Terms and Conditions Anker Crew Insurance vw-aci-eur-en dec Anker Verzekeringen n.v.

Transcription

1 Terms and Conditions Anker Crew Insurance vw-aci-eur-en dec-2010 Anker Verzekeringen n.v.

2 vw-aci-eur-en dec-2010 page 2 of 24

3 ANKER CREW INSURANCE TERMS AND CONDITIONS VW-ACI-EUR-EN DEC-2010 CONTENTS INTRODUCTION GENERAL TERMS AND CONDITIONS Article 1 Definitions Article 2 Insurance basis Article 3 Registration of insured persons Article 4 Obligation to disclose Article 5 Commencement, duration and termination of the insurance Article 6 Commencement, duration and termination of the insurance cover Article 7 Determination, calculation and change of the premium, periodical specification and setoff Article 8 Payment of the premium Article 9 General obligations, obligations in the event of an occurrence and verification Article 10 Sanctions in case of failure to fulfil the obligations Article 11 Payment of the insurance benefit Article 12 Territorial scope of the insurance Article 13 Concurrence Article 14 Recovery from third parties Article 15 Changes of address and/or in risk Article 16 Prescription Article 17 General exclusions Article 18 Terrorism risk cover Article 19 Liability indemnification SPECIAL CONDITIONS MEDICAL EXPENSES, REPATRIATION AND EXTRAORDINARY EXPENSES MODULE Article 20 Essence of the module Article 21 Extent of the cover for medical expenses Article 22 Extent of the cover for repatriation costs in the event of death Article 23 Extent of the cover for rendering of assistance Article 24 Extent of the cover for the cost of a travel ticket Article 25 Extent of the cover for loss of equipment Article 26 Additional obligations in the event of an occurrence Article 27 Specific exclusions MEDICAL EXPENSES HOMELAND MODULE Article 28 Essence of the module Article 29 Extent of the cover for medical and dental expenses Article 30 Maximum compensation Article 31 Additional obligations in the event of an occurrence Article 32 Specific exclusions TEMPORARY DISABILITY MODULE Article 33 Essence of the module Article 34 Extent of the cover for temporary disability Article 35 Determination of temporary disability, sick leave verification and the extent of the insurance benefit Article 36 Mediation Article 37 Special clauses for Filipino insured persons Article 38 Additional obligations at the commencement and during the term of the insurance Article 39 Additional obligations in the event of temporary disability Article 40 Specific exclusions PERMANENT DISABILITY MODULE Article 41 Essence of the module Article 42 Extent of the cover for permanent disability Article 43 Determination of permanent disability and the extent of the insurance benefit Article 44 Arbitration Article 45 Additional obligations in the event of permanent disability Article 46 Specific exclusions vw-aci-eur-en dec-2010 page 3 of 24

4 CONTRACTUAL PAYMENT OBLIGATION MODULE IN THE EVENT OF PERMANENT DISABILITY OR PERMANENT INCAPACITY FOR WORK Article 47 Essence of the module Article 48 Extent of the cover for a contractual payment obligation in the event of permanent disability or permanent incapacity for work Article 49 Determination of permanent disability or permanent incapacity for work and the extent of the insurance benefit Article 50 Mediation Article 51 Specific clauses for Filipino insured persons Article 52 Payment of the insurance benefit Article 53 Additional obligations at the commencement and during the term of the insurance Article 54 Additional obligations in the event of permanent disability or permanent incapacity for work Article 55 Specific exclusions LOSS OF LIFE MODULE Article 56 Essence of the module Article 57 Extent of the cover in case of death Article 58 Additional obligations in case of death Article 59 Specific exclusions FINAL CLAUSES Article 60 Maximum insurance benefit per occurrence per ship (accumulation) Article 61 Choice of law, complaints and disputes Article 62 Registration of personal data Article 63 Difference as to the interpretation of texts vw-aci-eur-en dec-2010 page 4 of 24

5 INTRODUCTION The purpose of this insurance is to provide employers in the maritime service industry, such as, for instance, ship owners, crewing agents and ship managers, with an insurance against the consequences and financial consequences of occurrences which may happen to their employees during the exercise of their duties. These insurable occurrences are placed in insurance modules which can be taken out independently of each other. The following modules can be taken out: Medical expenses, repatriation and extraordinary expenses module. Medical expenses homeland module (this insurance module can only be taken out in combination with the abovementioned medical expenses, repatriation and extraordinary expenses module). Temporary disability module. This insurance module offers the policyholder the option to take out insurance against temporary disability of the insured persons due to an illness, due to an accident or due to an illness and an accident.* Permanent disability module. This insurance module offers the policyholder the option to take out insurance against permanent disability of the insured persons due to an illness, due to an accident or due to an illness and an accident.* Contractual payment obligation module in the event of permanent disability or permanent incapacity for work of the insured persons whereby the policy holder has the option to take out insurance against permanent disability or permanent incapacity for work due to an illness, due to an accident or due to an illness and an accident.* Loss of life module. This insurance module offers the policyholder the option to take out insurance against the death of the insured persons due to an illness, due to an accident or due to an illness and an accident.* * The policy schedule expressly shows the applicable insurance cover. The terms and conditions of these modules will only apply if the policy schedule expressly shows that the module in question has been included under the policy. The policyholder is exclusively entitled to an insurance payment and this payment will be exclusively made to the policyholder. GENERAL TERMS AND CONDITIONS Applicability and clause precedence These General Terms and Conditions are applicable to the entire contract of insurance. With respect to the execution of this insurance, clauses take precedence over the stipulations of the Modules and the stipulations of the Modules take precedence over the General Terms and Conditions. Article 1 Definitions In these terms and conditions the following words shall have the following meanings: 1.1 Emergency centre: The body designated by Anker to provide assistance as specified in article 23 herein. The contact details of this emergency centre are incorporated in the Claims Procedure. 1.2 A.M.A.-guide: Guides to the Evaluation of Permanent Impairment. This is a publication of the American Medical Association (A.M.A.) providing precise criteria which are in general use for establishing disability. Anker uses the version of this A.M.A.-guide set out in the policy schedule. 1.3 Physician: A medical practitioner who is legally authorised at the treatment location to practise medicine and who is generally recognised accordingly by the official, legally competent authorities. 1.4 Permanent disability: It will only be considered as permanent disability if there are disorders that can be objectively established on medical grounds in relation to an illness and/or an accident, which fully or partially incapacitates the insured person to carry out any work. Anker will establish the disability on the basis of the terms laid down in the individual employment contract or the collective bargaining agreement. The criteria for establishing permanent disability may include; Occupational disability: It will only be considered as permanent disability if there are disorders that can be objectively established on medical grounds in relation to an illness and/or an accident which fully or partially incapacitates the insured person to carry out the work agreed between him or her and the policyholder. In this respect the occupational activities which generally and reasonably may be expected from the insured person are taken as a basis, and the possibilities for sheltered employment and circumstances, and a shift in duties within one s profession and/or company will also be given due consideration. vw-aci-eur-en dec-2010 page 5 of 24

