms and Conditions of AWP P&C S.A., Germany Branch General Provisions and the contract enters into force again. However, no insurance Terms and Conditions of the VB AB-CLA 20 MST cover is provided for insured events occurring after the expiry of the period set for payment. Health Insurance VB K-CLA 20 MST The regulations as stipulated under §§ 1 to 11 apply to all MAWISTA Student insurance products. § 5 In which cases does insurance cover not apply? § 1 What is insured? The Terms and Conditions (VB) printed below apply to the respec- No insurance cover is provided in the following cases: 1. The insurance covers the costs of: tive insurance. Insurance cover is provided if you have contractually 1. Damage or loss caused by strikes, nuclear energy, confiscation a) Medical treatment agreed the insurance concerned. and other invention acts by public authority, as well as damage b) Patient repatriation transportation or loss in areas for which the German Federal Foreign Office has c) Repatriation of mortal remains in case of death § 1 Who is eligible for insurance cover? issued a travel warning. If an insured person is at such a location in the event of acute illnesses and accidental injuries occurring in 1. The following are eligible for insurance cover: at the time when a travel warning is issued, insurance cover ends the agreed area of validity within the insured period. a) Residents of Germany who are travelling abroad as language 14 days after the issuance of the travel warning; insurance cover 2. Insurance cover is provided in the agreed area of validity for the pupils, students, scholarship holders, candidates for a continues in spite of the travel warning if the end of travel is costs of the medical treatment during pregnancy and childbirth doctor‘s degree, guest researchers, practical trainees, or who delayed for reasons for which the insured person is not only if the pregnancy (conception) occurred after the commen- are participating in „work- & holiday“-programs as well as responsible. cement of insurance. Irrespective of the time when pregnancy accompanying members of his or her family. 2. Damage or loss due to war or events similar to war; however, occurred and the waiting period, the insurer will reimburse the b) Persons residing in Germany who are in possession of a insurance cover does exist if the damage or loss occurs in the costs of medical treatment in case of the occurrence of acute residence permit for educational purposes, and the first 14 days after the beginning of the events; insurance cover complications in the pregnancy including miscarriage and pre- accompanying members of their family. continues if the end of travel is delayed for reasons for which the mature birth. c)  Persons in possession of another type of temporary insured person is not responsible. This does not apply in case of 3. Flat-rate expense allowance in case of hospitalisation: residence permit for Germany. stays in countries in whose territory war or civil war is already If the costs are paid by a third party in case of medically The requirement is that the person has not yet reached their ongoing or where such an outbreak was foreseeable. Damage or necessary treatment as an inpatient in the agreed area of 55th birthday on the date on which the insurance policy begins. loss through active participation in war, civil war or events similar validity, the insurer will pay a maximum flat-rate expense 2. Insurance cover applies to the person specifically named in the to war are not covered by the insurance. allowance of € 30 per day for a maximum period of 45 days from insurance policy documentation for their temporary period of 3. Damage or losses intentionally caused by the insured person. the commencement of inpatient treatment (for telephone, TV, residence in accordance with the agreed area of validity. additional meal allowance for visitors etc.). § 6 What are the duties and obligations of the insured person § 2 What area of validity does the insurance apply to? in the event of a claim? § 2 What costs are reimbursed for medical treatment? Insurance cover is valid for insured persons The insured person is obliged to: 1. The insurer reimburses expenditures for all necessary medical 1.  with Germany as home country for the temporary stay 1. Minimise the loss as far as possible and avoid unnecessary costs. treatment in the agreed area of validity, including costs incurred outside Germany. There is no insurance coverage for stays in 2. Report the loss to the insurer without delay. for: Germany. 3. Describe the damaging event and the extent of damage and a) Outpatient treatment by a physician. 2. with temporary resident status in Germany, for the temporary truthfully provide the insurer with any and all pertinent infor- b) Medical treatment and medication prescribed by a physician stay in Germany, in addition to periods that count as holiday or mation. The insured person must furnish proof in the form of for the insured person. for training purposes in the EU as well as in Switzerland, Liech- original bills and receipts, release physicians from their confiden- c) Inpatient treatment in hospital, including operations that tenstein, Norway, United Kingdom and Iceland. There is no insu- tiality obligation as necessary – including the physicians of the cannot be postponed. In case of premature birth, the costs rance cover outside the above-stated countries. Assistance – and allow the insurer to reasonably examine the of treatment required for the newborn child in the agreed cause and amount of the asserted claim. area of validity will also be covered up to € 100,000 § 3 When does the insurance begin and end? (notwithstanding § 1 VB AB-CLA 20 MST). Insurance cover § 7 When does AWP pay compensation? The following applies for inpatient medical treatment and 1. begins at the time stated in the insurance policy (start of As soon as the insurer has determined whether and to what extent childbirth in Germany: General hospital costs (multi-bed insurance), however not before applying for insurance, not it has an duty to indemnify, compensation is paid within two weeks. room) are reimbursed and according to the Federal Nursing before crossing the border and not before the expiry of any Care Tariff Ordinance and the Hospital Remuneration Act; waiting periods. Waiting periods are calculated from the § 8 What applies if the insured person has claims for damages expenses for optional services (private medical treatment) commencement of insurance. against third parties? are not covered by the insurance. 2. ends at the agreed time, at the latest at the end of the insured 1. In accordance with statutory regulations, claims for damages d) Patient transportation deemed medically necessary for stay in the agreed area of validity. against third parties pass to the insurer up to the level of payment inpatient treatment at the nearest and appropriate hospital in 3. can be extended for up to 48 months (= maximum tariff-based effected, provided that the insured person suffers no the agreed area of validity and back to the insured person‘s term of insurance) upon application before the expiry of the disadvantage thereby. accommodation. original term of contract insofar as the temporary period of 2. The insured person is obliged to confirm the assignment of e) Pain-killing dental treatment and repairs of dentures and residency continues and the insurance policyholder is willing claims to this extent in writing upon request by the insurer. provisional measures up to € 500 per insurance year . and able to pay the premiums applicable at the time of the 3. Any duties to indemnify arising under other insurance contracts f) The medical care and treatment of pregnancies which extension of cover. If the maximum tariff-based term of and other social insurance institutions will have precedence over occurred after the commencement of insurance and after the insurance of 48 months has been completed, a new contract can those of the insurer. The insurer will be deemed to have made expiry of a waiting period of three months. The special waiting be applied for if the requirements stipulated in No. 4 below are advance payment, if the original bills are first presented to the period for childbirth is eight months. met. insurer for payment. g) Aids required as a result of an accident up to € 250 per 4. For persons with temporary resident status in Germany, a insurance year. maximum term of 60 months (= statutory limit of 60 months) § 9 When does the insured person forfeit claims to insurance h) Medically prescribed treatment (e.g. massages, fango or may not be exceeded, taking into account any similar insurance benefits due to a breach of duties and the statute of lymph drainage treatments) up to six (medical) applications policies with other insurers. limitations? in total per insurance year, even then if multiple (medical) ap- 1. If a breach of duty is intentionally committed, the insurer is plications are carried out within one treatment. § 4 What term of validity does the contract have? When is the released from its duty to indemnify; in case of grossly negligent i) Medically necessary rehabilitation measures as subsequent premium payable? violation, AWP is entitled to reduce its payment in proportion to medical treatment prescribed by a physician. 