MAWISTA Visum Comfort: die Bedingungen im Volltext

[Seite 1] Travel Insurance Insurance Product Information Document Company: AWP P&C S.A., Germany Branch Product: MAWISTA Visum Comfort 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 Visum Comfort is a comprehensive Travel Insurance and includes the following benefits: Foreign Travel Health Insurance, Patient Repatriation Transportation, Travel Assistance and Travel Liability Insurance. What is insured? What is not insured? Foreign Travel Health Insurance and Travel Assistance Foreign Travel Health Insurance and Travel Assistance Which events are insured? x Benefits in those countries in which the insured person has a permanent residence. ✓ Illness or accident during the temporary travel in the agreed area of validity x Medical treatment and other measures ordered by a physician that the insured person What will be reimbursed? knew were necessary prior to inception of insurance cover or at the time of taking out the ✓ Costs for outpatient treatment by a physician insurance or which he or she could have expected in the circumstances of which he or she ✓ Costs for medical treatment and medication prescribed by a physician was aware. ✓ Costs for inpatient treatment in a hospital x Massage and wellness treatment, fango and lymph drainage ✓ Up to € 5,000 for the costs of search, rescue and recovery measures after an accident x Childbirth after the 36th week of pregnancy as well as abortions and the consequences thereof that are not medically indicated and can be postponed Deductible for all insured events: For persons up to 64 years of age: No deductible Travel Liability Insurance For persons from 65 up to 80 years of age: x Liability claims among and between insured persons travelling together - € 100 per person in case of outpatient treatment x Loss or damage caused by the use of a motor vehicle, aircraft or motor-driven watercraft - € 500 per person in case of outpatient treatment As part of Travel Assistance: Assistance for personal emergencies (illness, accident, death) and organisation of repatriation with medically adequate means, as soon as this is medically Are there any restrictions on cover? advisable and reasonable. Foreign Travel Health Insurance and Travel Assistance Patient Repatriation Transportation ! A maximum of € 250 for dental treatment and repairs to dentures and provisional ✓ Reimburses the costs of the medically advisable and appropriate return transportation dentures after an accident to the nearest suitable hospital to the place of residence and, in the event of death, the ! Costs of medical treatment up to the day the insured is fit to be transported, repatriation of mortal remains. however a maximum of 45 days from the start of medical treatment ! In Germany, medical and dental treatment as an outpatient is reimbursed at the 1.8 fold Travel Liability Insurance rate of the Scale of Medical Fees (GOA) or the Scale of Dental Fees (GOZ), services mainly ✓ Provides insurance cover if third parties assert claims for damages based on a damaging of a medico-technical nature are reimbursed at a 1.3 fold rate at the maximum, laboratory event that occurred during your travel. services at a 1.15 fold rate at the maximum ! The costs of inpatient hospital treatment are reimbursed according to the applicable Sums insured: € 1,000,000 per person in case of personal injury and damage to property, regular rate of the local health insurance responsible for the locality. € 250,000 for damage to rented property Where am I covered? ✓ Germany, Switzerland and Schengen states; no insurance cover is provided in those countries, in which the insured person maintains a permanent residence. What are my obligations? - You are obliged to report the damage or loss to us promptly. Foreign Travel Health Insurance and Patient Repatriation Transportation - In case of severe injuries or serious illnesses, particularly prior to hospitalisation, you have to contact the Assistance immediately. Travel Liability Insurance - If a claim has been asserted against you, you must notify us thereof within one week. If the liability claim is taken to a court of law, you shall allow us to conduct the proceedings and grant the legal counsel full power of attorney. When and how do I pay? The premium is due as soon as the insurance contract is concluded and must be paid by the chosen means of payment upon delivery of the insurance policy. When does the cover start and end? Insurance cover commences: - for the insured person from a visa requiring country within the before entry agreed term upon crossing the border into a country included in the agreed area of validity and ends with the departure from the agreed area of validity, however at the latest at the time agreed. - for the insured person from a non visa requiring country within the agreed term and ends with the departure from the agreed area of validity, however at the latest at the time agreed. 2018-1102 AVB 17_IPID zu 2018-1102 - when agreed to insurance contracts after the entry to a country included in the agreed area, after a waiting period of 7 days – 0:00 a.m. on day 8 – from the attachment date. In case of an accident, insurance cover shall apply from the inception of insurance cover. The maximum per year for a term of insurance is 183 days. Insurance cover shall be provided insofar as the insurance policy is purchased within one month after the insured person’s arrival to the area of validity or within one week after the expiration of an insurance contract with validity from the date of entry. How do I cancel the contract? The insurance contract ends at the agreed point in time. You do not have to cancel. -1- [Seite 2] Documents to Insurance Policy The insurance purchased is documented in the insurance policy! Overview of Benefits Table of contents MAWISTA VISUM Comfort Terms and Conditions 3 • Foreign Travel Health Insurance General Provisions 3 Deductible for all insured events: Foreign