Aon Expat Insurance Package
Policy Terms & Conditions PK 150-15
Aon Expats Insurance 2016-1 PK 150-15
Table of contents
Section I General Terms and Condition ………..………….. 3
SPECIAL CONDITIONS ……… 8
Section II Contents ………... 9
Section III Liability ………14
Section IV Continuous Travel ………20
Section V Accidents ………30
Section VI Valuables ……… 34
Section VII Extra Flight ……….37
Aon Expat Insurance Package
This contract meets the requirement of uncertainty as referred to in Article 7:925 of the Dutch Civil Code (DCC) if, and to the extent that, the damage suffered by the Insured Person or by third parties for which compensation is being claimed from the Insurer or an Insured Person is the result of an event in relation to which the fact that damage had arisen therefrom or would arise therefrom in accordance with the normal course of circumstances was uncertain for the parties at the time the insurance was concluded. The only consequence of the absence of uncertainty is that such damage is not covered; the insurance remains in full force.
The provisions of Article 7:928 paragraphs 2 and 3 of the Dutch Civil Code are not applicable to the disclosure obligation of the Policyholder at the conclusion of this insurance.
SECTION I - GENERAL TERMS AND CONDITIONS
These insurance terms and conditions consist of general terms and conditions and special terms and conditions. If the special terms and conditions deviate from the general terms and conditions, the provisions in the special terms and conditions apply.
1.1 Definitions
1.1.1 Aon
Aon is taken to mean the division of Aon Nederland that has brokered the establishment of the insurance.
1.1.2 Insurer
The Insurer is the party that bears the insured risk: ACE European Group Ltd, Marten Meesweg 8–10, 3068 AV Rotterdam, the Netherlands.
1.1.3 Insured Person
The Insured Person is anyone indicated as such in the policy conditions.
1.1.4 Policyholder
The Policyholder is the person who has contracted the insurance with the Insurer.
1.1.5 Country of Origin
The country where the Insured Person normally resides and to which, in principle, the Insured Person will return after his/her stay in the Country of Residence.
1.1.6 Country of Residence
The country where the Insured Person resides in connection with the work-related secondment.
1.1.7 Premium
The amount paid by the Policyholder to the Insurer in return for the cover provided under this insurance, including the costs and insurance premium tax as stated on the policy.
1.2 Premium Payment
1.2.1 The Policyholder will pay the premium no later than the 30th day after it becomes due.
1.2.2 If the Policyholder does not pay the amount due within the period or refuses to pay,
suspension of the cover will take place with effect from the first day on which the amount was due. The Policyholder is required to pay the amount still owed.
1.2.3 There is no cover during the suspension. Cover will only commence again on the day
after the insurer has received and accepted the amount owed.
1.2.4 During the suspension, the insurance may be terminated in accordance with Article
1.3.3.1.
1.3 Duration and Termination
1.3.1 The insurance is valid for a period of one year. After each insured year, the policy is
automatically renewed, unless the insurance is cancelled in accordance with Article 1.3.2, first dash.The Policyholder can cancel this insurance in writing at any time from the effective date, with due observance of a notice period of one month.
1.3.2 The Insurer and the Policyholder are entitled to terminate the insurance in writing;
- at the end of an insured year in order to avoid extension. In this case, the Insurer will comply with a notice period of two months and the Policyholder will comply with a notice period of one month.
- after Aon is notified of a claim, no later than 30 days after the date the damage occurred, with a notice period of two months;
- when the Policyholder returns to the Country of Residence; and/or by debt-adjustment imposed by the courts.
1.3.3 The insurance ends;
1.3.3.1 by written cancellation by the Insurer;
- within two months of the discovery that the Policyholder failed to comply with the disclosure obligation when entering into the insurance, whereby the Policyholder intended to mislead the Insurer or the Insurer would not have concluded the insurance if the Policyholder had provided the correct information. In these cases, the insurance ends on the date stated in the cancellation letter.
- without observance of a notice period during the suspension mentioned in Article 1.2.4. The insurance ends on a date determined by the Insurer.
- without observing a notice period in the case of intent of an Insured Person to mislead the Insurer. The insurance ends on a date determined by the Insurer.
1.3.3.2 by written notice by the Policyholder, or if they are deceased, by their heir(s), within two
months after the Insurer has called upon non-performance of the disclosure obligation by the Policyholder when taking out the insurance. The insurance then ends on the date of the cancellation letter.
1.3.4 The insurance also ends at such time as the Policyholder is in a state of bankruptcy.
1.3.5 Upon premature termination of the insurance or one or more sections of the insurance,
the Policyholder will receive a pro rata refund of premium paid for the unexpired portion of the insurance term. This does not apply if the insurance ends in connection with deliberate deception by an Insured Person.
1.4 Cover 1.4.1 Local cover
This insurance also provides cover in accordance with applicable legal requirements and demonstrable cover in the country of abode, if it is common for local insurers to offer cover.
1.4.2 Acts of War
This insurance covers acts of war everywhere in the world, with the exception of the countries mentioned by name on the Insurer’s website
www.acegroup.com/nl-nl/voor-bedrijven-makelaars/conflictgebieden.aspx
1.4.3 Salvage costs
The Insurer will reimburse all reasonable salvage costs above the insured amount, if necessary, including costs and sacrifices which can be measured in terms of money, that are attached to the measures referred to in Article 7:957 of the Dutch Civil Code taken by or on behalf of the Insured Persons. The rules regarding underinsurance are not applicable.
1.5 General Exclusions
In addition to the exclusions listed in the specific policy section(s), this insurance doesnot provide cover for the following damage:
1.5.1 Intentional false data
Not covered is damage for which an Insured Person intentionally provided false data. In the section Accidents, this insurance also does not provide cover if, in case of death, the beneficiary intentionally provided false data.
1.5.2 Nuclear reactions
Damage caused by, occurring with or stemming from nuclear reactions is not covered, regardless of how the reaction was caused.
This exclusion does not apply to radioactive isotopes located outside of a nuclear installation and which are used or intended for use for industrial, commercial, agricultural, medical or scientific purposes.
1.5.3 Restriction of terrorism risk
For damage and Accidents resulting from terrorism, malicious contamination and/or preventive measures, and acts or conduct in preparation thereof, referred to hereafter both collectively and individually as the ‘terrorism risk’, the damage compensation/cover is limited to the payment as described in the Clauses Sheet Terrorism Cover by the Nederlandse
Herverzekeringsmaatschappij voor Terrorismeschaden N.V. (Dutch Terrorism Risk Reinsurance Company). The settlement of a claim filed on grounds of the terrorism risk takes place in
accordance with the Claims Settlement Protocol of the Nederlandse
Herverzekeringsmaatschappij voor Terrorismeschaden N.V. The Clauses Sheet Terrorism Cover and corresponding Claims Settlement Protocol, including explanatory notes, were filed with the court registry of the District Court of Amsterdam on 10 January 2007 under number 3/2007 and 12 June 2003 under number 79/2003, respectively.
1.6 Other Insurance
1.6.1 Other insurance takes precedence
If the same damage insured under this insurance is also covered by any other insurance or would have been covered if this insurance did not exist, this insurance provides cover: - in excess of the insured amount covered under the other insurance policy, without
applying the deductible of this insurance and/or,
- for the difference in conditions in relation to the other insurance.