1. The insurance contract can be agreed for full months in each the degree of fault of the insured person. j) In this context, the insurer shall pay for methods of examina- case and for a maximum term of 48 months. 2. The insured person must furnish proof that no gross negligence tion or treatment widely accepted by conventional medicine 2. The insured person can give notice of termination of the was involved. Except in case of fraudulent intent, the insurer is to the extent stated in the contract. In addition, the insurer insurance contract daily to the end of the month. obliged to indemnify if the insured person furnishes proof that shall pay for methods and medication which have shown 3. The premium is due for the first time on commencement of the breach of duty is not the cause of either the occurrence themselves to be just as promising in practice and which the insurance contract and is payable each month in advance. or the determination or the scope of the insurer’s duty to are applied because no conventional medical methods or The payment of the premium can be made by using one of indemnify. medication is available. However, the insurer may reduce the the available payment methods (e.g. SEPA direct debit or 3.  The claim to an insurance benefit lapses in three years, payment to the amount which would have been incurred if credit card). calculated from the end of the year in which the claim conventional medical methods or medicine had been applied. If the first premium has not been paid upon the occurrence of occurred and the insured person obtained knowledge of the 2. The insurer reimburses the costs in accordance with the the insured event, the insurer shall not have a duty to indemnify, circumstances in order to assert the claim, or would have conditions for a duration of up to six weeks after the agreed unless the insured person is not responsible for non-payment. obtained knowledge without gross negligence. term of validity of the insurance contract until the date when the If the insurer has been authorized to debit the premium from insured person can be transported at the latest, if patient repa- the selected payment method, the payment shall be deemed to § 10 What form must be followed for submitted declarations of triation was not advised for medical reasons during the term of have been made, if there is sufficient cover on the stated pay- intent? the contract. ment method at the time of debiting. 1. Notices and declarations of intent from the insured person and 4. If a contract is valid for a term of longer than one month, the the insurer are required to be in text form (e.g. letter, fax or e-mail). § 3 What costs does the insurer reimburse in case of patient renewal premium is payable on the 1st day of the new month 2. Insurance agents are authorised to accept such documents and repatriation transportation and repatriation of mortal respectively. forward them to the insurer. remains? If the insurer has been authorized to debit the premium from the The insurer reimburses the following: selected payment method, the payment shall be deemed to have § 11 Which court in Germany is responsible for dealing with the 1. The costs of the medically advisable and justifiable repatriation been made, if there is sufficient cover on the stated payment assertion of claims based on the insurance contract and of the insured person to a suitable hospital located closest to method at the time of debiting. which law applies? the place of residence of the insured person in his or her home If the renewal premium is not paid, the insurer may set a period 1. At the option of the insured person, the courts of Munich or country. for payment of at least two weeks in text form. If an insured event the place in Germany where the insured person has his or her In addition, the costs of the medically advisable and justifiable occurs after the expiry of the period and the insured person is still permanent residence or habitual abode at the time the legal repatriation are reimbursed upon request by the insured person in arrears with the payment of the renewal premium, the insurer is action is brought will have jurisdiction and venue. where continued hospital treatment is expected to exceed 14 exempted from its duty to indemnify. The insurer may terminate 2. The laws of the Federal Republic of Germany apply insofar as days in the opinion of the physician giving treatment. the contract instantly if the insured person is still in arrears with they do not conflict with international law. Irrespective of this, the costs of the patient‘s repatriation to his or payment after the expiry of the period. If payment is made with- her home country are paid if these remain within the limits of the in one month after termination or after the expiry of the period expected costs of continued medical treatment. set for payment, the effect of the termination ceases to apply -3- [Seite 11] 2. The actual costs of up to € 25,000 for the repatriation of the § 2 What help does the Assistance provide in case of illness deceased insured person for a funeral in his or her home country and accident? or, alternatively, the actual costs of a local funeral up to the costs 1. Outpatient treatment of repatriation at the maximum. The Assistance provides information on the possibilities of medical care and names a physician who speaks German or § 4 What limitations on insurance cover are to be noted? English as far as possible. However, the Assistance does not No insurance cover is provided for the following: contact the physician. 1. Medical treatment and other measures ordered by a physician, 2. Inpatient treatment where the purpose of the stay in the agreed area of validity was In case of inpatient treatment of the insured person at a to seek such treatment. hospital, the Assistance provides the following services: 2. Medical treatment and other measures ordered by a physician a) Support that the insured person knew were necessary prior to the stay If required, the Assistance establishes contact through its in the agreed area of validity or at the time of taking out the contract physician to the respective family physician of the insurance or which he or she could have expected in the insured person and to the hospital physicians providing circumstances of which he or she was aware. treatment. It ensures that information is passed between the 3. Nutriments and tonics. physicians involved. Upon request, the Assistance informs 4. Orthodontic treatment, dental treatment other than pain-killing relatives of the insured person. treatment, repairs to dentures and provisional measures . b) Patient visits 5. Medical treatment (e.g. massages, fango or lymph drainage In case of the inpatient treatment of the insured person, the treatments) which exceed eight treatments per insurance year. Assistance organises the travel for one person close to the 6. The purchase of prostheses and other medical aids; insured person to the hospital where the insured person is notwithstanding this, insurance cover is provided up to € 250 per staying and back to his or her place of residence in his or her year for aids required as a result of an accident. home country. The insurer pays the costs of transport in case 7. Treatment of alcoholism, drug addiction and other addictions as of a life-threatening illness of the insured person or if inpati- well as the consequences thereof. ent treatment lasts for longer than 14 days. 8. Treatment of pregnancies which occurred before the c) Declaration to meet costs commencement of insurance and for the treatment of In case of inpatient hospital treatment, the insurer will give pregnancies within the waiting period after the commencement the insured person a declaration that it will meet the costs up of insurance. to an amount of € 15,000. This declaration does not involve 9. Treatment or accommodation caused by infirmity, need of any recognition that the insurer has a duty to indemnify. The nursing care or detention. insurer assumes settlement with the payer responsible in the 10.  Psychoanalytical and psychotherapeutic treatment and name of the insured person. hypnosis 3. Patient repatriation transportation 11.  For fees and charges which exceed the extent considered As soon as medically advisable and appropriate, or if the generally customary and reasonable in the country concerned duration of the hospital stay is expected to exceed 14 days in the and for optional benefits such as a single room or treatment by opinion of the physician giving treatment, the Assistance will the head physician. The reimbursement may be reduced to the organise return transportation using medically adequate means customary rates in the country. of transport (including air ambulances) to the closest suitable 12. Patient repatriation transport caused by one of the reasons hospital to the insured person‘s place of residence after prior mentioned under no. 1, 2, 7 and 9. consultation between the contract physician of the Assistance 13. Prophylactic examinations and check-ups, check-ups of child- and the local physicians handling the case. ren and young people, dental check-ups and dental prophylaxis, vaccinations as well as any charges and fees for medical certifi- § 3 Does the Assistance procure the necessary medications for cates, reports on diagnostic findings and doctor’s certificates for the insured person? inability to work, which were not requested by the insurer. In concert with the family physician of the insured person, the Assistance takes care of procuring medically prescribed medi- § 5 What are the duties and obligations of the insured person cation and sending it to the insured person, if this is possible. The in case of damage or loss? insured person must reimburse the costs of the medication to the The insured person is obliged to: Assistance within one month. 