Travel Health Insurance 3 For persons up to 64 years of age: No deductible Patient Repatriation Transportation 3 For persons from 65 up to 80 years of age: Travel Assistance 4 • € 100 per person in case of outpatient treatment Travel Liability Insurance 4 • € 500 per person in case of outpatient treatment Declarations and information on data processing 5 • Patient Repatriation Transportation • Travel Assistance • Travel Liability Insurance  Sum insured: € 1,000,000 per person in case of personal injury and damage to Please note the following important information property, € 250,000 for damage to rented property. Scope of validity: Germany, Switzerland and Schengen states; no insurance cover is provided in those countries, in which the insured person maintains a permanent We are there for you residence. Maximum insured travel duration: The insurances are valid for the agreed term, maximum 183 days. Assistance in an emergency Insurable persons: Insurable are persons up to an age of 80 who do not maintain a If you require help in an emergency the Assistance is there for you. Our 24-hour permanent residence in the country to visit. emergency service guarantees rapid and expert assistance all over the world! Guidelines on taking out insurance: Insurance can be taken out within one month after entering the area of validity or within one week after the expiration of an Phone: +49.89.6 24 24-496 insurance contract with validity from the date of entry. There is a waiting period of 7 days, if insurance is taken out after entering the area of validity. The waiting period Important for help in an emergency: does not apply in case of accident. If insurance is taken out before departure, the • Please hold the exact address and phone number of your current whereabouts waiting period is not applicable. ready to hand. • Note down the name of your contacts, e.g. physician, hospital or police. Insurance cover is provided only for the person named on the insurance policy. • Describe as exactly as possible the facts of the case and have the necessary infor- The premium is due as soon as the insurance contract is concluded and must be paid mation at hand. upon delivery of the insurance policy. The payment of the premium can be made by using one of the available payment methods (e.g. SEPA direct debit or credit card). Notification of claim If the insurer has been authorized to debit the premium from the selected payment The simplest and quickest way of notifying us of your claim is via method, the payment shall be deemed to have been made, if there is sufficient cover on the stated payment method at the time of debiting. The amount of the premiums www.mawista.com/schaden-melden is usually based on the selected insurance cover and the term of the contract. (or alternatively by post to our Claims Department). AWP P&C S.A. Niederlassung für Deutschland There is no insurance cover if the non-recurring or initial premium (Germany Branch) has not been paid, unless the insured party is not responsible for MAWISTA Schadenabteilung non-payment. Bahnhofstraße 16 D - 85609 Aschheim (near Munich) Telefon: +49.89.6 24 24-0 The contractually agreed insurance payments are offered by AWP P&C S.A. Telefax: +49.89.6 24 24-222 (Allianz Partners) in compliance with the Terms and Conditions of Insurance named below. This translation is for information purposes only. In the event of any conflict or inconsistency between the German and the English versions, the German original shall prevail. Verbal agreements are invalid. Insurance tax is included in the premiums. General information in the event of claim No fees are charged. The premiums and service specifications documented in the insurance policy are relevant for the scope of insurance. 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 suitable 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 travel? (Travel Health Insurance / Patient Repatriation Insurance / Travel Assistance) Olaf Nink, Chief Executive Officer Please immediately contact the Assistance in case of severe injuries or serious illnesses, particularly prior to hospitalisation, so that adequate treatment or repatriation transport can be ensured. For the Allianz Partners Chief Executive Officer: Olaf Nink reimbursement of the costs you have paid at the location, please submit original bills and/or prescrip- tions. AWP P&C S.A. Registration Court: München HRB 4605 Important: The bills must show the name of the person receiving treatment, the name of the illness, Niederlassung für Deutschland VAT ID no: DE 129274528 the treatment data and the individual medical services provided and the costs of these. Prescriptions (Germany Branch) Insurance tax no.: 802/V90802001910 must provide information on the medications prescribed, the prices and bear the stamp of the pharmacy. Bahnhofstraße 16 What should you remember for claims under the Travel Liability Insurance? D - 85609 Aschheim (near Munich) Please note the names and addresses of witnesses who saw the damaging event. Ask for a copy of the police report if the police was called in to investigate the matter. Notify AWP and submit these AWP P&C S.A. documents and information with your loss report. Public limited company under French law Registered Office: Saint-Ouen (France) Commercial register: R.C.S. Bobigny 519 490 080 Board of Management: Rémi Grenier (Chairman), Dan Assouline, Fabio de Ferrari, Ulf Lange, Claudius Leibfritz, Lidia Luka-Lognoné, Mike Nelson, Sylvie Ouziel -1- [Seite 3] Complaint Notice: Our goal is to offer first-class services. It is equally important to us Right to revoke contracts valid for a term of one month or more: to respond to your concerns. If you are not satisfied with any of our You can revoke your contractual declaration within 14 days in products or our service, please notify us directly. writing (e.g., letter, fax, e-mail) without stating reasons. The period begins after you have received the insurance certificate, You