1 Motor vehicle insurance Customer information according to the Swiss Law on Insurance Contracts (VVG) and General Conditions of Insurance (GCI) Contents Page Page Customer information according to the Swiss Law on Insurance Contracts (VVG) 2 General Conditions of Insurance (GCI) Edition Common provisions 1 Basis of the contract 4 2 Object of the insurance 4 3 Duration 4 4 Geographical limits 4 5 Change in the risk 4 6 Payment of premiums and adjustment of contract 4 7 Refund of premiums 5 8 Premium based on loss experience 5 9 Cancelation in the event of a claim 6 10 Interchangeable license plates 6 11 Replacement (substitute) vehicles 6 12 Deposited license plates 6 13 Deductibles 6 14 Obligations in the event of a claim 7 15 Ascertaining the facts 8 16 Consequences of conduct contrary to the terms of the contract 8 17 Assignment of claims 8 18 Notices to Zurich 8 19 Brokers commission 8 20 Place of performance and jurisdiction 8 21 Applicable law 8 Third party liability insurance 101 Scope of the insurance Insured persons Insurance benefits Exclusions and limitations of the scope of insurance Recovery Refund of the deductible 10 Hull insurance Accident insurance 301 Insured persons Definition of accident Insured accidents Uninsured accidents Insurance benefits Contributory effect of illnesses Increase in risk Offsetting against liability claims 16 Roadside assistance CH/FL 401 Insured vehicles Insured persons Insured events Insurance benefits Uninsured damage Claims against third parties Claims under other insurance policies/agreements Third-party claims 17 Legal protection insurance 501 Insured persons Scope of insurance Uninsured legal disputes Insurance benefits Reductions to benefits Definition of legal dispute Processing Differences of opinion 20 Liability arising out of the transportation of hazardous loads 601 Scope of insurance 20 Liability arising out of work accident risk 701 Scope of insurance 21 Glossary 22 Product overview 23 Key words Scope of the insurance Insured events Insurance benefits Exclusions 13 The wording of the German original shall take precedence.
2 2 Customer information according to the Swiss Law on Insurance Contracts (VVG) Edition 01/2012 Dear Client, Motor vehicle insurance from Zurich provides you with customized insurance protection. Thank you for the interest you have shown in our services and the confidence you have placed in us. If you have any questions, please do not hesitate to contact us. The following customer information shows a clear and summarized overview of the identity of the insurer and the material content of the insurance contract ( 3 of the Federal Law on Insurance Contracts, VVG/LCA). The rights and obligations of the contracting parties arise from the proposal/offer, the policy itself, the contractual conditions and the applicable laws, especially the VVG/LCA. After acceptance of the proposal/offer the Policyholder will be issued with a policy, the contents of which will reflect the proposal/offer. Who is the insurer? The insurer is Zurich Insurance Company Ltd, hereinafter referred to as Zurich, with registered office at Mythenquai 2, 8002 Zurich. In terms of legal protection insurance, the insurer is Orion Legal Expenses Insurance Company, hereinafter referred to as Orion, with registered office at Centralbahnstrasse 11, 4002 Basel. Zurich and Orion are stock corporations under Swiss law. Which risks are insured and what is the scope of the insurance cover? The insured risks and the scope of the insurance cover are determined by the proposal/offer or the policy and by the contractual conditions. What is the premium amount? The premium amount depends on the respective insured risks and the designated level of cover. A fee may be charged for payment in installments. All information on the premium and any applicable fees are included in the proposal/offer or in the policy itself. Under what circumstances is the premium refunded? If the premium has been paid in advance for a specific period of insurance and the contract is canceled before the end of the period, Zurich will refund the premium in respect of the unexpired period of insurance. The premium remains payable in full to Zurich if: the insurance benefit was provided on the basis of the cessation of risk; the insurance benefit was provided for a partial loss and the Policyholder cancels the contract during the year after the contract was concluded. Which other obligations does the Policyholder have? Changes in risk: If an important fact changes during the term of the policy, resulting in a material increase in risk, then Zurich must be notified in writing without delay. Ascertainment of the facts: The Policyholder must provide assistance for investigations relating to the insurance contract, e.g. breaches of the duty of disclosure, increases in risk, checking benefits, etc. and provide Zurich and Orion with all pertinent information and documentation or obtain such information from third parties for submission to Zurich and Orion, and authorize third parties in writing to issue the appropriate information, documentation, etc. to Zurich and Orion. Zurich and Orion are also entitled to carry out their own investigations. Insured event: The insured event must be reported to Zurich without delay. This list only contains the most common obligations. The contractual conditions and the VVG/LCA contain further obligations. When does the insurance cover begin? The insurance cover begins on the day stated in the proposal/ offer or in the policy itself. If an insurance certificate has been issued, Zurich will provide the insurance cover in accordance with applicable law or the terms of contract until the policy is issued. When can Zurich adjust the insurance contract? If there is a change in the basic premiums, fees or terms and conditions of insurance (e.g. premium rate, deductible rule or scope of coverage), Zurich may require adjustment of the contract with effect from the following year of insurance.
3 3 When does the insurance cover end? The Policyholder can terminate the contract by giving notice: at the latest three months before the end of the contract or, if agreed, three months before the end of the insurance year. The termination shall be deemed valid if it is received by Zurich at the latest on the last day before commencement of the three-month period. If the contract is not terminated, it shall be automatically extended for one year at a time. Fixed-term contracts with no renewal clause end on the day specified in the proposal/offer or policy; after every insured event for which a claim is payable, at the latest 14 days after notification that Zurich has paid; if Zurich changes the basic premium or the terms and conditions of insurance pursuant to 6.5 GCI. In this case the notice of termination must reach Zurich no later than the last day of the insurance year; if Zurich breaches the statutory information obligations pursuant to 3 VVG/LCA. The right of termination lapses four weeks after the insured has received notification of this breach, but at the latest one year after the breach. Zurich can terminate the contract by giving notice: at the latest three months before the end of the contract or, if agreed, three months before the end of the insurance year. The termination shall be deemed valid if it is received by the Policyholder at the latest on the last day before commencement of the three-month period. If the contract is not terminated, it shall be automatically extended for one year at a time. Fixed-term contracts with no renewal clause end on the day specified in the proposal/offer or policy; after every insured event for which a claim is payable, on condition that notice of termination is given at the latest at the same time as payment is made; if material risk factors have been concealed or falsely communicated (breach of the duty of disclosure). How do Zurich and Orion handle data? Zurich and Orion process data disclosed on the policy documentation or during the course of issuing the policy, and use them mainly for the purpose of setting premiums, provid - ing information on risk, processing claims, making statistical evaluations and marketing purposes. The data are stored in hard copy form or electronically. Zurich shall be entitled to transfer any data that may be required for processing pur - poses to any third parties in Switzerland or abroad who are involved in issuing the policy, including but not limited to coinsurance and reinsurance companies, and to subsidiaries of Zurich Insurance Group Ltd located within or outside Switzerland. For the purpose of fraud prevention in motor vehicle insurance, vehicle-specific claims data may be filed with SVV Solution AG (a subsidiary of the Swiss Insurance Asso - ciation, SVV) for inclusion in the centralized Car Claims Info database. Zurich and Orion shall also be entitled to procure pertinent information from government offices and third parties, in particular information with respect to the loss expe - rience. This consent shall be valid regardless of whether the contract is concluded. The Policyholder has the right to request that Zurich and Orion provide information envisaged under legislation in respect of the processing of data per - taining to him/her. Zurich can cancel the contract: if the Policyholder is late in paying the premium, has received a reminder and Zurich does not call it in; if the Policyholder does not fulfil his/her obligation to assist with the ascertainment of the facts. Zurich is entitled to cancel the insurance contract retrospectively within two weeks after the expiry of a four-week time extension agreed in writing; in the event of insurance fraud. This list only contains the most common possible reasons for termination. The contractual conditions and the VVG/LCA contain other possible reasons.
