Public Liability & Personal Accident Insurance Policy

Transcription

1 Public Liability & Personal Accident Insurance Policy Arranged by: Qdos Broker & Underwriting Services Limited Underwritten by: Royal & Sun Alliance Insurance plc Royal & Sun Alliance Insurance plc (No ). Registered in England and Wales at St Mark's Court, Chart Way, Horsham, West Sussex, RH12 1XL. Authorised and regulated by the Financial Services Authority. Page 1 of 16

2 PREAMBLE This Policy and the Schedule forms the legal contract between the You and the Insurer (Royal & Sun Alliance Insurance plc) This Policy and the Schedule (including any Schedule issued in substitution) shall be considered one document and any word or expression to which a specific meaning has been attached shall bear such meaning wherever it appears RSA will provide the insurance described in this Policy and the Schedule subject to the Policy Terms and Conditions for the Period of Insurance shown in the Schedule and any subsequent period which You shall pay and RSA shall agree to accept the Premium Page 2 of 16

3 Contents Terms and Conditions Section 1 Public Liability Insurance Definitions 5 What We Cover 6 What We Do Not Cover 6 Claims Requirements 8 Section 2 Personal Accident Insurance Definitions 9 What We Cover 11 What We Do Not Cover 11 General Conditions 12 General Claims Settlement Conditions 12 Guidance When Making A Claim 14 Complaints Procedure 15 Fair Processing Notice 16 Page 3 of 16

4 TERMS AND CONDITIONS Oberservance of the terms of this Policy relating to anything to be done or complied with by You is a condition precedent to any liability of the Company. Taking Care You must take reasonable precautions to prevent any circumstances or to cease any activity which may cause a claim on this Policy. Fraud If dishonesty is used by You or anyone acting on behalf of You in connection with a claim Your policy cover may be invalidated and legal action may be taken against You. Other RSA Insurance If you or any person is entitled to any indemnity under this policy no.rkk and also entitled to an indemnity under any other RSA policy in respect of the same event the limit of indemnity provided under both policies shall not exceed the higher limit of indemnity applicable to each Policy. For the avoidance of doubt if there is more than one RSA policy the indemnity limit is not the combined indemnity limits in both policies. Nothing in this clause is intended to alter the operation of the other insurance clause in relation to any other policy which is not provided by the RSA. Law Applicable Under the laws of the United Kingdom (England, Scotland, Wales and Northern Ireland) both parties may choose the law which applies to this contract, to the extent permitted by those laws. Unless the parties agree otherwise in writing, We have agreed with You that the law which applies to this contract is the law which applies to the part of the United Kingdom in which the Insured is based, or, if based in the Channel Islands or the Isle of Man, the law of whichever of those two places in which You are based. The parties have agreed that any legal proceedings between them in connection with this contract will only take place in the courts of the part of the United Kingdom in which You are based, or, if You are based in either the Channel Islands or the Isle of Man, the courts of whichever of those two places in which You are based. Page 4 of 16

5 SECTION ONE PUBLIC LIABILITY INSURANCE Definitions applicable to Section One - Public Liability Insurance Abuse a) acts of hurting or injuring mentally or physically by maltreatment or ill-use; b) acts of forcing sexual activity rape or molestation; or c) repeated or continuing contemptuous coarse or insulting words or behaviours. Accidental Damage Sudden, unexpected and visible damage which has not been caused on purpose. Heat a) Use of: b) Arc welding; c) Blow lamps; d) Blow torches; e) Gas welding and cutting; f) Hot air paint strippers; g) Laser beams; h) Thermal lances; i) Tar and bitumen boilers; j) Portable grinding wheels, angle grinders and disk cutters; or k) Space heaters, i.e. mobile LPG direct fired space heaters. Insurer/RSA/Us/We/Company/Our Royal & Sun Alliance Insurance plc. Mechanical Vehicles a) mechanically propelled vehicle; b) aircraft or other aerial device; c) aerospatial device; d) hovercraft; e) water-borne craft; or f) railway locomotive or tram. Policyholder/You/Your Any volunteer aged 16 years and above holding a fully paid up active membership with Your Square Mile Mutual Limited Terrorism The use, or threat of use, of biological, chemical and/or nuclear force or contamination by any person(s), whether acting alone or on behalf of or in connection with any organisation(s) or government(s), committed for political, religious, ideological or similar purposes including the intention to influence any government(s) or put any section of the public in fear. Volunteer Act An activity within Great Britain Northern Ireland the Channel Islands or the Isle of Man which involves spending time, unpaid (except for travel and other approved out-of-pocket expenses), doing something which aims to benefit some third party other than or in addition to a close relative, to promote good, improve quality of life or to the enhancement of the community and being performed while a member of Your Square Mile Mutual Limited. Page 5 of 16