6 Incapacity for suitable employment: It will only be considered as permanent disability if there are disorders that can be objectively established on medical grounds in relation to an illness and/or an accident which fully or partially incapacitate the insured person to engage in an occupation which is suited to the strength and skills of the insured person and which in view of his or her education and work experience can reasonably be expected from this insured person. In establishing the degree of disability the reduced opportunity to gain employment will not be taken into account. Incapacity for regular employment: It will only be considered as permanent disability if there are disorders that can be objectively established on medical grounds in relation to an illness and/or an accident which fully or partially incapacitate an insured person to carry out work which is suited to his or her strength and skills and which is regarded as generally accepted work, irrespective of occupation, education and work experience. 1.5 Permanent disability: Permanent total or partial loss or loss of the function of any part of the body or organ (or a part thereof). 1.6 Relatives by blood or affinity once or twice removed: These refer to: a. parents and parents-in-law, foster parents or step-parents; b. sons and sons-in-law, daughters and daughters-in-law, foster children, stepchildren and grandchildren; c. grandparents, also including the grandparents of the partner in life; d. brothers and foster brothers or stepbrothers and sisters and foster sisters or stepsisters, brothers-in-law and sisters-in-law. 1.7 Claims Procedure: A document containing instructions for reporting an occurrence and obligations in the event of an occurrence. This document forms a part of this contract of insurance and is issued together with the policy and the policy conditions. 1.8 Clause: A stipulation used for addition to or restriction of these policy conditions. 1.9 Collective Bargaining Agreement: A compilation of agreements made by employers or their representatives and the representatives of the employees. The collective bargaining agreement constitutes an addition to the individual employment contract concluded between an employer and his employee Contractual payment obligation in the event of permanent disability or permanent incapacity for work: The obligation to pay that the policyholder in his capacity as employer has with respect to the insured person in the event of permanent disability or permanent incapacity for work pursuant to an individual employment contract and/or a collective bargaining agreement Deductible period: The period specified in the policy schedule, the waiting period, during which the policyholder is not entitled to receive any insurance benefits under this insurance Occurrence: An incident or a series of incidents that for the policyholder could give rise to a claim for an insurance benefit and/or provision of services by Anker, and where at the commencement of the insurance and the cover thereof it was uncertain to Anker and the policyholder that, when or up to which amount these would lead to a claim for an insurance benefit and/or provision of services or would have led to such a claim in the normal course of events Medical treatment: A treatment given in accordance with generally recognised medical standards by a physician who or institution which is locally recognised as being legally authorised to practise medicine and generally recognised accordingly by the official, legally competent authorities Medical expenses: The necessary medical expenses incurred by: a. physicians fees and the treatments, examinations and medicine and bandage prescribed in respect thereof; b. paramedics fees and the treatments, examinations and medicine and bandage prescribed by these paramedics; c. admission into and nursing in a hospital or rehabilitation centre; d. patient transport by ambulance, airplane, boat or taxi, to and from the nearest hospital or the location where treatment will take place; e. first prostheses and forearm or underarm crutches Medicine: A chemical substance or a compound of chemical substances with an intended pharmacological, immunological or metabolic effect on the human body and which has exclusively been prescribed in a prescription issued by a physician. This medicine may only be prepared and/or supplied by an official, legally authorised body. vw-aci-eur-en dec-2010 page 6 of 24

7 1.16 Individual employment contract: An agreement concluded in writing between the employer and the employee where the employment conditions are laid down to which both parties have bound themselves Annual salary: The yearly salary contractually agreed by the policyholder with the insured person Calendar year: The period from 1 January up to and including 31 December of any year Children: The unmarried children of the insured person living at home, including foster children and stepchildren, and the children studying and living away from home, up to the age specified in the policy schedule Partner in life: The spouse of the insured person or the person with whom he or she is permanently living together Accident: A sudden, unexpected and unintended violent external impact on the body of the insured person which is the direct and exclusive cause of an injury that is to be objectively established on medical grounds. The term accident also refers to: a. acute poisoning caused by the sudden and unintended inhaling and/or swallowing of gases, fumes, liquid or solid substances, other than poisoning by the use of medicine, alcoholic beverages, narcotics or stimulants and other than swallowing allergens; b. infection by germs (pathogenic organisms) or an allergic reaction if this infection or reaction is directly and exclusively caused by an unintended fall in the water or in any other substance, or is caused by entering this water or substance in an attempt to save people, animals or things; c. the unintended and sudden inhaling and/or swallowing of substances or objects into the digestive tract, the respiratory tracts, the eyes or the ears leading to internal injury, except for the entering of germs or allergens; d. asphyxiation, drowning, freezing, sunburn, sunstroke and heat stroke; e. exhaustion, starvation and dehydration caused by unforeseen circumstances; f. wound infection or blood poisoning by the entry of germs as a direct and exclusive consequence of an injury caused by an insured accident; g. complications or worsening of the accident injury directly and exclusively caused by first aid or by the medical treatment made necessary as a result of the accident; h. muscle strain, blistering, wrenching, dislocation, straining and spraining, if these injuries have been caused suddenly and on condition that the nature and location thereof can be objectively established on medical grounds Hospitalisation: Admission for longer than 24 hours into a hospital or rehabilitation centre if and for as long as nursing, examination and/or treatment has to be offered on medical grounds Paramedics: Persons practising a profession related to medicine and who are legally authorised at the place of the treatment and are generally recognised accordingly by the official, legally competent authorities. For the purpose of these terms and conditions paramedics are also defined as: physiotherapists, manual therapists and speech therapists Repatriation: The transport of the insured person who is injured or suffering from a disease or of his or her mortal remains to his or her homeland Rehabilitation centre: A centre for treatment during or after an illness and/or accident which is authorised at the place of the treatment and is generally recognised accordingly by the official, legally competent authorities. The treatment should be aimed at preventing, reducing or overcoming a disability caused by disorders or impairments in mobility, or a disability caused by a central nervous disorder leading to loss of the power of speech function, cognition or behavioural restrictions Dental expenses: The necessary medical expenses incurred by physicians and dentists fees for dental examinations and treatment to the natural teeth and the prescribed medicine, dental aids and the X-rays needed for the treatment Homeland: The country where the insured person has his or her domicile or the country where he or she is registered as a resident Temporary disability: It will only be considered as temporary disability if there are disorders that can be objectively established on medical grounds in relation to an illness and/or an accident, which incapacitates the insured person to carry out the work agreed between him or her and the policyholder and where there remains the prospect of recovery to resume his or vw-aci-eur-en dec-2010 page 7 of 24