4 4 General Conditions of Insurance (GCI) Edition Common provisions 1 Basis of the contract 1.1 The Insurance shall be based on the declarations which you, as Policyholder (applicant), make in the application form. 1.2 The rights and obligations of the contracting parties shall be laid down in the policy, the general conditions of insurance and in any special conditions applicable. 2 Object of the insurance Depending on what is agreed, the insurance of the vehicle described in the policy shall cover: Third party liability insurance Hull insurance Accident insurance Roadside assistance CH/FL Legal protection The insurance coverages you have taken out are listed in the policy. For a product overview, please refer to page 23. The following types of vehicle use are only insured if this has been agreed in the policy. Commercial transport of persons Commercial rental to self-drive customers Commercial use as a driving school vehicle 3 Duration The insurance shall take effect on the day specified in the policy. If a cer - tificate of insurance has been issued, Zurich shall provide provisional insurance coverage, until receipt of the policy, for liability claims in accordance with the legal minimum guarantee amount; for hull claims, in accordance with the signed application received by Zurich for a maximum duration of four weeks after the registration date. However, indemnity shall be limited to CHF 60,000 for motorcycles and CHF 150,000 for all other motor vehicles. Zurich shall, however, have the right to reject the application up to the time of delivery of the policy. If it avails itself of this right, then its obligation to pay shall be canceled 3 days after notification of refusal is served on you. Zurich shall be owed the pro rata premium up to the date of expiry of the obligation to pay. The insurance shall apply to losses which are caused within the contract term. In the case of legal protection insurance, any need for legal protection (i.e. the causal event) must also arise within the contract term. If notice of termination of the contract is not served at least 3 months before it expires, then it shall be renewed auto - matically for one year. Notice of ter - mination shall be deemed to have been served in good time if it reaches Zurich or you not later than the last day before the three month period begins. Where an insurance period of less than one year has been agreed, the contract shall lapse automatically on the date specified in the policy. 4 Geographical limits The insurance (with the exception of assistance) shall be valid in respect of accidents occurring in Switzerland and the Principality of Liechtenstein, the European states as well as in the countries bordering on the Mediterranean Sea and in Mediterranean island states. In the event of transport across the open sea, the coverage shall not cease if the points of departure and destination are located within the geographical limits. Roadside assistance is valid in Switzerland and the Principality of Liechtenstein. However, the insurance shall not be valid in the following states: Belarus, Moldavia, Ukraine, Russian Federation, Georgia, Armenia, Azerbaijan, Kazakhstan, Algeria, Egypt, Lebanon, Libya and Syria. The insurance shall lapse if the owner gives up his/her residence or legal domicile in Switzerland and takes up residence in another country (with the exception of the Principality of Liechtenstein), such lapse to take effect at the earliest when the Swiss or Liechtenstein license (number) plates are deposited with the Road Traffic Authority, not later than at the end of the year of insurance in which the move takes place, or as soon as the insured vehicle is registered outside Switzerland or Liechtenstein. 5 Change in the risk If in the course of the insurance a change occurs to an important fact stated in the application form, and if such change results in a material increase in risk, you must notify Zurich of such a change in writing without delay. The insurance shall then also extend to such an increase in risk, unless Zurich cancels the contract within 14 days from receipt of the notice. If you fail to notify Zurich of the increase in risk, then Zurich shall no longer be bound by the contract. If a decrease in risk occurs, Zurich shall reduce the premium accordingly after receipt of the relevant information with effect from the following year of insurance. 6 Payment of premiums and adjustment of contract 6.1 Initial premium The first premium shall fall due when the certificate of insurance is generated or, if coverage excludes third party liability, when the policy is handed over. 6.2 Balances The contracting parties shall waive the right to call in balances arising from premium invoices which are less than CHF Installment plan If payment of the premium by installments was agreed upon, the correspon-
5 5 ding fee shall be payable; payment of the remaining installments shall be deemed to be deferred. The fee for premium payment by installments does not form part of the basic premium. 6.5 below is thus not applicable to any change in this fee. Zurich is entitled to adjust this fee with effect from the main premium payment date. You then have the right to change your method of payment as you wish. To be deemed valid, notification to this effect must be received by Zurich at the latest on the date when the corre - sponding premium is due. 6.4 Rating characteristics Basic premiums shall be based on the rating characteristics stated in your policy under the driver and vehicle details including the physical address. If any of these characteristics changes, you must notify Zurich in writing without delay. Zurich shall have the right to adjust your contract accord - ingly. 6.5 Adjustment of contract If the basic premiums increase (except as a result of changes to the characteristics mentioned in the previous paragraph) or if the conditions of insurance change (e.g. the premium rate system, the insured sum, the deductible rules or the coverages), Zurich may require adjustment of the contract with effect from the following year of insurance. To this end, it must notify you of the new contractual provisions at the latest 25 days before expiry of the year of insurance. You shall then have the right to cancel the contract either with respect to that part affected by the change or in its entirety at the end of the current year of insurance. In order to be valid, the notice of termination must be received by Zurich at the latest on the last day of the year of insurance. If you fail to serve notice of cancelation, you shall be deemed to have consented to the adjustment to the contract. 6.6 Consequences of default If the policyholder is unable to meet the payment obligations, a payment request shall be issued and the policyholder shall be liable for the dunning charge and default interest. The policyholder must also bear the costs that arise for Zurich as the result of a license plate revocation. 7 Refund of premiums If the premium has already been paid in advance for a specific period of insurance, and the contract is canceled prior to the expiration of the said period, Zurich shall refund you the premium in respect of the unexpired period of insurance and forgo any outstanding installments. Zurich reserves the right to offset such refunds against other claims under this contract. However, the premium shall remain owed for the whole insurance year: if the contract is terminated due to the fact that the risk no longer exists (total loss); if you cancel the contract in the event of partial loss within one year of the contract being concluded. 8 Premium based on loss experience 8.1 Premium rate systems The third party liability insurance falls under System N, or if Bonus guarantee is agreed, under System G (see table below) or System Z. Premium rate % of the basic premium Systems N and G System Z: The premium shall always amount to 100% irrespective of loss experience. The system applicable, the basic pre - mium and the premium rate applicable at the inception of the insurance shall be stated in the policy. For the following years of insurance, as far as system N and system G are concerned, the premium shall be fixed according to loss experience, whereas in the case of system Z, the premium does not depend thereon. The following provisions shall not therefore apply to system Z. 8.2 Period of observation The period of observation covers 12 months and expires 3 months before the annual premium falls due. 8.3 Change to premium rate If, during the period of observation during which time the insurance was in force, no claim was registered in respect of which Zurich was liable to pay an indemnity or set aside a reserve (Zurich s own expenses not being taken into account), the premium for the following year of insurance shall be calculated in accordance with the rate immediately lower in the scale, unless you have already reached the lowest rate in the scale. On the other hand, in system N, each claim resulting in an indemnity or a reserve shall entail an upward adjustment by 4 premium rates in the scale in the following year of insurance, but no higher than premium rate 19. In the case of system G, the first claim that results in an indemnity or reserve shall have no influence on the rate in the following year of insurance. Only upon occurrence of the second claim during the same period of observation shall the applicable premium rate be adjusted upwards by 4 premium rates, at the most however up to pre - mium rate 19. The application date is decisive in all occurrences of loss. 8.4 No change in premium rate If a claim proves to have no consequences, it shall be deemed not to have occurred and the premium rate shall be adjusted accordingly. Accidents which occur during the period from the date of the application to the inception of the insurance shall be taken into account by subse-
6 6 quent adjustment of the premium rate. The following shall not be taken into account: claims for which an indemnity was payable, although no insured person was in any way to blame (strict liability); claims in the case of thug rides; provided the owner is not to blame for the theft of the vehicle; claims for which you assume financial responsibility, provided you refund to Zurich the latter s outlays within 30 days of your having obtained knowledge of the settlement; collision damage for which the insured person is not responsible in any way and for which the replacement value indemnity was covered 100% by the colliding party or his/her third party liability insurer and for which the benefit under this policy is limited to payment of the difference between the replacement value indemnity and the cash value supplementary indemnity (according to the indemnity table under 203.2). Where there is a change of primary driver, Zurich shall fix a new premium rate for the contract with effect from the date of the change. 9 Cancelation in the event of a claim Following each claim for which a benefit is payable, Zurich shall be entitled to cancel the contract not later than upon payment of the indemnity (or before the claim is processed by Orion), and you shall be entitled to cancel it not later than 14 days after obtaining knowledge of such a payment (or of the claim having been settled by Orion, as the case may be). If either party elects to cancel, coverage shall cease 14 days after the other party s receipt of the notice of cancelation. 