6 Public Liability Insurance We Cover Your personal legal liability for accidental death, disease, illness or accidental physical injury to anyone or Accidental Damage to physical property arising from any Volunteer Act undertaken by You happening during any Period of Insurance shown on Your Schedule The most we will pay for any one occurrence or all occurrences of a series consequent on or attributable to one source or original cause is the Limit of Indemnity shown on Your Schedule plus defence costs agreed by us in writing Legal liability for claimants costs and expenses in respect of the above Indemnity in respect of the costs of legal representation at 1) any coroner`s inquest or inquiry in respect of any death 2) the defence of any criminal proceedings brought in appeal against You for an offence of manslaughter which may be the subject of indemnity under the Public Liability cover provided All other costs and expenses in relation to any matter which may form the subject of a claim for indemnity under the Public Liability cover provided Incurred with the Company s written consent Cover applies to You when volunteering in person If we ask You to attend court as a witness in connection with a claim in respect of which You are entitled to claim under this Policy, we compensate You 50 for each day on which Your attendance at court is required Public Liability Insurance - We do not Cover Abuse Liability from Abuse Asbestos Liability of whatsoever nature directly or indirectly caused or contributed to or occurring by the presence of Asbestos Asbestos Containing Materials or Asbestos Dust or the release of Asbestos Dust or the exposure of persons buildings or property to Asbestos Asbestos Containing materials or Asbestos Dust. Contractual Liability Liability accepted by You under any agreement, unless the liability would exist without the agreement. Date Change and Computer Viruses Any direct or indirect loss caused: a) to equipment by its failing correctly to recognise data representing a date in such a way that it does not work properly or at all; or b) by computer viruses. Employers Liability Liability arising from death disease illness bodily injury or mental injury caused to any person employed by You. Page 6 of 16

7 Entity Risks Any liability incurred by or attaching to any organisation, group, company, charity, club, sports club or committee to include any unincorporated association (whether formal or otherwise) established or operated by You. Existing and Deliberate Damage Any loss, damage, liability, cost or expense of any kind occurring, or arising from an incident occurring, before the insurance period starts or caused deliberately by You. Fines or Penalties a) fines or penalties; b) compensation ordered or awarded by a Court of Criminal Jurisdiction; or c) aggravated exemplary or punitive damages awarded by any court outside Great Britain Northern Ireland the Channel Islands or the Isle of Man. Hazardous Activites Liability arising from any of the following activities: a) use of Heat; b) use of fireworks or arranging of firework displays; c) use of bouncy castles or other inflatable equipment; d) circuses or circus performances; e) equestrian activities or riding establishments; f) working on railways or working trackside; or g) demolition or erection of buildings; Infectious Diseases Liability arising from You passing on any disease or virus. Mechanical Vehicles Liability arising from the use of the ownership possession or use by or on behalf of You of any Mechanical Vehicles Pollution or Contamination Any claim or expense of any kind directly or indirectly caused by or arising out of pollution or contamination unless caused by: a) a sudden unexpected incident; or b) oil or water escaping from a fixed oil or fixed water installation, and, which, was not the result of an intentional act and which occurs during any Period of Insurance. All pollution or contamination which arises out of one incident shall be deemed to have occurred at the time such incident takes place Professional Risks Liability arising from the treatment of any persons if You are or have been a physician doctor consultant midwifesurgeon resident medical officer or dentist. Liability arising from or in connection with any professional advice, specification or design. Property in Your custody or control Anything owned or held in trust by You or anything which is Your legal responsibility or in Your custody or control other than legal liability arising from the following which are covered: a) visitors personal effects including vehicles and their contents; b) premises not owned or leased or rented by You where You are undertaking a Voluntary Act. Page 7 of 16