1. Contact the Assistance immediately in the event of inpatient treatment at a hospital, prior to the commencement of any § 4 What services does the Assistance provide in case of the extensive diagnostic or therapeutic procedures as an inpatient or death of the insured person? outpatient, and prior to any submission of acknowledgements of If the insured person dies during his or her stay in the agreed area of payment. The insurer will reimburse the documented costs for validity, the Assistance will organise a funeral in the agreed area of making contact up to € 25. validity or the repatriation the deceased person‘s mortal remains to 2. Consent to return or repatriation to his or her home country, the place of the funeral in his or her home country as requested by assuming the insured person is fit to be transported and the deceased person‘s relatives. provided that the requirements under § 3 No. 1 VB K-CLA 20 MST have been met, if the Assistance authorises the return journey in view of the nature of the illness and the treatment required. 3. Submit to the insurer the original invoices or duplicates with an original reimbursement stamp by another insurance company concerning the benefits granted; these will then become the property of the insurer. § 6 What deductible does the insured person pay? The deductible ist € 50 for each insured event, however a maximum of € 5,000 per calender year. Terms and Conditions of the Emergency Call Insurance VB N 20 MST N.B.: The Assistance is entrusted with the provision of services under the Emergency Call Insurance. § 1 What services does the insurer provide? 1. The insurer provides assistance and support to the insured person during his or her stay in the agreed area of validity in the emergencies named below and pays the costs incurred up to the limits specified in each case. The insurer reserves the right to check cover. Services provided by the Assistance and declara- tions on its part to meet costs as well as any orders placed with service providers do not include any acknowledgement of the insurer‘s duty to indemnify under the insurance contract vis-à- vis the insured person as a basic principle. 2. The insurer has entrusted the Assistance with the provision of services named below for the insured person as a 24-hour ser- vice. 3. The insured person must contact the Assistance without delay to claim the services in an emergency. 4. Insofar as the insured person cannot claim the reimbursement of amounts paid out from the insurer or from another payer, the insured person must repay the amounts to the insurer within one month of invoicing. -4- [Seite 12] MAWISTA Student – Insurance Benefits at a Glance / Tariff Table MAWISTA Student Classic ® MAWISTAStudent Classic ® plus MAWISTA Student Comfort ® General Provisions § 2 No. 1 Insurance cover for Germans in Germany if the stay abroad is not insured not insured up to 6 weeks per insurance year interrupted. Health Insurance § 2 No. 1 Amount of costs reimbursed for … Outpatient treatment unrestricted unrestricted unrestricted Medical treatment and medication unrestricted unrestricted unrestricted Inpatient treatment unrestricted unrestricted unrestricted Medical treatment of a newborn baby if born prematurely max. € 100,000 max. € 100,000 max. € 100,000 Medically necessary patient transportation to a hospital unrestricted unrestricted unrestricted Pain-killing dental treatment per insurance year max. € 500 max. € 500 max. € 1,000 Dentures per insurance year 60 % of the total costs, not insured not insured max. € 1,000 Treatment of pregnancy unrestricted, after the expiry of a waiting unrestricted, after the expiry of a waiting unrestricted period of 8 months period of 8 months Aids required as a result of an accident per insurance year max. € 250 max. € 250 max. € 1,000 Visual aids required as a result of an accident per insurance year not insured not insured max. € 100 Vaccination max. € 250 throughout the entire term of not insured not insured the contract Treatment (e.g. massages, fango and lymph drainage treatment) max. 6 treatments max. 8 treatments max. 8 treatments per insurance year Rehabilitation measures unrestricted unrestricted unrestricted § 2 No. 2 Provision of the insurance benefit subsequently after the expiry of max. 6 weeks max. 6 weeks max. 8 weeks the insurance contract if the insured person is unfit to travel § 3 No. 1 The costs of the medically advisable and justifiable patient repatriation transportation to the nearest hospital in the insured person‘s home Patient repatriation transportation to the home country country at an unlimited amount, also if hospital treatment lasts longer than 14 days on request by the insured person. § 3 No. 2 Reimbursement of costs for repatriation of mortal remains to home max. € 25,000 max. € 25,000 max. € 25,000 country § 3 No. 2 up to the costs of the repatriation of mortal up to the costs of the repatriation of mortal up to the costs of the repatriation of mortal Reimbursement of costs for local funeral remains at the maximum remains at the maximum remains at the maximum §6 € 50 per claim for outpatient and dental no deductible no deductible Deductible treatments Emergency Call Insurance §1-§4 Offers immediate assistance worldwide in case of an emergency in the agreed area of validity § 2 No. 2 max. € 15,000 max. € 15,000 max. € 15,000 Declaration of amount of costs assumed for inpatient treatment Accident Insurance §3 not insured € 10,000 € 10,000 Sum insured in case of death §4 not insured max. € 140,000 max. € 140,000 Sum insured in case of disability § 6 No. 1 not insured max. € 5,000 max. € 5,000 Rescue costs § 6 No. 2 not insured max. € 1,500 max. € 1,500 Health spa allowance Liability Insurance §1 • max. € 1,000,000 for personal injury and • max. € 1,000,000 for personal injury and Sums insured property damage property damage not insured • max. € 250,000 for damage to rented • max. € 250,000 for damage to rented property property Monthly Premiums up to 40 years € 33.10 € 59.70 € 39.70 € 63.80 € 76.80 € 76.80 Duration of insurance in months 1st to 12th 13th to 48th 1st to 12th 13th to 48th 1st to 12th 13th to 48th 41 to 55 years € 69.90 € 114 € 74.90 € 119 € 129.90 € 134 Duration of insurance in months 1st to 12th 13th to 48th 1st to 12th 13th to 48th 1st to 12th 13th to 48th 2020-1072 -5-

[Seite 1] Insurance Cover for stays abroad Insurance Product Information Document Product: MAWISTA Student Company: AWP P&C S.A., Germany Branch Classic This information sheet provides you with a brief overview of the essential contents of our insurance product. The insurance cover is exhaustively described in the General Policy Conditions. To be fully informed, please read all documents. What is this type of insurance? MAWISTA Student Classic is a comprehensive Insurance and includes the following benefits: Health Insurance and Emergency Call Insurance. What is insured? What is not insured? Health Insurance and Emergency Call Insurance Health Insurance and Emergency Call Insurance Which events are insured? x Medical treatment and other measures ordered by a physician that the insured person ✓ Illness or accident knew were necessary prior to inception of insurance cover or at the time of taking out the ✓ Pregnancy and childbirth (after the expiry of a waiting period of three or eight months insurance or which he or she could have expected in the circumstances of which he or she respectively) was aware. What will be reimbursed? x Treatment of pregnancies which occurred before the commencement of insurance ✓ Costs for outpatient treatment by a physician x Treatment of pregnancies within the waiting period after the commencement of insurance ✓ Costs for medical treatment and medication prescribed by a physician x Psychoanalytical and psychotherapeutic treatment and hypnosis ✓ Costs for inpatient treatment in a hospital x Prophylactic examinations and check-ups ✓ Costs for Pain-killing dental treatment x Dentures ✓ Costs of the medically advisable and appropriate return transportation to the nearest x Visual aids required as a result of an accident suitable hospital to the place of residence and, in the event of death, the repatriation of mortal remains As part of the Emergency Call Insurance: Assistance for personal emergencies (illness, accident, death) and organisation of repatriation with medically adequate means, Are there any restrictions on cover? as soon as this is