1.6.2 Claims settlement
If the Insured Person still wants to submit the claim under this insurance, the Insurer will handle the claim and reimburse the loss/damage under this insurance.
1.6.3 Recourse
The amount the Insurer will pay above what it owes in accordance with Article 1.6.1 is provided in the form of an interest-free loan if the other insurance has no provision similar to Article 1.6.1. The Insurer is automatically authorised to recover this amount on behalf of the Insured Persons on grounds of the other insurance and to keep the amounts thus recovered as repayment of the interest-free loan. If the amount provided in accordance with Article 1.6.2 is not (fully) recovered, the interest-free loan is regarded as damage compensation that is covered by this insurance contract.
1.7 Loss/Damage 1.7.1 Obligations
In case of damage or an event that could lead to loss/damage, the Insured Person has the following obligations:
1.7.1.1 To report the loss/damage to the Insurer as soon as is reasonably possible.
1.7.1.2 To provide all information and documents that are relevant for assessing the damage
within a reasonable period.
1.7.1.3 To provide all cooperation reasonably expected for the settlement and determination of the damage.
1.7.1.4 To make every effort to limit the damage and follow all instructions given by the Insurer
or the appointed expert(s).
1.7.1.5 To report any burglary, theft, misappropriation, loss, robbery, extortion or vandalism to
the police immediately.
1.7.1.6 To refrain from acknowledging liability, from entering into settlements or from making
payments without the consent of the Insurer in accordance with the Dutch Civil Code.
1.7.1.7 To follow the directions of the Insurer or the experts it has appointed and to fully and
truthfully answer the relevant questions regarding the damage.
1.7.1.8 In the event of death, the obligations set out above are vested in the beneficiary (or
1.7.2 Non-performance
If the Insured Person fails to comply with the obligations referred to above, the Insurer may deduct any damage it suffers as a result, from the compensation.
1.8 Limitation Period
In any event, a claim for payment expires if the filing of the claim does not take place within three years from the moment at which the Insured Person or person with an interest in the payment became aware or could have become aware of that event which could result in a payment obligation for the Insurer.
1.9 Communications
1.9.1 All communications that have to be made to the Insurer by the Insured Person or the
aggrieved party, will also be considered made, as soon as these are communicated to Aon.
1.9.2 Communications to the Policyholder and/or Insured Person can be done legally by Aon,
to the last known address Aon has of the Policyholder and/or Insured Person.
1.10 Applicable Law
Dutch law applies to this contract.
1.11 Revision of Rates and/or Conditions 1.11.1 Revision
If the Insurer revises the rates and/or conditions for insurance of the same kind as this, it will be entitled to adjust this policy to the new rates and/or conditions. If it wishes to exercise this right, the Insurer will announce this adjustment in advance.
1.11.2 The Policyholder has the right to refuse the amendment to the new rates and/or
conditions if the amendment results in a premium increase and/or restriction of cover, unless the amendments result from statutory legislation or provision.
If the Policyholder wishes to exercise this right, he/she must cancel the insurance within 30 days of receipt of the written announcement. The insurance ends on the day on which the amendment takes effect according to the written announcement by the Insurer, but no earlier than one month after the date of such announcement.
1.11.3 Continuation of the insurance
If the Policyholder has not exercised his/her right under Article 1.11.2, he/she will be deemed to have accepted the adjustment. In that case the insurance will be continued under the new rates and/or conditions.
1.12 Transfer
If, during the term of this insurance, a share accepted by or for an Insurer is fully or partially transferred to another insurer, then the acquiring insurer participates under the same conditions,
agreements, rights and obligations as those applicable at the time of transfer, unless the acquiring insurer has expressly agreed otherwise at the time of the transfer.
With this and with respect to the transfer, the acquiring insurer waives the right to rely on, amongst other things, the disclosure obligation under Article 7:928 of the Dutch Civil Code. However, where the original Insurer involved in this insurance relies or has relied on such a right, this right is transferred without prejudice to the acquiring insurer.
1.13 Complaints
Complaints relating to the insurance contract can be submitted in writing, referencing the name, address and policy number, to the management board of Aon, PO Box 518, 3000 AM Rotterdam, The Netherlands.
Our website also provides the opportunity to respond. You can do this using our online complaints form, which can be found at www.aon.nl.
If the complaint is not handled to your satisfaction, you may contact the agency below: Klachteninstituut Financiële Dienstverlening (KiFiD)
PO Box 93257
2509 AG The Hague, The Netherlands
Telephone: 0900 3338999 (The Netherlands only)
(KiFiD is the Financial Services Complaints Institute in The Netherlands.) You can also turn to the court.
1.14 Privacy, Personal Data Processing
Personal data is requested when applying for a personal insurance. This is processed by the Insurer for the purpose of concluding and implementing contracts; to carry out marketing activities; for the purpose of ensuring the security and the integrity of the financial industry; for statistical analysis and to meet statutory requirements. The Code of Conduct ‘Verwerking Persoonsgegevens Financiële Instellingen’ (Processing Private Data Financial Institutions) is applicable to the processing of personal data. A consumer brochure of the Code of Conduct can be requested from ACE European Group, telephone +31 (0)10 289 3500. The full text of the Code of Conduct can be consulted on the website of the Association of Insurers
www.verzekeraars.nl. The Code of Conduct can also be requested from the Association of Insurers (PO Box 93450, 2509 AL The Hague, The Netherlands, telephone +31 (0)70 3338500). The data subject has the right to access personal data concerning him/her, as well as the right to correct any incorrect, incomplete or irrelevant data. The data subject also has the right to object to the processing of their personal data for direct marketing purposes. The Insurer will not use the personal data of the Insured Person, Policyholder and/or the beneficiary for telemarketing
purposes if these personal data are included in the Do Not Call registry.
1.15 Penalties
There is no cover under this policy if resolutions of the United Nations or trade or economic sanctions, laws or regulations of the European Union, Member States of the European Union or the United States prohibit insurers from providing cover, including - but not limited to - the payment of a benefit, compensation or any other advantage.
SPECIAL CONDITIONS
These special conditions form a single entity with the General Terms and Conditions and relate to the following sections:
- Section II Contents - Section III Liability
- Section VI Continuous Travel - Section V Accidents
- Section VI Valuables - Section VII Extra Flight
- Section VIII Legal Fees Assistance
The sections apply only if these have been concluded by you and insured sums are included on the policy for them.
2. SECTION II - CONTENTS 2.1 Definitions
2.1.1 Audio and visual equipment
All equipment (excluding musical instruments) that records audio and/or video, displays, receives and/or transmits, such as television, radio, photographic/film/video products, mobile
communication devices and peripherals associated with the equipment. The sound and/or image carriers are part of the equipment.
2.1.2 Salvage costs
All reasonable salvage costs, which means costs and sacrifices which can be measured in terms of money that are attached to the measures referred to in Article 7:957 of the Dutch Civil Code taken by or on behalf of the Insured Persons.
2.1.3 Forced entry
Forced entry is; gaining unlawful access through violence, and with visible damage to the exterior of the home.