8 her profession on board. The foregoing is based on the occupational activities which generally and reasonably may be expected from the insured person Insurer: Anker Verzekeringen n.v. in Groningen, the Netherlands, referred to as Anker in these policy conditions Insured person: The crew member employed by the policyholder who for a specific period performs work against payment of wages on the basis of an employment contract Policyholder: The employer who has entered into the contract of insurance with Anker Hospital: An institution for the nursing, examination and treatment of patients and/or injured persons, which is generally recognised accordingly by the official, legally competent authorities Patient transport: Medically indicated transportation of the ill or injured insured person other than by public transport Illness: Every process in the organism due to harmful external or internal influences other than an accident which causes changes in the quantitative or qualitative effect of cells or tissues, as a result of which the functional balance of body and/or spirit is disturbed and a response to restore this (or a new) equilibrium is established. Article 2 Insurance basis The insurance is based on: a. the completed and signed application form as well as any statements, data and documents provided separately by or on behalf of the policyholder; b. the policy schedule, including any accompanying clause sheets; c. the terms and conditions herein; d. the Claims Procedure. Article 3 Registration of insured persons 3.1 The policyholder is obliged to provide a survey of the composition of the staff to be insured, as well as the wage and salary bill for each employee, on the commencement date of the insurance and at the beginning of each calendar year. 3.2 At the start of the following calendar year, the policyholder is obliged to provide a survey of the composition of the actual insured staff over the past year, as well as the wage and salary bill for each employee. The policyholder is obliged to inform Anker in writing on interim alterations in the composition of the staff and/or the wage and salary bills for each employee and on all crew members to be insured that have signed on and signed off within 5 days by means of the medium made available by Anker. 3.3 Registered crew members who have to be insured up to and including the age of 66, who are in good health and in possession of a valid medical certificate attesting that he or she is medically fit to be employed on a sea-going ship or a certificate deemed by Anker to be comparable, are considered by Anker as insured persons without any further underwriting. This certificate must have been issued for a minimum period of 12 months. 3.4 If the crew member to be covered by the insurance is aged 67 or above when signing on, or suffers from an existing illness, ailment, disorder or disability, the policyholder must inform Anker thereof before signing on this crew member. Subsequently, Anker is entitled to charge an adjusted insurance premium for this crew member and/or to apply modified insurance conditions, to exclude the existing illness(es), ailments or disabilities from cover, or to exclude the crew member in question from any insurance cover. 3.5 If the policyholder fails to meet the notification requirement referred to in this article, the crew member in question will not be considered as an insured person. The policyholder cannot rely on this insurance for the crew member in question and cannot derive any rights from this insurance. Article 4 Obligation to disclose 4.1 Prior to and during the term of this contract of insurance the Policyholder is under the obligation to answer the questions raised by Anker fully and truthfully, including the questions asked in the application/registration form, the health certificates and medical examination reports. 4.2 If the policyholder fails to meet the disclosure obligation referred to in article 4.1 herein and the notification requirement referred to in article 3 herein, it may result in the fact that the insurance payment will be refused, limited and/or will or will partially be reclaimed. Anker also has the possibility to alter the premium or to alter the premium with retroactive effect. 4.3 If the policyholder has acted with the deliberate intention to deceive Anker, or if Anker would not have granted the insurance cover when it would have been aware of the true state of affairs, Anker can terminate the insurance. Article 5 Commencement, duration and termination of the insurance 5.1 The insurance commences on the date stated in the policy schedule. 5.2 The insurance is taken out for the current calendar year and the following calendar year and, unless notice is given, will thereafter be tacitly renewed from year to year. 5.3 Both the policyholder and Anker can terminate the contract of insurance with effect from the contract expiry date with due regard to a notice period of two calendar months. vw-aci-eur-en dec-2010 page 8 of 24

9 5.4 The insurance ends by written notice of termination by Anker: a. If the policyholder fails to pay the premium payable in time or refuses to pay this premium, however, only if Anker has in vain demanded payment of the premium from the policyholder following expiry of the premium due date. b. If the policyholder has failed to meet the disclosure obligation upon taking out the insurance or when registering the insured person for insurance cover and the policyholder has in this connection acted with the deliberate intention to deceive Anker, or if Anker would not have effected the insurance had it been aware of the true state of affairs. c. If, with respect to the periodical specification or a loss-causing occurrence report, the policyholder deliberately misrepresents the facts and/or gives a false or incorrect specification and has in this connection acted with the deliberate intention to deceive Anker. d. If Anker uses its right to terminate the insurance in case of a risk modification as referred to in article 15.3 herein or in case of a modification of the contractual payment obligation as referred to in articles 38.2 and 53.2 herein. The contract of insurance terminates on the date specified in the letter of notice. 5.5 The insurance ends by written notice of termination by the policyholder: a. If the policyholder does not agree to the written notification of Anker concerning a change to the premium and/or conditions at the expense of the policyholder, as referred to in articles 7.7, 15.3, 38.2 and 53.2 herein. b. After Anker with respect to the policyholder has invoked the failure to comply with the disclosure obligation upon taking out the insurance or when registering the insured person for insurance cover. c. If the policyholder does not agree to an increase of premium of more than 25% by virtue of article 7.6.b herein. The insurance terminates on the date specified in the articles in question. 5.6 The contract of insurance ends automatically on the date: a. of termination, dissolution, winding-up, discontinuation or transfer of the policyholder s company; b. on which the policyholder is put into bankruptcy or is granted a moratorium on payments or debt rescheduling. Article 6 Commencement, duration and termination of the insurance cover Within the term of validity of the insurance the following applies with respect to the cover of an insured person: 6.1 The insurance cover for an insured person commences on the date on which he or she is deemed to be on board the ship and he or she has been registered in the muster roll or crew list. 6.2 The insurance cover of an insured person ends on the date on which a. the insured person is relieved of his or her duties on board or abandons his or her duties in the next port of call. b. the insurance ends. 6.3 The period travelling from the port or airport of departure in the homeland of an insured person directly to the ship or from the ship directly to the port or airport of arrival in the homeland of the insured person is included under the policy up to a maximum of 48 hours. 6.4 Those occurrences are covered by the insurance which take place during the term of the insurance and the duration of the cover and which are also reported to Anker in writing, also during the term of the insurance. From the foregoing it follows that any claims or circumstances reported to Anker after the termination of the insurance are not covered by insurance. Article 7 Determination, calculation and change of the premium, periodical specification and setoff 7.1 Premium calculation a. The premium specified in the policy schedule constitutes an advance premium. At the start of the insurance Anker calculates the advance premium based on the data provided by the policyholder prior to the commencement date. b. At the beginning of each calendar year Anker will calculate the advance premium for that specific year on the basis of the data over the previous calendar year. As long as no new advance premium has been determined, the policyholder shall pay this advance premium by renewal. Anker will setoff this advance premium against the new advance premium as soon as this new premium has been determined. c. The policyholder owes premium for new insured persons from the date of signing on until the date of signing off. Setoff of the premium due will only take place at the annual setoff. 7.2 Periodical specification Without delay but at the latest within three calendar months of the expiry of the policy year the policyholder is obliged to provide a specification of: a. the composition of the number of staff to be insured over the previous policy year, and the wage and salary bill for each employee over the previous policy year; b. the composition of the number of staff per 1 January of the new calendar year and the wage and salary bill for each employee at the beginning of the new calendar year. On request, the policyholder is obliged to provide Anker with a further specification by submitting the (collective) wage and salary bill and to have the aforementioned statement verified by an accountant or chartered accountant. 7.3 Sanctions in case of failure to provide a periodical specification in time a. The insurance will not be in force with respect to occurrences in the new policy year if Anker has not received the specification referred to in article 7.2 herein within the stipulated term of three calendar months. b. In that case Anker will also defer the adjustment of any current claims. c. The cover of this insurance will take effect again and Anker will resume the adjustment of any current claims on the date on which it receives the aforementioned specification. Notwithstanding, the policyholder remains obliged to pay the premium and costs. d. In addition, Anker has the right to reclaim payments which it has made for insured persons for whom no or not enough premium has been paid as a result of the fact that the specification referred to in this article has not been provided. vw-aci-eur-en dec-2010 page 9 of 24