medically advisable and reasonable. Health Insurance and Emergency Call Insurance Deductible: € 50 for outpatient and dental treatments for each insured event, max. € 5,000 per ! Pain-killing dental treatment: up to € 500 calender year ! Medically prescribed treatment (e.g. massages, fango or lymph drainage treatments): up to six (medical) applications ! Aids required as a result of an accident: up to € 250 ! Repatriation costs: up to € 25,000 Where am I covered? ✓ Insurance cover is valid for insured persons with Germany as home country for the temporary stay outside Germany. ✓ Insurance cover is valid for insured persons with home country outside Germany for the temporary stays within Germany and the rest of the EU, as well as in Switzerland, Liechtenstein, Norway, United Kingdom and Iceland. ✓ In general, no coverage exists in areas for which the Federal Foreign Office of Germany has issued a travel warning at the time of your entry into this area. What are my obligations? - You are obliged to report the damage or loss to us promptly. Health Insurance and Emergency Call Insurance - In case of severe injuries or serious illnesses, particularly prior to hospitalisation, you have to contact us immediately. When and how do I pay? The premium is due for the first time on commencement of the insurance contract and is payable each month in advance. The payment of the premium can be made by using one of the available payment methods (e.g. SEPA direct debit or credit card). If a contract is valid for a term of longer than one month, the renewal premium is payable on the 1st day of the new month respectively. When does the cover start and end? Insurance cover begins at the time stated in the insurance policy (start of insurance), however not before applying for insurance, not before crossing the border and not before the expiry of any waiting periods. Waiting periods are calculated from the commencement of insurance. Insurance cover ends at the agreed time, at the latest at the end of the insured stay in the agreed area of validity. The insurance contract can be agreed for full months in each case and for a maximum term of 48 months. How do I cancel the contract? You may cancel your policy at any time. It will then expire at the end of that month. 2020-1072 AVB 20 -1- [Seite 2] Documents to Insurance Policy Overview of Benefits Table of contents MAWISTA Student - Tariff Classic Data Protection and General Information in the Event of Claim 2 • Health Insurance Terms and Conditions 3  Deductible: € 50 for outpatient and dental treatments for each insured event, General Provisions 3 max. € 5,000 per calender year Health Insurance 3 • Emergency Call Insurance Emergency Call Insurance 4 MAWISTA Student – Insurance Benefits at a Glance / Tariff Table 5 We are there for you Please note the following important information Assistance in an emergency Area of validity: see §2 VB AB-CLA 20 MST If you require help in an emergency the Assistance is there for you. Our 24-hour Maximum insured travel duration: The insurances are valid for the agreed term, emergency service guarantees rapid and expert assistance all over the world! maximum 48 months. Insurable persons: see §1 No. 1 VB AB-CLA 20 MST Phone: +49.89.6 24 24-496 Guidelines on taking out insurance: The policy can be purchased at any time, effective on the first day of any month. Insurance cover commences at the time specified in the insurance policy, but not before applying for insurance, not Important for help in an emergency: before crossing the border and not before the expiry of any waiting periods. • Please hold the exact address and phone number of your current whereabouts ready to hand. Insurance cover is provided only for the person named on the insurance policy. • Note down the name of your contacts, e.g. physician, hospital or police. The premium is due for the first time at the beginning of the insurance contract • Describe as exactly as possible the facts of the case and have the necessary infor- and is payable monthly in advance. The payment of the premium can be made by mation at hand. using one of the available payment methods (e.g. SEPA direct debit or credit card). If the insurer has been authorized to debit the premium from the selected payment Notification of claim method, the payment shall be deemed to have been made, if there is sufficient cover The simplest and quickest way of notifying us of your claim is via on the stated payment method at the time of debiting. The amount of the premiums https://www.mawista.com/en/file-a-claim/ is usually based on the selected insurance cover and the term of the contract. or alternatively by post to our MAWISTA Claims Department (see adress on the right). If the insured event occurs, we will only be obliged to provide indem- nity if the premium has been paid, or if you, as the policyholder, are not at fault for the non-payment of the premium. You are required to prove this to us. AWP P&C S.A. General Representative: Jacob Fuest Niederlassung für Deutschland Registration court: Munich HRB 4605 Complaints, Applicable Law and Withdrawal (Germany Branch) Bahnhofstraße 16 VAT ID No. DE 129274528 Complaint Notice: D - 85609 Aschheim (near Munich) Our goal is to offer first-class services. It is equally important to us to respond to your concerns. If you are Germany not satisfied with any of our products or our service, please notify us directly. AWP P&C S.A. You can send us your complaints relating to contract or claim issues using any means of com- Public Limited Company incorporated under French law munication. You can reach us by telephone at +49.89.6 24 24-460, in writing by e-mail to beschwerde-reise@allianz.com, or by regular mail to AWP P&C S.A., Beschwerdemanagement, Registered Office: Saint-Ouen (France) Bahnhofstrasse 16, D - 85609 Aschheim (bei München), Germany. Additional information on our com- Commercial register: R.C.S. Bobigny 519 490 080 plaint process can be found at www.allianz-reiseversicherung.de/beschwerde. We will not participate in Chairman of the Board of Management: Sirma Boshnakova dispute settlement proceedings before a consumer arbitration board. In the event of complaints relating to all types of insurance, please contact the responsible superviso- ry authority, Bundesanstalt für Finanzdienstleistungsaufsicht (BaFin - the German Federal Financial Supervisory Authority), Graurheindorfer Strasse 108, D - 53117 Bonn, Germany (www.bafin.de). This translation is for information purposes only. In the event of any The contract is governed by the laws of the Federal Republic of Germany, unless this conflicts with in- conflict or inconsistency between the German and the English versi- ternational law. Legal action based on the insurance contract can be brought by the policyholder or the ons, the German original shall prevail. insured person before the court with jurisdiction over the principal place of business or the branch of the insurer. If the policyholder or the insured person is a natural person, legal action can also be brought before the court in the district of which the policyholder or the insured person has his place of residence when the legal action is brought or, if he does not have a place of residence, his habitual place of abode. Right to revoke contracts valid for a term of one month or more: Consequences of revocation: You can revoke your contractual declaration within 14 days in writing (e.g., letter, fax, e-mail) without When revocation is effective, insurance cover ceases and we shall refund to you that portion of the stating reasons. The period begins after you have received the insurance certificate, the terms of the premium allocated to the period after receipt of the revocation if you consented to insurance cover contract including the Terms and Conditions of Insurance, the additional information pursuant to § 7 beginning prior to the end of the revocation period. We are entitled in this case to retain that portion (1) and (2) of the Insurance Contracts Act (VVG) in conjunction with §§ 1 through 4 of the VVG Decree of the premium that is allocated to the period until receipt of the revocation. This is a sum calculated on Information Duties - each of these notifications in written form. In case of contracts in electronic proportionally by days. Amounts to be refunded will be remitted without undue delay, no later than commerce (§ 312i (1)(1) of the German Civil Code (BGB), this period shall not commence prior to 30 days after receipt of the revocation. If insurance cover does not commence prior to the end of the our performance of our duties pursuant to § 312i (1)(1) of the German Civil Code in conjunction with revocation period, then effective revocation means that payments received must be refunded and uses Article 246c of the Introductory Law to the German Civil Code (EGBGB). made thereof (e.g., interest) must be disbursed. The deadline for revocation is deemed met if the revocation is dispatched in good time. It must be sent to: Special notes: AWP P&C S.A., Bahnhofstraße 16, D - 85609 Aschheim (bei München), Telefax + 49.89.6 24 24-244, Your right of revocation lapses when the contract is completely performed both by you and also by