10 Interchangeable license plates 10.1 If the insurance was taken out in respect of vehicles being used with interchangeable license plates, the insurance shall be valid: in full, for the vehicle fitted as prescribed with the interchangeable license plates; for other vehicles not fitted with these plates, only insofar as the accident does not occur on a public road If a loss for which Zurich has to pay an indemnity under the third party liability insurance occurs on public roads, it shall have a right of recovery against you and the insured for the vehicle not in circulation in accordance with the regulations. No coverage shall exist in respect of all other losses In motor vehicles which are driven with interchangeable license plates are subject to different premium rates, these premium rates shall be linked to the relevant vehicle. If a vehicle is replaced, the replacement vehicle shall assume the premium rate of the vehicle it is replacing The switch from interchangeable to individual plates (or vice versa) may result in a change in the premium. 11 Replacement (substitute) vehicles If, with the consent of the competent authority, the owner uses, instead of the insured vehicle, a replacement (substitute) vehicle of the same cat - egory, fitted with the license plates of the insured vehicle, then the third party liability, accident and legal protection insurance and roadside assistance shall apply exclusively to the replacement (substitute) vehicle. The hull insurance shall apply to a replacement (substitute) vehicle of equivalent value and shall remain in force for the replaced vehicle with the exception of accidental damage (Article 202.1). If official authorization for use of the replacement (substitute) vehicle has not been obtained, then Zurich or Orion shall not be liable to pay a benefit to the insured. If the replaced vehicle is being used again with its own license plates or if the owner ceases to use the replacement (substitute) vehicle, the insurance of the replacement (substitute) vehicle shall lapse. 12 Deposit of license plates If the license plates are deposited with the competent authority, the insurance shall be suspended from the time that the license plates are deposited until such time as they are redeemed for the insured vehicle as per the following specifications: During the suspension, but for a maximum period of 12 months, the third party liability insurance and the hull insurance shall continue with unchanged scope. Collision and third-party losses shall, however, only be covered insofar as the accidents did not occur on public roads. The accident insurance, legal protection insurance, and roadside assistance shall be completely suspended. Zurich shall grant you a suspension discount in the amount of the premium accruing for the suspension period. The contract is automatically cancelled if the license plates have not been redeemed within 12 months of being deposited. 13 Deductibles The deductible stipulated in the policy shall apply for each loss for which Zurich is required to pay benefits. It shall be payable by you. The agreed deductible shall apply to each and every claim Third party liability and collision Drivers If, in the event of a claim, the driver of the vehicle is under 25 years of age, even though none of the main drivers or additional drivers were declared
7 7 as under 25 in the application, then the deductible agreed in the policy for third party liability and collision damage shall be increased by CHF Liability The deductible agreed for young drivers shall apply if the driver of the vehicle is under 25 years of age at the time of the accident The deductible agreed for other drivers shall apply if the driver of the vehicle was over 25 years of age at the time of the accident No deductible shall apply if the indemnity was payable although no insured person was in any way to blame (strict liability), or for claims arising during thug rides, if the owner is in no way to blame for the theft of the vehicle; during driving lessons given by an officially recognized driving instructor; during an official driving test Hull insurance Travel effects and protective clothing No deductible generally applies for travel effects or protective clothing Towing vehicle and trailer In the event that a towing vehicle and trailer are insured with Zurich and if both sustain loss or damage in the same event, you shall only be required to bear one deductible. In the case of different deductibles, the higher amount shall be applied. 14 Obligations in the event of a claim 14.1 Immediate notification The insured must notify Zurich immediately of the loss event if its consequences may be likely to involve the insurance. The claim notification may be sent in writing using the claim form or may be made by telephone. Zurich or Orion shall have the right to require a written claim notification to be sent for loss events of which notification has already been made by telephone. Zurich must be notified of fatal accidents (if necessary by telephone, or fax) in sufficient time for Zurich, if necessary, to arrange for a postmortem at its own expense before the burial In terms of third party liability insurance The insured must notify Zurich of the loss event if liability claims are made against him/her in connection with this event, whether judicially or extraju - dicially, or if criminal proceedings are instituted against him/her or he/she is fined. Zurich shall conduct negotiations with the claimant at its own discretion, either as the representative of the insured or in its own name. In the event of accidents in foreign countries, Zurich shall be entitled to entrust the authorities, competent by virtue of the Green Card or another inter - national agreement in its stead, and by virtue of foreign compulsory insurance laws, with the handling of the third party claim. The settlement of the third party claim by Zurich shall, in all cases, be binding upon the insured. The insured shall assist Zurich in ascertaining the facts and refrain from giving any opinion of his/her own on the claims of the third party (contractual fidelity). In particular, the insured shall neither admit liability claims nor make any payments to the injured party; furthermore, he/she shall leave the conduct of any civil lawsuit to Zurich In terms of hull insurance Zurich must be given the opportunity of inspecting the damaged vehicle prior to and following repairs. Otherwise, the benefit payable by Zurich may be reduced or even canceled altogether If Help Point PLUS has been concluded, you must report hull claims by telephone or contact one of our Help Points so that Zurich can initiate the claims process and arrange for the necessary repair to be carried out in a repair shop designated by Zurich. In the event that this provision is not complied with, the deductible agreed for the insured events of hull insurance shall be increased by CHF 500. This provision shall remain expressly subject to 16 of the GCI You must moreover notify the police without delay and, at the request of Zurich, bring a charge against the thief in the event of theft of insured travel effects or protective clothing. Where stolen articles are subsequently recovered, the indemnity, less the compensation for any reduction in value, shall be repaid to Zurich, or the items of property placed at Zurich s disposal; in the event of theft of the vehicle. If a missing vehicle is recovered within 30 days of Zurich receiving the notification of theft, you must take it back after the repairs, if any, have been carried out at Zurich s expense. In the event of loss or damage caused while parked, Zurich shall only be liable to pay a benefit provided you have arranged for a charge to be brought against the person or persons unknown and have provided a statement to the police, or if the parking damage has been determined by a Zurich vehicle expert. In the event of damage caused by animals, you or the driver must imme - diately ensure that public authorities, such as the police, gamekeepers, etc., draw up a report on the circumstances of the accident or that the animal owner confirms the occurrence. Failing this, Zurich shall pay an indemnity only if damage caused by collision is insured, and then only subject to the conditions applying to such insurance In terms of accident insurance As soon as possible after the accident, a registered doctor shall be called in and arrangements made for proper medical care. Furthermore, the insured person or the claimant, respectively, shall do everything which may assist in clarifying the circumstances of the accident and its consequences; in particular, the insured person shall release the doctors who are attending him/ her from their professional obligation of confidentiality towards Zurich and shall consent to an examination by the doctors appointed by Zurich; in the event of death, the next of kin entitled to claim shall give their consent to a post-mortem examination, insofar as there may also be other causes of death than the accident.
8 In terms of Roadside assistance In order to be able to claim benefits under Roadside assistance, Zurich must be immediately informed of the event by phone. This benefit lapses if even just one of a number of assis - tance measures was not organized, arranged or implemented by Zurich. 15 Ascertaining the facts The person who is subject to the duty of disclosure must provide assistance in investigations relating to the insurance contract, such as breaches of the duty of disclosure, increases in risk, checking benefits, etc., and provide Zurich/Orion with all pertinent information and documentation or to obtain such information from third parties for submission to Zurich/Orion, and to authorize third parties in writing to issue the appropriate information, documentation, etc. to Zurich/Orion. Zurich/ Orion is entitled to carry out its own investigations. If the person subject to the duty of disclosure does not comply with this requirement, Zurich/Orion is entitled to refuse the claim or withdraw from the insurance contract, as the case may be, retroactively within two weeks of the expiry of a four-week extension period of which it must notify the insured in writing. The same obligations shall apply to the Policyholder, insured parties and claimants as to the person subject to the duty of disclosure, and to their representatives, provided that such persons are not the same as the person subject to the duty of disclosure. 16 Consequences of conduct contrary to the terms of the contract In the event of a violation of the obli - gations incumbent on you or other insured parties, Zurich/Orion shall no longer be obliged to pay any benefit. This disadvantage shall not arise if, in the circumstances, the violation is to be regarded as not being anyone s fault. Missed premium payment due to inability to pay on the part of the premium payer shall not be covered by the above clause. 17 Assignment of claims Without the express consent of Zurich, the claims to the insured benefits may not be assigned or pledged before they have been finalized. 18 Notices to Zurich All notices should be forwarded to the agent named on the last policy or premium invoice, or else to the Zurich Insurance Company Ltd, P.O. Box, 8085 Zurich. 19 Brokers commission If a third party such as a broker rep - resents the interests of the Policyholder when concluding or administering this insurance contract, it is possible that Zurich may pay this third party com - mission in return for his or her activities on the basis of an agreement. If the Policyholder wishes to receive further information about this, he/she should contact the third party. 20 Place of performance and jurisdiction The obligations under this insurance are to be performed in Switzerland and in Swiss currency. In the event of disputes arising from this contract, the Policyholder or the claimant may select as the place of jurisdiction either: Zurich or Basel; the location of the Zurich branch which has a practical connection to this contract; the domicile or the head office of the Policyholder or claimant in Switzerland or the Principality of Liechtenstein, but not in any other, foreign country. 21 Applicable law In addition, the provisions of the Swiss Federal Law on Insurance contracts shall apply and, with respect to the third party liability insurance, the provisions of the road traffic legislation shall be applicable.