can send us your complaints relating to contract or claim issues the terms of the contract including the Terms and Conditions of using any means of communication. You can reach us by telephone Insurance, the additional information pursuant to § 7 (1) and at +49.89.6 24 24-460, in writing by e-mail to service@allianz- (2) of the Insurance Contracts Act (VVG) in conjunction with assistance.de, or by regular mail to AWP P&C S.A., §§ 1 through 4 of the VVG Decree on Information Duties Beschwerdemanagement, Bahnhofstrasse 16, D - 85609 Aschheim - each of these notifications in written form. In case of (bei München), Germany. Additional information on our complaint contracts in electronic commerce (§ 312i (1)(1) of the process can be found at www.allianz-reiseversicherung.de/ German Civil Code (BGB), this period shall not commence prior beschwerde. We will not participate in dispute settlement to our performance of our duties pursuant to § 312i (1)(1) of proceedings before a consumer arbitration board. the German Civil Code in conjunction with Article 246c of the Introductory Law to the German Civil Code (EGBGB). In the event of complaints relating to all types of insurance, please The deadline for revocation is deemed met if the revocation is contact the responsible supervisory authority, Bundesanstalt dispatched in good time. It must be sent to: für Finanzdienstleistungsaufsicht (BaFin - the German Federal AWP P&C S.A., Bahnhofstraße 16, D - 85609 Aschheim (near Financial Supervisory Authority), Graurheindorfer Strasse 108, Munich), Fax + 49.89.6 24 24-244, E-mail: service@allianz- D - 53117 Bonn, Germany (www.bafin.de). assistance.de The contract is governed by the laws of the Federal Republic of Ger- Consequences of revocation: many, unless this conflicts with international law. Legal action based When revocation is effective, insurance cover ceases and we shall on the insurance contract can be brought by the policyholder or the refund to you that portion of the premium allocated to the period insured person before the court with jurisdiction over the principal after receipt of the revocation if you consented to insurance co- place of business or the branch of the insurer. If the policyholder ver beginning prior to the end of the revocation period. We are or the insured person is a natural person, legal action can also be entitled in this case to retain that portion of the premium that brought before the court in the district of which the policyholder or is allocated to the period until receipt of the revocation. This is a the insured person has his place of residence when the legal action sum calculated proportionally by days. Amounts to be refunded is brought or, if he does not have a place of residence, his habitual will be remitted without undue delay, no later than 30 days after place of abode. receipt of the revocation. If insurance cover does not commence prior to the end of the revocation period, then effective revocation Data protection: means that payments received must be refunded and uses made In accordance with the provisions of the German Federal Data Pro- thereof (e.g., interest) must be disbursed. tection Act, we hereby inform you that if a claim is filed your per- sonal data which is required to implement the insurance contract Special notes: will be stored. To check the application or the damage, inquiries will Your right of revocation lapses when the contract is completely also be sent to other insurers and inquiries by other insurers will be performed both by you and also by us at your express request answered. Moreover, data will be sent to the reinsurer.The addresses before you have exercised your right of revocation. of each recipient of data will be provided upon request. Collection, processing and use of health data and disclosure of Your AWP P&C S.A., Germany Branch data to other parties: Upon conclusion of contract the declarations of consent required to implement or terminate your insurance con- tract were given. You will find statements and information on data processing following the conditions. -2- [Seite 4] Terms and Conditions of AWP P&C S.A., Germany Branch AWP is the abbreviation of Allianz Partners and will hereinafter be § 7 When does the insurer pay compensation? § 3 What limitations on insurance cover are to be noted? referred to as “the insurer”. As soon as the insurer has determined whether and to what extent 1. No insurance cover is provided for the following: it has an obligation to indemnify, compensation is paid within two a) Medical treatment and other measures ordered by a weeks. physician, where the purpose of travel was to seek such General Provisions treatment. AVB AB 17MV § 8  What applies if the insured person has claims for damages b) Medical treatment and other measures ordered by a against third parties? physician that the insured person knew were necessary prior The regulations as stipulated under §§ 1 to 11 apply to all MAWISTA 1. In accordance with statutory regulations, claims for damages to departure or at the time of taking out the insurance or Visum insurance products. against third parties pass to the insurer up to the level of payment which he or she could have expected in the circumstances of The regulations printed thereafter apply to the respective insurance. effected, provided that the insured person suffers no which he or she was aware. Insurance cover is provided if you have contractually agreed the disadvantage thereby. c) Dental treatment other than pain-killing treatment, repairs to insurance concerned. 2. Upon request by the insurer, the insured person is obliged to dentures and provisional measures. confirm in writing the transfer of claims to this extent. d) Massage and wellness treatment, fango and lymph drainage § 1 Who is insured? 