10 7.4 Sanctions for providing an incorrect periodical specification a. The policyholder cannot derive any rights from this insurance if he provides an incomplete or incorrect periodical specification and as a result thereof Anker is prejudiced in its interests. Anker will be entitled to reclaim the payments already made to the insured person. b. If, when a notification of claim is submitted, Anker establishes that it concerns a crew member who has not been registered in accordance with article 7.2.b herein, who was employed at the beginning of the previous calendar year, the crew member in question will not be considered as an insured person. The policyholder cannot derive any rights from this insurance for the crew member in question. 7.5 Adjustment setoff a. On the basis of the actual information provided about the previous calendar year, Anker will determine the final premium over the previous year and will set off the premium against the advance premium paid over that calendar year. b. Anker will recalculate the advance premium and set this premium off against the advance premium paid on the basis of the information as at 1 January of the new calendar year and on the basis of the claim amounts specified in article 7.6 herein. 7.6 Change in premium basis a. Anker has the right to change the premium basis in view of the realised loss figures over the previous three calendar years. This new premium basis will be backdated to 1 January of the new calendar year. b. If the change constitutes an increase of premium of more than 25%, the policyholder will have the right to terminate the insurance. The policyholder will be notified of this change in writing and will be deemed to have agreed thereto unless he cancels this insurance in writing within 30 days of receiving the written notification of the change in question from Anker. In that case the insurance will end on the first day of the month following the month that Anker has received the written cancellation from the policyholder. The increase of premium is maximized at 25 % until the termination date. 7.7 En-bloc change to the premium a. Anker has the right to alter the premium and/or the insurance conditions en bloc on an interim basis and to alter this insurance accordingly. Anker will notify the policyholder of this change in writing. The policyholder will be deemed to have agreed thereto unless he terminates the insurance in writing within 30 days of receiving the written notification of Anker concerning the change. The insurance ends on the date on which the change comes into effect. b. This possibility of terminating the insurance by the policyholder does not apply if: - the change to the premium and/or the insurance conditions will arise from a statutory regulation and/or provision; - the change will constitute a premium reduction and/or an extension of the cover for the policyholder. Article 8 Payment of the premium 8.1 The premium is payable by the policyholder on the premium due date. If the policyholder fails to pay the amount due in time, the insurance cover will be suspended. Anker will suspend the cover for 14 days after it has demanded payment in writing from the policyholder after the due date and full payment has not been received. The suspension has retroactive effect to the first day of the period over which the premium was payable. 8.2 The policyholder remains obliged to pay the premium, charges, and, if applicable, premium tax. The cover will resume on the date following the date on which payment is received by Anker. 8.3 All judicial and extrajudicial costs incurred by Anker for collection of the overdue premium and the statutory interest relating thereto shall be borne by the policyholder. 8.4 Other than in the case of termination by Anker by reason of intent to deceive it, refund of the premium paid will be made on a pro rata basis in case of interim termination of the insurance. Article 9 General obligations, obligations in the event of an occurrence and verification 9.1 Obligation to limit the loss The policyholder and the insured persons are obliged to do or refrain from doing everything necessary to prevent the risk that a loss-causing occurrence arises and to limit the consequences of a loss-causing occurrence as much as possible. In this context the policyholder and the insured persons are anyway obliged to observe the applicable legislation and regulations. 9.2 Notice of claim obligation The policyholder is obliged to notify Anker in writing of an occurrence which could lead to a payment obligation and/or provision of services on the part of Anker as soon as possible, but within the term specified in the module in question at the latest. 9.3 Loss information obligation a. The policyholder and the insured person are obliged to provide Anker and/or the medical and other experts to be appointed by it as soon as possible with all information, powers of attorney and documents which Anker requires in order to be able to assess its obligation to make an insurance payment or to render services. b. The policyholder and the insured person are obliged to provide Anker as soon as possible with a claim form truthfully completed and signed. c. The policyholder is obliged to provide Anker with a copy of the medical certificate attesting that he or she is medically fit to perform duties at sea or other certificates which are comparable in the opinion of Anker, a copy of the muster roll or the crew list respectively and the individual employment contract and/or the collective bargaining agreement of the insured person in question. d. The policyholder is obliged to provide Anker with all required documents and information in either Dutch or English. vw-aci-eur-en dec-2010 page 10 of 24

11 9.4 Obligation to cooperate a. In the context of the execution of this contract of insurance the policyholder and the insured person are obliged to render the cooperation required by Anker and to refrain from anything that could prejudice the interests of Anker. b. The policyholder and the insured person are obliged to ensure that the sick or injured insured person consults a physician for medical treatment without delay, does everything possible to stimulate his or her recovery and refrains from anything that could delay or prevent his or her recovery. c. The insured person is obliged to undergo a medical examination or medical treatment by a physician appointed by Anker, or to have himself or herself admitted into a hospital or other medical institution designated by Anker at its request and expense. d. The policyholder and the insured person are obliged to render their full cooperation in the investigation of Anker into the cause and/or the facts of the loss and/or damage. e. If the insured person is relieved as a direct and exclusive result of an illness which reveals itself and/or an accident which occurs during the period referred to in articles 5 and 6 herein, the insured person is obliged to seek treatment from a physician to be appointed by Anker within 3 days. 9.5 Verification Anker has the right to appoint medical and other experts for assessing and/or verifying the reported illnesses or accidents and the treatments thereof. Anker has the right to have the insured person called to the Netherlands at the expense of Anker to have these illnesses and accidents assessed and/or verified. The policyholder and the insured person are obliged to render their full cooperation therein. Article 10 Sanctions in case of failure to fulfil the obligations 10.1 The policyholder cannot derive any rights from this insurance if he and/or the insured person fails to fulfil one or more of his or her obligations with respect to Anker and as a result thereof the interests of Anker are harmed. The policyholder and the insured person are in any event obliged to fulfil the obligations incorporated in these policy conditions and in the Claims Procedure If Anker is not harmed in a reasonable interest, as a result of the aforementioned policyholder and/or insured person s failure to fulfil the obligations it may nevertheless deduct the loss and/or damage sustained, or the costs incurred as a result thereof, from the insurance payment If the policyholder or the insured person fails to meet his or her obligations with respect to Anker with the intention of deceiving it, all rights to insurance benefits and/or provision of services will lapse, unless the deception does not justify the lapse of rights. Article 11 Payment of the insurance benefit 11.1 After having established that there is a right to insurance benefit and after having determined the extent and the duration of this benefit, Anker will proceed to pay the insurance benefit to the policyholder. It is the exclusive decision of Anker to grant advance payments. Any advance payments made by Anker will be deducted from the final settlement Anker will make the insurance payment in the currency specified in the policy schedule If costs are compensated on the basis of accounts drawn up in Euros (EUR) or another foreign currency, Anker will use the exchange rate applicable on the date of invoice The policyholder is exclusively entitled to insurance payments. Anker will only make insurance payments to the policyholder. Article 12 Territorial scope of the insurance The insurance provides a world-wide cover, unless stated otherwise in the policy schedule. Article 13 Concurrence 13.1 The policyholder will not be entitled to any insurance benefit for which, if this insurance had not existed, he and/or the insured person could claim compensation under any other agreement or contract of insurance, statutory benefit or suchlike provisions In that case Anker will only pay the balance exceeding the payment pursuant to other agreements, contracts of insurance or benefits The policyholder and/or the insured person are in that case obliged to provide all relevant information on these other agreements, contracts of insurance or benefits. Article 14 Recovery from third parties 14.1 In the event that a liable third party is involved in the occurrence resulting in an obligation for Anker to make an insurance payment or to provide services, the policyholder and/or the insured person will be obliged to inform Anker thereof as soon as possible. The policyholder and/or the insured person must also mention whether he intends to recover the loss and/or damage sustained from this liable third party The policyholder and/or the insured person are obliged to inform Anker about the outcome of the recourse, or to provide all relevant information and to render full cooperation to make recovery from a liable third party possible. This may include legally assigning the claim to Anker Without prior written permission of Anker the policyholder and/or the insured person are not entitled to effect an arrangement with the liable third party or to waive his or her right of recourse If the loss and/or damage is recoverable from a liable third party, the insurance payment made by Anker will be deemed to be made by way of an advance payment. In case of full or partial recovery of the loss and/or damage from a liable third party, the policyholder is obliged to repay Anker the whole advance payment or part thereof. vw-aci-eur-en dec-2010 page 11 of 24