9 9 Third party liability insurance 101 Scope of the insurance Insured claims Zurich shall provide insurance coverage for civil law claims which are made against the insured persons by virtue of statutory provisions concerning liability in respect of death of or injury to persons (bodily injury), destruction of or damage to property (property damage) Cause of claim The insurance covers bodily injury and property damage caused by the use of the motor vehicle described in the policy and the trailers pulled or vehicles towed by the said motor vehicle; in the course of a road (traffic) accident caused by these vehicles when they are not in use; as a result of assistance given after accidents in which these vehicles were involved. The liability of insured persons in respect of unhitched trailers within the meaning of Article 2 of the Swiss Road Traffic Insurance Ordinance shall also be covered. Zurich shall further provide insurance coverage for civil law claims made against the insured persons, arising out of accidents when mounting or dismounting the motorcycle, or climbing into or out of the vehicle, when opening or closing the doors, hood, sunroof or trunk as well as when hitching up or unhitching a trailer or towed vehicle Loss prevention costs If, because of an unforeseen event, the occurrence of an insured loss is im - mediately imminent, the coverage shall also include those costs which the insured person incurs in taking appropriate measures to prevent this danger Supplementary insurance The following supplementary insurance coverage shall apply subject to the appropriate agreement in the policy: Coverage for gross negligence If coverage is agreed for gross negligence, Zurich shall waive its right of recovery against you or the insured parties on grounds of having caused the occurrence of loss through gross negligence as defined in Article 14 paragraphs 2 and 3 of the Swiss Federal Law on Insurance Contracts (LIC). If the loss was caused in a state of inebriation or when driving while impaired or due to a speeding offence as defined in Article 90 paragraph 4 of the Swiss Road Traffic Act (RTA), Zurich will exercise its right of recovery against you or the insured parties. The extent to which this is done will depend on the degree of fault and the financial circumstances of the person against whom the right of recovery is exercised. Zurich will also exercise a right of recovery if the occurrence of loss was caused through willful intent or indirect intent. 102 Insured persons The owner and the persons for whom he/she is responsible according to road traffic legislation shall be insured. 103 Insurance benefits Basic principle The insurance shall pay for justified claims and protect you from unjustified claims. The benefits payable by Zurich shall be limited to CHF 100 million, including any interest on the loss or damage, lawyers fees and court costs without prejudice to the claimant s rights Restrictions The amount of the benefits payable for any bodily injury and property damage caused by fire, explosion or nuclear energy subject to as well as for the cost of loss prevention measures shall be limited to a total of CHF 5 million per loss event. If a higher level of coverage is prescribed by Swiss road traffic legis - lation, such higher coverage shall apply and shall also be deemed to be the maximum benefit payable by Zurich as described above. 104 Exclusions and limitations of the scope of insurance The insurance shall not apply to claims in respect of losses listed under to below: Property damage claims made by individuals Claims in respect of property damage made by the owner, his/her spouse or registered partner, his/her relatives in the ascending and descending lines, as well as his/her brothers and sisters residing in a common household with the owner; Damage to the vehicle Claims in respect of loss of or damage to the insured vehicle, trailer, as well as loss of or damage to other items attached to or conveyed in these vehicles, with the exception of items which the injured party has with him/her, in partic - ular luggage and similar effects; Racing and similar activities Claims made by injured parties, arising out of accidents which occur in the course of motor races, rallies and similar competitions, as well as any driving on a racetrack or its ancillary roads. However, in the case of sporting events of such a nature in Switzerland and the Principality of Liechtenstein, claims by third parties within the meaning of Article 72, paragraph 4 of the Swiss Road traffic Act (SVG) shall only be excluded if the insurance prescribed by law was effected in respect of the sporting event in question; Nuclear energy Claims arising out of damage or loss for which liability is subject to the legislation on nuclear energy; The restrictions under Articles to above cannot be cited in rebuttals to the injured party unless the legal provisions permit such restrictions Illegal driving The liability of any driver of the vehicle who is not in possession of the driver s license (or the learner s license for motorcycles) required by law, as well as of any driver in possession of a learner s license, who drives without being accompanied as prescribed by law or who carries passengers without a permit to do so; furthermore,
10 10 the liability of persons who entrust the insured vehicle to such a driver although they know or could have known, had they conscientiously taken care, that he/she is not in possession of the required license or that he/she is driving without being accompanied as required by law, or is carrying passengers without a permit to do so; Thug rides In the case of thug rides: the liability of persons who have taken the insured vehicle for their own use without permission and the liability of any driver who, at the start of the trip, knew or could have known, had he/she taken care in a conscientious manner, that the vehicle had been taken for the said purpose without permission; Unauthorized driving The liability arising out of any trip not officially allowed and the liability of persons who have used the vehicle entrusted to them for trips which they were not authorized to make. 105 Recovery Zurich shall have, up to the amount of its benefits, including lawyers fees and court costs paid by it, a right of recovery against you and the insured parties, insofar as it is entitled under this contract or under applicable law to refuse or reduce its benefits, for example, on account of the restrictions to the scope of insurance according to the preceding Articles , simultaneous use in public traffic of vehicles insured with interchangeable license plates, use of the replacement (substitute) vehicle against the law or contrary to the terms of the contract, conduct contrary to the terms of the contract in the event of a claim or in the event that the accident is caused by gross negligence. Zurich may also effect recovery against you or the insured parties if, by virtue of the Green Card (international motor insurance card) or another inter - national agreement taking its place, and of foreign compulsory insurance laws, it still has to pay indemnities after the expiry of the insurance. 106 Refund of the deductible If a deductible to be paid by you was agreed upon and Zurich effected a direct settlement of the third party claim, then, notwithstanding Article , you shall refund to Zurich at the latter s first request the indemnity paid by it up to the amount of the deductible agreed upon, irrespective of who was driving the vehicle at the time of the accident. If you do not pay within 4 weeks of notification by Zurich, you shall be requested in writing, being reminded at the same time of the consequences of a default, to make payment within 14 days of dispatch of the reminder. If the reminder is ineffective, the insurance shall cease in its entirety on expiration of the reminder period. Moreover, Zurich s right to demand payment of the deductible and the costs for demanding payment of the deductible, as well as enforcing any other indemnity claim, shall not be affected hereby. Hull insurance 201 Scope of the insurance Vehicle The insurance shall cover damage caused against your will and the will of the driver to the vehicle declared in the policy, as well as to spare parts, accessories and integral equipment fitted as standard Equipment and accessories In the case of private motor vehicles, delivery vehicles and motorcycles, equipment and accessories which do not form part of the standard pro - duction equipment and which are purchased at extra charge shall also be insured without any special stipulation up to a maximum amount of 10% of the catalog price of the declared vehicle In the case of all other motor vehicles, extras and special equipment shall be included in the insurance only if they are declared with their value as new in the application. If these values and/or the catalog price are declared at an amount which is too low, the insurance benefits shall be reduced proportionally The insurance shall not cover accessories and devices such as telephones, navigation systems, MP3 players, etc.; sound, image and data carriers, which may also be used independently of the vehicle; protective clothing as defined in Insured events The following events shall be insured only if they are listed in the policy.