us E-Mail: service-reise@allianz.com. at your express request before you have exercised your right of revocation. Your AWP P&C S.A., Germany Branch -1- [Seite 3] Data Protection In accordance with Art. 13 and 14 of the General Data Protec- In these cases, the legal basis of the data processing is provided III To what recipients will we communicate your data? tion Regulation (GDPR), we are informing you about how your by the relevant statutory regulations in conjunction with Art 6 Recipients of your personal data may include: selected external ser- personal data is processed by AWP P&C S.A., Niederlassung für (1) c) GDPR. vice providers (e.g. assistance service providers, benefit processors, Deutschland (Germany Branch), and about the rights to which transport service providers, technical service providers, etc.), other you are entitled under data protection law. Please make all co- We may also process your data in accordance with Art 6 (1) d) insurers (e.g. in the case of multiple insurance coverage). insured individuals (e. g. your spouse) aware of this policy. GDPR in order to protect your vital interests, or if you have con- sented to the data processing, Art. 6 (1) a) GDPR. We also insure some of the risks that we cover with specialist in- I Who is responsible for processing your personal data? surance companies (re-insurers). To this end, it may be necessary Responsibility for processing your personal data rests with If we wish to process your data for any purpose other than those to send your contract and, where relevant, your claims information specified above, we will notify you in advance within the frame- to a re-insurer, to enable it to form its own opinion of the risk or the AWP P&C S.A., Niederlassung für Deutschland work of the statutory regulations. insured event. Bahnhofstraße 16 D - 85609 Aschheim (near Munich). 2. What applies to special categories of personal data, especially If you join a group insurance contract as an insured person, (e.g. health data? when acquiring a credit card), we may disclose your personal data to The Data Protection Officer can be contacted by standard mail at the There are special safeguards on the processing of special the policyholder (a bank for example), if it has a legitimate interest aforementioned address, using the suffix “Data Protection Officer“, categories of personal data, of which health data is one. As a rule, in knowing this information. or by email at datenschutz-azpde@allianz.com. processing is permitted only if you have consented to the pro- cessing in accordance with Art. 9 2) a) GDPR, or if this is a case of In addition, we may also communicate your personal data to other II F or what purpose is your data processed, and on what legal one of the other situations defined by law, Art. 9 (2) b) – j) GDPR. recipients, such as public authorities for the fulfilment of statutory basis does this take place? duties of notification (e.g. finance authorities or criminal investiga- 1. What applies to all categories of personal data? a) Processing of your special categories of personal data tion agencies). We process your personal data in compliance with the EU In many cases, in order to review the benefit entitlement, we General Data Protection Regulation (GDPR), the German Fe- require personal data belonging to a special category (sensi- The forwarding of data is a form of data processing, and is likewise deral Data Protection Act (BDSG), the provisions of the German tive data). This includes health data, for example. If, in connec- performed within the framework of the principles set out in Art. 6 Insurance Contract Act (VVG) relevant to data protection law, as tion with a specific insured event, you provide us with such (1) and Art. 9 (2) GDPR. well as all other applicable laws. data together with a request to review and process the claim, you are explicitly permitting us to process your sensitive data IV How long will we retain your data? When you apply for insurance cover, we will require the informa- necessary in order to process the insured event. We will again We will retain your data for the period during which claims may be tion provided by you at this point in order to arrange the contract remind you specifically of this fact in the claim form. made against our company (statutory limitation period of 3 to 30 years). and to estimate the risk assumed by us. If the insurance contract We will also retain your data if we are under a legal obligation to do so, comes into being, we will process this data for the implementati- You may withdraw your consent at any time, with future e.g. according to the provisions of the German Commercial Code, the on of the contractual relationship, such as for invoicing purposes. effect. However, we explicitly inform you that it may in that German Fiscal Code or the German Money Laundering Act. The relevant We require information about loss or damage in order to be able case no longer be possible to review our indemnity obligati- retention periods range up to ten years. to assess whether an insured event has occurred and determine on in connection with the insured event. If the review of the the extent of this loss or damage. claim is already concluded, there may be statutory retention V Where will your data be processed? obligations that mean the data cannot be erased. If we should transfer your data to service providers located outside It is not possible to arrange and implement the insurance of the European Economic Area (EEA), the transfer within the Allianz contract without processing your personal data. We may also process your sensitive data if this is necessary to Group will be performed on the basis of “Binding Corporate Rules“, protect your vital interests, and if you are physically or legally which have been approved by the data protection authorities. These Art. 6 (1) b) GDPR constitutes the legal basis for the processing incapable of giving consent, Art. 9 (2) c) GDPR. This may be the form part of the “Allianz Privacy Standard“. These Corporate Rules of personal data for pre-contractual and contractual purposes. case if you suffer a serious accident while travelling, for example. are binding on all companies within the Allianz Group, and they ensure an appropriate level of protection for personal data. The Alongside that, Art. 6 (1) a) and c) – f) GDPR contain other legally In the case of multiple insurance policies, if another insurer “Allianz Privacy Standard“ and the list of Allianz Group companies defined situations in which we are entitled to process personal seeks recourse from us or if we seek recourse from another bound by this standard, can be viewed here: https://www.allianz- data. insurer, we may process your sensitive data in order to assert partners.com/allianz-partners---binding-corporate-rules-.html. and defend the statutory claim for settlement, Art. 9 (2) f) GDPR. We will process your data in order to fulfil a legal obligation in In those cases in which the “Allianz Privacy Standard“ does not apply, accordance with Art 6 (1) c) GDPR, such as to review claims for b) Requesting health data from third parties for review of the transfer of data to third countries will take place in accordance settlement, if another insurer seeks recourse from us due to the the indemnity obligation with Art. 44 – 50 GDPR. existence of multiple insurance policies. In order to review our indemnity obligation, it may be ne- cessary for us to review information about the state of your VI What are your rights? We will also process your data in order to uphold our legitimate health, as provided by you for the substantiation of claims, or You have the right to be informed about all of the information re- interests or the legitimate interests of others, Art. 6 (1) f) GDPR. which is contained in the documents submitted (e.g. invoices, tained by us, and to demand that incorrect data be rectified. Under This may be the case particularly: prescriptions, medical reports) or statements, such as from a certain conditions, you also have the right to the erasure of data, the • for ensuring IT security and IT operations doctor or other member of the healthcare profession. right to object to processing, the right to the restriction of proces- • for marketing our own insurance products, and for conducting sing and the right to data portability. marketing surveys and opinion polls For this purpose, we will require your consent, including a • for the prevention and investigation of criminal activities (in par- confidentiality waiver covering us and all agencies subject to Right of objection ticular, we employ data analyses to detect possible indications of a duty of confidentiality, and which are required to provide You may object to the processing of your data for direct insurance fraud). information for review of the indemnity obligation. marketing purposes. If we process your data in order to protect legitimate interests, you may object to this processing for reasons As a rule, we only process that data that we have received directly We will notify you in each specific case about what persons pertaining to your particular situation. from you. In certain cases we may also receive such data