Insurance terms and conditions

Terms and conditions

GENERAL

Definitions:

This contract means by:

1.1. The insurer: AGA International S.A. – Belgian branch (hereafter called: Allianz Global Assistance), Rue des Hirondelles 2, 1000 Bruxelles, certification no. 2769 – company registration no.: 0837.437.919.

1.2. Policyholder:
The physical person or legal entity having signed this contract with the insurer.

1.3. Insured people:
Physical persons whose names are mentioned under the header “Insured People” of the Specific Terms and Conditions. They must have their residence in a country not belonging to the Schengen area, reside there for at least 9 months of the year and make a private or professional trip within the Schengen area of maximum three consecutive months.
In the Terms and Conditions, insured people are addressed as “you” or “your”.

1.4. Place of residence – Residence:
Residence must be in a country not belonging to the Schengen area.

1.5. Travel compagnon:
The insured person with whom you have booked a joint trip and whose presence is absolutely necessary for the trip to go well.

1.6. Travel contract:

The contract with a professional tour operator or rental company in order to get you there as either traveler and/or tenant, a travel arrangement. Said contract must comply with all legislation dealing with these matters.

1.7. Minors:
Children younger than 18.

1.8. Illness:
A change in your health situation caused by something else than an accident and having been diagnosed and recorded by a doctor.

1.9. Accident:
A sudden and external event, outside of your control, causing a physical injury diagnosed and recorded by a doctor.

1.10. Repatriation:
Return to your residence.

1.11. Medical costs:
If they are the result of doctor or dentist’s prescription:

Medical fees, medication costs and admission and treatment costs in case of hospitalisation with a maximum of €30,000.- per insured person with an excess of 10% (min. €30 EUR – max. €150) per accident;

Emergency dental care costs with a maximum of €150 per insured person with an excess of €30 per accident.

1.12. Schengen area:
The area where people can travel freely between these countries: Germany, Austria, Belgium, Denmark, Spain, Finland, France, Greece, Iceland, Italy, Luxembourg, Norway, the Netherlands, Portugal, Sweden and Switzerland.

Subject of the contract

Within the limits of the terms and conditions and amounts specified in the General and Specific Terms and Conditions, this contract guarantees payment of the amounts specified and fulfillment of specified services.

Term of this contract – guarantee

3.1. This contract becomes valid from the moment the policyholder agrees fully with the pre-signed policy and ends on the last day of the trip as it is listed in the Specific Terms and Conditions.

3.2. Guarantee becomes valid at midnight of the departure date listed in the Terms and Conditions and ends at midnight of the last day of the trip listed in the Terms and Conditions. Guarantee is only valid when it is signed for the whole duration of the trip in the Schengen area.

3.3. Guarantee does in any case only become valid on the day after Allianz Global Assistance receives the pre-signed and considered as completed policy and at the earliest after payment of the owed and indivisible premium by the policyholder.

3.4. Guarantee is extended automatically up until your first possible return if you had to extend your stay for medical reasons, or if the means of transport used for your return home could not be used because of breakdown, accident, theft, fire, vandalism or strikes.

Where is the guarantee valid

Within the country/countries belonging to the Schengen area where you are staying during your trip.

What amount are you insured for

The insured amounts are the maximum amounts possible for the whole of the insured period. 9. Whatever the no. of contracts signed with Allianz Global Assistance, the maximum amounts you can be insured for are those listed in this contract.

How does transport or repatriation of people take place?

Unless otherwise agreed, people are transported by plane in economy or by train first class if the distance is less than 1,000 km and then with the necessary transport from airport or train station.

Allianz Global Assistance shall always check whether the means of transport originally planned can still be used for repatriation.

Declaration of obligation – aggravation of risk:

Policyholder must, both when signing this contract and for the duration of it, communicate all existing circumstances, new or modified, they are aware of and what they reasonably must consider as being essential elements for Allianz Global Assistance when assessing all risks.

If you have other insurance policies for that same risk, you need to tell Allianz Global Assistance their cover and identity of the insurers.

Your obligation

In case of an accident – after having received First Aid – immediately contact Allianz Global Assistance and follow their instructions: call (24/7) this no.: +32 2 529 76 96, or fax your message (24/7) to no. +32 2 290 61 01. No assistance, costs or service delivered shall be repaid if no prior agreement has been requested from Allianz Global Assistance and Allianz Global Assistance had not given their approval.
Every bit of assistance, transport, repatriation is carried out with your agreement and under your control. Only the service provider is responsible for work carried out by them.
Both in your country of residence and during your stay abroad, you must take all measures necessary in order to be able to recover all your expenses from Social Security and each insurer.
You need to inform Allianz Global Assistance in writing of any accident as soon as possible and at the latest within 7 calender days.
You need to supply Allianz Global Assistance immediately and in any case within 30 days with all useful information and reply to any questions you are asked in order to determine the circumstances and extent of the accident.
Take all reasonable measures in order to prevent and mitigate consequences of the accident.
You need to transfer to Allianz Global Assistance all original pieces of evidence concerning the circumstances, consequences and extent of your damages.
You need to have your illness or injuries in case of an accident unbiased and medically assessed.