11 Loss or damage resulting from Accidental damage This shall include damage caused by sudden violent, external means, i.e. in particular damage caused by impact, collision, rollover, falling, or sinking in, even if such damage is the consequence of damage due to the operation of the vehicle, breakage or wear and tear; likewise, damage caused by willful or malicious acts of third parties. Coverage shall further include alignment damage to the vehicle as a result of tilting, loading or offloading operations even where no external causes were present Partial Casco a) Theft This shall include loss, destruction of or damage to the vehicle as a result of actual theft, use without permission or robbery in terms of criminal law. This list is definitive. The insurance shall also cover damage caused to the vehicle in the course of an attempted theft or attempted use without permission or an attempted robbery. No insurance coverage exists if the insured vehicle was stolen by persons that live in the same household as the policyholder or the beneficiary. b) Fire This shall include fire damage, irre - spective of whether the cause is internal or external, as well as damage caused by short circuit, explosion and lightning; damage to electronic and electrical instruments and components are, however, insured only if the cause is not a result of an internal defect. Damage caused to the vehicle while the fire is being extinguished shall also be covered. Singeing damage however shall not be covered. Fire damage shall be covered only during the period of warranty insofar as no claims are made under the warranty against the vendor or supplier. c) Natural hazards This shall be deemed to be loss or damage as a direct consequence of rockslides, falling stones, falling ice, landslides, avalanches, snow pressure, snow slides, storm (= wind of a velocity of at least 75 kilometers per hour that uproots trees and blows the roofs off buildings in the vicinity of the vehicle declared in the policy), hail, high water and floods, all other loss or damage caused by natural hazards being excluded. Loss events caused by falling aircraft such as airplanes, spacecraft or parts thereof shall also be included in the coverage. d) Glass This shall be understood to mean breakage of the windshield, side, roof or rear windows made of glass or other materials used as a glass substitute. This list is definitive. The scope of coverage for motorcycles corresponds to the Glass PLUS option. There shall be no indemnity under Glass or Glass PLUS if the total repair costs (costs of glass and other repair) equal or exceed the cash value of the vehicle declared in the policy or if the damaged vehicle components cannot be replaced or repaired. e) Animals This shall be understood to mean damage resulting from collision of the declared vehicle with animals. Damage caused by evasive maneuvers con - stitutes collision damage in terms of rather than damage caused by animals. f) Vandalism Such loss or damage shall be understood to mean the wilful or malicious breaking off of antennas, rear view mirrors, windshield wipers or trim, puncturing tires and pouring damaging matter into the fuel tank. This list is definitive Supplementary insurances The following supplementary insurance coverage shall apply subject to the appropriate agreement in the policy: Coverage for gross negligence arising in the event of collision Zurich shall waive its right to reduce its benefit payments when the occurrence of loss is due to gross negligence as defined in Article 14 paragraphs 2 and 3 of the Swiss Federal Law on Insurance Contracts (LIC). If the loss was caused in a state of inebriation or when driving while impaired, Zurich will reduce the benefits to the extent of the degree of fault. Zurich will also reduce the benefits if the occurrence of loss was caused through indirect intent. All benefits lapse in the case of willful intent Glass PLUS Supplementary to d) Glass, the insurance shall cover breakage of all parts of the vehicle which are made of glass or artificial materials used as glass substitutes. Light bulbs shall also be included in the insurance if they are destroyed in the event of glass breakage Martens This shall be understood to mean damage to the vehicle declared in the policy caused by the gnawing of martens (including consequential damage) Parking damage This shall be understood to mean damage to the vehicle declared in the policy while it is parked, caused by unknown vehicles or persons. There is a limit of two claims per calendar year; the date of announcement by policyholder is decisive. The maximum amount is limited to CHF 1,000 per claim. Parking damage PLUS If Parking damage PLUS insurance has been agreed, this limit shall not apply. There is a limit of two claims per calendar year Travel effects This shall include the following damage: damage to or destruction of the personal requisites (travel effects) of the passengers/users being conveyed in the vehicle declared in the policy, when loss or damage occurs to the vehicle in question; theft of the personal requisites (travel effects) of the passengers/users being conveyed in the vehicle declared in the policy, provided that, at the time of the theft, they were located in a completely locked vehicle or attached to the vehicle in locked theft-proof containers. The following items shall not be insured: cash; bank and postal debit, store, and credit cards; travel tickets and season tickets; securities; savings books; precious metals; items of jewelry; sound, image and data carriers; computer hardware and software as well as any TV, communication and navigation equipment; motor vehicles, commercial
12 12 goods and items used for carrying out a trade or pro fession. Animals and subjective values shall not be indemnified. The following are deemed not to be travel effects in the case of motorcycles: helmets, safety suits, one-piece suits, protectors, motorcycle boots, gloves (protective clothing). Travel effects PLUS If Travel effects cover has been agreed, for passenger cars, vans or motorcycles, the scope of insurance also includes electronic devices such as smartphones, laptops, navigations devices, etc. The benefits per claim shall be limited to CHF 5,000 for all travel effects together Protective clothing (for motorcycles) The protective clothing insured shall include: Helmets Safety suits, one-piece suits including protectors Boots Gloves The list is conclusive. Damage to protective clothing shall be understood to mean: damage or destruction that is directly related to an accident involving the motorcycle used; damage visible to the eye which does not impair the clothing s protective features is not insured; theft, provided that the items insured were in fully locked containers attached to the motorcycle and secured against theft; theft of helmets is also insured if they were secured to the motorcycle with a helmet lock. The insurance shall cover damage to both the protective clothing of the driver of the insured motorcycle as well as that of any passengers. It shall also apply to you as the driver or passenger of any other motorcycle. The benefits per claim shall be limited to CHF 3, Insurance benefits Partial loss Zurich shall pay the cost of the repairs incurred as a result of an insured event, taking into consideration the cash value of the vehicle. The Policyholder may choose the repair shop he/she wishes to use (except where Help Point PLUS is insured). Insofar as Zurich cannot reach an agreement with the repair shop appointed by the Policyholder regarding the proposed cost estimate, Zurich reserves the right to recommend other repair shops. If the Policyholder is not willing to accept this recommendation, Zurich shall be entitled to discharge its obligations by paying the repair costs deemed appropriate by its expert. If lack of maintenance, wear and tear or pre-existing damage have raised the cost of the repairs substantially or if, as a result of the repairs, the condition of the vehicle has improved considerably, you shall bear a fair share of these costs to be determined by Zurich s vehicle experts. Tires shall be indemnified on the basis of their degree of wear. If the claimant is entitled to pre-tax deductions, the value-added tax component shall be deducted. In the event that payment is made but no repairs are carried out, the repair costs determined shall be reimbursed excluding VAT Total loss If the costs of repair reach or exceed in the first two years of service, 65% of the indemnity listed in the table set out hereinafter; after more than two years of service, the actual cash value of the vehicle at the time of the accident (cash value); or if the missing vehicle is not recovered within 30 days of Zurich receiving notification of theft, then Zurich shall pay the following benefits: Compensation table Year of service as a % of the replacement value as new* during the 1 st year 100% during the 2 nd year 95% 85% during the 3 rd year 85% 75% during the 4 th year 75% 65% during the 5 th year 65% 55% during the 6 th year 55% 45% during the 7 th year 45% 40% more than replacement 7 years value *declared catalog price and accessories If the indemnity exceeds the price which was paid for the vehicle, coverage shall extend to no more than the price paid and to no less than the replacement value. If the replacement value is above the original new value, then the latter shall be the maximum indemnity. An agreed deductible and preexisting but unrepaired damage shall be deducted from the indemnity. If the claimant is entitled to pre-tax deductions, the value-added tax component shall be deducted. These conditions shall apply accordingly to individual items of equipment and accessories Costs In the event of an insured loss, Zurich shall pay the cost of: recovering and towing the vehicle to the nearest garage where the necessary repairs can be carried out; the amount of customs duty for which you may be held liable; damage to the interior of the car caused during the provision of assistance to persons involved in an accident shall also be covered; return transport of the vehicle to Switzerland. This shall not apply: in the event of a total loss; if the repair can be carried out on-site; if you or the driver are able to bring back the vehicle yourselves; if alternative insurance exists covering the costs of return trans - portation.