from or institutions require information for what purpose. You may other sources (such as if another insurer seeks recourse from us then decide in each case whether you consent to us collecting If you have any objections concerning the handling of your data, due to the existence of multiple insurance policies). and using your health information, and whether to release the you may contact the aforementioned Data Protection Officer in this named persons or institutions and their duty of non-disclo- connection. You are also entitled to lodge an objection with a data We also process your personal data in order to fulfil other sure, and if you agree to the communication of your health protection supervisory authority statutory obligations, such as regulatory requirements, as well as data to us, or if you want to personally provide the necessary data retention obligations imposed by commercial and tax law. documentation. General Information in the Event of Claim What do you do in any case of damage? The insured person must minimise and document the damage as far as possible. For this reason, please ensure that you have suita- ble proof of the occurrence of the damage (e.g. confirmation of damage, medical certificate) and of the extent of damage (e.g. bills, receipts). What should you do if you fall ill, injure yourself or any other emergency occurs during your stay in the agreed area of validi- ty? (Health Insurance, Emergency Call Insurance) Please immediately contact the Assistance in case of severe injuries or serious illnesses, particularly prior to hospitalisation, so that adequa- te treatment can be ensured or repatriation transport arranged. For the reimbursement of the costs you have paid at the location, please submit original bills and/or prescriptions. Important: The bills must show the name of the person receiving treatment, the name of the illness, the treatment data and the in- dividual medical services provided and the costs of these. Prescrip- tions must provide information on the medications prescribed, the prices and bear the stamp of the pharmacy. -2- [Seite 4] Terms and Conditions of AWP P&C S.A., Germany Branch General Provisions and the contract enters into force again. However, no insurance Terms and Conditions of the VB AB-CLA 20 MST cover is provided for insured events occurring after the expiry of the period set for payment. Health Insurance VB K-CLA 20 MST The regulations as stipulated under §§ 1 to 11 apply to all MAWISTA Student insurance products. § 5 In which cases does insurance cover not apply? § 1 What is insured? The Terms and Conditions (VB) printed below apply to the respec- No insurance cover is provided in the following cases: 1. The insurance covers the costs of: tive insurance. Insurance cover is provided if you have contractually 1. Damage or loss caused by strikes, nuclear energy, confiscation a) Medical treatment agreed the insurance concerned. and other invention acts by public authority, as well as damage b) Patient repatriation transportation or loss in areas for which the German Federal Foreign Office has c) Repatriation of mortal remains in case of death § 1 Who is eligible for insurance cover? issued a travel warning. If an insured person is at such a location in the event of acute illnesses and accidental injuries occurring in 1. The following are eligible for insurance cover: at the time when a travel warning is issued, insurance cover ends the agreed area of validity within the insured period. a) Residents of Germany who are travelling abroad as language 14 days after the issuance of the travel warning; insurance cover 2. Insurance cover is provided in the agreed area of validity for the pupils, students, scholarship holders, candidates for a continues in spite of the travel warning if the end of travel is costs of the medical treatment during pregnancy and childbirth doctor‘s degree, guest researchers, practical trainees, or who delayed for reasons for which the insured person is not only if the pregnancy (conception) occurred after the commen- are participating in „work- & holiday“-programs as well as responsible. cement of insurance. Irrespective of the time when pregnancy accompanying members of his or her family. 2. Damage or loss due to war or events similar to war; however, occurred and the waiting period, the insurer will reimburse the b) Persons residing in Germany who are in possession of a insurance cover does exist if the damage or loss occurs in the costs of medical treatment in case of the occurrence of acute residence permit for educational purposes, and the first 14 days after the beginning of the events; insurance cover complications in the pregnancy including miscarriage and pre- accompanying members of their family. continues if the end of travel is delayed for reasons for which the mature birth. c)  Persons in possession of another type of temporary insured person is not responsible. This does not apply in case of 3. Flat-rate expense allowance in case of hospitalisation: residence permit for Germany. stays in countries in whose territory war or civil war is already If the costs are paid by a third party in case of medically The requirement is that the person has not yet reached their ongoing or where such an outbreak was foreseeable. Damage or necessary treatment as an inpatient in the agreed area of 55th birthday on the date on which the insurance policy begins. loss through active participation in war, civil war or events similar validity, the insurer will pay a maximum flat-rate expense 2. Insurance cover applies to the person specifically named in the to war are not covered by the insurance. allowance of € 30 per day for a maximum period of 45 days from insurance policy documentation for their temporary period of 3. Damage or losses intentionally caused by the insured person. the commencement of inpatient treatment (for telephone, TV, residence in accordance with the agreed area of validity. additional meal allowance for visitors etc.). § 6 What are the duties and obligations of the insured person § 2 What area of validity does the insurance apply to? in the event of a claim? § 2 What costs are reimbursed for medical treatment? Insurance cover is valid for insured persons The insured person is obliged to: 1. The insurer reimburses expenditures for all necessary medical 1.  with Germany as home country for the temporary stay 1. Minimise the loss as far as possible and avoid unnecessary costs. treatment in the agreed area of validity, including costs incurred outside Germany. There is no insurance coverage for stays in 2. Report the loss to the insurer without delay. for: Germany. 3. Describe the damaging event and the extent of damage and a) Outpatient treatment by a physician. 2. with temporary resident status in Germany, for the temporary truthfully provide the insurer with any and all pertinent infor- b) Medical treatment and medication prescribed by a physician stay in Germany, in addition to periods that count as holiday or mation. The insured person must furnish proof in the form of for the insured person. for training purposes in the EU as well as in Switzerland, Liech- original bills and receipts, release physicians from their confiden- c) Inpatient treatment in hospital, including operations that tenstein, Norway, United Kingdom and Iceland. There is no insu- tiality obligation as necessary – including the physicians of the cannot be postponed. In case of premature birth, the costs rance cover outside the above-stated countries. Assistance – and allow the insurer to reasonably examine the of treatment required for the newborn child in the agreed cause and amount of the asserted claim. area of validity will also be covered up to € 100,000 § 3 When does the insurance begin and end? (notwithstanding § 1 VB AB-CLA 20 MST). Insurance cover § 7 When does AWP pay compensation? The following applies for inpatient medical treatment and 1. begins at the time stated in the insurance policy (start of As soon as the insurer has determined whether and to what extent childbirth in Germany: General hospital costs (multi-bed insurance), however not before applying for insurance, not it has an duty to indemnify, compensation is paid within two weeks. room) are reimbursed and according to the Federal Nursing before crossing the border and not before the expiry of any Care Tariff Ordinance and the Hospital Remuneration Act; waiting periods. Waiting periods are calculated from the § 8 What applies if the insured person has claims for damages expenses for optional services (private medical treatment) commencement of insurance. against third parties? are not covered by the insurance. 