To take all necessary measures in order to inform Allianz Global Assistance of all medical information relating to the person in question. Moreover, authorise the doctors of Allianz Global Assistance to receive all medical information relating to the person in question. You also need to authorise the doctor appointed by Allianz Global Assistance to examine the person in question.
If you fail to comply with one of your obligations, which then causes the accident, you will lose all right to insurance cover. However, in case of articles I.8.c., I.8.d., I.8.e. and I.8.f. and if such failure brought about damage to Allianz Global Assistance, they can only reduce their work up to the level of damage suffered. Failure from the client’s part to fraudulently comply with their obligations, their intentional omission or inaccuracy in the statement shall always lead to losing all rights to insurance cover.

Exclusions

Thermal therapies, heliotherapy, diets, preventive medicine, check-ups, regular monitoring and observation consultations, contraception, prosthesis, opticians’ costs, glasses, lenses, contact lenses, crutches, medical equipment, vaccinations, vaccines.
Plastic or cosmetic surgery, except if it is absolutely necessary because of physical injury.
All diagnostics, treatment and medication not recognised by the Social Security system of your home country (ex.: Belgium: INAMI).
Pregnancy, except in case of evident and unforeseeable complications. Every accident after 26 weeks of pregnancy, abortion, or delivery and all interventions and consequences resulting from it are in any case excluded from this guarantee.
All chronic illness with an either infectious or parasitic origin and also any illness or accident which already existed when the policy in question became valid, and their consequences.

Are however not excluded: an unforeseeable relapse or complication after the policy in question became valid of an illness or accident which already existed when the policy in question became valid on the condition that that illness or the consequences of the accident had been stable for six months before the policy became valid and no treatment had been started or adjusted during the six months preceding the policy becoming valid.

All illness with cancer origins.
All illness popping up during a trip which was undertaken to find diagnosis and/or treatment.
Mental, psycho-somatic or neurology problems.
All circumstances known or present when the policy in question became valid, which one could reasonably expect to cause damage.

Abuse of medication, drugs, downers or uppers, alcoholism or intoxication,
All intentional or voluntary actions, reckless attitude.
Participation in bets, crimes or affray, except in case of legal self defence.

Participation, either professionally or with a contract against remuneration, in any sport or competition and training. Moreover, any participation in a sport or competition for which motorised vehicles are used (trials, competitions, rallys, raids,…) and their training.
All activities linked with specific work or business risks.
Strikes, decisions by the authorities, limitation of free movement, radioactivity or all voluntary non-compliance with legal or official provisions.
War, civil war, revolutions, mutiny or riots.

All acts of terrorism and their consequences except for repatriation and medical costs less than €2,500.-.

Any delays or non-compliance with services agreed in case of force majeure, unforeseeable events, strike, war or civil war, revolution, mutiny, decisions by the authorities, restriction of free movement, radioactivity, explosions, sabotage, terrorism or embezzlement.
Epidemics and quarantine.
All consequences of the exclusions listed in this contract.

Cancellation options:

If this contract is for at least thirty days:
policyholder can terminate this contract within thirty days after Allianz Global Assistance has received the pre-signed contract. Termination becomes valid immediately at the time of notification.
Allianz Global Assistance can terminate this contract within thirty days after receiving the pre-signed contract. Termination becomes valid eight days after notification.
Both Allianz Global Assistance and the policyholder can terminate this contract after an accident or a request for assistance, however at the latest one month after compensation is paid, assistance has been carried out or compensation and assistance have been refused. Termination becomes valid after one month starting from the day after special delivery was sent, a writ was served or date of receipt in case termination letter was sent.
All premiums paid relating to the period after termination became valid will be paid back within two weeks after said termination.

Subrogation:

Allianz Global Assistance is subrogated, in case of compensation paid, in your rights and actions against third parties. If, because of your fault, subrogation cannot be carried out, Allianz Global Assistance can reclaim off you restitution of compensation paid for damages incurred.

Expiry:

any action resulting from this contract expires three years after the date of the event which led to the action.