13 Wreck of the vehicle The benefit shall always be reduced by the value of the wreck (i.e. the unrepaired vehicle or article). If this value is not deducted from the maximum indemnity, then the wreck or the vehicle or article shall become the property of Zurich when the payment is made. If compensation for a lost vehicle or lost article has been paid, then the rights of ownership shall pass to Zurich Travel effects Zurich shall pay for the costs of the repairs, albeit up to a maximum of the amount required for replacement with a new article of equal value at the time of the loss. The maximum in - demnity shall be reduced by the residual value Protective clothing (for motorcycles) Zurich shall pay for the costs of repairs, but at a maximum the following amounts: in the first two years after purchase of the new item, the amount required to purchase an item of equivalent value at the time of the insured event; subsequently the indemnity will be reduced to 75% of the price of replacing the item Motorized mobile homes and campers/trailers The costs of repair will only be indemnified if the damage is fully repaired and proof of repair can be provided in the form of an invoice. If such repairs are not carried out, benefits shall be restricted to the loss in value of the vehicle Reduction of benefits Zurich shall be entitled to reduce or refuse its benefit payments insofar as it is entitled to do so in accordance with the Swiss Federal Law on Insurance Contracts (VVG/LCA). If the insured event has been caused through gross negligence, indirect intent or willful intent on the part of somebody who lives in the same household as the Policyholder or claimant, Zurich reserves the right to refuse its benefit payments or reduce them to the same extent that they would be payable if the damage had been caused by the Policyholder or claimant him/herself. 204 Exclusions Damage due to vehicle operation Loss or damage due to vehicle operation, breakage and wear and tear, in particular also breakage of springs caused by shocks sustained by the vehicle on the road or losses caused by the loaded goods (except after an event insured under loss or damage due to collision); damage due to inappro - priate handling; damage due to the use of inappropriate fuels or fluids; damage due to lack of oil; damage due to lack of or freezing of the coolant; damage affecting exclusively the tires or the batteries; theft of fuel Illegal driving Loss or damage caused while the vehicle is being driven by a driver who is not in possession of the driver s license (or learner s license, for motorcycles) required by law or a driver in possession of a learner s license, who drives without being accompanied as prescribed by law or who transports passengers without a permit to do so, provided you were aware of this infringement or could have been aware of it, had you taken care in a conscientious manner Warlike events Loss or damage as a result of warlike events, violations of neutrality, rev - olution, rebellion, insurrection and the measures taken against them, as well as in the event of earthquakes, volcanic eruptions or changes in the structure of the atomic nucleus, insofar as you do not prove that the loss or damage is in no way connected with these events Civil unrest Loss or damage in the event of civil unrest (acts of violence against persons or objects at riotous assemblies, riots or disturbances) and the measures taken against them, unless you can satisfactorily show that you or the driver have taken reasonable precautions to prevent the damage Racing and similar activities Loss or damage which occurs while the vehicle is requisitioned by the authorities and while taking part in motor races, rallies and similar compe - titions, as well as any driving on racetracks including their ancillary roads Depreciation in value Depreciation in value, reduced power or serviceability of the vehicle as well as loss of use Motorcycle unlocked Damage arising as a result of theft, if the motorcycle was kept outside, in a collective garage or or in an unlocked room without an activated steering column lock Alcohol/infringement of traffic regulations Damage if, at the time of the accident, the driver has a blood alcohol level of 1.6 (average value) or more or is under the effect of narcotic substances. If an alcohol breath test was performed rather than a blood test, the above value (blood alcohol content) also applies to the alcohol breath test. Likewise, damage caused by particularly flagrant disregard of the speed limit, hazardous overtaking or participation in an illegal race with motor vehicles pursuant to Article 90, paragraph 3 Swiss Road Traffic Act (RTA) Unauthorized driving Trips that are not officially allowed.
14 14 Accident insurance 301 Insured persons Insured persons under the policy The persons stated in the policy are insured Accident and breakdown helpers The following persons shall also be insured: persons not connected with the vehicle who render assistance at accidents or breakdowns to passengers/users of the vehicle declared in the policy, excluding, however, persons who render such assistance in per - formance of their professional activities or in an official function (such as police, paramedics, employees of the auto - motive industry, professional roadside assistance, etc.) Persons insured in the event of accidents in other people s vehicles In the event of accidents in other people s vehicles (personal motor vehicles and delivery vehicles with a total weight of max. 3,500 kg and seating no more than 9 persons), the insurance shall cover the Policyholder (provided that this is a natural person) and the persons living in the same household as listed below: Spouse/partner or registered partner, Relatives in the ascending and descending line, Brothers and sisters as the driver or passenger Vehicles registered to the insured persons listed above shall not fall under the category other people s vehicles The insurance shall apply within the territorial limits and worldwide for a maximum of six weeks after leaving the territorial limits in accordance with Article 4 of the General Condi - tions of Insurance. The death and disability benefits specified in the policy are insured. Several registered vehicles in the same household with accident insurance entitle the insured person to claim the aforementioned benefits only once. The coverage with the highest benefits applies in each case. 302 Definition of accident Any bodily injury in terms of the Swiss Federal Law on Accident Insurance (UVG/LAA). Equivalent to accidents shall be: involuntary inhalation of any gas, fumes or vapors; frostbite, heat-stroke, sun-stroke, as well as impairment of health by ultraviolet rays, with the exception of sunburn; drowning. 303 Insured accidents Coverage shall apply in respect of accidents in which the insured persons sustain during use of the vehicle described in the policy or of other people s vehicles. In this context, coverage shall be extended also to accidents sustained by the insured persons while assisting other persons involved in an accident or breakdown. 304 Uninsured accidents The insurance shall not apply to accidents: Warlike events as a result of warlike events in Switzerland, in foreign countries, unless the accident occurs within 14 days after such events took place for the first time in the country in which the insured person is staying, and provided he/she was taken unawares there by the outbreak of warlike actions; Civil unrest of whatever kind caused by riots or civil unrest of whatever kind and the measures taken against them, unless the claimant proves that the insured person was not engaged on the side of the trouble-makers, either actively or as an agitator; Earthquakes caused by earthquakes in Switzerland; Crimes while deliberately committing crimes and offenses or while attempting to do so; Racing and similar activities while taking part in motor races, rallies and similar competitions, as well as while driving on racetracks and their ancillary roads; Requisition while the vehicle is requisitioned by the authorities; Illegal driving while the vehicle is being driven by a driver who is not in possession of the driver s license (or learner s license, for motorcycles) required by law, or by a driver in possession of a learner s license who is driving without being accompanied as prescribed by law or who is transporting passengers without a permit to do so, provided the insured was aware of this infringement or could have been aware of it, had he/she taken care in a conscientious manner; Thug riding while the vehicle is being used without authorization (thug riding, etc.) Alcohol/infringement of traffic regulations The insurance shall not cover claims submitted by a driver who, at the time of the accident, has a blood alcohol level of 1.6 (average value) or more or who is under the influence of narcotic substances. If an alcohol breath test was performed rather than a blood test, the above value (blood alcohol content) also applies to the alcohol breath test. Likewise, damage caused by particularly flagrant disregard of the speed limit, hazardous overtaking or participation in an illegal race with motor vehicles pursuant to Article 90, paragraph 3 Swiss Road Traffic Act (RTA). 305 Insurance benefits Zurich shall pay the benefits listed in the policy.