3. Any obligations to indemnify arising under other insurance as well as the purchase of prostheses and other medical aids. The persons named in the policy or the group of persons specified contracts and by social insurance institutions will have e) Treatment of alcoholism, drug addiction and other addictions, in the certificate of insurance are deemed insured persons, provided precedence over those of the insurer. If the insured person first and the consequences thereof. that the premium has been paid. presents original bills to the insurer for payment, the insurer will f) Childbirth after the 36th week of pregnancy as well as abor- be deemed to have made advance payment. tions and the consequences thereof that are not medically § 2 For which travel is the insurance applicable? indicated and can be postponed. Insurance cover applies to the respectively insured temporary travel § 9  When does the insured person forfeit claims to insurance g) Treatment or accommodation caused by infirmity, need of in Germany, Switzerland and throughout the sovereign territory of benefits due to a breach of obligations and the statute of nursing care or detention. the member states that fully apply the Schengen acquis (area of limitations? h) Psychoanalytical and psychotherapeutic treatment and validity). No insurance cover is provided in those countries, in which 1. If an obligation is intentionally violated, the insurer is released hypnosis. the insured person maintains a permanent residence. from its obligation to indemnify; in case of grossly negligent i) Injuries caused by actively participating in competitions held violation, the insurer is entitled to reduce its payment in by sports organisations and training in connection therewith. § 3 When is the premium payable? proportion to the seriousness of the fault of the insured person. j) Treatment by spouses, life partners, parents or children. Docu- 1. The premium is due as soon as the insurance contract is con- 2. The insured person must furnish proof that no gross negligence mented material expenses are reimbursed according to tariff. cluded and must be paid upon delivery of the insurance policy. was involved. Except in case of fraudulent intent, the insurer is 2. If the medical treatment or any other measure exceeds the 2. If the premium has not been paid upon the occurrence of the obliged to indemnify if the insured person furnishes proof that medically necessary measure, the insurer can reduce the benefit insured event, the insurer shall not have a duty to indemnify, the violation of the obligation is not the cause of either the to a reasonable amount. The fees and charges invoiced may not unless the insured person is not responsible for non-payment. occurrence or the determination or the scope of the insurer’s exceed the extent considered generally customary and reason- 3. In case of visa refusal, the premium shall be refunded via the obligation to indemnify. able in the country concerned. Otherwise the insurer may payment method specified at the time the insurance was taken 3. The claim to an insurance benefit lapses in three years, reduce the reimbursement to customary rates in that country. out, after the end of validity of the insurance policy (12 months) calculated from the end of the year in which the claim by presenting the written refusal of visa application, the original occurred and the insured person obtained knowledge of the § 4  What are the duties and obligations of the insured person insurance policy and a full copy of the insured person’s passport. circumstances in order to assert the claim, or would have in case of damage or loss? obtained knowledge without gross negligence. The insured person is obliged to do the following: § 4 When does the insurance begin and end? 1. Contact the Assistance immediately in the event of inpatient 1. Insurance cover shall be provided insofar as the insurance policy § 10  What form must be followed for submitting declarations of treatment at a hospital, prior to the commencement of any is purchased within one month after the insured person’s arrival intent? extensive diagnostic or therapeutic procedures as an inpatient to the area of validity or within one week after the expiration of 1. Notices and declarations of intent from the insured person and or outpatient, and prior to any submission of acknowledgements an insurance contract with validity from the date of entry. The the insurer must be in text form (e.g. letter, fax, e-mail). of payment. day of arrival and if so previous insurance cover shall be proved 2. Insurance brokers are authorised to accept and forward 2. Consent to return or repatriation to his or her home country, by the insured person. notifications and declarations of intention to the insurer. assuming the insured person is fit to be transported, if the 2. Insurance cover is valid for the agreed term. The maximum per Assistance authorises the return journey in view of the nature of year for a term of insurance is 183 days. § 11  Which court in Germany is responsible for dealing with the the illness and the treatment required. 3. Insurance cover commences – if premium was paid – assertion of claims based on the insurance contract and 3. Submit to the insurer the original invoices or duplicates with an a) for the insured person from a visa requiring country within which law applies? original reimbursement stamp by another insurance company the before entry agreed term upon crossing the border into a 1. The courts of Munich will have jurisdiction and venue. concerning the benefits granted; these will then become the country included in the agreed area of validity and ends with 2. The laws of the Federal Republic of Germany apply insofar as property of the insurer. the departure from the agreed area of validity, however at the they do not conflict with international law. latest at the time agreed. § 5  What additional rules apply to the insurance cover b) for the insured person from a non visa requiring country provided by the insurer Travel Health Insurance during within the agreed term and ends with the departure from Foreign Travel Health Insurance