General Conditions of Insurance (GCI)
Contents
Art. Page
Customer information according to the Swiss Law on
Insurance Contracts (VVG) 2
General Conditions
of Insurance (GCI) Edition 2014.01 4
Common provisions
1 Basis of the contract 4
2 Object of the insurance 4
3 Duration 4
4 Geographical limits 4
5 Change in the risk 4
6 Payment of premiums
and adjustment of contract 4
7 Refund of premiums 5
8 Premium based on loss
experience 5
9 Cancelation in the event
of a claim 6
10 Interchangeable license plates 6 11 Replacement (substitute)
vehicles 6 12 Deposited license plates 6
13 Deductibles 6
14 Obligations in the event
of a claim 7
15 Ascertaining the facts 8
16 Consequences of conduct contrary to the terms
of the contract 8 17 Assignment of claims 8 18 Notices to Zurich 8 19 Brokers’ commission 8 20 Place of performance and jurisdiction 8 21 Applicable law 8
Third party liability insurance
101 Scope of the insurance 9
102 Insured persons 9
103 Insurance benefits 9
104 Exclusions and limitations
of the scope of insurance 9 105 Recovery 10 106 Refund of the deductible 10
Hull insurance
201 Scope of the insurance 10
202 Insured events 10 203 Insurance benefits 12 204 Exclusions 13 Art. Page Accident insurance 301 Insured persons 14 302 Definition of accident 14 303 Insured accidents 14 304 Uninsured accidents 14 305 Insurance benefits 14 306 Contributory effect of illnesses 16 307 Increase in risk 16 308 Offsetting against liability claims 16 Roadside assistance CH/FL 401 Insured vehicles 16 402 Insured persons 16 403 Insured events 16 404 Insurance benefits 17 405 Uninsured damage 17
406 Claims against third parties 17 407 Claims under other insurance
policies/agreements 17
408 Third-party claims 17
Legal protection insurance
501 Insured persons 18
502 Scope of insurance 18
503 Uninsured legal disputes 18
504 Insurance benefits 19
505 Reductions to benefits 19 506 Definition of legal dispute 19 507 Processing 19 508 Differences of opinion 20
Liability arising out of the transportation of hazardous loads
601 Scope of insurance 20
Liability arising out of work accident risk
701 Scope of insurance 21
Glossary 22 Product overview 23
Key words 24
Dear Client,
Motor vehicle insurance from Zurich provides you with customized insurance protection. Thank you for the interest you have shown in our services and the confidence you have placed in us. If you have any questions, please do not hesitate to contact us.
The following customer information shows a clear and summarized overview of the identity of the insurer and the material content of the insurance contract (Art. 3 of the Federal Law on Insurance Contracts, VVG/LCA). The rights and obligations of the contracting parties arise from the proposal/offer, the policy itself, the contractual conditions and the applicable laws, especially the VVG/LCA.
After acceptance of the proposal/offer the Policyholder will be issued with a policy, the contents of which will reflect the proposal/offer.
Who is the insurer?
The insurer is Zurich Insurance Company Ltd, hereinafter referred to as Zurich, with registered office at Mythenquai 2, 8002 Zurich. In terms of legal protection insurance, the insurer is Orion Legal Expenses Insurance Company, here-inafter referred to as Orion, with registered office at Centralbahnstrasse 11, 4002 Basel. Zurich and Orion are stock corporations under Swiss law.
Which risks are insured and what is the scope of the insurance cover?
The insured risks and the scope of the insurance cover are determined by the proposal/offer or the policy and by the contractual conditions.
What is the premium amount?
The premium amount depends on the respective insured risks and the designated level of cover. A fee may be charged for payment in installments. All information on the premium and any applicable fees are included in the proposal/offer or in the policy itself.
Under what circumstances is the premium refunded?
If the premium has been paid in advance for a specific period of insurance and the contract is canceled before the end of the period, Zurich will refund the premium in respect of the unexpired period of insurance.
The premium remains payable in full to Zurich if: – the insurance benefit was provided on the basis of the
cessation of risk;
– the insurance benefit was provided for a partial loss and the Policyholder cancels the contract during the year after the contract was concluded.
Which other obligations does the Policyholder have?
–Changes in risk:If an important fact changes during the term of the policy, resulting in a material increase in risk, then Zurich must be notified in writing without delay.
–Ascertainment of the facts:The Policyholder must provide assistance for investigations relating to the insurance contract, e.g. breaches of the duty of disclosure, increases in risk, checking benefits, etc. and provide Zurich and Orion with all pertinent information and documentation or obtain such information from third parties for submission to Zurich and Orion, and authorize third parties in writing to issue the appropriate information, documentation, etc. to Zurich and Orion. Zurich and Orion are also entitled to carry out their own investigations.
–Insured event:The insured event must be reported to Zurich without delay.
This list only contains the most common obligations. The contractual conditions and the VVG/LCA contain further obligations.
When does the insurance cover begin?
The insurance cover begins on the day stated in the proposal/ offer or in the policy itself. If an insurance certificate has been issued, Zurich will provide the insurance cover in accor-dance with applicable law or the terms of contract until the policy is issued.
When can Zurich adjust the insurance contract?
If there is a change in the basic premiums, fees or terms and conditions of insurance (e.g. premium rate, deductible rule or scope of coverage), Zurich may require adjustment of the contract with effect from the following year of insurance.
When does the insurance cover end?
The Policyholder can terminate the contract by giving notice: – at the latest three months before the end of the contract or,
if agreed, three months before the end of the insurance year. The termination shall be deemed valid if it is received by Zurich at the latest on the last day before commence-ment of the three-month period. If the contract is not ter-minated, it shall be automatically extended for one year at a time. Fixed-term contracts with no renewal clause end on the day specified in the proposal/offer or policy; – after every insured event for which a claim is payable,
at the latest 14 days after notification that Zurich has paid; – if Zurich changes the basic premium or the terms and
conditions of insurance pursuant to Art. 6.5 GCI. In this case the notice of termination must reach Zurich no later than the last day of the insurance year;
– if Zurich breaches the statutory information obligations pursuant to Art. 3 VVG/LCA. The right of termination lapses four weeks after the insured has received notification of this breach, but at the latest one year after the breach. Zurich can terminate the contract by giving notice:
– at the latest three months before the end of the contract or, if agreed, three months before the end of the insurance year. The termination shall be deemed valid if it is received by the Policyholder at the latest on the last day before commencement of the three-month period. If the contract is not terminated, it shall be automatically extended for one year at a time. Fixed-term contracts with no renewal clause end on the day specified in the proposal/offer or policy;
– after every insured event for which a claim is payable, on condition that notice of termination is given at the latest at the same time as payment is made;
– if material risk factors have been concealed or falsely communicated (breach of the duty of disclosure). Zurich can cancel the contract:
– if the Policyholder is late in paying the premium, has received a reminder and Zurich does not call it in;
– if the Policyholder does not fulfil his/her obligation to assist with the ascertainment of the facts. Zurich is entitled to cancel the insurance contract retrospectively within two weeks after the expiry of a four-week time extension agreed in writing;
– in the event of insurance fraud.
This list only contains the most common possible reasons for termination. The contractual conditions and the VVG/LCA contain other possible reasons.