2.1.4 Computer equipment
All equipment capable of import/export or storage of data, such as personal computers and laptops and peripherals associated with the equipment. The information carriers and standard software are part of the equipment.
2.1.5 Current market value
The new value with a deduction of an amount for depreciation due to use, age, or wear and tear.
2.1.6 Money and valuable paper
Coined money and banknotes, which serve as legal tender.
Valuable paper refers to all paper money which is assigned a certain monetary value in the course of trade.
2.1.7 Repair costs
All costs associated with returning the insured item to its original condition or form, including the necessary costs of disposal and/or demolishing of the insured property in order to allow for recovery.
2.1.8 Tenant improvements
Architectural enhancements to the home, which are made at the expense of the tenant.
2.1.9 Home contents
All movable property belonging to the private household of the Insured Person, including satellite dishes and sun blinds attached to the home and tools for the performance of a profession in paid employment. Home contents do not include motor vehicles.
2.1.10 Personal jewellery
Jewellery, including watches, which is manufactured to be worn on the body and which is wholly or partly made up of precious or other metals, rocks, minerals, ivory, red coral (corallium rubrum), or other coral, or other similar materials including pearls.
2.1.11 New value
The amount required to acquire new items of the same type and quality.
2.1.12 Clean-up costs
Only those costs not already included in the loss assessment, including the costs of clearance, removal, destruction and/or demolition of insured property in as far as these are a necessary consequence of damage covered by the policy.
2.1.13 Premier risque
The maximum amount that is compensated in the event of damage or loss, regardless of the actual value. The rules regarding underinsurance are not applicable.
2.1.14 Damage
Damage tp or loss/theft of the insured home contents.
2.1.15 Insured Person
The Insured Persons are; - the Policyholder;
- any person with whom the Policyholder cohabits as a lasting family unit;
- household staff to the extent these are resident (e.g. an au pair) and in compliance with the provisions of Article 2.2.2.6.
-
2.1.16 Decrease in value
The impairment of the assets of the Insured Person due to the decline in economic value of the damaged property, as far as this decline cannot be nullified by repair of the property.
2.1.17 Home
The address mentioned on the policy, intended as a private residence and used as such. This includes the outbuildings, such as garages and sheds.
In the case of a block of flats or flat, the storage space or storage box is considered as an ancillary space, provided that this is exclusively accessible to the Insured Person for storaging and garaging.
2.2 Cover
2.2.1 Scope of the cover
This insurance covers damage to the insured home during the term of this insurance, regardless of the cause or whether the damage was caused by the nature or lack of home contents and subject to the restrictions set out in Articles 2.2.2 and 2.2.3. In the case of damage resulting from theft, there should be demonstrable signs of forced entry to the exterior of the home or that part of the home that has been in use by the Insured Person.
2.2.2 Restricted cover
Restricted cover applies to the items listed below. If the cover is limited to a maximum amount, that maximum amount is considered part of the total sum insured:
2.2.2.1 The cover for the contents of refrigerators and freezers due to power outage is limited to
EUR 1,250.
2.2.2.2 The cover for valuables, personal jewellery, home electronics, audio-visual and computer
equipment, antiques and furs is limited to EUR 2,500.
2.2.2.3 The cover for structural improvements made for an Insured Person’s own account is
limited to EUR 2,500.
2.2.2.4 For money or monetary instruments, the cover is limited to fire or theft damage with a
maximum of EUR 1,250. This amount is reduced by the amount to which the Insured Person is entitled as a compensation from the bank or other legal entity. Damage from theft or loss of money due to misuse of a bank card with use of the PIN code is not covered.
2.2.2.5 The cover for boats, trailers, spare parts and accessories for boats, caravans and motor
vehicles is limited to EUR 1,000 and this property must be located in the home at the address specified on the policy at the time of the damage.
2.2.2.6 For the domestic staff referred to in Article 2.1.15, the maximum insured sum is EUR
2,500.
2.2.3 Theft from a motor vehicle
This insurance covers up to EUR 500 for theft of belongings from a motor vehicle. The condition for cover is that clear signs of forced entry to the motor vehicle must be present, the motor vehicle must have been properly locked and the property must not have been visible from outside the motor vehicle.
2.2.4 Compensation on top of insured sum
In addition to the insured sum, this insurance covers:
The salaries and expenses of all experts and the specialists consulted by them. The salaries and the costs of the expert appointed by the Policyholder and the experts consulted by this expert are reimbursed only to the extent that this salary and these costs do not exceed the salary and the costs of the expert appointed by the Insurer and the experts consulted by this expert.
2.2.4.2 In the event of a covered event this insurance also covers;
- the clean-up costs;
- the extra costs of alternative accommodation, hotel, inn, storage and transport of contents; and
- the extra cost of living.
2.2.4.3 For each item up to 10% of the insured sum for;
- the costs of restoring landscaping, plants and paving, including any associated costs of disposal, to the extent not covered elsewhere under this insurance or another insurance; and
- the cost of repairing damage to the buildings by burglary, damage to painting work and wallpaper and/or cleaning costs, provided they are not covered by any other insurance.
2.3 Exclusions
This insurance does not cover damage;
2.3.1 that consists of or is the result of gradual weather and other influences;
2.3.2 caused by moisture permeating walls;
2.3.3 which is the result of rain, hail, snow or melt water, which has entered the home through
open windows, doors or hatches;
2.3.4 which consists of or was caused by inadequate maintenance, with regard to the home
contents and the home mentioned in the policy, which can be attributed to the Insured Person;
2.3.5 caused by theft, lost or missing property if these home contents were not present in the
home mentioned on the policy. This exclusion does not apply; - if the theft is preceded by forced entry;
- in the case of violent robbery or extortion;
- in the case of theft from a motor vehicle while an Insured Person was driving the motor vehicle and as such was present in that vehicle. In the case of theft of the entire motor vehicle, the requirement of forced entry does not apply if the Insured Person can demonstrate sufficiently that the motor vehicle was properly locked. The motor vehicle itself is not covered.
- in the case of theft of garden furniture and laundry, provided this was present in the garden or on the balcony belonging to the home of the Insured Person.
2.3.6 during or due to the modification, cleaning or repairing of the home contents;
2.3.7 through normal or abnormal use of the home contents causing, for example, stains,
cracks, tears, scratches or dents;
2.3.9 which consists of the burn-out of electrical appliances and motors;
2.3.10 which is caused by animals that are present in the home mentioned on the policy with the
approval of the Insured Person, and damage caused by pests.
2.4 Change of Risk
2.4.1 The location, type of construction, the use of the home and any second risk address
must be fully known by the Insurer at the time of entering into this insurance.
2.4.2 The Insured Person must notify the Insurer as soon as possible of, but no later than two
months after any significant change(s) in the risk, which at least includes; - changes in the use or intended purpose of the home;
- vacancy of the home;
- the inability to use the home for a consecutive period of two months or if that is expected to last longer than two months;
- squatting in the home or one of the outbuildings;
- any extension or change in the capacity of the Insured Person; and/or
- the storage of the insured item outside the country of domicile for a period longer than six months.