a stay in Germany? the agreed area of validity, however at the latest at the time AVB RK 17 MV In Germany, medical and dental treatment as an outpatient is agreed. reimbursed at the 1.8 fold rate of the Scale of Medical Fees (GOÄ) or c) when agreed to insurance contracts after the entry to a § 1 What is insured? the Scale of Dental Fees (GOZ) at the maximum in accordance with country included in the agreed area, after a waiting period of The costs of treatment occurring as a result of acute illnesses or § 2 AVB RK MV; services mainly of a medico-technical nature are 7 days – 0:00 a.m. on day 8 – from the attachment date. In accidents during temporary travel in Germany, Switzerland and reimbursed at a 1.3 fold rate at the maximum, laboratory services case of an accident, insurance cover shall apply from the throughout the sovereign territory of the member states that fully at a 1.15 fold rate at the maximum. The costs of inpatient hospital inception of insurance cover. apply the Schengen acquis (area of validity). treatment according to § 2 No. 1 and 2 AVB RK MV are reimbursed The costs of search, rescue and recovery measures are also covered according to the applicable regular rate of the local health insurance § 5 In which cases does insurance cover not apply? up to € 5,000 if the insured person has to be rescued or recovered responsible for the locality. No insurance cover is provided in the following cases: after an accident or if the insured person is missing and it is feared 1. Damage or loss caused by strikes, nuclear energy, confiscation that something has happened to him or her. and other invention acts by public authority, as well as damage Patient Repatriation Transportation or loss in areas for which the German Federal Foreign Office has § 2  What costs are reimbursed in case of medical treatment in AVB RT 17 MV issued a travel warning. If an insured person is at such a location the area of validity? at the time when a travel warning is issued, insurance cover ends 1. The insurer reimburses expenditures for all necessary medical § 1 What is insured? seven days after the issuance of the travel warning. assistance in the area of validity , including costs incurred for: The insurance covers the following: 2. Damage or loss due to war or events similar to war; however, a) Outpatient treatment by a physician. 1. Patient transportation due to acute illnesses and accidents insurance cover does exist if the damage or loss occurs in the b) Medical treatment and medication prescribed by a physician occurring during travel. first seven days after the beginning of the events. This does for the insured person. 2. Repatriation of mortal remains in the event of death. not apply in case of stays in countries in whose territory war c) Inpatient treatment in hospital, including operations that or civil war is already ongoing or where such an outbreak was cannot be postponed. In case of premature birth, the costs of § 2  What costs does the insurer reimburse in the event of foreseeable. necessary treatment of the newborn child abroad will also be patient repatriation transportation or repatriation of 3. Damage or losses intentionally caused by the insured person. covered up to € 10,000, (notwithstanding § 1 AVB AB MV). mortal remains? 4. Expeditions. d) Patient transportation deemed medically necessary for The insurer reimburses the following: inpatient treatment in the nearest hospital in the area of 1. The costs incurred for the medically advisable and appropriate § 6  What are the duties and obligations of the insured person validity and back to the insured person‘s accommodation. return transportation of the insured person to the nearest in the event of damage or loss? e) Walking aids deemed medically necessary and the rental fee suitable hospital to the insured person‘s place of residence. The insured person is obliged to for a wheelchair. 2. The direct costs for repatriation of the insured person‘s mortal 1. minimise the damage or loss as far as possible and avoid f) Pain-killing dental treatment, repairs to dentures and remains for burial or, alternatively, the direct costs for burial unnecessary costs; provisional measures up to € 250. at the place of death, up to the costs of repatriation. 2. report the damage or loss to the insurer without delay; 2. The insurer reimburses the costs of medical treatment up to the 3. prove the day of entry in an appropriate way (copy of entry day the insured is fit to be transported, however a maximum of § 3 What limitations on cover are to be noted? documents, passport/visa if required for entry, tickets etc.); 45 days from the start of medical treatment, insofar as return No insurance cover is provided for patient transportation or 4. describe the damaging event or the loss as well as the scope of the transport up to the end of the insured travel is not possible due to repatriation of mortal remains on account of the following: claim and truthfully provide the insurer with any and all pertinent the insured person‘s inability to be transported. 1. Medical treatment and other measures ordered by a physician, information. The insured person must furnish proof in the 3. Unless otherwise agreed, the insured person pays a deductible of where the purpose of travel was to seek such treatment. form of original bills and receipts, release physicians from their € 50 per insured event. 