How do Zurich and Orion handle data?
Zurich and Orion process data disclosed on the policy docu-mentation or during the course of issuing the policy, and use them mainly for the purpose of setting premiums, provid -ing information on risk, process-ing claims, mak-ing statistical evaluations and marketing purposes. The data are stored in hard copy form or electronically. Zurich shall be entitled to transfer any data that may be required for processing pur -poses to any third parties in Switzerland or abroad who are involved in issuing the policy, including but not limited to coinsurance and reinsurance companies, and to subsidiaries of Zurich Insurance Group Ltd located within or outside Switzerland. For the purpose of fraud prevention in motor vehicle insurance, vehicle-specific claims data may be filed with SVV Solution AG (a subsidiary of the Swiss Insurance Asso -ciation, SVV) for inclusion in the centralized Car Claims Info database. Zurich and Orion shall also be entitled to procure pertinent information from government offices and third parties, in particular information with respect to the loss expe -rience. This consent shall be valid regardless of whether the contract is concluded. The Policyholder has the right to request that Zurich and Orion provide information envisaged under legislation in respect of the processing of data per -taining to him/her.
Common provisions
Art. 1
Basis of the contract
1.1
The Insurance shall be based on the declarations which you, as Policyholder (applicant), make in the application form.
1.2
The rights and obligations of the contracting parties shall be laid down in the policy, the general conditions of insurance and in any special condi-tions applicable.
Art. 2
Object of the insurance
Depending on what is agreed, the insurance of the vehicle described in the policy shall cover:
– Third party liability insurance – Hull insurance
– Accident insurance – Roadside assistance CH/FL – Legal protection
The insurance coverages you have taken out are listed in the policy. For a product overview, please refer to page 23.
The following types of vehicle use are only insured if this has been agreed in the policy.
– Commercial transport of persons – Commercial rental to self-drive
customers
– Commercial use as a driving school vehicle
Art. 3 Duration
The insurance shall take effect on the day specified in the policy. If a cer -tificate of insurance has been issued, Zurich shall provide provisional insurance coverage, until receipt of the policy,
– for liability claims in accordance with the legal minimum guarantee amount;
– for hull claims, in accordance with the signed application received by Zurich for a maximum duration of four weeks after the registration date. However, indemnity shall be limited to CHF 60,000 for motorcycles and CHF 150,000 for all other motor vehicles.
Zurich shall, however, have the right to reject the application up to the time of delivery of the policy. If it avails itself of this right, then its obligation to pay shall be canceled 3 days after notifica-tion of refusal is served on you. Zurich shall be owed the pro rata premium up to the date of expiry of the obliga-tion to pay.
The insurance shall apply to losses which are caused within the contract term. In the case of legal protection insurance, any need for legal protection (i.e. the causal event) must also arise within the contract term.
If notice of termination of the contract is not served at least 3 months before it expires, then it shall be renewed auto matically for one year. Notice of ter -mination shall be deemed to have been served in good time if it reaches Zurich or you not later than the last day before the three month period begins. Where an insurance period of less than one year has been agreed, the contract shall lapse automatically on the date speci-fied in the policy.
Art. 4
Geographical limits
The insurance (with the exception of assistance) shall be valid in respect of accidents occurring in Switzerland and the Principality of Liechtenstein, the European states as well as in the countries bordering on the Mediter-ranean Sea and in MediterMediter-ranean island states. In the event of transport across the open sea, the coverage shall not cease if the points of departure and destination are located within the geo-graphical limits.
Roadside assistance is valid in Switzerland and the Principality of Liechtenstein.
However, the insurance shall not be valid in the following states: Belarus, Moldavia, Ukraine, Russian Federation,
Georgia, Armenia, Azerbaijan, Kazakhstan, Algeria, Egypt, Lebanon, Libya and Syria.
The insurance shall lapse if the owner gives up his/her residence or legal domicile in Switzerland and takes up residence in another country (with the exception of the Principality of Liechtenstein), such lapse to take effect at the earliest when the Swiss or Liechtenstein license (number) plates are deposited with the Road Traffic Authority, not later than at the end of the year of insurance in which the move takes place, or as soon as the in-sured vehicle is registered outside Switzerland or Liechtenstein.
Art. 5
Change in the risk
If in the course of the insurance a change occurs to an important fact stated in the application form, and if such change results in a material increase in risk, you must notify Zurich of such a change in writing without delay. The insurance shall then also ex-tend to such an increase in risk, un-less Zurich cancels the contract within 14 days from receipt of the notice. If you fail to notify Zurich of the increase in risk, then Zurich shall no longer be bound by the contract. If a decrease in risk occurs, Zurich shall reduce the premium accordingly after receipt of the relevant information with effect from the following year of insurance.
Art. 6
Payment of premiums and adjustment of contract
6.1 Initial premium
The first premium shall fall due when the certificate of insurance is generated or, if coverage excludes third party liability, when the policy is handed over.
6.2 Balances
The contracting parties shall waive the right to call in balances arising from pre-mium invoices which are less than CHF 5.
6.3 Installment plan
If payment of the premium by install-ments was agreed upon, the
correspon-ding fee shall be payable; payment of the remaining installments shall be deemed to be deferred. The fee for premium payment by installments does not form part of the basic premium. Art. 6.5 below is thus not applicable to any change in this fee. Zurich is entitled to adjust this fee with effect from the main premium payment date. You then have the right to change your method of payment as you wish. To be deemed valid, notification to this effect must be received by Zurich at the latest on the date when the corre -sponding premium is due.
6.4 Rating characteristics
Basic premiums shall be based on the rating characteristics stated in your policy under the driver and vehicle de-tails including the physical address. If any of these characteristics changes, you must notify Zurich in writing without delay. Zurich shall have the right to adjust your contract accord -ingly.
6.5 Adjustment of contract
If the basic premiums increase (except as a result of changes to the character-istics mentioned in the previous para-graph) or if the conditions of insurance change (e.g. the premium rate system, the insured sum, the deductible rules or the coverages), Zurich may require adjustment of the contract with effect from the following year of insurance. To this end, it must notify you of the new contractual provisions at the latest 25 days before expiry of the year of insurance. You shall then have the right to cancel the contract either with re-spect to that part affected by the change or in its entirety at the end of the current year of insurance. In order to be valid, the notice of termination must be received by Zurich at the latest on the last day of the year of insurance. If you fail to serve notice of cancela-tion, you shall be deemed to have sented to the adjustment to the con-tract.
6.6 Consequences of default
If the policyholder is unable to meet the payment obligations, a payment request shall be issued and the policy-holder shall be liable for the dunning charge and default interest. The policy-holder must also bear the costs that arise for Zurich as the result of a license plate revocation.
Art. 7
Refund of premiums
If the premium has already been paid in advance for a specific period of insur-ance, and the contract is canceled prior to the expiration of the said period, Zurich shall refund you the premium in respect of the unexpired period of insurance and forgo any outstanding installments. Zurich reserves the right to offset such refunds against other claims under this contract.
However, the premium shall remain owed for the whole insurance year: – if the contract is terminated due
to the fact that the risk no longer exists (total loss);
– if you cancel the contract in the event of partial loss within one year of the contract being concluded.