12 Article 15 Changes of address and/or in risk 15.1 Notifications given by Anker to the policyholder and/or the insured person should be sent in a legally valid manner to the most recent address known to Anker. The policyholder and/or the insured person are obliged to give written notice of a change of address to Anker as soon as possible The policyholder is obliged to inform Anker in writing of a change in risk as soon as possible, but at the latest within 30 days. A change in risk refers in any case to: a. changes in the nature of the company or in the business operations; b. changes in the vessel s trading area; c. involvement in a merger, restructuring, takeover, splitting, strike or other changes in the company; d. changes in circumstances which may affect the risk insured Anker has the right to terminate the insurance or to adjust the premium and/or the conditions according to the changed risk. In case of adjustment of the premium and/or the conditions, the insurance will be modified as from the date on which the change in risk occurred. Anker will notify the policyholder in writing of this modification. The policyholder will be deemed to have agreed to this change, unless he cancels the insurance in writing within 30 days of receipt of the written notification of Anker regarding the change. In that case the insurance ends on the date on which the change in risk occurred If the policyholder has failed to inform or timely inform Anker about a change in risk and reports a loss-causing occurrence, Anker will assess whether the change implies an increased risk. If there is no increase of the risk, the right to insurance benefit will be maintained. However, if there is a risk increase resulting in the fact that the insurance would only be continued on other conditions and/or at a higher premium, the insurance benefit will be determined with due observance of these other conditions and/or the premium paid in proportion to the premium payable on account of this increased risk. If the change in risk is of such a nature that Anker would not have continued the insurance contract if it had had knowledge of the true state of affairs, the right to insurance benefit will be nonexistent. Article 16 Prescription A legal claim of the policyholder against Anker for an insurance benefit and/or the provision of services shall become barred by the lapse of three years after the date following the date on which the policyholder has become or could have been aware of the exigibility thereof. The prescription can be interrupted by the policyholder by means of a written notification in which he lays claim to insurance benefit. A new prescription period starts on the date following the date on which Anker either recognizes the claim or has explicitly notified in writing that it rejects this claim. In the event that the claim is rejected, this legal claim shall become barred by the lapse of six calendar months. Article 17 General exclusions The policyholder cannot rely on this insurance and cannot derive any rights therefrom: 17.1 If the occurrence has been caused, created, aggravated or furthered by: a. kidnapping, detention and arrest; b. hijacking and piracy, unless these incidents took place in areas outside the Listed Areas specified by the Joint War Committee of the IUA and LMA. Hijacking and piracy remain excluded from cover when taking place in the Listed Areas specified by the Joint War Committee of the IUA and LMA. c. mines, torpedoes, bombs, missiles, grenades, explosives and other military weapons; d. intent, recklessness which may or may not be caused with intent or a wrongful act which may or may not be caused with intent by the policyholder and/or the insured person; e. hazardous undertakings by which life or the body is recklessly endangered, unless these undertakings are reasonably necessary for the exercise of the profession or at attempts to rescue oneself, other persons, animals or things; f. committing or participating in a criminal offence or an attempt thereto by the insured person; g. insured person s participation in wrong-doings, quarrels and fights, other than in lawful self-defence or in attempts to rescue oneself, other persons, animals or things; h. the insured person s participation in or training for speed racing events with motor boats and motor vehicles; i. practising dangerous sports by the insured person which involve a higher than normal risk such as: gliding, hang gliding, do parachuting, parasailing, mountaineering, glacier skiing, hunting and rodeo; j. deliberate self-injury or suicide attempt or suicide If the occurrence has been caused, created, aggravated or furthered by the fact that the insured person was under the influence of: a. alcoholic beverages. This will at all times be the case when the blood-alcohol content at the time of the occurrence proved to be 0.8 per mille or higher or when the breath-alcohol content was 359 ug/l or higher; b. any intoxicating or stimulating substance or a medicine not prescribed by a physician; c. the insured person s refusal to cooperate in a blood, breath or urine test will be considered equivalent to being under the influence If the occurrence has either directly or indirectly been caused, created, aggravated or furthered by an armed conflict, civil war, rebellion, internal civil commotion, riots and mutiny, all this in accordance with the definitions thereof as filed by the Federation of Insurers in the Netherlands dated 2 November 1981 at the Office of the District Court in The Hague If the occurrence has been caused by, taken place at or resulted from atomic nuclear reactions, irrespective of the cause thereof If the policyholder and/or the insured person deliberately conceals or has concealed information or has deliberately supplied or caused to supply incorrect information If the insured person does not hold a valid medical certificate attesting that he or she is medically fit to be employed at a sea-going ship or another comparable certificate. vw-aci-eur-en dec-2010 page 12 of 24

13 17.7 If the insured person holds a valid medical certificate attesting that he or she is medically fit to be employed at a sea-going ship or holds another comparable certificate, and the occurrence has been caused, created, aggravated or furthered by an illness, ailment, disorder or disability of the insured person of which he or she was already suffering prior to or at the commencement of the insurance cover or which gave rise to complaints. The foregoing only applies: a. in case of an incorrect or false representation, or concealment of the circumstances known to the insured person during the medical examination for the certificate referred to in this article, which is of such a nature that the insured person would not have received a valid medical certificate attesting that he or she is medically fit to be employed at a sea-going ship or another comparable certificate if the medical examiner had had knowledge of the true circumstances, or b. if Anker can prove that based on an aforementioned illness, ailment, disorder or disability, according to objective criteria, the insured person would not have received a valid medical certificate attesting that he or she is medically fit to be employed on a sea-going ship or another comparable certificate If no valid International Safety Management Certificate has been issued for the ship where the insured person is on board If the shipping company to which the ship belongs, where the insured person is on board, does not hold a valid Document of Compliance required by law If the ship, where the insured person is on board, does not meet the classification required by law or is not in possession of a valid classification certificate During the period that the insured person is detained. This will apply if it refers to custody during pre-trial detention, imprisonment and detention under a hospital order by the State. Article 18 Terrorism risk cover In derogation of and in addition to these terms and conditions the following applies to the risk of terrorism. As regards losses resulting from terrorism, malicious contamination and/or preventative measures, and acts or actions involved in the preparation thereof, hereinafter both jointly and separately referred to as the terrorism risk, the insurance cover will be limited to the insurance benefit as specified in the Clauses Sheet for Terrorism of the Nederlandse Herverzekeringsverzekeraar voor Terrorisme Schaden N.V. [ Dutch Terrorism Risk Reinsurance Company ]. The notification of a claim under the terrorism risk will be settled in accordance with the Protocol pertaining to the settlement of claims of the Nederlandse Herverzekeringsmaatschappij voor Terrorisme Schaden N.V. The Clauses Sheet for terrorism cover and the relevant Protocol for the settlement of claims of the Nederlandse Herverzekeringsmaatschappij voor Terrorisme Schaden N.V. were filed at the Office of the District Court in Amsterdam on 6 January 2005 under no. 6/2005 and at the Amsterdam Chamber of Commerce on 23 November 2007 under no respectively (this text can be read or downloaded via the website: Article 19 Liability indemnification Anker will not be liable to the policyholder and/or the insured person for any loss and/or damage which he may suffer as a result of any act or omission of a person or institution other than Anker to whom or which the policyholder or the insured person has applied for examination and/or treatment, not even if this examination or treatment constitutes part of this insurance and/or if Anker has appointed this person or designated this institution for examination and/or treatment. MEDICAL EXPENSES, REPATRIATION AND EXTRAORDINARY EXPENSES MODULE The terms and conditions of this module will only apply if the policy schedule expressly shows that this module has been included under the insurance policy. Article 20 Essence of the module The purpose of this module is to offer the policyholder insurance cover for medical expenses and the rendering of assistance outside the homeland of the insured person and compensation in case of a number of specified occurrences. This module provides insurance cover for: - medical expenses; - costs of repatriation after death; - the rendering of assistance; - the cost of a travel ticket; - loss of equipment. Article 21 Extent of the cover for medical expenses 21.1 Medical and dental care expenses Anker will reimburse the necessary medical and dental costs incurred by the insured person outside his or her homeland if these are the direct and exclusive result of an illness which manifests itself and/or an accident which occurs during the period referred to in articles 5 and 6 herein. Medical expenses will only be reimbursed insofar as the treatment cannot be postponed until the insured person has arrived in his or her homeland and if the purpose is not to undergo a better medical treatment than in his or her homeland (Helicopter) Emergency transport Anker will reimburse the costs of (helicopter) emergency transport up to a maximum of EUR 4,500 per occurrence. (Helicopter) Emergency transport costs will solely be reimbursed if it proves to be necessary from a medical point of vw-aci-eur-en dec-2010 page 13 of 24