2. Medical treatment and other measures ordered by a physician confidentiality obligation as necessary – including the physicians that the insured person knew were necessary prior to inception of the Assistance – and allow the insurer to reasonably examine of insurance cover or at the time of taking out the insurance or the cause and amount of the asserted claim. which he or she could have expected in the circumstances of which he or she was aware. -3- [Seite 5] 3. Alcoholism, drug addiction and other addictions, and the Travel Liability Insurance § 4  What are the duties and obligations of the insured person consequences thereof. AVB RH 17 MV after the occurrence of damage or loss? 4. Childbirth after the 36th week of pregnancy as well as abortions An insured event is deemed to be a damaging event that could and the consequences thereof that are not medically indicated § 1  What risk does the insurer assume? entail liability claims against the insured person. and can be postponed. The insurer provides insurance cover against everyday liability risks 1. Each and every insured event must be reported in text form 5. Injuries caused by actively participating in competitions held by if a third party asserts claims for damages against the insured per- (e.g. letter, fax, e-mail) the insurer immediately. sports organisations and training in connection therewith. son based on a damaging event that occurred during travel on the 2. The insured person must also immediately inform the insurer grounds of statutory liability provisions as defined under private of any initiation of a preliminary investigation or issuance of an § 4  What are the duties and obligations of the insured person law. Damaging events are defined as death, injury or impairment order of summary punishment or payment order, even if the in the event of damage or loss? to health (personal injury) or damage to or destruction of property insurer already knows about the insured event. The insured person is obliged to do the following: (damage to property). 3. If a claim for compensation has been asserted against the 1. Contact the Assistance immediately in the event of an acute insured person, he or she must notify the insurer thereof within serious illness or accidental injury. § 2  How does the insurer protect the insured person against one week after the claim is raised. 2. Comply with the formalities and other requirements necessary liability claims and to what extent does it pay indemnity? 4. The insured person must also notify the insurer when a claim has for discharge from inpatient treatment and for leaving the 1. The insurer examines liability claims regard to their validity, wards been asserted that involves judicial or state assistance. country. off unjustified claims and reimburses the compensation owed by 5. The insured person is obliged to take all possible steps to 3. Provide the insurer with all information required to organise and the insured person. The insurer reimburses the compensation if it minimise the loss while complying with the insurer‘s instructions carry out return transportation. recognises its duty to indemnify or approves admission of and to take every action necessary or useful to clarify the case of liability on the part of the insured person. The insurer also pays loss. The insured person must provide a detailed and truthful loss compensation if it effects or approves a settlement or where report, supply information on all circumstances connected with Travel Assistance decreed by a court ruling. the damaging event and submit the corresponding documents. AVB AS 17 MV 2. If the injured party or his or her legal successor asserts a liability 6. If the liability claim is taken to a court of law, the insured person claim in court, the insurer will conduct the legal dispute at its own shall allow the insurer to conduct the proceedings, grant the § 1  What services does the insurer provide under the expense on behalf of the insured person. legal counsel appointed and nominated by the insurer full power Assistance? 3. If the insurer requests or approves the appointment of a defence of attorney to act on his or her behalf and submit all declarations 1. The insurer provides assistance and support to the insured per- counsel in criminal proceedings against the insured person deemed necessary by the legal counsel or the insurer. Without son during travel in the event of any emergency defined below arising from an insured damaging event, the insurer will pay the awaiting instructions from the insurer, the insured person shall and will pay the costs at the amount stated in each case. The costs of the defence counsel. raise objections within the specified period or seek the necessary insurer reserves the right to check coverage. Services provided 4. If the insurer fails to settle a liability claim by admission, satisfaction legal remedies against orders for payment of damages decreed and any cost assumption statements made by the Assistance as or settlement on account of the resistance of the insured person, by the courts or by the state. well as the commissioning of service providers do not in principle the insurer shall not be required to pay any additional expenses 7. If the insured person obtains the right to demand the acknowledge the insurer‘s obligation to indemnify based on the incurred for the main issue, interest and the costs. cancellation or reduction of a payable annuity as a consequence insurance contract with the insured person. 5. The sums insured as stipulated in the insurance policy or in the of altered circumstances, the insured person is obliged to allow 2. The insurer has contracted the Assistance to provide the insured product and consumer information is the maximum limit of the insurer to exercise such right on his or her behalf. The persons of the insurer with the services named below on a benefits payable by the insurer. provisions of Nos. 3 to 5 apply accordingly. 24-hour basis. 8. The insurer is considered to have full authority to submit all 3. The insured person must immediately contact the Assistance in § 3 What risks are not insured? declarations on behalf of the insured that it deems suitable to an emergency in order to use the services. Insurance cover does not include the following: settle or ward off a claim. 