Art. 8
Premium based on loss experience
8.1 Premium rate systems
The third party liability insurance falls under System N, or if Bonus guarantee is agreed, under System G (see table below) or System Z.
Premium rate % of the basic
premium Systems N and G 1 30 2 35 3 39 4 43 5 47 6 51 7 55 8 60 9 65 10 70 11 75 12 80 13 90 14 100 15 110 16 120 17 130 18 140 19 150
System Z: The premium shall always amount to 100% irrespective of loss experience.
The system applicable, the basic pre -mium and the pre-mium rate applicable at the inception of the insurance shall be stated in the policy. For the fol-lowing years of insurance, as far as system N and system G are concerned, the premium shall be fixed according to loss experience, whereas in the case of system Z, the premium does not depend thereon. The following provi-sions shall not therefore apply to system Z.
8.2 Period of observation
The period of observation covers 12 months and expires 3 months before the annual premium falls due.
8.3 Change to premium rate
If, during the period of observation dur-ing which time the insurance was in force, no claim was registered in re-spect of which Zurich was liable to pay an indemnity or set aside a reserve (Zurich’s own expenses not being taken into account), the premium for the following year of insurance shall be cal-culated in accordance with the rate immediately lower in the scale, unless you have already reached the lowest rate in the scale.
On the other hand, in system N,each claim resulting in an indemnity or a reserve shall entail an upward adjust-ment by 4 premium rates in the scale in the following year of insurance, but no higher than premium rate 19. In the case of system G,the first claim that results in an indemnity or re-serve shall have no influence on the rate in the following year of insurance. Only upon occurrence of the second claim during the same period of obser-vation shall the applicable premium rate be adjusted upwards by 4 premium rates, at the most however up to pre -mium rate 19.
The application date is decisive in all occurrences of loss.
8.4 No change in premium rate
If a claim proves to have no conse-quences, it shall be deemed not to have occurred and the premium rate shall be adjusted accordingly.
Accidents which occur during the period from the date of the application to the inception of the insurance shall be taken into account by
subse-quent adjustment of the premium rate.
The following shall not be taken into account:
– claims for which an indemnity was payable, although no insured person was in any way to blame (strict liability);
– claims in the case of thug rides; provided the owner is not to blame for the theft of the vehicle;
– claims for which you assume financial responsibility, provided you refund to Zurich the latter’s outlays within 30 days of your having obtained knowledge of the settlement; – collision damage for which the
in-sured person is not responsible in any way and for which the replacement value indemnity was covered 100% by the colliding party or his/her third party liability insurer and for which the benefit under this policy is limited to payment of the difference between the replacement value indemnity and the cash value supplementary in-demnity (according to the inin-demnity table under Art. 203.2).
Where there is a change of primary driver, Zurich shall fix a new premium rate for the contract with effect from the date of the change.
Art. 9
Cancelation in the event of a claim
Following each claim for which a benefit is payable, Zurich shall be enti-tled to cancel the contract not later than upon payment of the indemnity (or before the claim is processed by Orion), and you shall be entitled to can-cel it not later than 14 days after ob-taining knowledge of such a payment (or of the claim having been settled by Orion, as the case may be).
If either party elects to cancel, coverage shall cease 14 days after the other party’s receipt of the notice of cancela-tion.
Art. 10
Interchangeable license plates
10.1
If the insurance was taken out in re-spect of vehicles being used with interchangeable license plates, the in-surance shall be valid:
– in full, for the vehicle fitted as pre-scribed with the interchangeable license plates;
– for other vehicles not fitted with these plates, only insofar as the accident does not occur on a public road.
10.2
If a loss for which Zurich has to pay an indemnity under the third party liability insurance occurs on public roads, it shall have a right of recovery against you and the insured for the vehicle not in circulation in accordance with the regulations. No coverage shall exist in respect of all other losses.
10.3
In motor vehicles which are driven with interchangeable license plates are subject to different premium rates, these premium rates shall be linked to the relevant vehicle. If a vehicle is replaced, the replacement vehicle shall assume the premium rate of the vehicle it is replacing.
10.4
The switch from interchangeable to individual plates (or vice versa) may result in a change in the premium.
Art. 11
Replacement (substitute) vehicles
If, with the consent of the competent authority, the owner uses, instead of the insured vehicle, a replacement (substitute) vehicle of the same cat -egory, fitted with the license plates of the insured vehicle, then the third party liability, accident and legal protec-tion insurance and roadside assistance shall apply exclusively to the replace-ment (substitute) vehicle. The hull insur-ance shall apply to a replacement (substitute) vehicle of equivalent value and shall remain in force for the re-placed vehicle with the exception of accidental damage (Article 202.1).
If official authorization for use of the replacement (substitute) vehicle has not been obtained, then Zurich or Orion shall not be liable to pay a benefit to the insured.
If the replaced vehicle is being used again with its own license plates or if the owner ceases to use the replace-ment (substitute) vehicle, the insurance of the replacement (substitute) vehicle shall lapse.
Art. 12
Deposit of license plates
If the license plates are deposited with the competent authority, the insurance shall be suspended from the time that the license plates are deposited until such time as they are redeemed for the insured vehicle as per the following specifications:
During the suspension, but for a maxi-mum period of 12 months, the third party liability insurance and the hull in-surance shall continue with unchanged scope. Collision and third-party losses shall, however, only be covered insofar as the accidents did not occur on public roads. The accident insurance, legal pro-tection insurance, and roadside assis-tance shall be completely suspended. Zurich shall grant you a suspension discount in the amount of the premium accruing for the suspension period. The contract is automatically cancelled if the license plates have not been redeemed within 12 months of being deposited.
Art. 13 Deductibles
The deductible stipulated in the policy shall apply for each loss for which Zurich is required to pay benefits. It shall be payable by you.
The agreed deductible shall apply to each and every claim.
13.1 Third party liability and collision Drivers
If, in the event of a claim, the driver of the vehicle is under 25 years of age, even though none of the main drivers or additional drivers were declared
as under 25 in the application, then the deductible agreed in the policy for third party liability and collision damage shall be increased by CHF 500.
13.2 Liability 13.2.1
The deductible agreed for young drivers
shall apply if the driver of the vehicle is under 25 years of age at the time of the accident.
13.2.2
The deductible agreed for other drivers
shall apply if the driver of the vehicle was over 25 years of age at the time of the accident.
13.2.3
No deductible shall applyif the indem-nity was payable although no insured person was in any way to blame (strict liability), or for claims arising
– during thug rides, if the owner is in no way to blame for the theft of the vehicle;
– during driving lessons given by an officially recognized driving instructor;
– during an official driving test.
13.3 Hull insurance 13.3.1 Travel effects and protective clothing
No deductible generally applies for travel effects or protective clothing.
13.3.2 Towing vehicle and trailer
In the event that a towing vehicle and trailer are insured with Zurich and if both sustain loss or damage in the same event, you shall only be required to bear one deductible. In the case of different deductibles, the higher amount shall be applied.
Art. 14
Obligations in the event of a claim
14.1 Immediate notification
The insured must notify Zurich immedi-ately of the loss event if its conse-quences may be likely to involve the insurance.