14 view that the insured person is disembarked during the ship s voyage to undergo medical treatment. This will apply if it is absolutely impossible to provide medical treatment on board and to postpone this treatment until the ship s arrival in the nearest port. In order to be entitled to reimbursement the policyholder will provide a certificate issued by a coastal station showing that a physician ashore considers this transport to be absolutely necessary Repatriation a. Anker will reimburse the costs of medically necessary transport of the patient by ambulance, airplane, boat or taxi to the place of follow-up treatment in the homeland of the insured person if these are the direct and exclusive result of an illness which manifests itself and/or an accident which occurs during the period specified in articles 5 and 6 herein. The foregoing includes the costs of supporting medical care which may be prescribed by a physician or a nurse during the transport. b. The repatriation costs are only reimbursed if: - The policyholder will provide Anker with a medical certificate of the attending physician attesting to the fact that repatriation is medically necessary, and - Anker has given its prior consent for the repatriation Vaccination Anker will reimburse the costs of vaccinations if due to unforeseeable circumstances the insured person has to be vaccinated for preventative reasons at an intermediate port during the period specified in articles 5 and 6 herein. The need for intermediate vaccination must be assessed by a physician on medical grounds. Anker will not reimburse any costs of normal vaccinations and revaccinations to be foreseeable prior to the commencement of the insurance cover Limitation of the insurance payments Anker only reimburses the costs: a. in so far the policyholder is obliged to pay these costs to the insured person; b. based on the locally recognized rates, however, subject to a maximum of 200% of the (maximum) statutory rate or rate in accordance with market terms established for the treatment in the Netherlands; c. incurred within 365 days, counting from the date of the accident, or in the event of illness the first day of the medical or dental treatment. However, the right to imbursement ends on the date that the insured person has returned or could have returned to his or her homeland, if this is an earlier date; d. of admittance into and care in a hospital or rehabilitation centre with a maximum of the costs of hospitalization and care in the lowest class. Article 22 Extent of the cover for repatriation costs in the event of death In the event of the insured person s death outside his or her homeland during the period specified in articles 5 and 6 herein, Anker will reimburse: 22.1 The costs of transport of the mortal remains of the insured person to his or her place of residence in the homeland, subject to a maximum amount of EUR 12, If the mortal remains of the insured person are buried or cremated at the place of death or the next port of call, Anker will reimburse these funeral or cremation costs and the related travel and accommodation expenses incurred by relatives by blood or affinity and the partner in life of the insured person for a three-day period. The payment thereof will never exceed the expenses which would have been reimbursed on the basis of the transport of the mortal remains of the insured person to his or her place of residence in the homeland. Article 23 Extent of the cover for rendering of assistance 23.1 The policyholder is entitled to assistance of the Emergency centre in the form of organisation and intermediation in respect of the following occurrences happening during the period referred to in articles 5 and 6 herein: a. illness and accident of the insured person; b. death of the insured person Anker will reimburse the cost of: a. arranging the transport of the sick or injured insured person to a hospital of his or her permanent home address in the homeland, and, if required and prescribed, under medical supervision of a physician or a nurse. b. the sending of medication, prostheses and aids required and prescribed by a physician and for which there are no alternatives available locally; c. arranging the transport of the mortal remains of the insured person to his or her place of residence in the homeland If Anker has granted a reimbursement for the cost and/or services incurred and/or rendered by Anker or the Emergency service which are not covered by this insurance, Anker will have the right to reclaim and/or to set off the cost already paid against the insurance payments to be made. The policyholder is obliged to pay the claim within 30 days Anker will reimburse the cost which, according to the local competent authorities, must be incurred with respect to locating, saving and/or recovering of a missing insured person up to a maximum of EUR 4,500 per occurrence. Article 24 Extent of the cover for the cost of a travel ticket Anker will per occurrence make a once-off payment for the cost of a travel ticket, lowest class, in the following cases: 24.1 In case of an unexpected recall of the insured person to his or her homeland In connection with a serious accident or illness insofar a relation by blood or affinity once or twice removed or the partner in life of the insured person is or may be in immediate peril of death in the period referred to in articles 5 and 6 herein. The cost of a travel ticket will only be reimbursed if: a. on the basis of the state of health of the family member in question or the partner in life the recall could not be foreseen at the time of signing up of the insured person, and vw-aci-eur-en dec-2010 page 14 of 24