2.4.3 After reporting a change in risk as referred to above, Aon and/or the Insurer have the
right to revise the premium and conditions or to terminate the insurance or the relevant policy section, with a notice period of 30 days.
2.4.4 If notification of a change in risk as referred to above does not take place or does not
take place in a timely fashion, the right to compensation lapses two months after the date of the change in risk. This does not apply if, after the notification of the change in risk, the insurance continues without change.
If Aon / the Insurer continues the insurance against a higher premium or under changed conditions, the compensation for any damage will take place proportionally regarding the premium paid to the payable premium, subject to such amended conditions.
2.5 Damage
2.5.1 Loss assessment
The damages will be determined in mutual consultation between Aon and the Insured Person or by an expert appointed by the Insurer, except where it is agreed that two experts will assess the damage. The Insurer and the Insured Person will then each appoint one expert.
Together, these experts will then, prior to commencing their activities, appoint a third expert who, in the event that no consensus is reached, will make a binding determination of the damages within the bounds of the two experts' assessments. Cooperation with the determination of the damages does not obligate the Insurer to make payment.
The appraisal of the expert(s) will mention;
- the difference between the new value of the home contents immediately before and immediately after the loss event;
- the new and current value of the home contents; and
- if the damage can be repaired, the repair costs immediately after the event and the decrease in value not nullified by the repair.
2.5.2 Compensation
In compliance with the maximum compensation referred to in Article 2.2.2, the Insurer will reimburse the damage based on the new value, unless the provisions below are applicable, in which case the compensation paid will be above the sum insured in accordance with Article 2.2.4.The Insurer does not reimburse the new value in the following cases. The Insurer reimburses;
2.5.2.1 the damage calculated in accordance with current market value if it concerns:
- property whose market value immediately before the loss event is less than 40% of the new value;
- property which has been withdrawn from the use for which it was intended; and/or - mopeds and motorised bicycles;
2.5.2.2 the value determined by experts if the damage is to art, antiques and/or collections;
2.5.2.3 the repair costs plus any depreciation, but not exceeding the new value, if the damage
can be repaired;
2.5.2.4 necessary expenses, other than those mentioned under Article 2.2.4, up to a maximum
of EUR 500.
3. SECTION III – LIABILITY 3.1 Definitions
3.1.1 Event
An event is an occurrence or series of related events as a result of which the damage (covered by insurance) occurred.
3.1.2 Motor vehicles
All cars and vehicles mentioned in Article 1 of the Motor Insurance Liability Act (WAM), with additions and amendments, except bicycles with electric power assistance (Elobike).
3.1.3 Joyriding
Joyriding refers to any unlawful use of a motor vehicle, without having the intention to appropriate the motor vehicle.
3.1.4 Joy-sailing
Joy-sailing refers to any unlawful use of a boat, without having the intention to appropriate the boat.
3.2 Insured Persons 3.2.1 The Policyholder.
3.2.2 The spouse or the registered partner of the Policyholder.
3.2.4 their minor children, including foster children and stepchildren;
3.2.5 their adult children, including foster children and stepchildren, who are unmarried and live
with them or who live elsewhere for study purposes;
3.2.6 their other relatives by blood and/or marriage who live with them;
3.2.7 their lodger(s), if their liability is not covered by any other insurance;
3.2.8 domestic staff, if the liability of this domestic staff is related to activities on behalf of an Insured Person as referred to in Article 3.2.1 to 3.2.7.
3.3 Insured Capacity
3.3.1 The insurance covers the liability of the Insured Person or Insured Persons in a private
capacity. The liability relating to the practice of a (subsidiary) business, (subsidiary) profession and/or carrying out paid manual labour are not covered.
3.3.2 These restrictions in the capacity do not apply to;
3.3.2.1 the domestic staff as referred to in Article 3.2.8;
3.3.2.2 Insured Persons referred to in Article 3.2.4 to 3.2.6 if they perform activities during
holidays or their spare time for persons other than the Insured Persons, whether or not for payment. In such cases the liability of these Insured Persons is only insured if their liability is not covered by any other insurance. Claims by the employer or the employer's assignees or surviving relatives are not covered;
3.3.2.3 Insured Persons who perform unpaid volunteer work for others who are not Insured
Persons.
3.4 Damage
3.4.1 Damage refers to damage to property and personal injury.
3.4.1.1 Personal injury means damage due to injury or impairment of the health of persons,
whether or not with fatal consequences, including the damage resulting therefrom.
3.4.1.2 Damage to property refers to damage due to the physical damaging, destruction, loss of
material property belonging to persons other than the Insured Persons, including the damage resulting therefrom.
The contamination or becoming dirty of property and foreign substances being thereon or therein, are also included.
3.5 Cover
3.5.1 Liability/damage
The liability is covered of Insured Persons in their capacity as referred to above for damages caused or arising during the duration of the insurance, and for all Insured Persons together up to a maximum of the amount per event as specified on the policy or in the most recent policy
endorsement. The liability for damage caused during the insured term, but emerging after the end of the insurance is covered if and to the extent that the liability for such damage is not covered by any other insurance.
3.5.2 Mutual liability of the Insured Persons
The liability of the Insured Persons towards each other is insured only for personal injury and if these Insured Persons have no claim elsewhere in respect to the incident.
The liability of an Insured Person towards domestic staff for damage resulting from work accidents is also insured in respect of damage to property.
3.5.3 Costs of litigation and statutory interest
In addition to the sum insured, the following will be reimbursed:
3.5.3.1 The costs of legal proceedings conducted with the approval of or at the request of the
Insurer and for legal assistance provided at the Insurer's instruction;
3.5.3.2 the statutory interest over the portion of the principal that is covered by the insurance;
and/or
3.5.3.3 The salvage costs incurred, even if they are made on behalf of the Insured Persons.
3.5.4 Security
If security should be provided in connection with a claim within the meaning of the insurance, the Insurer shall provide this security and compensate the costs incurred in connection with this up to a maximum of ten percent of the insured amount. The Insured Persons are required to authorise the Insurer to have disposal of the security as soon as it is released and also to lend any
cooperation required in order to secure its recovery.
3.6 Cover for Immoveable Property
3.6.1 With regard to immovable property, only the liability of the Insured Persons referred to in
Articles 3.2.1 to 3.2.6 and Article 3.2.8 or the Insured Persons living at home, is covered by the insurance;
3.6.1.1 as owner of the property in which he/she resides, with annexes and auxiliaries, also if
any part of it is leased, including garages and sheds with annexes and auxiliaries;
3.6.1.2 as owner of a property that is no longer inhabited by the owner, but that he/she still has
in his/her possession or that is already in his/her possession but is not yet inhabited by him/her;
3.6.1.3 as owner of a recreational home, static caravan, home on an allotment garden complex
or a second home situated in Europe, provided it is not used exclusively for letting to third parties; and/or
3.6.1.4 for damage caused by the home that is intended to be used an own home and that is
under construction, to the extent that liability is not covered by any other insurance.
3.6.2 Liability for damage caused by immovable property that is leased or rented is not
covered. This does not apply to the cases of rental mentioned in Articles 3.6.1.1 and 3.6.1.3.