Privacy:

Allianz Global Assistance manages all files. All data are collected in order to ensure management of this contract and accident dossiers. You can access and correct these data. You also have the option to obtain extra information from the public register of the Commission for the Protection of Privacy (identification nos. VT4003753 and VT4003754). You authorise Allianz Global Assistance, with the sole purpose of managing this contract and any accident dossiers, to process all sensitive, medical or legal documents which pertain to you and to communicate them to third parties (Law of 8.12.1992). You also authorise your doctor, in case you die, to give the Allianz Global Assistance doctor-consultant a certificate establishing the cause of death (Law of 25.6.1992).

Correspondence:

Allianz Global Assistance’s registered address is in Belgium, at Rue des Hirondelles 2, 1000 Brussels, and all correspondence must be sent to that address.
All written communication directed to you is correctly sent to the address stated in the Specific Terms and Conditions or to the address you originally gave Allianz Global Assistance.

Legal rules – Legal authority:

This contract is governed by these General and Specific Terms and Conditions, the dispositions of the Law on Terrestrial Insurance Contracts and Belgian legislation. All praise and complaints concerning our services must be sent to us:
– with courier for the attention of the quality dept.;
– by fax: +32-2-290 65 26;
– by e-mail: quality@allianz-global-assistance.be.

If, after your complaint has been processed by our services, a disagreement still persists, you have the option for appeal with the Insurances Ombudsman at de Meeûssquare 35, 1000 Brussels, info@ombudsman.as, fax +32-2-547 59 75. Court cases can only be brought before the authorised Courts at Brussels.
Apart from the possibility of instigating a legal case, any complaint regarding this contract can be sent to the Banking, Finance and Insurance Commission, Rue du Congrès 12-14, 1000 Brussels.

PERSONAL ASSISTANCE

WHAT SERVICES DOES ALLIANZ GLOBAL ASSISTANCE PROVIDE?

You pay your medical costs following your illness or accident, which happened in a country within the Schengen area:

Compensation: medical costs with an excess of 10% (min. €30 – max. €150) per accident, after deduction of payments which you are entitled to from your Social Security or the insurance of the mutual insurance system you’re a member of. In case of hospitalisation, Allianz Global Assistance can advance the 8. medical costs of local transport to the nearest doctor or hospital in order to receive First Aid and of local transport by ambulance, if so ordered by a doctor, up to €750.- per insured person.

Your state of health following your illness or accident requires transport or repatriation:

The organisation and payment of your transport from the hospital where you are immobilised to your home, to the hospital closest to your home or the hospital better equipped to continue your treatment.
Transport or repatriation takes place by air ambulance, by plane in economy, by ambulance, or by any other means of appropriate transport. Repatriation will take place under medical supervision if your health requires that.
The decision on transport and what kind of it to use, on repatriation and how to do it, on what hospital to go to is exclusively that of Allianz Global Assistance’s medical department, after consultation with the local attending doctor, taking into account solely the state of your health.
Organisation and compensation of the repatriation of an insured travel compagnon in order to accompany you back to your residence or the hospital.

You travel alone and you need to be hospitalised for more than 7 days after your illness or accident:

The organisation of and compensation for return transport, from their residence, of a family member, up to the second degree, in order for them to be by your bedside; payment for maximum 10 nights at a hotel up to €50.- per night for that person.

You need to return home prematurely because of the death of a parent or child, aged under 70: Organisation and payment of your repatriation.

Death of an insured person:

Payment of the repatriation of the body from the place where they died to the place of burial in their home country, including a zinc coffin, embalming and customs’ fees.
Payment for all post-mortem treatment, including coffin, up to €1,500.-/insured person. Costs for the funeral and burial shall never be paid by Allianz Global Assistance.
Payment for burial or cremation costs at their location in the country in the Schengen area where you are, up to €1,500.-/insured person, if the heirs prefer that. This will include post-mortem treatment and putting the body in the coffin, the coffin itself, local transport of the body, burial or cremation except for the funeral service and the repatriation of the urn.

Search and rescue costs:

Payment of up to €750.-/insured person of the operational costs of a search and rescue operation after your accident or disappearance.

Legal assistance:

Payment of solicitor’s fees up to €750.-/insured person if you are prosecuted after an accident.

You wish to send an urgent message to your family or employer: If you are ill or have an accident and you wish to send an urgent message to your family, employer or people close to you in your home country, Allianz Global Assistance shall try and get that message transferred to the people concerned.

Not covered assistance:

If your accident is not covered by this contract, Allianz Global Assistance can still assist you by providing human care under certain conditions. In a case like that, all costs must be paid in their entirety to Allianz Global Assistance before any assistance is organised.