15 In the event of death If an insured person dies as a result of an accident, Zurich shall pay the sum insured in the event of death to the following persons entitled to claim successively: 1. the spouse or registered partner; 2. the children, in equal shares. Children who, at the time of the accident, were taken in without charge for permanent care by the insured person shall also be deemed equal; 3. the parents, in equal shares; 4. the grandparents, in equal shares; 5. the brothers and sisters, in equal shares; in the absence of one of them, his/her share shall pass to his or her children. Each person or group of persons enumerated under sections 2 5 above shall be excluded by the existence of any preceding person or group of persons respectively. However, you may, by written notifi - cation to Zurich, designate beneficiaries to your insurance entitlements. If you do not take advantage of this option, and there are no such surviving relatives, only the funeral expenses shall be paid, up to an amount not exceeding 10% of the sum insured in the event of death. For insured persons, who, at the time of the accident, have not yet reached the age of 15, the death benefit may not exceed CHF 10, In the event of disability 1. If the accident results in a disability of an insured person, Zurich shall pay the sum insured in the event of disability, corresponding to the degree of disability and in accordance with the provisions of the Swiss Federal Law on Accident Insurance (UVG/ LAA) on the determination of degree of disability, but never more than 100%. 2. Any aggravation of the consequences of the accident due to pre-existing physical defects shall not entitle a person to a higher benefit than the benefit which would have been payable had the person sustaining the accident been physically intact. If any parts of the body were already totally or partially lost or could not be used at all or only partially prior to the accident, the degree of preexisting disability shall be deducted. 3. The degree of disability shall be determined in accordance with the insured s state of health only once it has been diagnosed as presumably permanent, however, not later than 5 years after the accident. 4. The benefit shall be determined as follows: for that part of the degree of disability not exceeding 25%: on the basis of the sum insured in the event of disability; for that part of the degree of disability exceeding 25%, but not 50%: on the basis of twice the sum insured in the event of disability; for that part of the degree of disability exceeding 50%: on the basis of three times the sum insured in the event of disability Daily allowance Zurich shall pay to the insured the daily allowance agreed upon for the period of the medical treatment required, however, at the longest until the payment of an indemnity for disability, if any, and, in any event, only for a maximum of 730 days within 5 years of the date of the accident, also in respect of Sundays and public holidays, and from the agreed day after the date of accident. The daily allowance shall be paid in full, as long as the insured is totally incapable of working; if and as long as he/she is partially incapable of working, a part of the daily allowance corre - sponding to the degree of incapacity to work shall be paid. Insured persons who at the time of the incapacity to work are under the age of 15 shall receive no daily allowance Daily allowance in the event of hospitalization Zurich shall pay the agreed daily allowance in the event of hospitalization during the necessary stay in the hospital, however for a maximum of 730 days within 5 years of the date of the accident, in addition to the daily allowance in accordance with Article above, if appropriate, and the defrayal of medical expenses in accordance with Article below. Any institution which exclusively admits persons who have sustained an accident or sick persons and which is under the supervision of a licensed doctor shall be deemed to be a hospital. Moreover, Zurich shall pay, within the aforementioned limits, the daily allowance in the case of hospitalization during health cures ordered by a doctor which are taken in a spe cialized es - tablishment with the consent of Zurich Medical expenses Zurich shall defray the costs as specified in sections 1 4 below, provided they are incurred within 5 years of the date of the accident. 1. The necessary costs of therapy given or ordered by a licensed doctor or dentist, as well as hospital charges and expenses for treatment, stay and board in a private ward; as well as expenses for health cures ordered by a doctor which are taken in a specialized establishment with the consent of Zurich; in addition, the daily allowance deduction for maintenance costs in a sanatorium as provided for in the Swiss Federal Law on Accident Insurance (UVG/LAA). 2. For the duration of the therapy, in accordance with section 1 above: the cost of services of qualified nursing staff or of nursing staff provided by a public or private institution as well as the cost of the hire of aids and appliances for patients; costs for psychological treatment by a qualified physician or psycho - logist after a traffic accident in the insured vehicle up to a maximum of CHF 1,500. ; and related expenses for medically prescribed driver safety training or for up to five driving lessons with a qualified driving instructor up to a total of CHF The cost of the initial purchase of prostheses, glasses, hearing aids and orthopedic aids and appliances and also of their repair or of their replacement (value as new), if they were damaged or destroyed in the course of an event which results in therapy as defined in section 1 above. 4. The costs of all transportation of the insured necessitated by the accident, however, as regards transportation by aircraft, only if this is absolutely essential on medical or technical grounds;
16 16 rescue operations occasioned by an accident, for the benefit of the insured person; operations to recover the body/bodies, provided that death occurred as a consequence of an insured accident; search operations with a view to rescuing the insured or recovering the body, up to a maximum of CHF 10,000 per insured person. If so requested, Zurich shall provide a warranty to defray the costs and expenses mentioned in sections 1 to 4 above. If the insured person is also entitled to benefits under a social insurance plan, Zurich will defray only the cost component not covered by such benefits. 306 Contributory effect of illnesses If, due to any pre-existing illness or due to any additional illness not brought on by the accident, the consequences of the accident are substantially ag - gravated, only a proportional part of the benefit shall be paid, according to the share attributable to the accident which is to be equitably assessed by a medical expert. However, this restriction shall not apply to the insurance of medical expenses. 308 Offsetting against liability claims The benefits due from Zurich under the insurance for death, disability, daily allowance and daily allowance for hospitalization shall be paid out subject to Article in addition to the benefits due under the third party liability insurance The benefits from Zurich shall be offset against any third party liability claims if the owner or driver of the vehicle is required to pay such liability claims himself/herself (e.g. as a result of cost recovery). Roadside assistance CH/FL 401 Insured vehicles Insurance applies to motor vehicles up to a total weight of 3,500 kg which are specified in the policy, irrespective of the driver permitted to operate the vehicle. Trailers attached to the insured vehicle are also covered. This applies even if only the trailer is affected by the breakdown. The insurance shall not cover: vehicles with a total weight of more than 3,500 kg; vehicles which are used for commercial rental to self-drivers; vehicles which are used for the commercial transportation of persons; replacement vehicles which are not used with the insured license plates; vehicles which are used with dealer plates. 402 Insured persons The insurance covers all persons traveling in the vehicles listed in the policy. 307 Increase in risk If, at the time of an accident, the number of passengers/users is greater than the number of seats declared in the vehicle license, the benefit in the event of death or disability shall be paid only in the proportion which the number of seats bears to the number of passengers/users. 403 Insured events Insurance protection is provided if the vehicle can no longer be used, owing to a breakdown; hull claims. Hull claims are understood to mean: unusability owing to a collision, damage caused by fire, natural hazards, theft, glass breakage and martens, damage while parked and vandalism; or as a result of the actual or attempted theft of the vehicle.
17 Insurance benefits Roadside assistance Organization and assumption of costs for the restoration of roadworthiness, provided that this is possible at the roadside Replacement of sundry parts If the vehicle is repaired at the roadside, the costs for replacing sundry parts, such as cables, tubes, fuses, etc. (excluding the battery), are assumed Towing costs If the vehicle cannot be repaired at the roadside, towing costs to the nearest garage suitable for the repairs, excluding repair and material costs, are assumed Recovery costs The costs for any necessary recovery of a motor vehicle and the trailer Key breakdown The insurance shall cover the following events: 1. If the key is left in the locked vehicle. 2. If the electric locking device no longer opens. 3. If the key or lock is damaged. 4. If the key is lost. Zurich shall pay benefits as follows: For the events listed in 1 3 above, services shall be provided as defined in 404, where appropriate. If the key is lost as described under item 4 above, the following benefits may be claimed: breakdown assistance on-site; towing to the nearest repair shop; cost of retrieving or forwarding the spare key; costs of continuing the journey using public transportation; costs of lodging. This list is definitive. Costs of alterations to the vehicle lock are excluded Fuel breakdown The costs for rectifying a fuel breakdown (vehicle immobilized due to a lack of fuel) are insured. If the vehicle was refueled with the wrong fuel, we only assume the cost of towing to the nearest garage. Coverage is not provided for consequential damage such as damage to the engine and catalytic converter Additional costs If the vehicle is no longer usable, Zurich shall assume the costs, per event and policy, for: onward journey by public transport or, if necessary, by taxi; necessary accommodation; transport of the vehicle in Switzerland if the repairs cannot be carried out on-site (storage charges are included) Replacement driver If the driver is no longer able to drive the vehicle due to an accident or serious illness or unknown whereabouts or if he has died, and no other passenger possesses a license, or if the passengers are unable to drive the vehicle as a result of the emergency situation, the costs for a chauffeur to return the vehicle and the passengers shall be assumed Limitation of benefits The indemnity for the above benefits ( ) is limited to a combined amount of CHF 1,000 for all persons per insured event. 405 Uninsured damage No benefits shall be paid for consequences relating to damage in accordance with 204.2, 204.3, 204.4, 204.5, and Claims against third parties If Zurich pays benefits for which the Policyholder or an insured person could also have claimed against third parties, the claimants shall cede those claims to Zurich. 407 Claims under other insurance policies/agreements Where insured persons are entitled to claim under other insurance contracts/ agreements, the cover shall be re - stricted to that part of the benefits under the Zurich policy which exceeds those under the other insurance contracts/agreements. However, under the present insurance policy an advance on those benefits will be granted. The claimants must cede their claims up to the amount of the advance granted to one of the aforementioned insurers. 408 Third-party claims No benefits shall be paid for consequences in connection with third-party claims.