3.7 Friendly Turn
If the Insured Person is not liable solely because the damage is related to performing a Friendly Turn, the Insurer will assess the liability without taking this circumstance into account.
In this case the compensation will be a maximum of EUR 2,500 per event.
Upon awarding the compensation, all claims for compensation that the victim may have on any other grounds will be deducted from the damages awarded.
No damage compensation will be granted if the claiming party is a party other than an injured natural person directly involved in the event or their survivors.
3.8 Exclusions and Limitations 3.8.1 Intent
Not covered is the liability of;
- an Insured Person for damages caused by and/or arising from his/her intentional unlawful acts or omissions against a person or property;
- an Insured Person belonging to a group, for damage caused by and/or arising from intentional unlawful actions or omissions directed against a person or property by one or more persons belonging to that group, even if the Insured Person himself/herself did not commit the act or omission. The intentional nature of this unlawful act or omission is not affected by the fact that the Insured Person, or, if the Insured Person belongs to a group, one or more of the persons belonging to the group, is/are under the influence of alcohol or other substances to such a degree that he/she/they is/are incapable of determining his/her/their intent.
3.8.2 Sexual behaviour
Not covered is the liability for;
- an Insured Person for damage caused by and/or arising from his/her sexual or sexually tinted behaviour of any nature whatsoever; and/or
- an Insured Person belonging to a group, for damage caused by and/or arising from sexual or sexually tinted behaviour of any nature whatsoever of one or more persons belonging to that group, even if the Insured Person himself/herself did not act in that manner.
3.8.3 Supervision
3.8.3.1 The liability of an Insured Person for damage is not covered during;
- the operation of a (subsidiary) business or exercising a (subsidiary) profession; and/or - the performance of manual labour other than by way of a friendly turn.
3.8.3.2 Not covered, is the liability for damage;
to motor vehicles, (static) caravans, folding trailers, motors, ships and boats, including sailing vessels and sailboards, and aircraft that the Insured Person, or someone on his/her behalf, has in his/her possession.
3.8.3.3 Not covered, is the liability of an Insured Person for damage to property that the Insured Person has in his/her possession or uses unlawfully. This provision will not apply if the Insured Person is under 14 years of age, unless an Insured Person aged 14 years or older also possesses or uses this property.
3.8.3.4 A maximum insured amount of EUR 2,500 applies for the liability of an Insured Person
for damage to property that an Insured Person, or anyone on his/her behalf, has in their possession, uses or has for any other reason, on the grounds of;
- a hire-, hire-purchase, usage-, lease-, ground lease-, pledge/cover agreement or usufruct (including the right of use and occupancy).
3.8.3.5 The liability of an Insured Person is covered for damage caused to;
- a rented home or part thereof if the liability arises from the rental agreement. Damage to the property of the lessor as a result of normal use / wear and tear by the Insured Person during the rental agreement, is not covered.
3.8.3.6 Damage is covered that is caused;
a. by an antenna that is attached to a building rented by the Insured Person, a holiday home used for holiday purposes or a rented (static) caravan;
b. by fire, fire extinguishing or an explosion at a home rented by the Insured Person, a holiday home used for holiday purposes or a rented (static) caravan and property contained therein and, if it is not covered by any other insurance, to rented trailers, boat trailers and similar items;
c. by water, to a holiday home used for holiday purposes by the Insured Person and property contained therein, if unforeseen water flowed from pipes, installations and appliances in the home;
d. as a passenger, to a vehicle which an Insured Person does not have under a rental-, hire-purchase-, lease-, or any other agreement.
3.8.3.7 Liability of the Insured Person for damage to a motor vehicle, incurred during joyriding,
provided the perpetrator is younger than 18 years of age, is insured for up to EUR 7,500 per event.
3.8.3.8 Other cases of liability for damage to property in the possession of the Insured Person
are insured for up to EUR 12,500 per event except in the cases provided for in Articles 3.8.3.4 and 3.8.3.7.
3.8.4 Motor vehicles
3.8.4.1 This insurance does not cover the liability for damage caused with or by a motor vehicle
that the Insured Person owns, possesses, keeps, drives or uses.
3.8.4.2 This exclusion does not apply to theliability of the Insured Person;
a. as a passenger of a motor vehicle; however, the provisions of Articles 3.8.3 and 3.5.2 remain fully applicable;
b. mentioned in Article 3.2.1 to 3.2.7 for damage caused by domestic staff with or by a motor vehicle, for which none of the other Insured Persons than the domestic staff are subject to compulsory insurance within the meaning of the Motor Insurance Liability Act (WAM) or similar foreign law;
c. for damage with or by motor-driven mowing machines, children's toys and/or other such consumer goods, provided these cannot exceed a speed of 10 kilometres per hour, including remote-controlled model cars;
d. for damage caused while joyriding with a motor vehicle, provided the perpetrator is younger than 18 years of age. Liability in the event of theft or misappropriation of the motor vehicle remains excluded.
In the event of nonviolent joyriding, this cover does not apply if a liability insurance has been taken out for the motor vehicle.
3.8.4.3 The cover described under Articles 38.4.2.a to 38.4.2.d does not apply if the liability is
covered by any other insurance.
3.8.5 Boats
3.8.5.1 The Liability for property damage caused with or by boats is not covered.
3.8.5.2 This exclusion does not apply to;
a. theliability of the Insured Person as a passenger of a ship. However, the provisions of Articles 3.8.3 and 3.5.2 remain fully applicable.
b. the liability for damage caused with or by;
- rowboats, canoes and other vessels designed to be propelled solely by bodily strength;
- model boats, even if they are operated remotely;
- boats equipped with an (outboard) motor with a capacity of no more than 3 kW (approximately 4 hp) in accordance with the provisions made in Article 3.8.5.3; - sailboards and sailboats with a sail surface area not exceeding 16 m²; and/or - houseboats without a propulsion system.
3.8.5.3 The liability for damage caused with or by boats, not including model boats, which are
equipped with an (outboard) motor capable of a speed of more than 20 kilometres per hour is not covered.
3.8.5.4 The liability of an Insured Person for damage caused while joy-sailing with a boat,
provided the perpetrator is younger than 18 years of age. Liability in the event of theft or misappropriation of the boat is excluded. In the event of nonviolent joy-sailing, this coverage does not apply if a liability insurance has been taken out for the boat.
3.8.5.5 The cover described under Articles 3.8.5.2.a to 38.5.2.b does not apply if the liability is
covered by any other insurance.
3.8.6 Aircraft
3.8.6.1 This insurance does not cover the liability for damage caused with or by an aeroplane, a
model aeroplane, a hang glider, a target aeroplane, a parasailer, a kite, an airship, a model rocket and/or a balloon with a diameter of more than 1 metre when fully inflated. An air cushion vehicle is considered an aircraft within the scope of this insurance.
3.8.6.2 This exclusion does not apply for;
a. theliability of the Insured Person as a passenger of an aircraft. However, the provisions of Articles 3.8.3 and 3.5.2 remain fully applicable.
b. liability for damage with or by remote-controlled model aeroplanes with a weight of a maximum of 20 kilogrammes; and/or
c. liability for damage caused with or by a kite with a maximum area of 1.5 m², hang gliding, parasailing and skydiving/parachuting.