4. Insofar as the insured person may be unable to claim the 1. Liability claims reimbursement of expenditures incurred from either the insurer a) insofar as these exceed the scope of the insured person‘s or from any other payer, the insured person must return the statutory liability as a result of contractual or other amounts to the insurer within one month of invoicing. commitments; b) among and between insured persons travelling together and § 2 What help does the Assistance provide in case of illness insured persons and their accompanying relatives; and accident? c) due to transmission of illness by the insured person; 1. Inpatient treatment / Cost assumption statement d) due to damage arising from professional activities. In case of inpatient hospital treatment, the insurer will provide 2. Liability claims against the insured person the hospital with a statement of cost assumption up to € 13,000. a) in connection with hunting activities; This statement does not imply that the insurer acknowledges b) due to damage caused to third-party property rented by or that it has a duty to indemnify. The insurer will assume the task of on loan to the insured person or obtained through unlawful carrying out settlement with the payer responsible in the name interference or in the insured person‘s custody. However, of the insured person. liability arising from damage to rooms and buildings during 2. Patient repatriation transportation travel is insured, in particular damage to rented holiday As soon as medically advisable and appropriate, the Assistance apartments and hotel rooms or the accommodation but not will will organise return transportation using medically adequate damage to furniture. Insurance cover is not provided for means of transport (including air ambulances) to the closest liability claims based on wear and tear or excessive use; suitable hospital to the insured person‘s place of residence after c) as the owner, possessor, keeper or driver of a motor vehicle, prior consultation between the contract physician of the aircraft or motor-driven watercraft due to damage caused by Assistance and the local physicians handling the case. the use of such a vehicle. d) as the owner or keeper of animals; § 3  What services does the Assistance provide in the event of e) for hazards directly related to the deliberate and illegal the insured person‘s death? commission of a punishable offence. If the insured person dies during travel, the Assistance organises burial in the area of validity or repatriation of the insured person‘s mortal remains to the place of burial in accordance with the wishes of family members. -4- [Seite 6] Declarations and information on data processing I.  Consent to the collection and use of 3. Disclosure of your health data and other data subject to Reinsurers use your personal data only for the purposes named secrecy to parties outside AWP P&C S.A. above. We will inform you of the transfer of your health data to health data and declaration of release We contractually oblige the parties named below to observe provisi- reinsurers. from secrecy. ons on data protection and data security. I consent to AWP P&C S.A. transferring my health data to The declarations of consent and of release from secrecy printed 3.1 Disclosure of data for medical assessment reinsurers, provided that this is necessary for the assertion of legal under I. were prepared as coordinated between the Gesamtver- To check our duty to indemnify, it may be necessary to call in medi- claims for reimbursement in my insurance case; that the health band der deutschen Versicherungswirtschaft e.V. (GDV) and data cal experts. We require your consent and release from secrecy for data is used appropriately and that the results are relayed back to protection authorities. this purpose if your health data and other data subject to secrecy are AWP. Insofar as is necessary, I release from their confidentiality transferred in this connection. You will be informed of each transfer obligations any persons acting on behalf of AWP P&C S.A. The Insurance Contract Act, the Federal Data Protection Act and of data. and consultants, with respect to the health data and further other data protection provisions do not include an adequate legal pursuant to data protected under Section 203 of the StGB basis for the collection, processing and use of health data by the I hereby consent and agree that AWP P&C S.A. may (German Criminal Code). insurer. For this reason we need your consent as required by data transmit my health data to medical experts if this is necessary for protection laws. In the event of a claim, we may require your release reviewing the obligation to pay benefits in my insurance claim from secrecy in order to obtain your health data from parties subject and that the health data are used there for the proper purpose Statements by the insured person(s) or the legal representative to secrecy (e.g. physicians). and the results are sent back to AWP. I release the persons of the person(s) to be insured: working for AWP P&C S.A. and the experts from their nondisclo- I hereby make the declarations on data processing submitted by the Furthermore, we require your release from secrecy in order to sure duty with respect to the health data and other data protected applicant or the person interested in insurance on my own behalf or disclose your health data or other data protected under § 203 of the under StGB (German Criminal Code) § 203. on behalf of the person(s) to be insured German Criminal Code, e.g. the fact that there is a contract with you, your customer number or other identification data, to other parties, 3.2 Transfer of tasks to other parties (business enterprises or 1)  Allianz Group companies (marked with *) and service providers e.g. assistance, logistics or IT service providers. persons) that use personal data on behalf of the insurer which are subject We do not perform in part certain tasks in the course of which your to secrecy and/or collect, process or use health data: The following declarations of consent are indispensable for the im- health data might be collected, processed and used. We have there- • Mondial Kundenservice GmbH * (claims