The claim notification may be sent in writing using the claim form or may be made by telephone. Zurich or Orion shall have the right to require a written claim notification to be sent for loss events of which notification has already been made by telephone.
Zurich must be notified of fatal acci-dents (if necessary by telephone, e-mail or fax) in sufficient time for Zurich, if necessary, to arrange for a postmortem at its own expense before the burial.
14.2 In terms of third party liability insurance
The insured must notify Zurich of the loss event if liability claims are made against him/her in connection with this event, whether judicially or extraju -dicially, or if criminal proceedings are instituted against him/her or he/she is fined.
Zurich shall conduct negotiations with the claimant at its own discretion, either as the representative of the in-sured or in its own name. In the event of accidents in foreign countries, Zurich shall be entitled to entrust the authorities, competent by virtue of the “Green Card” or another inter -national agreement in its stead, and by virtue of foreign compulsory insurance laws, with the handling of the third party claim. The settlement of the third party claim by Zurich shall, in all cases, be binding upon the insured.
The insured shall assist Zurich in ascer-taining the facts and refrain from giving any opinion of his/her own on the claims of the third party tractual fidelity). In particular, the insured shall neither admit liability claims nor make any payments to the injured party; furthermore, he/she shall leave the con-duct of any civil lawsuit to Zurich.
14.3 In terms of hull insurance
Zurich must be given the opportunity of inspecting the damaged vehicle prior to and following repairs. Otherwise, the benefit payable by Zurich may be reduced or even canceled altogether.
14.3.1
If Help Point PLUShas been concluded, you must report hull claims by tele-phone or contact one of our Help Points so that Zurich can initiate the claims process and arrange for the necessary repair to be carried out in a repair shop designated by Zurich. In the event that this provision is not complied with, the deductible agreed for the in-sured events of hull insurance shall be increased by CHF 500. This provision shall remain expressly subject to Art.16 of the GCI.
14.3.2
You must moreover notify the police without delay and, at the request of Zurich, bring a charge against the thief
–in the event of theft of insured travel effects or protective clothing.
Where stolen articles are subsequently recovered, the indemnity, less the compensation for any reduction in value, shall be repaid to Zurich, or the items of property placed at Zurich’s disposal;
–in the event of theft of the vehicle.
If a missing vehicle is recovered within 30 days of Zurich receiving the notification of theft, you must take it back after the repairs, if any, have been carried out at Zurich’s expense. In the event of loss or damage caused while parked,Zurich shall only be liable to pay a benefit provided you have arranged for a charge to be brought against the person or persons unknown and have provided a state-ment to the police, or if the parking damage has been determined by a Zurich vehicle expert.
In the event of damage caused by animals,you or the driver must imme -diately ensure that public authorities, such as the police, gamekeepers, etc., draw up a report on the circumstances of the accident or that the animal owner confirms the occurrence. Failing this, Zurich shall pay an indemnity only if damage caused by collision is in-sured, and then only subject to the conditions applying to such insurance.
14.4 In terms of accident insurance
As soon as possible after the accident, a registered doctor shall be called in and arrangements made for proper medical care. Furthermore, the insured person or the claimant, respectively, shall do everything which may assist in clarifying the circumstances of the accident and its consequences; in par-ticular, the insured person shall release the doctors who are attending him/ her from their professional obligation of confidentiality towards Zurich and shall consent to an examination by the doctors appointed by Zurich; in the event of death, the next of kin entitled to claim shall give their consent to a post-mortem examination, insofar as there may also be other causes of death than the accident.
14.5 In terms of Roadside assistance
In order to be able to claim benefits under Roadside assistance, Zurich must be immediately informed of the event by phone. This benefit lapses if even just one of a number of assis -tance measures was not organized, arranged or implemented by Zurich.
Art. 15
Ascertaining the facts
The person who is subject to the duty of disclosure must provide assistance in investigations relating to the insurance contract, such as breaches of the duty of disclosure, increases in risk, checking benefits, etc., and provide Zurich/Orion with all pertinent information and documentation or to obtain such infor-mation from third parties for submis-sion to Zurich/Orion, and to authorize third parties in writing to issue the appropriate information, documenta-tion, etc. to Zurich/Orion. Zurich/ Orion is entitled to carry out its own in-vestigations. If the person subject to the duty of disclosure does not comply with this requirement, Zurich/Orion is entitled to refuse the claim or withdraw from the insurance contract, as the case may be, retroactively within two weeks of the expiry of a four-week extension period of which it must notify the insured in writing.
The same obligations shall apply to the Policyholder, insured parties and claimants as to the person subject to the duty of disclosure, and to their representatives, provided that such per-sons are not the same as the person subject to the duty of disclosure.
Art. 16
Consequences of conduct contrary to the terms of the contract
In the event of a violation of the obli -gations incumbent on you or other in-sured parties, Zurich/Orion shall no longer be obliged to pay any benefit. This disadvantage shall not arise if, in the circumstances, the violation is to be regarded as not being anyone’s fault. Missed premium payment due to inability to pay on the part of the pre-mium payer shall not be covered by the above clause.
Art. 17
Assignment of claims
Without the express consent of Zurich, the claims to the insured benefits may not be assigned or pledged before they have been finalized.
Art. 18
Notices to Zurich
All notices should be forwarded to the agent named on the last policy or premium invoice, or else to the Zurich Insurance Company Ltd, P.O. Box, 8085 Zurich.
Art. 19
Brokers’ commission
If a third party such as a broker rep -resents the interests of the Policyholder when concluding or administering this insurance contract, it is possible that Zurich may pay this third party com -mission in return for his or her activities on the basis of an agreement. If the Policyholder wishes to receive further information about this, he/she should contact the third party.
Art. 20
Place of performance and jurisdiction
The obligations under this insurance are to be performed in Switzerland and in Swiss currency.
In the event of disputes arising from this contract, the Policyholder or the claimant may select as the place of jurisdiction either:
– Zurich or Basel;
– the location of the Zurich branch which has a practical connection to this contract;
– the domicile or the head office of the Policyholder or claimant in Switzerland or the Principality of Liechtenstein, but not in any other, foreign country.
Art. 21 Applicable law
In addition, the provisions of the Swiss Federal Law on Insurance contracts shall apply and, with respect to the third party liability insurance, the provisions of the road traffic legislation shall be applicable.
Third party liability insurance
Art. 101
Scope of the insurance
101.1 Insured claims
Zurich shall provide insurance coverage for civil law claims which are made against the insured persons by virtue of statutory provisions concerning liability in respect of
– death of or injury to persons (bodily injury),
– destruction of or damage to property (property damage).
101.2 Cause of claim
The insurance covers bodily injury and property damage caused
– by the use of the motor vehicle described in the policy and the trailers pulled or vehicles towed by the said motor vehicle;
– in the course of a road (traffic) accident caused by these vehicles when they are not in use;
– as a result of assistance given after accidents in which these vehicles were involved.
The liability of insured persons in respect of unhitched trailers within the meaning of Article 2 of the Swiss Road Traffic Insurance Ordinance shall also be covered.