3.8.6.3 The cover described under Articles 3.8.6.2.a to 38.6.2.c does not apply if the liability is covered by any other insurance.
3.8.7 Weapons
The liability of an Insured Person for damage caused in connection with the possession and/or use of weapons as provided for in the Weapons and Ammunition Act (WWM) is not covered, irrespective of whether the Insured Person holds a permit. The liability for damage in connection with ownership and/or use of weapons or firearms while hunting is also excluded from the cover of this insurance.
3.9 Damage
3.9.1 Loss assessment
The Insurer will make a decision regarding the determination of the damage, whether or not to make an amicable settlement before or during proceedings and conducting negotiations on this subject, any defence of the Insured Person in connection with a criminal prosecution against him/her, conducting a defence against or meeting a claim for compensation, the acquiescence of a court ruling and the like. If a claim for compensation exceeds the insured amount, the Insured Person and the Insurer will decide by mutual agreement on the aforementioned issues, as well as on any costs of legal proceedings and costs of legal assistance.
3.9.2 That which is due in compensation under this insurance may be paid directly to the
injured third party or parties, upon the instructions of the insurer to Aon.
Claims by injured parties for compensation of bodily injury will be handled and settled in compliance with the provisions of 7:954 of the Dutch Civil Code.
4. SECTION IV SPECIAL CONDITIONS CONTINUOUS TRAVEL INSURANCE 4.1 Definitions
4.1.1 Baggage
All property of the Insured Persons taken on, sent ahead or acquired, borrowed or hired during the trip, but excluding dentures, commercial goods, sample collections, valuables and passports, visas, identity documents, tourist cards, driving licences, licence plates, travel tickets, carnets and green cards.
4.1.2 Permanent disability
Permanent disability exists only in cases of permanent loss (of function) of any part or organ of the body of the Insured Person.
4.1.3 Medical expenses
Medical practitioner’s fees, costs made under medical prescription for pharmacies, hospital care, surgery, x-rays, radiation and physical therapy, and costs of medically necessary transport to and from medical practitioners and hospitals.
4.1.4 Valuables
Jewellery, real pearls, precious stones, watches, objects of gold, platinum or silver, fur, photo and video equipment, audio and visual equipment, (personal) computers including peripherals, software and audio-, image- or data carriers, paintings and other works of art.
4.1.5 Lodgings
The holiday accommodations at a (fixed or otherwise) location, not belonging to any of the Insured Persons and hired or used during the holiday period .
4.1.6 Accident
An accident is defined as; a sudden and immediate impact of an external force that causes bodily injury, the nature and location of which can be determined medically. The following are
considered equivalent to an accident:
a. Contamination by pathogens as the direct result of an involuntary fall into water or into any other substance, or is the result of being in such a substance (in an attempt) to rescue a person or animal.
b. Complications and aggravation of the accidental injury resulting directly from first aid or from medically necessary treatment.
c. The involuntary ingestion of substances or objects, with the exception of pathogens.
d. Suffocation, drowning, sunstroke, hyperthermia, freezing, burning, corrosion by caustic liquids, lightning strike or other electrical discharge.
e. Exhaustion, starvation, dehydration and sunburn as the result of a disaster.
4.1.7 Other payments
All necessary extra costs that an Insured Person must incur on his/her own behalf due to unforeseen exceptional circumstances that have occurred during the validity of this insurance, with the exception of medical costs as further specified under Other compensation in Article 4.5.
4.1.8 Damage
Damage is defined as the diminishment of the assets of an Insured Person due to physical damage or loss of the insured property.
4.1.9 Insured Persons are;
a. you, the Policyholder;
b. your spouse or partner with whom you permanently cohabit;
c. the unmarried children of you, your spouse or partner, that live at home with you, including foster and stepchildren; and/or
d. the children referred to under (c) living elsewhere for education purposes.
4.2 Validity
4.2.1 Geographical Insurance Area
This section provides cover for insured events that occur during the holiday or business trip anywhere in the world. Notwithstanding the aforementioned provisions, the insurance is only valid in the Insured Person's Country of Residence if the damage-causing event takes place;
a. while the Insured Person was travelling directly from his/her place of residence to a destination outside their country of residence, or from abroad directly to his/her place of residence in the country of residence;
b. during a holiday trip of at least two consecutive days, that was booked in advance. The original booking form must be submitted to us upon our request.
c. during an intended stay on a pleasure craft or in a (static) caravan/holiday home. For the purposes of this Article, an intended stay also includes the trip from the place of residence in the country of residence to and from the pleasure craft or (static)
caravan/holiday home.
In the country of residence, this section does not offer cover for the costs of medical or dental treatment.
4.2.2 Period of validity
All trips of the Insured Persons, that do not exceed a period of 90 consecutive days, are insured.
4.3 Baggage and Valuables 4.3.1 Cover
This insurance covers damage to or loss of baggage and valuables subject to the following:
a. The total compensation per event for the baggage and valuables of all Insured Persons combined, will not exceed two times the insured sum per Insured Person as stated on the policy
b. The maximum compensation per event for damage to or loss of collapsible and inflatable boats and sailing planks is EUR 125.
c. The maximum compensation per event for damage to or loss of bicycles, wheelchairs / invalid carriages and baby carriages is EUR 250.
d. The total maximum compensation for damage to and loss of telecommunication equipment, including mobile communication equipment, and accessories is EUR 300 for all devices together.
e. The maximum compensation for cash and monetary instruments is EUR 250 per event.
4.3.2 Exclusions
We will not reimburse damage;
a. due to theft or loss of valuables if these are left unattended and/or without direct supervision, unless these have been stored safely;
- in the closed baggage compartment of a means of transport, so as to be fully obscured from sight; or
- in another properly sealed space that is not a means of transport. b. consisting of full or partial loss of documents of value, postage stamp- or coin collections;
c. to animals;
d. to motor vehicles, including mopeds, scooters, camper vans, and (air) craft and their accessories, parts and accessories. This exclusion does not apply for tools, spare parts, snow chains, roof boxes/ski boxes and car audio equipment with battery connection to the motor vehicles, camper vans and (air) craft used by Insured Persons;
e. to skis, if the damage occurs during participation in or preparation for (cross-country) skiing competitions;
f. consisting of damage to lights, video/audio heads of audio and video equipment; g. consisting of cosmetic damage, scratches, dents and the like, to suitcases, if the suitcases can still be used; and/or
h. due to wear and tear, gradual influences or pests.
4.4 Medical Expenses 4.4.1 Cover
This insurance covers medical expenses, provided that the Insured Person has a primary health insurance. Compensation of Medical Expenses can only be claimed after the existing agencies for social facilities, basic healthcare insurance and/or the European Health Insurance Card (EHIC) or any other primary health insurance have indicated that they do not offer any cover for these expenses.