15 b. Anker has given its prior consent thereto, and c. the policyholder provides a medical certificate attesting to the serious nature of the condition of the family member in question or the partner in life, or d. the policyholder submits a judicial death certificate or another judicial declaration of death comparable thereto according to Anker of the relation by blood or affinity or the partner in life of the insured person In the event of sending a relief person or replacement if: a. the insured person is repatriated owing to a serious illness or accident; b. the insured person dies; c. the insured person is relieved in connection with the unexpected recall to his or her homeland, as defined in article 24.1 herein. The cost incurred for a travel ticket will only be reimbursed if: - the occurrence referred to in article 24.2 herein has taken place during the period referred to in articles 5 and 6 herein; - the relief person is signed on in the same function or rank as the insured person to be repatriated, and - Anker has given its prior consent thereto In the event that the insured person is admitted into a hospital outside of his or her homeland: If the insured person is admitted into a hospital outside of his or her homeland as a direct and exclusive result of an illness which manifests itself and/or an accident which occurs during the period referred to in articles 5 and 6 herein, and a family member once or twice removed or the partner in life pays him or her a visit in the hospital. Anker will also reimburse the accommodation expenses incurred by this visitor up to a maximum of 3 days. These expenses will only be reimbursed if: a. the insured person is affected by a severe accident or illness to the extent that this accident or illness constitutes or may constitute an immediate danger to life; b. in the opinion of Anker the insured person must be admitted into a hospital outside of his or her homeland for at least one week; c. Anker has given its prior consent thereto. Article 25 Extent of the cover for loss of equipment Anker will compensate the insured person if his or her equipment and deposited goods are lost due to a shipping disaster. The insured person must provide a specification of the lost goods. In case of loss of equipment the insurance payment will be made on the basis of the actual purchase price of the goods from which an amount for a decrease in value or wear and tear will be deducted. The compensation will not exceed the maximum amount of EUR 3,000 for an insured person. Article 26 Additional obligations in the event of an occurrence The policyholder is obliged: a. to inform Anker in writing about the admittance of the insured person into a hospital or rehabilitation centre without delay, but not later than 48 hours of the admittance; b. to provide Anker with a certificate of the attending physician attesting to the fact that the admittance, the treatment, the transport of the patient, the emergency transport (by helicopter) and/or repatriation is necessary on medical grounds; c. to request the prior consent of Anker in case of repatriation of the insured person by reason of illness, an accident or death; d. to provide Anker with an original account of the expenses which qualify for compensation. This account must be specified in such a manner that, without making any further enquiries, Anker can deduce therefrom which compensation it is obliged to pay; e. to provide this original account to Anker within one year of the date thereof. No compensation will be paid if the policyholder is unable to provide the original account within the specified term. Article 27 Specific exclusions The policyholder cannot invoke this insurance or derive any rights therefrom: 27.1 if and to the extent the policyholder is not obliged to reimburse the cost incurred by the insured person under the individual employment contract and/or the collective bargaining agreement; 27.2 for form-enhancing surgery and the consequences thereof when the reason for this surgery arises from a personal need or personal circumstance; 27.3 for dental treatment caused by deferred dental maintenance. MEDICAL EXPENSES HOMELAND MODULE The terms and conditions of this module will only apply if the policy schedule expressly shows that this module has been included under the insurance policy. Article 28 Essence of the module The purpose of this module is to offer the policyholder an insurance policy providing cover for medical expenses incurred in the homeland of the insured person. Article 29 Extent of the cover for medical and dental expenses If proven medically necessary, Anker will reimburse the expenses incurred by the insured person in his or her homeland for medical and dental care needed as immediate and exclusive result of an illness which has manifested itself and/or an accident which has occurred during the period referred to in articles 5 and 6 herein. vw-aci-eur-en dec-2010 page 15 of 24

16 Article 30 Maximum compensation Anker will only cover: 30.1 The expenses: a. insofar as the policyholder is obliged to reimburse these expenses to the insured person; b. based on the locally recognized rates, however, subject to a maximum of 200% of the (maximum) statutory rate or rate in accordance with market terms established for treatment in the Netherlands; c. incurred within 365 days, counting from the date of the accident, or in the event of an illness, the first day of the medical or dental treatment; d. not exceeding the maximum amounts referred to in this article a. The costs of admittance into and treatment in a hospital or rehabilitation centre up to a maximum of EUR 250,000 per occurrence, including the nursing costs not exceeding a sum of EUR 750 per day. The costs of admittance into and care in a hospital or rehabilitation centre are covered up to a maximum not exceeding the costs of hospitalization and care in the lowest class. b. If the insured person is admitted into hospital several times due to one and the same occurrence, this repeated hospitalization will be considered as one admittance The medical expenses which do not involve an admittance into a hospital or rehabilitation centre, up to a maximum of EUR 15,000 per occurrence The costs of medication or dressing materials up to a maximum of EUR 2,500 per occurrence, on a physician s orders and charged by an official body legally authorised in that capacity The costs of artificial appliances and devices up to a maximum of EUR 3,500 per insured person after receiving prior written consent of Anker in case of: - hand, arm, foot and leg prostheses; - facial prostheses; - eye prostheses Dental expenses up to a maximum of EUR 1,000 per insured person per occurrence The costs of patient transport necessary on medical grounds, both from and to the nearest hospital or the place where the treatment is given, up to a maximum of EUR 2,000 per insured person per occurrence. Article 31 Additional obligations in the event of an occurrence The policyholder is obliged: a. to inform Anker in writing about an admittance of the insured person into a hospital or rehabilitation centre without delay, but not later than 48 hours of this admittance; b. to provide Anker with a certificate of the attending physician attesting to the fact that hospitalization, treatment and/or patient transport are necessary on medical grounds; c. to request the prior consent of Anker in case there are costs involved for artificial appliances and devices; d. to provide Anker with an original account of the expenses which qualify for compensation. This account must be specified in such a manner that, without making any further enquiries, Anker can deduce therefrom which compensation it is obliged to pay; e. to provide Anker with this original account within one year of the date thereof. No compensation will be paid if the policyholder is unable to provide the original account within the specified term. Article 32 Specific exclusions The policyholder cannot invoke this insurance or derive any rights therefrom: 32.1 if and to the extent the policyholder is not obliged to reimburse the costs incurred by the insured person under the individual employment contract and/or the collective bargaining agreement; 32.2 for form-enhancing surgery and the consequences thereof when the reason for this surgery arises from a personal need or personal circumstance; 32.3 for dental treatment caused by deferred dental maintenance. TEMORARY DISABILITY MODULE The terms and conditions of this module will only apply if the policy schedule expressly shows that this module has been included under the insurance policy. Article 33 Essence of the module The purpose of this module is, in the event of an insured person s sick leave due to illness, to assess, on the instruction and on behalf of the policyholder, the temporary disability of the insured person, to verify the sick leave due to illness arising therefrom and to grant an insurance benefit in connection with this sick leave due to illness. The policy schedule expressly shows whether the policy provides cover for temporary disability as a result of: a. an illness, or c. an accident, or d. an illness and an accident. Article 34 Extent of the cover for temporary disability If the insured person has become temporarily incapacitated for work as an immediate and exclusive result of an illness which has manifested itself and/or an accident which has occurred during the period referred to in articles 5 and 6 herein, the policyholder will be entitled to the following services and insurance benefit: a. establishing the temporary disability and verification of the sick leave due to illness arising therefrom; b. an insurance benefit by virtue of the assessed temporary disability. vw-aci-eur-en dec-2010 page 16 of 24