Zurich shall further provide insurance coverage for civil law claims made against the insured persons, arising out of accidents when mounting or dis-mounting the motorcycle, or climbing into or out of the vehicle, when open-ing or closopen-ing the doors, hood, sunroof or trunk as well as when hitching up or unhitching a trailer or towed vehicle.
101.3 Loss prevention costs
If, because of an unforeseen event, the occurrence of an insured loss is im -mediately imminent, the coverage shall also include those costs which the insured person incurs in taking appro-priate measures to prevent this danger.
101.4 Supplementary insurance
The following supplementary insurance coverage shall apply subject to the appropriate agreement in the policy:
101.4.1 Coverage for gross negligence
If coverage is agreed for gross negli-gence, Zurich shall waive its right of recovery against you or the insured par-ties on grounds of having caused the occurrence of loss through gross negli-gence as defined in Article 14 para-graphs 2 and 3 of the Swiss Federal Law on Insurance Contracts (LIC). If the loss was caused in a state of inebriation or when driving while impaired or due to a speeding offence as defined in Article 90 paragraph 4 of the Swiss Road Traffic Act (RTA), Zurich will exer-cise its right of recovery against you or the insured parties. The extent to which this is done will depend on the degree of fault and the financial circumstances of the person against whom the right of recovery is exercised. Zurich will also exercise a right of recovery if the occurrence of loss was caused through willful intent or indirect intent.
Art. 102 Insured persons
The owner and the persons for whom he/she is responsible according to road traffic legislation shall be insured.
Art. 103
Insurance benefits
103.1 Basic principle
The insurance shall pay for justified claims and protect you from unjustified claims.
The benefits payable by Zurich shall be limited to CHF 100 million, including any interest on the loss or damage, lawyers’ fees and court costs without prejudice to the claimant’s rights.
103.2 Restrictions
The amount of the benefits payable for any bodily injury and property damage caused by fire, explosion or nuclear energy – subject to Art.104.4 – as well as for the cost of loss prevention measures shall be limited to a total of CHF 5 million per loss event.
If a higher level of coverage is prescribed by Swiss road traffic legis -lation, such higher coverage shall apply and shall also be deemed to be the maximum benefit payable by Zurich as described above.
Art. 104
Exclusions and limitations of the scope of insurance
The insurance shall not apply to claims in respect of losses listed under Art.104.1 to 104.7 below:
104.1 Property damage claims made by individuals
Claims in respect of property damage made by the owner, his/her spouse or registered partner, his/her relatives in the ascending and descending lines, as well as his/her brothers and sisters residing in a common household with the owner;
104.2 Damage to the vehicle
Claims in respect of loss of or damage to the insured vehicle, trailer, as well as loss of or damage to other items at-tached to or conveyed in these vehicles, with the exception of items which the injured party has with him/her, in partic -ular luggage and similar effects;
104.3 Racing and similar activities
Claims made by injured parties, arising out of accidents which occur in the course of motor races, rallies and simi-lar competitions, as well as any driving on a racetrack or its ancillary roads. However, in the case of sporting events of such a nature in Switzerland and the Principality of Liechtenstein, claims by third parties within the meaning of Article 72, paragraph 4 of the Swiss Road traffic Act (SVG) shall only be excluded if the insurance prescribed by law was effected in respect of the sporting event in question;
104.4 Nuclear energy
Claims arising out of damage or loss for which liability is subject to the legis-lation on nuclear energy;
The restrictions under Articles 104.5 to 104.7 above cannot be cited in rebut-tals to the injured party unless the legal provisions permit such restrictions.
104.5 Illegal driving
The liability of any driver of the vehicle who is not in possession of the driver’s license (or the learner’s license for motorcycles) required by law, as well as of any driver in possession of a learner’s license, who drives without being accompanied as prescribed by law or who carries passengers with-out a permit to do so; furthermore,
the liability of persons who entrust the insured vehicle to such a driver al-though they know or could have known, had they conscientiously taken care, that he/she is not in possession of the required license or that he/she is driving without being accompanied as required by law, or is carrying passengers without a permit to do so;
104.6 Thug rides
In the case of thug rides: the liability of persons who have taken the insured vehicle for their own use without permission and the liability of any driver who, at the start of the trip, knew or could have known, had he/she taken care in a conscientious manner, that the vehicle had been taken for the said purpose without permission;
104.7 Unauthorized driving
The liability arising out of any trip not officially allowed and the liability of persons who have used the vehicle en-trusted to them for trips which they were not authorized to make.
Art. 105 Recovery
Zurich shall have, up to the amount of its benefits, including lawyers’ fees and court costs paid by it, a right of re-covery against you and the insured parties, insofar as it is entitled under this contract or under applicable law to refuse or reduce its benefits, for exam-ple, on account of the restrictions to the scope of insurance according to the preceding Articles 104.5 –104.7, simultaneous use in public traffic of ve-hicles insured with interchangeable license plates, use of the replacement (substitute) vehicle against the law or contrary to the terms of the contract, conduct contrary to the terms of the contract in the event of a claim or in the event that the accident is caused by gross negligence.
Zurich may also effect recovery against you or the insured parties if, by virtue of the “Green Card” (international motor insurance card) or another inter -national agreement taking its place, and of foreign compulsory insurance laws, it still has to pay indemnities after the expiry of the insurance.
Art. 106
Refund of the deductible
If a deductible to be paid by you was agreed upon and Zurich effected a direct settlement of the third party claim, then, notwithstanding Article 13.2.3, you shall refund to Zurich at the latter’s first request the indemnity paid by it up to the amount of the deductible agreed upon, irrespective of who was driving the vehicle at the time of the accident. If you do not pay within 4 weeks of notification by Zurich, you shall be requested in writing, being reminded at the same time of the consequences of a default, to make payment within 14 days of dispatch of the reminder. If the reminder is inef-fective, the insurance shall cease in its entirety on expiration of the reminder period. Moreover, Zurich’s right to demand payment of the deductible and the costs for demanding payment of the deductible, as well as enforcing any other indemnity claim, shall not be affected hereby.
Hull insurance
Art. 201
Scope of the insurance
201.1 Vehicle
The insurance shall cover damage caused against your will and the will of the driver to the vehicle declared in the policy, as well as to spare parts, accessories and integral equipment fitted as standard.
201.2 Equipment and accessories 201.2.1
In the case of private motor vehicles, delivery vehicles and motorcycles,
equipment and accessories which do not form part of the standard pro -duction equipment and which are pur-chased at extra charge shall also be insured – without any special stipulation – up to a maximum amount of 10% of the catalog price of the declared vehicle.
201.2.2
In the case of all other motor vehicles,
extras and special equipment shall be included in the insurance only if they are declared with their value as new in the application. If these values and/or the catalog price are declared at an amount which is too low, the insurance benefits shall be reduced proportionally.
201.2.3
The insurance shall not cover
– accessories and devices such as tele-phones, navigation systems, MP3 players, etc.; sound, image and data carriers, which may also be used independently of the vehicle; – protective clothing as defined in
Art. 202.3.6.
Art. 202 Insured events
The following events shall be insured only if they are listed in the policy.