4.4.1.1 The following costs are covered if requirement in Article 4.4.1 has been met:
a. The cost of medical treatment of an Insured Person, during a period of a maximum of 12 months calculated from the starting date of the treatment, as long as the first treatment takes place within the validity of the insurance.
b. The costs incurred for urgent dental treatment up to a maximum of EUR 250 per insurance year.
c. The costs of acquired or replacement artificial limbs, eyes and braces, that are prescribed by a specialist and acquired within 12 months after the cause of the damage/loss.
d. The costs related to medical treatment (of an Insured Person) relating to the cost of longer hotel stays or multiple hotel costs, up to EUR 50 per person for a maximum of 10 days.
e. For a person to nurse and assist an Insured Person who is traveling alone and who is ill: The cost of transport based on the lowest class of transport for the in- and outward journeys; the cost of living and a hotel up to a maximum of EUR 50 per day for a maximum of 10 days.
4.4.1.2 The costs of the following are covered:
Medically necessary repatriation by ambulance (aircraft) for further treatment to a hospital in the Country of Residence or the Country of Origin.
Medical supervision.
The medical need for transport is determined through consultation between the attending
physician abroad and Aon’s / the Insurer’s medical advisor. The intention of repatriation is to save lives, or prevent or reduce disability.
4.4.1.3 In the event of burial or cremation abroad:
The costs of burial or cremation on the spot up to a maximum of EUR 3,500.
The cost of transport (lowest class ticket) for the in- and outward journeys of 1st or 2nd degree relatives.
The cost of accommodation for these relatives up to a maximum of three days. In the event of burial or cremation in The Netherlands, provided that death occurred abroad:
The cost of transport of the remains to the place of residence. The cost of acquiring the documents necessary for the transport. The inner casket.
4.4.2 Exclusions
We will not reimburse;
a. the costs relating to a medical treatment which gave rise to the trip;
b. the costs of treatment by a dental technician and/or costs associated with this; c. the costs of medical treatment for which there would have been an entitlement to compensation under any other insurance or statutory provision if this insurance had not existed.
d. Statutory and voluntary deductibles do not fall under the cover of this insurance policy.
4.5 Other Compensation
4.5.1 In addition to the costs mentioned in the Baggage and Medical Expenses sections, Aon /
the Insurer compensates the following:
a. The cost of repatriation from abroad of the luggage, the motor vehicle and the touring/folding caravan, up to a total maximum of EUR 1,250 per insurance year for all Insured Persons together.
b. The additional travel costs to reach the place of residence from abroad if the journey cannot reasonably take place in the originally scheduled manner or at the originally scheduled time, due to unforeseen exceptional circumstances.
c. The costs of the journey back to the original holiday destination abroad if the return journey is made within 21 days after returning to The Netherlands and it is to continue the trip that was interrupted due to an insured event.
e. Telephone, fax, telegram and telex costs up to a maximum of EUR 125 per insurance year.
f. The cost of renting skis, if the skis taken on holiday can no longer be used during the period of validity, due to breakage or theft.
4.5.2 Other necessary unforeseen costs incurred abroad, up to a maximum of EUR 1,000 per
insurance year if made with the advance permission of the insurer.
Unforeseen costs incurred with the advance permission of the Insurer are covered, with the understanding that;
- a deduction of 10% is applied to the cost of living, to reflect cost savings;
- an amount of EUR 0.20 per km will be reimbursed for the use of the car with which the trip was started.
4.6 Determination of the Damage
4.6.1 The damages will be assessed in mutual consultation between the Insured Person and
Aon / the Insurer or by an expert appointed by the Insurer, unless it is agreed that two experts will assess the damage. The Insurer and the Policyholder will then appoint one expert each.
4.6.2 Together, these experts will then, prior to commencing their activities, appoint a third
expert who, in the event that no consensus is reached, will make a binding determination of the damage within the bounds of the two experts' assessments.
4.6.3 The Insured Person must prove the damage consisting of medical costs or unforeseen
costs by submitting the original invoices. Aon’s / The Insurer’s cooperation with the assessment of the damage does not obligate Aon / the Insurer to provide compensation.
4.6.4 Scope of the damages/payment
The Insurer will reimburse the following:
Damages under the baggage and valuables component:
The new value, which is defined as the value required to purchase a similar,
new replacement of the damaged or lost item if the damaged or lost item was less than 12 months old and this can be proven by submitting the original purchase invoice.
The new value, as defined above, under deduction of an assumed improvement of new for old, if the damaged or lost item was at least 12 months old, or if the age of the item cannot be proven by submitting the original purchase invoice.
The repair costs plus any applicable depreciation if the item can be repaired. However, the compensation will under no circumstances exceed the amount that would have been paid if the damages had been calculated in accordance with the first or second abovementioned dash.
4.6.5 Deductible
The compensation for the first claim under the baggage component in any calendar year will be made without application of a deductible. For every subsequent claim in the same calendar year, for which compensation is owed, a deductible applies of EUR 100 per event.
If other insured property is also damaged by the same event, an applicable deductible will only be applied once per event.
4.7 Cancellation Costs
4.7.1 Cover and Damage Determination
4.7.1.1 The coverage for cancellation costs as described below is limited to a total amount of
EUR 3,000 per trip/rental arrangement for all Insured Persons together, unless stated otherwise on the policy. The Insured Person is entitled to compensation for cancellation costs if a trip or rental arrangement is cancelled as a result of unforeseen exceptional circumstances occurring during the insurance term.
4.7.1.2 In the event the trip has to be terminated prematurely as the result of unforeseen
exceptional circumstances occurring during the trip, the Insured Person is entitled to pro rata termination compensation. This compensation will also be paid if premature
termination is impeded by hospitalisation of at least 1 day of any of the Insured Persons, insofar as that person is or was a part of the travel group. The termination compensation will be paid, under deduction of refunds received under any other title, based on the number of unused days in proportion to the total number of intended holiday days, and will be calculated over the total cost of the trip/rental sum.
4.7.1.3 In the event of cancellation or termination by an Insured Person who is travelling with one
or more Insured Persons under this section, the cancellation costs or termination compensation will be paid for all Insured Persons.
4.7.1.4 In the event of delays, due to transport-technical reasons, in travel by boat, bus, train or
aeroplane to the holiday destination, as a result of which the Insured Persons arrive at the holiday destination later than planned, compensation will be paid for unused holiday days, under deduction of refunds received under any other title, as follows: In the event of a delay of 8 to 20 hours, one day; of 20 to 32 hours, two days; and of 32 hours or longer, three days, provided the trip/rental arrangement was scheduled to last longer than three days. The compensation is calculated over the total cost of the trip/rental term. 4.7.1.5 The costs of prepaid but not yet (fully) used ski passes and ski lift tickets will be
compensated pro rata if the Insured Person can no longer ski on medical grounds due to illness or an accident.
4.7.2 Exclusion
No compensation will be provided for damage / loss arising from the bankruptcy of an airline/tour operator/travel agency.
4.7.3 Insurance Term
The insurance term of this coverage component starts on the booking date of the trip/rental arrangement and ends upon the Insured Person's return to the permanent residential address.
4.8 Obligations of the Insured Persons
In the event of unforeseen exceptional circumstances leading to the cancellation of a trip/rental contract, the Insured Persons must notify Aon immediately, but no later than 72 hours after the occurrence of the circumstances. In the event any claim is made under this component of the insurance, the Insured Persons must submit documentation upon Aon’s request.