8 Radioactive Contamination Any loss, damage, liability, cost or expense of any kind caused directly or indirectly by: a) ionising radiation or radioactive contamination from any nuclear fuel or waste which results from the burning of nuclear fuel; or b) the radioactive, toxic, explosive or other dangerous properties of nuclear machinery or any part of it. Sonic Bangs Any loss, damage, liability, cost or expense of any kind caused directly or indirectly by pressure waves from aircraft Terrorism Any loss, damage, liability, cost or expense of any kind directly or indirectly caused by, resulting from or in connection with any act of Terrorism. War Risks Any loss, damage, liability, cost or expense of any kind caused directly or indirectly by war, invasion or revolution. Public Liability Claim Conditions and Requirements Observance of the terms of this Policy relating to anything to be done or complied with by You is a condition precedent to any liability of the Company. You must notify Qdos Broker & Underwriting Services Limited as soon as possible of any incident which may give rise to a claim. Such notifications may be made by calling the help line on , by ing or by writing to: Claims Department Qdos Broker & Underwriting Services Limited Qdos Court Rossendale Road Earl Shilton Leicestershire LE9 7LY If someone is holding You responsible for an injury or any damage, You must not admit responsibility. You must provide full details in writing as soon as You can and any claim form, application notice, legal document or other correspondence sent to You must be provided to Qdos Broker & Underwriting Services Limited straightaway without being answered. You must not settle, reject, negotiate or offer to pay any claim You have made or intend to make under this Policy without Our written permission. We have the right, if we choose, in Your name but at Our expense to take over the defence or settlement of any claim and to start legal action to get back from anyone else payments that have already been made. You must give us, at Your reasonable expense, all the information we ask for about any claim. You must help us to take legal action against anyone or help us defend any legal action if we ask You to. Other Insurance if at the time of any claim there is or but for the existence of this Policy there would be any other insurance covering the same legal liability the indemnity will not apply except in respect of any amount beyond that which would have been payable under such other insurance had this Policy not been effected Page 8 of 16

9 SECTION TWO PERSONAL ACCIDENT INSURANCE Definitions applicable to Section Two Personal Accident Insurance Accident A sudden unexpected unforeseen and identifiable incident. Aircraft Accumulation All Insured Persons travelling in any aircraft or airship. Britain England, Wales, Scotland, Northern Ireland, Channel Islands and the Isle of Man. Benefits Reference Benefit Sum Insured Disablement Benefits 2 to 4 1 Death 25,000 2 Loss of two or more Limbs or Loss of both Eyes or 25,000 one of each 3 a) Loss of one Limb or Loss of one Eye 25,000 b) Permanent total loss of speech 25,000 c) i) Permanent total loss of hearing in both ears: 25,000 ii) Permanent total loss of hearing in one ear: 6,250 4 Permanent Total Disablement from gainful employment of any and every kind 25,000 Incident All individual losses arising out of and directly occasioned by one sudden unexpected specific event occurring at an identifiable time and place Insured/Insured Person/You/Your Any volunteer aged between 16 and 75 years holding a fully paid up active membership with Your Square Mile Mutual Limited Insurer/RSA/Us/We/Company/Our Royal & Sun Alliance Insurance plc. Loss of Eye Permanent and total loss of sight which will be considered as having occurred: a) in both eyes if Your name is added to the Register of Blind Persons on the authority of a fully qualified ophthalmic specialist b) in one eye if the degree of sight remaining after correction is 3/60 or less on the Snellen scale (meaning seeing at 3 feet what the Insured Person should see at 60 feet) Page 9 of 16