202.1 Loss or damage resulting from Accidental damage
This shall include damage caused by sudden violent, external means, i.e. in particular damage caused by impact, collision, rollover, falling, or sinking in, even if such damage is the conse-quence of damage due to the operation of the vehicle, breakage or wear and tear; likewise, damage caused by willful or malicious acts of third parties. Coverage shall further include align-ment damage to the vehicle as a result of tilting, loading or offloading operations even where no external causes were present.
202.2 Partial Casco
a) Theft
This shall include loss, destruction of or damage to the vehicle as a result of actual theft, use without permission or robbery in terms of criminal law. This list is definitive.
The insurance shall also cover damage caused to the vehicle in the course of an attempted theft or attempted use without permission or an attempted robbery.
No insurance coverage exists if the insured vehicle was stolen by persons that live in the same household as the policyholder or the beneficiary.
b) Fire
This shall include fire damage, irre -spective of whether the cause is inter-nal or exterinter-nal, as well as damage caused by short circuit, explosion and lightning; damage to electronic and electrical instruments and components are, however, insured only if the cause is not a result of an internal defect. Damage caused to the vehicle while the fire is being extinguished shall also be covered. Singeing damage however shall not be covered. Fire damage shall be covered only during the period of warranty insofar as no claims are made under the warranty against the vendor or supplier.
c) Natural hazards
This shall be deemed to be loss or dam-age as a direct consequence of rock-slides, falling stones, falling ice, land-slides, avalanches, snow pressure, snow slides, storm (= wind of a velocity of at least 75 kilometers per hour that up-roots trees and blows the roofs off
buildings in the vicinity of the vehicle declared in the policy), hail, high water and floods, all other loss or dam-age caused by natural hazards being excluded. Loss events caused by falling aircraft such as airplanes, spacecraft or parts thereof shall also be included in the coverage.
d) Glass
This shall be understood to mean breakage of the windshield, side, roof or rear windows made of glass or other materials used as a glass substi-tute. This list is definitive.
The scope of coverage for motorcycles
corresponds to the Glass PLUS option. There shall be no indemnity under Glass or Glass PLUS if the total repair costs (costs of glass and other repair) equal or exceed the cash value of the vehicle declared in the policy or if the damaged vehicle components cannot be replaced or repaired.
e) Animals
This shall be understood to mean dam-age resulting from collision of the declared vehicle with animals. Damage caused by evasive maneuvers con -stitutes collision damage in terms of Art. 202.1 rather than damage caused by animals.
f) Vandalism
Such loss or damage shall be under-stood to mean the wilful or malicious breaking off of antennas, rear view mirrors, windshield wipers or trim, puncturing tires and pouring damaging matter into the fuel tank. This list is definitive.
202.3 Supplementary insurances
The following supplementary insurance coverage shall apply subject to the appropriate agreement in the policy:
202.3.1 Coverage for gross negligence arising in the event of collision
Zurich shall waive its right to reduce its benefit payments when the occurrence of loss is due to gross negligence as defined in Article 14 paragraphs 2 and 3 of the Swiss Federal Law on Insurance Contracts (LIC). If the loss was caused in a state of inebriation or when driving while impaired, Zurich will reduce the benefits to the extent of the degree of fault. Zurich will also reduce the bene-fits if the occurrence of loss was caused
through indirect intent. All benefits lapse in the case of willful intent.
202.3.2 Glass PLUS
Supplementary to Art. 202.2 d) Glass, the insurance shall cover breakage of all parts of the vehicle which are made of glass or artificial materials used as glass substitutes. Light bulbs shall also be included in the insurance if they are de-stroyed in the event of glass breakage.
202.3.3 Martens
This shall be understood to mean damage to the vehicle declared in the policy caused by the gnawing of martens (including consequential damage).
202.3.4 Parking damage
This shall be understood to mean damage to the vehicle declared in the policy while it is parked, caused by unknown vehicles or persons. There is a limit of two claims per calendar year; the date of announcement by policyholder is decisive. The maximum amount is limited to CHF 1,000 per claim.
Parking damage PLUS
If Parking damage PLUS insurance has been agreed, this limit shall not apply. There is a limit of two claims per calendar year.
202.3.5 Travel effects
This shall include the following damage:
– damage to or destruction of the per-sonal requisites (travel effects) of the passengers/users being conveyed in the vehicle declared in the policy, when loss or damage occurs to the vehicle in question;
– theft of the personal requisites (travel effects) of the passengers/users being conveyed in the vehicle declared in the policy, provided that, at the time of the theft, they were located in a completely locked vehicle or attached to the vehicle in locked theft-proof containers.
The following items shall not be insured: cash; bank and postal debit, store, and credit cards; travel tickets and sea-son tickets; securities; savings books; precious metals; items of jewelry; sound, image and data carriers; computer hardware and software as well as any TV, communication and navigation equipment; motor vehicles, commercial
goods and items used for carrying out a trade or pro fession. Animals and subjective values shall not be indemni-fied.
The following are deemed not to be travel effects in the case of motorcy-cles: helmets, safety suits, one-piece suits, protectors, motorcycle boots, gloves (protective clothing).
Travel effects PLUS
If Travel effects cover has been agreed, for passenger cars, vans or motorcycles, the scope of insurance also includes electronic devices such as smartphones, laptops, navigations devices, etc. The benefits per claim shall be limited to CHF 5,000 for all travel effects together.
202.3.6 Protective clothing
(for motorcycles)
The protective clothing insured shall include:
– Helmets
– Safety suits, one-piece suits including protectors – Boots
– Gloves
The list is conclusive.
Damage to protective clothing shall be understood to mean:
– damage or destruction that is directly related to an accident involving the motorcycle used; damage visible to the eye which does not impair the clothing’s protective features is not insured;
– theft, provided that the items insured were in fully locked containers at-tached to the motorcycle and secured against theft; theft of helmets is also insured if they were secured to the motorcycle with a helmet lock. The insurance shall cover damage to both the protective clothing of the driver of the insured motorcycle as well as that of any passengers. It shall also apply to you as the driver or passenger of any other motorcycle.
The benefits per claim shall be limited to CHF 3,000.
Art. 203
Insurance benefits
203.1 Partial loss
Zurich shall pay the cost of the repairs incurred as a result of an insured event, taking into consideration the cash value of the vehicle.
The Policyholder may choose the repair shop he/she wishes to use (except where Help Point PLUS is insured). Inso-far as Zurich cannot reach an agree-ment with the repair shop appointed by the Policyholder regarding the proposed cost estimate, Zurich reserves the right to recommend other repair shops. If the Policyholder is not willing to accept this recommendation, Zurich shall be entitled to discharge its obligations by paying the repair costs deemed ap-propriate by its expert.
If lack of maintenance, wear and tear or pre-existing damage have raised the cost of the repairs substantially or if, as a result of the repairs, the condition of the vehicle has improved consider-ably, you shall bear a fair share of these costs to be determined by Zurich’s vehicle experts.
Tires shall be indemnified on the basis of their degree of wear.
If the claimant is entitled to pre-tax deductions, the value-added tax com-ponent shall be deducted.
In the event that payment is made but no repairs are carried out, the repair costs determined shall be reimbursed excluding VAT.