4.9 Accidents 4.9.1 Cover
4.9.1.1 Compensation in the Event of Death (A)
Upon the death of the Insured Person directly and solely as a result of an accident of the Insured Person occurring during the period of validity of this insurance, the insured sum for death will be paid once. A compensation for permanent disability as a result of the same accident will be deducted from the amount to be paid for death. Compensation(s) that have already been paid out, will not be recovered.
4.9.1.2 Compensation for Permanent disability (B)
In the case of permanent disability of the Insured Person directly and solely as a result of an accident of the Insured Person occurring during the period of validity of this insurance, the compensation will be determined as soon as the degree of permanent disability can be
determined medically but no later than two years after the accident. This lump sum compensation is a percentage of the insured sum for permanent disability, as shown below:
- complete paralysis 100% - full mental incapacity 100% - total loss or loss of function of
- sight in both eyes 100%
- sight in one eye 35%
- hearing in both ears 60% - hearing in one ear 25%
- an arm 65% - a hand 55% - a thumb 25% - an index finger 15% - a middle finger 10% - a ring finger 5% - a little finger 5% - a leg 60% - a lower leg 55% - a foot 40% - a big toe 10%
- any other toe 5%
- the spleen 5%
- a kidney 5%
- the sense of smell or taste 6% - a natural dental element 1%
- In the event of partial loss (of function) of the body part/organ listed, a proportionate part of the percentage mentioned above, will be paid out.
4.9.1.3 In all cases of permanent disability not listed here, the payment percentage will be
determined in accordance with the degree of permanent disability, which that injury causes to the body as a whole, where the profession of the Insured Person will not be taken into account.
4.9.1.4 The degree of permanent disability will be determined based on the loss (of function)
without taking into account external prostheses and aids.
In the case of internal prostheses or aids, the resulting lower loss (of function) will be taken into account.
4.9.1.5 The determination of the percentage of loss (of function) takes place in accordance with objective criteria and conform the most recent edition of the ‘Guides to the Evaluation of Permanent Impairment’ of the American Medical Association (A.M.A.) supplemented with the guidelines from the Dutch Specialists’ Associations.
4.9.1.6 Pre-existing conditions
a. If a pre-existing condition is aggravated by an accident, the compensation will be calculated based on the difference between the percentage of permanent disability before and after the last accident.
b. If the consequences of an accident are exacerbated by a morbid condition or by a physical or mental illness / disorder of the Insured Person, the compensation will be no higher than if the accident had happened to a fully able and healthy person.
4.9.1.7 Maximum benefit;
The total of all compensation for permanent disability occurring during the term of this insurance, will never exceed 225% of the insured sum for permanent disability.
4.9.1.8 If the compensation for permanent disability cannot be determined within six months after
the accident, we will provide an interest payment that is equal to the statutory interest over the compensation for permanent disability to be determined later. This interest compensation is calculated from the seventh month after the accident, until such time as the compensation for permanent disability is granted.
4.9.2 Exclusions
4.9.2.1 We do not provide compensation in respect of accidents that befall the Insured Person;
a. that are the intended or certain consequence of the conduct or omission of the Insured Person or anyone who has an interest in the compensation;
b. during a period when the Continuous Travel Insurance section is not applicable; c. during the (joint) committing of a crime by the Insured Person or participation in a
hijacking or other terrorist act, or knowingly taking part in serious breaches of the peace. ‘Committing’ also refers to the preparation for and participation in such activities.
d. at fights or high-risk undertakings other than in (self-)defence, rescue or preservation/protection of persons, animals or property.
e. High-risk undertakings are, in this context, understood to be; in principle a reckless activity/venture without any professional or expert guidance.
f. due to excessive alcohol consumption, unless it is proven that the Insured Person had less alcohol per mil in his/her blood at the time of the accident than he/she was legally allowed to have;
g. that were in any way related to the use of or addiction to narcotics, stimulants or similar substances, unless use is in accordance with a prescription from a physician and the Insured Person has adhered to the instructions for use;
h. while travelling in a motorised aircraft, other than as a passenger;
i. resulting in an abdominal hernia, spinal disc herniation (herniated nucleus pulposus) and/or mental disorders unless medically proven to be the result of brain damage
caused by the accident;
j. from self-mutilation, (attempted) suicide, whether or not the Insured Person was accountable by reason of mental disorder when carrying out his/her intention.
4.10 Damage
4.10.1 Obligations after an accident
4.10.1.1 The Insurer must be notified as soon as possible, but at the latest within three
months of an accident for which a right to compensation for permanent disability may arise.
If the notification takes place later, entitlement to compensation may still exist, provided it is proven that;
- the disability is directly and solely the result of an accident;
- the effects of an accident are not exacerbated by a morbid condition or by a physical or mental illness / disorder of the Insured Person;
- the Insured Person has complied with the instructions of the attending physician in all respects.
4.10.1.2 In case of death of the Insured Person, the beneficiaries must cooperate with all
measures to establish the cause of death.
4.10.1.3 The Insured Person is obligated;
- to seek medical treatment from a physician immediately and to do everything possible to further his/her own recovery;
- if requested and at the Insurer's expense, to submit to an examination by a physician appointed by the Insurer or to be admitted to a Hospital, or other medical facility appointed by the Insurer, for an examination;
- to give an authorisation for acquiring information from third parties;
- to provide, or arrange for the provision to Aon or the experts appointed by the Insurer, of all information deemed necessary and to not conceal any facts or circumstances relevant to the assessment of the degree of disability; - to notify Aon immediately of his/her full or partial recovery;
- to notify Aon in good time in the case of departure abroad. 4.10.2 Determination of compensation
The amount of compensation and the degree of permanent disability will be determined by the Insurer based on the information from medical and other experts. The Insured Person, or in case of death of the Insured Person, the person who is entitled to the compensation in case of death, will be notified as soon as possible of the determination after receipt of the information necessary for making this assessment.
4.10.3 Payment of the compensation
4.10.3.1 The Insurer will make payment within 30 days after the determination of a
compensation.
4.10.3.2 Unless otherwise stated in the policy, the following will be considered as the
beneficiaries: a. Policyholder b. Spouse or partner c. Children
d. Heirs
4.10.3.3 A public authority will never be regarded as a beneficiary.
5. SECTION V – ACCIDENTS 5.1 Definitions
5.1.1 Accident
An accident is defined as a sudden and immediate impact of an external force that causes bodily injury, the nature and location of which can be determined medically. The following are considered equivalent to an accident:
a. Contamination by pathogens as the direct result of an involuntary fall into water or into any other substance, or is the result of being in such a substance (in an attempt) to rescue a person or animal.
b. Complications and aggravation of the accidental injury resulting directly from first aid or from medically necessary treatment.
c. The involuntary ingestion of substances or objects, with the exception of pathogens. d. Suffocation, drowning, sunstroke, hyperthermia, freezing, burning, corrosion by
caustic liquids, lightning strike or other electrical discharge.
e. Exhaustion, starvation, dehydration and sunburn as the result of a disaster.
5.1.2 Permanent disability
Permanent disability exists only in cases of permanent loss (of function) of any body part or organ of the body of the Insured Person.
5.1.3 Insured Person(s)