10 Loss of Limb a) in the case of a leg loss by permanent physical severance at or above the ankle or permanent and total loss of use of a complete foot or leg. b) in the case of an arm loss by permanent physical severance of the four fingers at or above the meta carpo phalangeal joints (where the fingers join the palm of the hand) or permanent and total loss of use of a complete arm or hand. Maximum Incident Limit The maximum amount the Company will pay under this Policy and any other policy of Personal Accident Insurance issued by the Company in the Insured s name in respect of all losses and in respect of all Insured Persons arising out of one and the same Incident. The duration and radius of any one Incident shall be limited to: a) 72 consecutive hours b) 100 miles No loss which occurs outside this distance or period shall be included in that Incident The liability of the Company under this Policy in respect of any one Incident shall not exceed the Maximum Incident Limit of 25,000,000 subject to the following inner limits: 1. Aircraft Accumulation a. Multi engined aircraft 5,000,000 b. Any other aircraft or airship 250, Terrorism 5,000,000 Nuclear Chemical or Biological Cause Use of any nuclear weapon or device or the deliberate emission discharge dispersal release or escape of any solid liquid or gaseous chemical agent and/or Biological agent Biological agent shall mean any pathogenic micro-organism and/or biologically produced toxin(s) including genetically modified organisms and chemically synthesised toxins Terrorism Any act including but not limited to the use of force or violence and/or threat thereof of any person or group(s) of persons whether acting alone or on behalf of or in connection with any organisation(s) or government(s) committed for political religious ideological or similar purposes including the intention to influence any government and/or to put the public or any section of the public in fear Voluntary Activity An activity within Great Britain Northern Ireland the Channel Islands or the Isle of Man which involves spending time, unpaid (except for travel and other approved out-of-pocket expenses), doing something which aims to benefit some third party other than or in addition to a close relative, to promote good, improve quality of life or to the enhancement of the community and being performed while a member of Your Square Mile Mutual Limited excluding travel to and from such activity. War War invasion act of foreign enemy hostilities (whether war be declared or not) civil war rebellion revolution insurrection or military or usurped power Page 10 of 16

11 Personal Accident Insurance We Cover The Cover If during the Period of Insurance whilst engaging in a Voluntary Activity You sustain bodily injury following an Accident which within two years is the sole and independent cause of Death or Disablement We will pay You the appropriate Benefit shown in the Schedule subject to the Maximum Incident Limit (and inner limits where applicable). Special Conditions Benefits a) We will not pay more than one of Benefits 1 to 4 in connection with the same Accident. b) Any disablement under Benefits 2 to 4 must be proved to Our reasonable satisfaction to be permanent and without expectation of recovery before We will pay the Benefit. Disappearance In the event of Your disappearance if after a suitable period of time it is reasonable to believe that Death has occurred as a result of bodily injury following an Accident Benefit 1 shall become payable subject to a signed undertaking by You that if the belief is subsequently found to be wrong such amount shall be refunded to Us. Exposure If You suffer Death or Disablement as a result of exposure to the elements We will consider that as having been caused by bodily injury following an Accident. Personal Accident Insurance We will not Cover We will not pay any Benefit where bodily injury following an Accident is the result of or is contributed to by: 1. You committing or attempting to commit suicide or as a result of self inflicted injury; 2. You engaging in flying of any kind other than as a passenger; 3. illness or disease (not resulting from bodily injury following an Accident); 4. any naturally occurring condition or degenerative process; 5. any gradually operating cause; 6. post traumatic stress disorder or any psychological or psychiatric condition (not resulting from bodily injury following an Accident); 7. radioactive contamination whether arising directly or indirectly; 8. Terrorism occasioned by any Nuclear Chemical or Biological Cause; 9. War We will not pay any claim: 10. after the expiry of the Period of Insurance in which You attain the age of 75 years; 11. whatsoever to or on behalf of the Insured to the extent that it would be in breach of an embargo or sanction imposed by law or regulation which governs this Policy the Company its parent company or its ultimate controlling entity the Insured or any other entity with whom the Company would be expected to transact Page 11 of 16