203.2 Total loss
If the costs of repair reach or exceed
– in the first two years of service, 65% of the indemnity listed in the table set out hereinafter;
– after more than two years of service, the actual cash value of the vehicle at the time of the accident (cash value); or if the missing vehicle is not recovered within 30 days of Zurich receiving notification of theft, then Zurich shall pay the following benefits:
Compensation table
Year of service as a % of the replacement value as new*
during the 1styear 100%
during the 2ndyear 95% – 85%
during the 3rdyear 85% – 75%
during the 4thyear 75% – 65%
during the 5thyear 65% – 55%
during the 6thyear 55% – 45%
during the 7thyear 45% – 40%
more than replacement
7 years value
*declared catalog price and accessories If the indemnity exceeds the price which was paid for the vehicle, cover-age shall extend to no more than the price paid and to no less than the replacement value. If the replace-ment value is above the original new value, then the latter shall be the maximum indemnity.
An agreed deductible and preexisting but unrepaired damage shall be deducted from the indemnity. If the claimant is entitled to pre-tax deductions, the value-added tax com-ponent shall be deducted.
These conditions shall apply accordingly to individual items of equipment and accessories.
203.3 Costs
In the event of an insured loss, Zurich shall pay the cost of:
– recovering and towing the vehicle to the nearest garage where the necessary repairs can be carried out; – the amount of customs duty for
which you may be held liable; – damage to the interior of the car
caused during the provision of assistance to persons involved in an accident shall also be covered; – return transport of the vehicle to
Switzerland. This shall not apply: – in the event of a total loss; – if the repair can be carried out
on-site;
– if you or the driver are able to bring back the vehicle yourselves; – if alternative insurance exists
covering the costs of return trans -portation.
203.4 Wreck of the vehicle
The benefit shall always be reduced by the value of the wreck (i.e. the unre-paired vehicle or article). If this value is not deducted from the maximum in-demnity, then the wreck or the vehicle or article shall become the property of Zurich when the payment is made. If compensation for a lost vehicle or lost article has been paid, then the rights of ownership shall pass to Zurich.
203.5 Travel effects
Zurich shall pay for the costs of the repairs, albeit up to a maximum of the amount required for replacement with a new article of equal value at the time of the loss. The maximum in -demnity shall be reduced by the residual value.
203.6 Protective clothing
(for motorcycles)
Zurich shall pay for the costs of repairs, but at a maximum the following amounts: in the first two years after purchase of the new item, the amount required to purchase an item of equivalent value at the time of the insured event; subsequently the in-demnity will be reduced to 75% of the price of replacing the item.
203.7 Motorized mobile homes and campers/trailers
The costs of repair will only be indemni-fied if the damage is fully repaired and proof of repair can be provided in the form of an invoice. If such repairs are not carried out, benefits shall be re-stricted to the loss in value of the vehicle.
203.8 Reduction of benefits
Zurich shall be entitled to reduce or refuse its benefit payments insofar as it is entitled to do so in accordance with the Swiss Federal Law on Insur-ance Contracts (VVG/LCA).
If the insured event has been caused through gross negligence, indirect intent or willful intent on the part of somebody who lives in the same house-hold as the Policyhouse-holder or claimant, Zurich reserves the right to refuse its benefit payments or reduce them to the same extent that they would be payable if the damage had been caused by the Policyholder or claimant him/herself.
Art. 204 Exclusions
204.1 Damage due to vehicle operation
Loss or damage due to vehicle opera-tion, breakage and wear and tear, in particular also breakage of springs caused by shocks sustained by the vehicle on the road or losses caused by the loaded goods (except after an event insured under loss or damage due to collision); damage due to inappro -priate handling; damage due to the use of inappropriate fuels or fluids; damage due to lack of oil; damage due to lack of or freezing of the coolant; dam-age affecting exclusively the tires or the batteries; theft of fuel.
204.2 Illegal driving
Loss or damage caused while the vehicle is being driven by a driver who is not in possession of the driver’s license (or learner’s license, for motorcycles) re-quired by law or a driver in possession of a learner’s license, who drives without being accompanied as prescribed by law or who transports passengers with-out a permit to do so, provided you were aware of this infringement or could have been aware of it, had you taken care in a conscientious manner.
204.3 Warlike events
Loss or damage as a result of warlike events, violations of neutrality, rev -olution, rebellion, insurrection and the measures taken against them, as well as in the event of earthquakes, volcanic eruptions or changes in the structure of the atomic nucleus, insofar as you do not prove that the loss or damage is in no way con-nected with these events.
204.4 Civil unrest
Loss or damage in the event of civil un-rest (acts of violence against persons or objects at riotous assemblies, riots or disturbances) and the measures taken against them, unless you can satisfacto-rily show that you or the driver have taken reasonable precautions to prevent the damage.
204.5 Racing and similar activities
Loss or damage which occurs while the vehicle is requisitioned by the au-thorities and while taking part in motor races, rallies and similar compe -titions, as well as any driving on racetracks including their ancillary roads.
204.6 Depreciation in value
Depreciation in value, reduced power or serviceability of the vehicle as well as loss of use.
204.7 Motorcycle unlocked
Damage arising as a result of theft, if the motorcycle was kept outside, in a collective garage or or in an unlocked room without an activated steering column lock.
204.8 Alcohol/infringement of traffic regulations
Damage if, at the time of the accident, the driver has a blood alcohol level of 1.6‰ (average value) or more or is under the effect of narcotic substances. If an alcohol breath test was performed rather than a blood test, the above value (blood alcohol content) also applies to the alcohol breath test. Likewise, damage caused by particularly flagrant disregard of the speed limit, hazardous overtaking or participation in an illegal race with motor vehicles pursuant to Article 90, paragraph 3 Swiss Road Traffic Act (RTA).
204.9 Unauthorized driving
Accident insurance
Art. 301 Insured persons
301.1 Insured persons under the policy
The persons stated in the policy are insured.
301.2 Accident and breakdown helpers
The following persons shall also be insured: persons not connected with the vehicle who render assistance at accidents or breakdowns to passen-gers/users of the vehicle declared in the policy, excluding, however, persons who render such assistance in per -formance of their professional activities or in an official function (such as police, paramedics, employees of the auto -motive industry, professional roadside assistance, etc.).
301.3 Persons insured in the event of accidents in other people’s vehicles 301.3.1
In the event of accidents in other people’s vehicles (personal motor vehi-cles and delivery vehivehi-cles with a total weight of max. 3,500 kg and seating no more than 9 persons), the insurance shall cover the Policyholder (provided that this is a natural person) and the persons living in the same household as listed below:
– Spouse/partner or registered partner, – Relatives in the ascending and
descending line, – Brothers and sisters as the driver or passenger.
301.3.2
Vehicles registered to the insured persons listed above shall not fall under the category “other people’s vehicles.”
301.3.3
The insurance shall apply within the territorial limits and worldwide for a maximum of six weeks after leaving the territorial limits in accordance with Article 4 of the General Condi -tions of Insurance. The death and disability benefits specified in the policy are insured. Several registered vehicles in the same household with accident insurance entitle the insured person to
claim the aforementioned benefits only once. The coverage with the highest benefits applies in each case.
Art. 302
Definition of accident
Any bodily injury in terms of the Swiss Federal Law on Accident Insurance (UVG/LAA).