processing) plementation or termination of your insurance contract (processing fore transferred these tasks to other companies. If your data subject • AWP Romania SA * (claims processing) of your claim). Should you not submit these, it will not usually be to secrecy are disclosed in the course of this, we require your release • Simplepaper Archive Management GmbH (claims proces- possible to enter into any contract. from secrecy for us and, where necessary, for other parties. sing) • Allianz Handwerker Services GmbH * (technical services for The declarations relate to the way we handle your health data and  e carry out a constantly updated list of the parties and categories W companies of the Allianz Group) other data subject to secrecy (under 1.), in connection with reque- of parties that collect, process or use data subject to secrecy on our • Allianz Technology SE * (shared services for companies of the sting these from third parties (under 2.) and when disclosing them behalf as agreed. This list shows the tasks which have been trans- Allianz Group) to parties external to the insurer (under 3.) ferred to the individual parties. The currently valid list is enclosed • AWP Service Deutschland GmbH * (assistance services) directly with the declarations.1) An up-to-date list can also be viewed • rehacare GmbH *, medical and professional rehabilitation The declarations also apply to persons legally represented by you on the Internet under www.allianz-reiseversicherung.de/daten- company (rehab services) who are included in the insurance, e.g. to your children, if they do verarbeitung or requested from us (AWP P&C S.A., Bahnhofstraße •  MAWISTA GmbH * (sales and customer-related services, not recognise the significance of this consent and thus cannot sub- 16, D - 85609 Aschheim (near Munich), Phone +49.89.62424-460, telephone service) mit their own declarations. service@allianz-assistance.de). We need your consent for the dis- • PCI Holdings AG (technical services) closure of your health data and for use of such data by the parties •  tricontes GmbH (sales and customer-related services, 1. Consent to the collection, saving and use of your health listed at these points. telephone service) data • IMB Consult GmbH (support in the preparation of medical I consent to AWP P&C S.A. transferring my health data to the reports) I consent to AWP P&C S.A. collecting, saving and using the health parties named in the list mentioned above and to the collection, • ViaMed GmbH (medical consulting, support in the preparati- data notified by me in the future, provided that this is required to processing and use of my health data by those parties for the on of medical reports) implement or terminate the insurance contract. purposes stated to the same extent as AWP P&C S.A. would be • Experts (medical and nursing assessment and preparation of allowed to do. Insofar as necessary, I release the employees of expert reports) AWP P&C S.A. as well as those of the parties entrusted with this • Nursing services and providers of medical aids (arrangement 2. Request of health data from third parties to verify the duty task from secrecy for the disclosure of health data and other data of nursing services and medical aid providers) to indemnify protected under § 203 of the German Criminal Code. • Patient repatriation transports (medically advisable or neces- To check our duty to indemnify it may be necessary for us to check sary repatriation from abroad) information on your state of health which you provided to substanti- ate claims or which is shown in the documents submitted (e.g. bills, 3.3 Disclosure of data to reinsurers prescriptions, expert opinions) or notifications, e.g. by a physician or To ensure that your claims are satisfied, AWP P&C S.A. can conclude II. Disclosure of data to other insurers other member of the health profession. contracts with reinsurers that partially or completely assume the risk insured by us. In some cases the reinsurers use other reinsurers for Pursuant to the Insurance Contract Act the insured person must This verification is carried out only to the extent necessary. To do so, this purpose to whom they also transfer your data. To allow the rein- notify the insurer of all important circumstances for claim settle- we require your consent including a release from secrecy for us and surer to check whether AWP P&C S.A. has correctly assessed a claim, ment in case of damage. This can also include previous illnesses for these parties if, in the course of these requests, health data or AWP P&C S.A. might be required to present your claim documents and claims or notifications about other similar insurance. In certain other information subject to secrecy are disclosed. to the reinsurer. cases, such as double insurance, legal subrogation and where the- re are cost sharing agreements, personal data must be exchanged We will inform you in each individual case of the persons or esta- To settle insurance claims, data on your existing contracts might also between insurers. Also to prevent any misuse of insurance it may be blishments that are required to provide information and for what be disclosed to reinsurers. necessary to request information from other insurers or to provide purpose. You can then decide in each case whether you consent to suitable information upon request. In the process, the data of the the collection and use of your health data by the insurer, release the As far as possible, anonymised and pseudoanonymised data are person affected are disclosed, such as his or her name and address, persons or establishments named and their employees from secre- used for the purposes named above, but personal health data might type of insurance cover and the risk or information on the claim cy and consent to the transfer of your health data to the insurer, or also be used. (type of damage, amount of claim, date of damage). whether you will provide the required documents yourself. 2018-1102 -5-