12 Personal Accident Insurance - General Conditions Cancellation of Terrorism Cover The Company may cancel any insurance provided by this Policy against Terrorism by giving 7 days notice to the Insured at the Insured s last known registered address Law Applicable Under the laws of the United Kingdom (England, Scotland, Wales and Northern Ireland) both parties may choose the law which applies to this contract, to the extent permitted by those laws. Unless the parties agree otherwise in writing, the Insurer has agreed with the Insured that the law which applies to this contract is the law which applies to the part of the United Kingdom in which the Insured is based, or, if based in the Channel Islands or the Isle of Man, the law of whichever of those two places in which the Insured is based. The parties have agreed that any legal proceedings between them in connection with this contract will only take place in the courts of the part of the United Kingdom in which the Insured is based, or, if the Insured is based in either the Channel Islands or the Isle of Man, the courts of whichever of those two places in which the Insured is based. Policy Cancellation This Policy may be cancelled either by the Insured or the Company by giving 30 days written notice to the Company or the Insured at their last known registered address Personal Accident Insurance General Claims Settlement Conditions Assignment We will not be bound to accept or be affected by any trust charge lien assignment or other dealing with or relating to this Policy. Claims Notification We will have no liability under this Policy in respect of any matter which You do not notify to Us in accordance with the requirements of this condition. As a condition precedent to the Your right to be indemnified under this Policy You must provide notification to Us no later than 90 days of the occurring of any Accident Incident event or circumstance which may give rise to a loss which is covered under this Policy. Claims must be notified to Qdos Broker & Underwriting Services Limited by calling the help line on by ing or by writing to: Claims Department Qdos Broker & Underwriting Services Limited Qdos Court Rossendale Road Earl Shilton Leicestershire LE9 7LY Page 12 of 16

13 Evidence Required You must produce for Us at Your own expense all the detailed particulars and evidence relating to the cause and amount of the loss damage or expenses If We considers it necessary You must also agree to have a medical examination (which We will pay for) as often as We may require in connection with any claim. Interest Interest will not be added to any amount paid. Other Interests Your receipt shall discharge Our liability to pay any amount in respect of a claim You or Your personal representatives shall have no right to claim from or sue Us If the Insured comprises more than one party having an interest in the Insured Person insured the settlement made by the Company shall represent the total amount payable in respect of that Insured Person for all interests covered by this Policy. Reasonable Care You must take all reasonable steps to avoid or minimise any loss or injury and must also make every reasonable effort to recover any property which has been lost or stolen. Third Party Contract Rights No person other than You or Us may enforce the terms of this Policy and the provisions of the Contract (Rights of Third Parties) Act 1999 do not apply. Page 13 of 16

14 Guidance when Making a Personal Accident Claim Claim Notification Conditions that apply to this Policy and in the event of a claim are set out above. It is important that You comply with all policy conditions and you should familiarise yourself with any requirements contained in the Policy. Directions for claim notification are included in the claims conditions. Please be aware that events that may give rise to a claim under the insurance must be notified within 90 days of its occurrence. Further guidance is provided above. Claims conditions require You to provide Us with any reasonable assistance and evidence that We require concerning the cause and value of any claim. Ideally, as part of the initial notification, You will provide: Your name, address, and your home and mobile telephone numbers Personal details necessary to confirm your identity Policy number The date of the incident The cause of the injury Details of the injury and prognosis Police details where applicable Names and addresses of any other parties involved or responsible for the incident (including details of injuries) and addresses of any witnesses. This information will enable Us to make an initial evaluation on policy liability and claim value. We may, however, request additional information depending upon the circumstances. Sometimes We, or someone acting on Our behalf, may wish to meet with You to discuss the circumstances of the claim or to undertake further investigations. Page 14 of 16