2. ends at the agreed time, at the latest at the end of the insured 1. In accordance with statutory regulations, claims for damages d) Patient transportation deemed medically necessary for stay in the agreed area of validity. against third parties pass to the insurer up to the level of payment inpatient treatment at the nearest and appropriate hospital in 3. can be extended for up to 48 months (= maximum tariff-based effected, provided that the insured person suffers no the agreed area of validity and back to the insured person‘s term of insurance) upon application before the expiry of the disadvantage thereby. accommodation. original term of contract insofar as the temporary period of 2. The insured person is obliged to confirm the assignment of e) Pain-killing dental treatment and repairs of dentures and residency continues and the insurance policyholder is willing claims to this extent in writing upon request by the insurer. provisional measures up to € 500 per insurance year . and able to pay the premiums applicable at the time of the 3. Any duties to indemnify arising under other insurance contracts f) The medical care and treatment of pregnancies which extension of cover. If the maximum tariff-based term of and other social insurance institutions will have precedence over occurred after the commencement of insurance and after the insurance of 48 months has been completed, a new contract can those of the insurer. The insurer will be deemed to have made expiry of a waiting period of three months. The special waiting be applied for if the requirements stipulated in No. 4 below are advance payment, if the original bills are first presented to the period for childbirth is eight months. met. insurer for payment. g) Aids required as a result of an accident up to € 250 per 4. For persons with temporary resident status in Germany, a insurance year. maximum term of 60 months (= statutory limit of 60 months) § 9 When does the insured person forfeit claims to insurance h) Medically prescribed treatment (e.g. massages, fango or may not be exceeded, taking into account any similar insurance benefits due to a breach of duties and the statute of lymph drainage treatments) up to six (medical) applications policies with other insurers. limitations? in total per insurance year, even then if multiple (medical) ap- 1. If a breach of duty is intentionally committed, the insurer is plications are carried out within one treatment. § 4 What term of validity does the contract have? When is the released from its duty to indemnify; in case of grossly negligent i) Medically necessary rehabilitation measures as subsequent premium payable? violation, AWP is entitled to reduce its payment in proportion to medical treatment prescribed by a physician. 1. The insurance contract can be agreed for full months in each the degree of fault of the insured person. j) In this context, the insurer shall pay for methods of examina- case and for a maximum term of 48 months. 2. The insured person must furnish proof that no gross negligence tion or treatment widely accepted by conventional medicine 2. The insured person can give notice of termination of the was involved. Except in case of fraudulent intent, the insurer is to the extent stated in the contract. In addition, the insurer insurance contract daily to the end of the month. obliged to indemnify if the insured person furnishes proof that shall pay for methods and medication which have shown 3. The premium is due for the first time on commencement of the breach of duty is not the cause of either the occurrence themselves to be just as promising in practice and which the insurance contract and is payable each month in advance. or the determination or the scope of the insurer’s duty to are applied because no conventional medical methods or The payment of the premium can be made by using one of indemnify. medication is available. However, the insurer may reduce the the available payment methods (e.g. SEPA direct debit or 3.  The claim to an insurance benefit lapses in three years, payment to the amount which would have been incurred if credit card). calculated from the end of the year in which the claim conventional medical methods or medicine had been applied. If the first premium has not been paid upon the occurrence of occurred and the insured person obtained knowledge of the 2. The insurer reimburses the costs in accordance with the the insured event, the insurer shall not have a duty to indemnify, circumstances in order to assert the claim, or would have conditions for a duration of up to six weeks after the agreed unless the insured person is not responsible for non-payment. obtained knowledge without gross negligence. term of validity of the insurance contract until the date when the If the insurer has been authorized to debit the premium from insured person can be transported at the latest, if patient repa- the selected payment method, the payment shall be deemed to § 10 What form must be followed for submitted declarations of triation was not advised for medical reasons during the term of have been made, if there is sufficient cover on the stated pay- intent? the contract. ment method at the time of debiting. 1. Notices and declarations of intent from the insured person and 4. If a contract is valid for a term of longer than one month, the the insurer are required to be in text form (e.g. letter, fax or e-mail). § 3 What costs does the insurer reimburse in case of patient renewal premium is payable on the 1st day of the new month 2. Insurance agents are authorised to accept such documents and repatriation transportation and repatriation of mortal respectively. forward them to the insurer. remains? If the insurer has been authorized to debit the premium from the The insurer reimburses the following: selected payment method, the payment shall be deemed to have § 11 Which court in Germany is responsible for dealing with the 1. The costs of the medically advisable and justifiable repatriation been made, if there is sufficient cover on the stated payment assertion of claims based on the insurance contract and of the insured person to a suitable hospital located closest to method at the time of debiting. which law applies? the place of residence of the insured person in his or her home If the renewal premium is not paid, the insurer may set a period 1. At the option of the insured person, the courts of Munich or country. for payment of at least two weeks in text form. If an insured event the place in Germany where the insured person has his or her In addition, the costs of the medically advisable and justifiable occurs after the expiry of the period and the insured person is still permanent residence or habitual abode at the time the legal repatriation are reimbursed upon request by the insured person in arrears with the payment of the renewal premium, the insurer is action is brought will have jurisdiction and venue. where continued hospital treatment is expected to exceed 14 exempted from its duty to indemnify. The insurer may terminate 2. The laws of the Federal Republic of Germany apply insofar as days in the opinion of the physician giving treatment. the contract instantly if the insured person is still in arrears with they do not conflict with international law. Irrespective of this, the costs of the patient‘s repatriation to his or payment after the expiry of the period. If payment is made with- her home country are paid if these remain within the limits of the in one month after termination or after the expiry of the period expected costs of continued medical treatment. set for payment, the effect of the termination ceases to apply -3- [Seite 5] 2. The actual costs of up to € 25,000 for the repatriation of the § 2 What help does the Assistance provide in case of illness deceased insured person for a funeral in his or her home country and accident? or, alternatively, the actual costs of a local funeral up to the costs 1. Outpatient treatment of repatriation at the maximum. The Assistance provides information on the possibilities of medical care and names a physician who speaks German or § 4 What limitations on insurance cover are to be noted? English as far as possible. However, the Assistance does not No insurance cover is provided for the following: contact the physician. 1. Medical treatment and other measures ordered by a physician, 2. Inpatient treatment where the purpose of the stay in the agreed area of validity was In case of inpatient treatment of the insured person at a to seek such treatment. hospital, the Assistance provides the following services: 2. Medical treatment and other measures ordered by a physician a) Support that the insured person knew were necessary prior to the stay If required, the Assistance establishes contact through its in the agreed area of validity or at the time of taking out the contract physician to the respective family physician of the insurance or which he or she could have expected in the insured person and to the hospital physicians providing circumstances of which he or she was aware. treatment. It ensures that information is passed between the 3. Nutriments and tonics. physicians involved. Upon request, the Assistance informs 4. Orthodontic treatment, dental treatment other than pain-killing relatives of the insured person. treatment, repairs to dentures and provisional measures . b) Patient visits 5. Medical treatment (e.g. massages, fango or lymph drainage In case of the inpatient treatment of the insured person, the treatments) which exceed eight treatments per insurance year. Assistance organises the travel for one person close to the 6. The purchase of prostheses and other medical aids; insured person to the hospital where the insured person is notwithstanding this, insurance cover is provided up to € 250 per staying and back to his or her place of residence in his or her year for aids required as a result of an accident. home country. The insurer pays the costs of transport in case 7. Treatment of alcoholism, drug addiction and other addictions as of a life-threatening illness of the insured person or if inpati- well as the consequences thereof. ent treatment lasts for longer than 14 days. 8. Treatment of pregnancies which occurred before the c) Declaration to meet costs commencement of insurance and for the treatment of In case of inpatient hospital treatment, the insurer will give pregnancies within the waiting period after the commencement the insured person a declaration that it will meet the costs up of insurance. to an amount of € 15,000. This declaration does not involve 9. Treatment or accommodation caused by infirmity, need of any recognition that the insurer has a duty to indemnify. The nursing care or detention. insurer assumes settlement with the payer responsible in the 10.  