18 18 Legal protection insurance 501 Insured persons The insurance shall cover: the Policyholder as the owner, keeper, driver, or passenger of the insured motor vehicle, any drivers authorized to use the insured motor vehicle (except persons renting the vehicle) as well as any passengers traveling with them on journeys made with said motor vehicle. 502 Scope of insurance Orion shall provide the insured with legal protection in the following areas of law: Law of damages Assertion of non-contractual claims for damages with regard to damage to property or personal injury (physical injury/death) as well as financial losses directly resulting from such damage that the insured person suffers in traffic accidents (excluding offences relating to libel); Criminal charges Filing of criminal charges if this is neces - sary for the enforcement of the claims for damages listed above by an insured person (excluding offences relating to libel); Defense In the event of criminal or administrative proceedings instituted against the insured person in connection with a traffic accident or a violation of traffic regulations; Confiscation of driver s license In the event of confiscation of the driver s license or vehicle registration documents; Social insurance law Disputes under social insurance law with insurance companies, pension plans or health insurers as a result of an insured traffic accident; Other insurance law Disputes arising out of the insurance contract with private insurance companies; Medical law & patients rights Disputes regarding the treatment of injuries from an insured traffic accident against physicians, hospitals and other medical institutions; Vehicle contract law Disputes arising out of the following contracts governed by the Swiss Code of Obligations with regard to insured vehicles (including their accessories, such as child car seats, car radios, etc.): purchase, rental, loan, leasing, deposit, repairs; Garage rental Disputes in the Policyholder s capacity as a long-term tenant of a garage or parking space rented for an insured vehicle. 503 Uninsured legal disputes The following are not insured (all exclusions supersede the provisions set out under 502): all capacities of the insured person which are not specified under 501, as well as any areas of the law not expressly defined as insured under 502; disputes regarding claims which have been assigned to an insured person, or which an insured person has assigned; the rebuttal of non-contractual claims for damages made by third parties; disputes in connection with war, unrest, strikes or lockouts or resulting from involvement in brawls or fights; disputes with another person insured under this contract or its liability insurance (this restriction does not apply to the Policyholder him/herself); legal protection in connection with the collection of uncontested claims; disputes under the law on debt enforcement and bankruptcy (through collection procedures arising from insured cases in accordance with paragraph 6); disputes with Orion, its corporate bodies and employees; disputes where the driver used a vehicle which was not permitted to drive on public roads, was not au - thorized to drive the vehicle, did not hold a valid driver s license or was driving a vehicle which was not equipped with valid license plates; in procedures for the purpose of acquiring or converting a driver s license and also for reinstating a license which has been legally confiscated; disputes in connection with active participation in motorsport competitions and races, including training; purchase/sale of vehicles and vehicle accessories if the insured person pursues these activities commercially, as well as disputes where he/she is the owner/keeper of vehicles used commercially, e.g. taxis, coaches, delivery vans and trucks, driving school vehicles, etc.; disputes involving allegations of exceeding the maximum speed limit by 30 km/hr or more in built-up areas, by 40 km/hr or more outside built-up areas and on highways (Autostrassen), or by 50 km/hr or more on expressways (Autobahnen); disputes in connection with the following events in the case of recurrence: allegations of driving while incapacitated due to the effects of alcohol, medication or drugs, and refusal to submit to a blood test; allegations of violation of traffic regulations for stationary traffic (no stopping or parking, etc.).
19 Insurance benefits In connection with the insured legal disputes listed above, Orion will indemnify up to CHF 250,000 (or up to CHF 50,000 for legal disputes whose place of jurisdiction is outside Europe) per dispute: Orion s processing of the legal disputes, the fee for a lawyer or counsel or mediator, the costs of obtaining an expert opinion provided that Orion gives its consent or it is ordered by the court, court costs or other costs of the proceedings borne by the insured, including advances, indemnifications awarded to the counterparty and imposed on the insured by the court, including any security to be provided, the collection of any claims due to an insured under an insured case until such time as a provisional or definitive certificate of shortfall is issued or a filing made for protection from creditors or for bankruptcy, advances with regard to bail after an accident to avoid being remanded in custody Payment of the following is generally not insured: fines, costs of blood alcohol and drug analyses ordered in traffic-related matters and medical or psychological examinations, and remedial driving training, compensation for loss and damages, costs and fees of the first notification in criminal proceedings regarding traffic violations (such as penalty orders, imposition of fines, etc.) and administrative procedures (e.g. cautions, confiscation of driver s license or remedial driving training, etc.). These shall be borne by the insured, also in the case of any appeals, costs and fees that a third party is required to pay or that are payable by a liable party or liability insurer, in which cases Orion shall pay only advances, the costs and fees of bankruptcy proceedings and filing for protection from creditors, of proceedings contesting claims or creditors rankings, or the separation of assets, translation and travel costs. All disputes that arise from the same cause or that are indirectly or directly connected with the same event shall be deemed one claim only. The sum insured shall be indemnified once only per claim, even if several areas of the law are involved. Any security and advances provided shall be offset in full against the sum insured. Such advances and security must be refunded to Orion. If an event affects several or several policies held by the insured, Orion reserves the right to limit its benefit payments to out-of-court settlements until such time as the lawyers of its choice shall have obtained landmark court decision. The benefits paid out to all insured covered by the same policy will be added together. 505 Reductions to benefits Orion expressly waives its legal right to reduce the applicable benefits on the grounds of the insured event having been caused through gross negligence, except in the case of convictions under the law for driving while inca - pacitated by the effects of alcohol, medication or drugs, and refusal to submit to a blood test. 506 Definition of legal dispute A claim shall be deemed to have arisen: in terms of the law of damages and insurance law: at the time of the traffic accident criminal law: at the time of the actual or alleged contravention of penal provisions in all other cases: at the time of the actual or alleged breach of legal provisions or contractual obligations, unless the insured is in a position to anticipate that legal differences might arise. In this last case, the time by which such anticipa - tion is possible shall be authoritative. 507 Processing Orion shall determine the procedure to be adopted on behalf of the insured. It shall conduct negotiations in an out-of-court settlement and recommend mediation in appropriate cases. It shall also decide on the engagement of a lawyer or mediator and on the compilation of expert reports. Orion may limit the content and amount of the guarantee for payment of costs. If the insured person engages a lawyer or counsel or mediator before reporting the case, indemnification of his/her costs prior to filing the claim shall be limited to CHF 500. Conditional fees may be agreed upon only with the prior consent of Orion. Orion will not cover any conditional fee agreement concluded by the insured with the lawyer. Orion shall give the insured a free choice of lawyer if a legal representative needs to be engaged for court or administrative proceedings and in the event of any conflict of interests. If the insured withdraws his/her mandate at a later date, he/she shall bear any extra costs arising therefrom. Orion reserves the right to reject a lawyer proposed by the insured. The insured may then propose three lawyers from different law firms, from which Orion shall select the lawyer to be appointed. No reason need be given for rejecting a particular lawyer.
20 20 The insured must furnish Orion with all the necessary information and powers of attorney. All records in con - nection with the case, such as fines imposed, summonses, judgments, correspondence, etc., must be forwarded to Orion without delay. Where a lawyer has been appointed the insured must authorize such lawyer to keep Orion informed of the progress of the case and, in particular, to make available the documents necessary to assess the insurance coverage or the likely outcome of the proceedings. If the insured fails in this duty of cooperation despite being requested to do so by Orion, he/she shall be granted an appropriate deadline by which to do so under the threat of losing his/her insurance coverage. Settlements which contain obligations on the part of Orion may only be concluded by the insured with Orion s consent. All court or legal expenses which are awarded to the insured (judicially or extrajudicially) shall pass to Orion up to the amount of the payments it has made. 508 Differences of opinion If differences of opinion exist with regard to the proceedings in an insured legal dispute or to the likelihood of success of the legal dispute, Orion will immediately communicate its legal viewpoint in writing and will simultaneously draw the insured s attention to their right to initiate arbitration proceedings within 20 days. If the insured does not request arbitration proceedings within this period, they shall be deemed to have waived this right. After receiving this notification, the insured themselfs must take all necessary measures to protect their own interests. Orion is not liable for the consequences of inadequate representation of interests, in particular missed deadlines. The costs of these arbitration proceedings are to be advanced in equal parts by the parties and shall be charged to the unsuccessful party. If one party fails to advance their share of the costs, this shall be considered as acceptance of the legal viewpoint of the other party. The parties shall jointly appoint a sole arbitrator. The proceedings shall be restricted to a single exchange of briefs with applications detailing reasons and stating the evidence upon which the parties have based their arguments and upon which the arbitrator shall base their decision. In all other respects, the provisions of the Concordat on arbitration shall apply. If the insured institutes proceedings at their own expense upon Orion s refusal to pay a benefit and secures a judgment that is more in their favor than the solution laid down in writing by Orion or the result of the arbitration proceedings, Orion shall meet the costs incurred as if it had given its consent. Liability arising out of the transportation of hazardous loads 601 Scope of insurance The following insurance shall also apply subject to appropriate agreement in the policy: Towing vehicle incl. any trailers The insured vehicle is also used to carry hazardous loads as defined by Swiss road traffic legislation. In variance from 103, the indemnity awarded by Zurich for damage resulting from the hazardous nature of loads carried, including any loss prevention costs attributable to the hazardous nature of such loads, shall be limited to CHF 20 million per event, for persons, property damage and loss prevention costs combined Trailers In the case of trailers, the following shall also apply: The insurance shall, within the scope prescribed, also cover the liability of the holder of the towing vehicle if this holder is not the same as the holder the trailer. The insurance shall not extend to claims in respect of damage to the towing vehicle, claims by the holder of the towing vehicle and claims for property damage caused by his/her spouse or registered partner and relatives in the ascending and descending lines, as well as any siblings residing with the holder in a common household. The insurance coverage provided under the policy shall lapse if the carriage of hazardous loads is insured under the liability coverage for the towing vehicle.
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