15 Complaints Procedure At RSA We are committed to going the extra mile for Our customers and wherever possible, exceeding their expectations If you believe that we have not delivered the service you expected or you are concerned about any aspect of the service we have provided, then in the first instance you should contact: Qdos Broker & Underwriting Services Limited Qdos Court Rossendale Road Earl Shilton Leicestershire LE9 7LY Tel: If your complaint is not resolved or you are not happy with the response and the course of action proposed, you can progress your complaint to Our Customer Relations Team who will conduct a separate investigation and full review that will be concluded by us issuing a final response letter. Customer Relations Office RSA Bowling Mill Dean Clough Industrial Park Halifax HX3 5WA Tel: Fax: halifax.customerrelationsoffice@uk.rsagroup.com If you are still not satisfied after the review, or you have not received a written offer or resolution within 8 weeks of the date we received your complaint, Royal & Sun Alliance Insurance plc is regulated by the Financial Services Authority whose arbitration service is the Financial Ombudsman Service and you can refer your complaint to them. Financial Ombudsman Service South Quay plaza 183 Marsh Wall London E14 9SR Tel: Website: You must approach the Financial Ombudsman service within 6 months of Our final response to your complaint. We will remind you of the time limits in Our final response. Your rights as a customer to take legal action remain unaffected by the existence or use of any complaints procedures referred to above. However the Financial Ombudsman Service will not adjudicate on any cases where litigation has commenced. Page 15 of 16

16 Fair Processing Notice How we use Your Information Please read the following carefully as it contains important information relating to the details that You have given Us. You should show this notice to any other party related to this insurance. Who we are This product is arranged and administered by Your Square Mile on behalf of Qdos Broker & Underwriting Services Limited and is underwritten by Royal & Sun Alliance Insurance plc. You are giving Your information to Royal & Sun Alliance Insurance plc, which is a member of the RSA Group of companies (the Group). How Your information will be used and who we share it with Your information comprises of all the details we hold about You and Your transactions and includes information obtained from third parties, including Your Square Mile. If You contact us electronically, we may collect Your information identifier, e.g. Internet Protocol (IP) Address or telephone number supplied by Your Service Provider. We may use and share Your information with other members of the Group to help us and them: Assess financial and insurance risks; Recover debt; Prevent and detect crime; Develop Our services, systems and relationships with You; Understand Our customers' requirements; Develop and test products and services We do not disclose Your information to anyone outside the Group except: Where We have Your permission; or Where We are required or permitted to do so by law; or To credit reference and fraud prevention agencies and other companies that provide a service to us, Our partners or You; or Where We may transfer rights and obligations under this agreement. We may transfer Your information to other countries on the basis that anyone We pass it to, provides an adequate level of protection. In such cases, the Group will ensure it is kept securely and used only for the purpose for which You provided it. Details of the companies and countries involved can be provided on request. From time to time We may change the way We use Your information. Where We believe You may not reasonably expect such a change We shall write to You. If You do not object, You will consent to that change. We will not keep Your information for longer than is necessary. Sensitive Information Some of the information We ask You for may be sensitive personal data, as defined by the Data Protection Act 1998 (such as information about health or criminal convictions). We will not use such sensitive personal data about You or others except for the specific purpose for which You provide it and to carry out the services described in Your policy documents. Please ensure that You only provide us with sensitive information about other people with their agreement. How to contact us On payment of a small fee, You are entitled to receive a copy of the information We hold about You. If You have any questions, or You would like to find out more about this notice You can write to: Data Protection Liaison Officer, Customer Relations Office, RSA, Bowling Mill, Dean Clough Industrial Estate Halifax, HX3 5WA. Page 16 of 16