Psychoanalytical and psychotherapeutic treatment and name of the insured person. hypnosis 3. Patient repatriation transportation 11.  For fees and charges which exceed the extent considered As soon as medically advisable and appropriate, or if the generally customary and reasonable in the country concerned duration of the hospital stay is expected to exceed 14 days in the and for optional benefits such as a single room or treatment by opinion of the physician giving treatment, the Assistance will the head physician. The reimbursement may be reduced to the organise return transportation using medically adequate means customary rates in the country. of transport (including air ambulances) to the closest suitable 12. Patient repatriation transport caused by one of the reasons hospital to the insured person‘s place of residence after prior mentioned under no. 1, 2, 7 and 9. consultation between the contract physician of the Assistance 13. Prophylactic examinations and check-ups, check-ups of child- and the local physicians handling the case. ren and young people, dental check-ups and dental prophylaxis, vaccinations as well as any charges and fees for medical certifi- § 3 Does the Assistance procure the necessary medications for cates, reports on diagnostic findings and doctor’s certificates for the insured person? inability to work, which were not requested by the insurer. In concert with the family physician of the insured person, the Assistance takes care of procuring medically prescribed medi- § 5 What are the duties and obligations of the insured person cation and sending it to the insured person, if this is possible. The in case of damage or loss? insured person must reimburse the costs of the medication to the The insured person is obliged to: Assistance within one month. 1. Contact the Assistance immediately in the event of inpatient treatment at a hospital, prior to the commencement of any § 4 What services does the Assistance provide in case of the extensive diagnostic or therapeutic procedures as an inpatient or death of the insured person? outpatient, and prior to any submission of acknowledgements of If the insured person dies during his or her stay in the agreed area of payment. The insurer will reimburse the documented costs for validity, the Assistance will organise a funeral in the agreed area of making contact up to € 25. validity or the repatriation the deceased person‘s mortal remains to 2. Consent to return or repatriation to his or her home country, the place of the funeral in his or her home country as requested by assuming the insured person is fit to be transported and the deceased person‘s relatives. provided that the requirements under § 3 No. 1 VB K-CLA 20 MST have been met, if the Assistance authorises the return journey in view of the nature of the illness and the treatment required. 3. Submit to the insurer the original invoices or duplicates with an original reimbursement stamp by another insurance company concerning the benefits granted; these will then become the property of the insurer. § 6 What deductible does the insured person pay? The deductible ist € 50 for each insured event, however a maximum of € 5,000 per calender year. Terms and Conditions of the Emergency Call Insurance VB N 20 MST N.B.: The Assistance is entrusted with the provision of services under the Emergency Call Insurance. § 1 What services does the insurer provide? 1. The insurer provides assistance and support to the insured person during his or her stay in the agreed area of validity in the emergencies named below and pays the costs incurred up to the limits specified in each case. The insurer reserves the right to check cover. Services provided by the Assistance and declara- tions on its part to meet costs as well as any orders placed with service providers do not include any acknowledgement of the insurer‘s duty to indemnify under the insurance contract vis-à- vis the insured person as a basic principle. 2. The insurer has entrusted the Assistance with the provision of services named below for the insured person as a 24-hour ser- vice. 3. The insured person must contact the Assistance without delay to claim the services in an emergency. 4. Insofar as the insured person cannot claim the reimbursement of amounts paid out from the insurer or from another payer, the insured person must repay the amounts to the insurer within one month of invoicing. -4- [Seite 6] MAWISTA Student – Insurance Benefits at a Glance / Tariff Table MAWISTA Student Classic ® MAWISTAStudent Classic ® plus MAWISTA Student Comfort ® General Provisions § 2 No. 1 Insurance cover for Germans in Germany if the stay abroad is not insured not insured up to 6 weeks per insurance year interrupted. Health Insurance § 2 No. 1 Amount of costs reimbursed for … Outpatient treatment unrestricted unrestricted unrestricted Medical treatment and medication unrestricted unrestricted unrestricted Inpatient treatment unrestricted unrestricted unrestricted Medical treatment of a newborn baby if born prematurely max. € 100,000 max. € 100,000 max. € 100,000 Medically necessary patient transportation to a hospital unrestricted unrestricted unrestricted Pain-killing dental treatment per insurance year max. € 500 max. € 500 max. € 1,000 Dentures per insurance year 60 % of the total costs, not insured not insured max. € 1,000 Treatment of pregnancy unrestricted, after the expiry of a waiting unrestricted, after the expiry of a waiting unrestricted period of 8 months period of 8 months Aids required as a result of an accident per insurance year max. € 250 max. € 250 max. € 1,000 Visual aids required as a result of an accident per insurance year not insured not insured max. € 100 Vaccination max. € 250 throughout the entire term of not insured not insured the contract Treatment (e.g. massages, fango and lymph drainage treatment) max. 6 treatments max. 8 treatments max. 8 treatments per insurance year Rehabilitation measures unrestricted unrestricted unrestricted § 2 No. 2 Provision of the insurance benefit subsequently after the expiry of max. 6 weeks max. 6 weeks max. 8 weeks the insurance contract if the insured person is unfit to travel § 3 No. 1 The costs of the medically advisable and justifiable patient repatriation transportation to the nearest hospital in the insured person‘s home Patient repatriation transportation to the home country country at an unlimited amount, also if hospital treatment lasts longer than 14 days on request by the insured person. § 3 No. 2 Reimbursement of costs for repatriation of mortal remains to home max. € 25,000 max. € 25,000 max. € 25,000 country § 3 No. 2 up to the costs of the repatriation of mortal up to the costs of the repatriation of mortal up to the costs of the repatriation of mortal Reimbursement of costs for local funeral remains at the maximum remains at the maximum remains at the maximum §6 € 50 per claim for outpatient and dental no deductible no deductible Deductible treatments Emergency Call Insurance §1-§4 Offers immediate assistance worldwide in case of an emergency in the agreed area of validity § 2 No. 2 max. € 15,000 max. € 15,000 max. € 15,000 Declaration of amount of costs assumed for inpatient treatment Accident Insurance §3 not insured € 10,000 € 10,000 Sum insured in case of death §4 not insured max. € 140,000 max. € 140,000 Sum insured in case of disability § 6 No. 1 not insured max. € 5,000 max. € 5,000 Rescue costs § 6 No. 2 not insured max. € 1,500 max. € 1,500 Health spa allowance Liability Insurance §1 • max. € 1,000,000 for personal injury and • max. € 1,000,000 for personal injury and Sums insured property damage property damage not insured • max. € 250,000 for damage to rented • max. € 250,000 for damage to rented property property Monthly Premiums up to 40 years € 33.10 € 59.70 € 39.70 € 63.80 € 76.80 € 76.80 Duration of insurance in months 1st to 12th 13th to 48th 1st to 12th 13th to 48th 1st to 12th 13th to 48th 41 to 55 years € 69.90 € 114 € 74.90 € 119 € 129.90 € 134 Duration of insurance in months 1st to 12th 13th to 48th 1st to 12th 13th to 48th 1st to 12th 13th to 48th 2020-1072 -5-