Equivalent to accidents shall be: – involuntary inhalation of any gas,
fumes or vapors;
– frostbite, heat-stroke, sun-stroke, as well as impairment of health by ultraviolet rays, with the exception of sunburn; drowning.
Art. 303
Insured accidents
Coverage shall apply in respect of accidents in which the insured persons sustain during use of the vehicle de-scribed in the policy or of other people’s vehicles. In this context, coverage shall be extended also to accidents sus-tained by the insured persons while assisting other persons involved in an accident or breakdown.
Art. 304
Uninsured accidents
The insurance shall not apply to accidents:
304.1 Warlike events
as a result of warlike events – in Switzerland,
– in foreign countries, unless the acci-dent occurs within 14 days after such events took place for the first time in the country in which the insured person is staying, and provided he/she was taken unawares there by the outbreak of warlike actions;
304.2 Civil unrest of whatever kind
caused by riots or civil unrest of what-ever kind and the measures taken against them, unless the claimant proves that the insured person was not en-gaged on the side of the trouble-makers, either actively or as an agitator;
304.3 Earthquakes
caused by earthquakes in Switzerland;
304.4 Crimes
while deliberately committing crimes and offenses or while attempting to do so;
304.5 Racing and similar activities
while taking part in motor races, rallies and similar competitions, as well as while driving on racetracks and their ancillary roads;
304.6 Requisition
while the vehicle is requisitioned by the authorities;
304.7 Illegal driving
while the vehicle is being driven by a driver who is not in possession of the driver’s license (or learner’s license, for motorcycles) required by law, or by a driver in possession of a learner’s license who is driving without being ac-companied as prescribed by law or who is transporting passengers without a permit to do so, provided the insured was aware of this infringement or could have been aware of it, had he/she taken care in a conscientious manner;
304.8 Thug riding
while the vehicle is being used without authorization (thug riding, etc.).
304.9 Alcohol/infringement of traffic regulations
The insurance shall not cover claims submitted by a driver who, at the time of the accident, has a blood alcohol level of 1.6‰ (average value) or more or who is under the influence of narcotic substances. If an alcohol breath test was performed rather than a blood test, the above value (blood alcohol content) also applies to the alcohol breath test. Likewise, damage caused by particularly flagrant disregard of the speed limit, hazardous overtaking or participation in an illegal race with motor vehicles pur-suant to Article 90, paragraph 3 Swiss Road Traffic Act (RTA).
Art. 305
Insurance benefits
Zurich shall pay the benefits listed in the policy.
305.1 In the event of death
If an insured person dies as a result of an accident, Zurich shall pay the sum insured in the event of death to the following persons entitled to claim suc-cessively:
1. the spouse or registered partner; 2. the children, in equal shares.
Children who, at the time of the accident, were taken in without charge for permanent care by the insured person shall also be deemed equal;
3. the parents, in equal shares; 4. the grandparents, in equal shares; 5. the brothers and sisters, in equal
shares; in the absence of one of them, his/her share shall pass to his or her children.
Each person or group of persons enumerated under sections 2–5 above shall be excluded by the existence of any preceding person or group of persons respectively.
However, you may, by written notifi -cation to Zurich, designate beneficiaries to your insurance entitlements. If you do not take advantage of this option, and there are no such surviving relatives, only the funeral expenses shall be paid, up to an amount not ex-ceeding 10% of the sum insured in the event of death.
For insured persons, who, at the time of the accident, have not yet reached the age of 15, the death benefit may not exceed CHF 10,000.
305.2 In the event of disability
1. If the accident results in a disability of an insured person, Zurich shall pay the sum insured in the event of disability, corresponding to the degree of disability and in accordance with the provisions of the Swiss Federal Law on Accident Insurance (UVG/ LAA) on the determination of degree of disability, but never more than 100%.
2. Any aggravation of the consequences of the accident due to pre-existing physical defects shall not entitle a person to a higher benefit than the benefit which would have been payable had the person sustaining the accident been physically intact. If any parts of the body were already totally or partially lost or could not be used at all or only partially prior to
the accident, the degree of preexisting disability shall be deducted.
3. The degree of disability shall be determined in accordance with the insured’s state of health only once it has been diagnosed as presumably permanent, however, not later than 5 years after the accident.
4. The benefit shall be determined as follows:
– for that part of the degree of disability not exceeding 25%: on the basis of the sum insured in the event of disability;
– for that part of the degree of disability exceeding 25%, but not 50%: on the basis of twice the sum insured in the event of disability;
– for that part of the degree of disability exceeding 50%: on the basis of three times the sum insured in the event of disability.
305.3 Daily allowance
Zurich shall pay to the insured the daily allowance agreed upon for the period of the medical treatment required, how-ever, at the longest until the payment of an indemnity for disability, if any, and, in any event, only for a maximum of 730 days within 5 years of the date of the accident, also in respect of Sundays and public holidays, and from the agreed day after the date of accident. The daily allowance shall be paid in full, as long as the insured is totally in-capable of working; if and as long as he/she is partially incapable of working, a part of the daily allowance corre -sponding to the degree of incapacity to work shall be paid.
Insured persons who at the time of the incapacity to work are under the age of 15 shall receive no daily allowance.
305.4 Daily allowance in the event of hospitalization
Zurich shall pay the agreed daily al-lowance in the event of hospitalization during the necessary stay in the hospital, however for a maximum of 730 days within 5 years of the date of the accident, in addition to the daily allowance in accordance with Article 305.3 above, if appropriate, and the defrayal of medical expenses in accor-dance with Article 305.5 below. Any institution which exclusively admits per-sons who have sustained an accident or sick persons and which is under the
supervision of a licensed doctor shall be deemed to be a hospital. Moreover, Zurich shall pay, within the aforementioned limits, the daily al-lowance in the case of hospitalization during health cures ordered by a doctor which are taken in a spe cialized es -tablishment with the consent of Zurich.
305.5 Medical expenses
Zurich shall defray the costs as specified in sections 1–4 below, provided they are incurred within 5 years of the date of the accident.
1. The necessary costs of therapy given or ordered by a licensed doctor or dentist, as well as hospital charges and expenses for treatment, stay and board in a private ward; as well as expenses for health cures ordered by a doctor which are taken in a specialized establishment with the consent of Zurich; in addition, the daily allowance deduction for main-tenance costs in a sanatorium as provided for in the Swiss Federal Law on Accident Insurance (UVG/LAA). 2. For the duration of the therapy, in accordance with section 1 above: – the cost of services of qualified
nursing staff or of nursing staff provided by a public or private institution as well as
– the cost of the hire of aids and appliances for patients;
– costs for psychological treatment by a qualified physician or psycho -logist after a traffic accident in the insured vehicle up to a maxi-mum of CHF 1,500.–; and related expenses for medically prescribed driver safety training or for up to five driving lessons with a quali-fied driving instructor up to a total of CHF 500.–.
3. The cost of the initial purchase of prostheses, glasses, hearing aids and orthopedic aids and appliances and also of their repair or of their replace-ment (value as new), if they were damaged or destroyed in the course of an event which results in therapy as defined in section 1 above. 4. The costs of
– all transportation of the insured necessitated by the accident, how-ever, as regards transportation by aircraft, only if this is absolutely essential on medical or technical grounds;