17 Article 35 Determination of temporary disability, sick leave verification and the extent of the insurance benefit 35.1 On the instructions and on behalf of the policyholder Anker will determine the disability and the extent and duration of the insurance benefit on the basis of the report or reports drawn up by the medical and other experts to be appointed by Anker. The disability is determined on the basis of the occupational disability criterion. In addition, Anker will verify the course and duration of the sick leave due to illness The entitlement to insurance benefit commences on expiry of the excess period. This excess period starts on the date that the insured person consults a physician for treatment and this physician has issued a certificate of incapacity Anker determines the insurance benefit for each insured person per working day on the basis of the percentage of the insured person s annual salary specified in the policy schedule, which is applicable on the first day of absence The entitlement to services and insurance benefit by virtue of this module ends on the date that the insured person is fully recovered and has been declared fit for work, or if earlier: a. on the date that the duration of the insurance benefit specified in the policy schedule has expired, or b. on the date that the policyholder s payment obligation for temporary disability under the individual employment contract and/or collective bargaining agreement ends, or c. on the date that the permanent disability or permanent incapacity for work of the insured person can be determined, or d. on the date of death of the insured person, or e. on the date on which the employment contract is terminated For calculating the duration of the insurance benefit and the excess period, the periods of illness will be added up if one period of illness is followed by another with an interruption of less than 30 days, unless the disability prior or contiguous to this period cannot reasonably be deemed to arise from the same cause When Anker considers the insured person to be completely recovered and fit for work on the basis of information furnished by the medical and other experts appointed by Anker, it will provide the policyholder with a written certificate of fitness for work within 48 hours. Article 36 Mediation 36.1 If Anker has certified that the insured person is fully recovered and fit for work and this insured person disagrees, the ability or disability to work will be decided by mediation Anker will give the insured person the opportunity to appoint a physician at his or her option. On the instructions of Anker this physician must certify objectively and on medical grounds whether the insured person is fully recovered and fit for work. In respect of the disorder of the insured person this physician must be legally authorised to practise medicine and be recognized by the official, legally competent authorities accordingly Prior to this certification Anker will provide the following information to the appointed physician: a. all medical and other data on the basis of which Anker has certified that the insured person is fully recovered and fit for work; b. the criteria by which the ability or disability to work must be determined. The costs attaching thereto shall be borne by Anker If the physician appointed by the insured person deems this insured person to be not fully recovered and fit for work, Anker will arrange one or more mediation sessions where the following persons will be represented: a. The medical and other experts appointed by Anker and possibly a lawyer on behalf of Anker; b. The insured person, the physician appointed by him or her and possibly a lawyer on behalf of the insured person; c. An independent mediator appointed by Anker. The purpose of these mediation sessions is to try to reach agreement on the ability or disability to work of the insured person. If an agreement is reached, the mediator will draw up a contract of settlement which must be signed by all the parties involved in these mediation sessions. After having signed the contract of settlement, this contract will have a binding effect on the parties If parties are unable to reach an agreement, Anker will request the mediator to deliver an opinion on the ability or disability to work of the insured person. In the context of this contract of insurance this opinion will have a binding effect on Anker, the insured person and the policyholder. If the insured person fails to refer to the mediator s opinion, there will be lack of insurance cover. The provision of services by Anker will end at that very time. The insurance payment to the policyholder amounts to the sum determined on the basis of the recommendations made by the mediator The costs involved in determining this sum by mediation shall be borne by Anker If the insured person refuses to render his or her cooperation in determining this sum by mediation, there will lack of insurance cover. The provision of services by Anker will end at that very time. The insurance payment to the policyholder amounts to the sum determined in accordance with article 35 herein. Article 37 Special clauses for Filipino insured persons If the insured person is a resident of the Philippines, the contents of article 36 herein, Mediation, will be considered to be replaced by the contents of this article If Anker has certified that the insured person is fully recovered and fit for work and this insured person disagrees, the dispute will be submitted to the National Labor Relations Commission (NLRC) for settlement With respect to the costs attaching to this settlement of disputes, Anker will comply with the apportionment of costs of the National Labor Relations Commission (NLRC) If the insured person refuses to render his or her cooperation in the settlement of the dispute by the National Labor Relations Commission (NLRC), there will be lack of insurance cover. The provision of services by Anker will end at that very time and the insurance payment to the policyholder amounts to the sum determined in accordance with article 35 herein. vw-aci-eur-en dec-2010 page 17 of 24

18 Article 38 Additional obligations at the commencement and during the term of the insurance The policyholder is obliged to: 38.1 provide Anker at the commencement of the insurance with the individual employment contract and the collective bargaining agreement concluded with the insured person, on which his obligation to pay rests in case of temporary disability due to illness and to inform Anker on the alterations thereto without delay but within 30 days at the latest provide Anker with those modifications made to the individual employment contract and the collective bargaining agreement on which the payment obligation rests which imply a change of the insured contractual payment obligation, without delay but within 30 days at the latest. Anker is entitled to terminate the contract of insurance or to adjust the premium and/or the conditions to the altered contractual payment obligation. In the event that the premium and/or conditions are adjusted, the insurance will be altered as from the date on which the alteration of the policyholder s contractual payment obligation has entered into force. Anker will notify the policyholder of this alteration in writing. The policyholder will be deemed to be in agreement with this alteration, unless he cancels the insurance policy within 30 days of receipt of the written notification of Anker pertaining to the alteration. In that case the insurance will end on the date on which the alteration of the policyholder s contractual payment obligation has entered into force. If the policyholder has failed to inform or timely inform Anker of an alteration of his contractual payment obligation, his contractual payment obligation will be determined on the basis of the most recent individual employment contract and collective bargaining agreement on which this payment obligation rests provide Anker at the commencement of the insurance with a written authorisation and instructions by which the policyholder authorizes and instructs Anker to establish a temporary disability and to verify the sick leave due to illness of an insured person arising therefrom. Article 39 Additional obligations in the event of temporary disability 39.1 The policyholder is obliged to inform Anker in writing of the insured person s disability without delay but within 5 days at the latest The policyholder is obliged to provide Anker with the certificate attesting to the disability as defined in article 35.2 herein The policyholder and the insured person are obliged to render their full cooperation in establishing the ability or disability to work, the related insurance benefit and, if applicable, determination thereof on the basis of mediation The policyholder is obliged to refrain from any commitment, statement or act with respect to the insured person pertaining to the insured person s temporary disability or the determination thereof The policyholder is obliged to provide Anker without delay with all information he receives relating to the insured person s disability or the determination thereof For the purpose of promoting the reintegration of the insured person, the policyholder and the insured person are obliged to render their cooperation in adapting the work, the work conditions or job shifts which can in reasonableness be expected from the policyholder and the insured person The policyholder is obliged to notify Anker in writing of the death of the disabled insured person without delay but within 5 days thereof at the latest. Article 40 Specific exclusions The policyholder cannot invoke this insurance or derive any rights therefrom: 40.1 If and to the extent the policyholder is not obliged to pay the insured person an insurance benefit for temporary disability due to illness pursuant to the individual employment contract and/or the collective bargaining agreement If the insured person impedes his or her recovery process If the insured person fails to cooperate in determining his or her temporary disability and the verification of the sick leave due to illness arising therefrom If, irrespective of the determination of his or her temporary disability pursuant to articles 35, 36 or 37 herein, the insured person claims a higher insurance benefit or a longer duration of this benefit from the policyholder by other means. The provision of services by Anker will end on that very day. The insurance payment made to the policyholder amounts to the sum determined pursuant to articles 35, 36 or 37 herein If the insured person is unwilling to perform the agreed work which he or she is considered capable of carrying out by the medical or other appointed experts, or is not given the opportunity by the policyholder to perform the agreed work. PERMANENT DISABILITY MODULE The terms and conditions of this module will only apply if the policy schedule expressly shows that this module has been included under the insurance policy. Article 41 Essence of the module The purpose of this module is to provide an insurance benefit to the policyholder in the event of permanent disability of an insured person. The policy schedule expressly shows whether the policy provides cover for permanent disability as a result of: a. an illness, or b. an accident, or c. an illness and an accident. vw-aci-eur-en dec-2010 page 18 of 24

19 Article 42 Extent of the cover for permanent disability Anker will pay an insurance benefit if the insured person has become permanently, wholly or partially, disabled as an immediate and exclusive result of an illness which has manifested itself and/or an accident which has occurred during the period referred to in articles 5 and 6 herein. Article 43 Determination of permanent disability and extent of the insurance benefit 43.1 a. Anker will assess the presence and degree of disability after 365 days, counting from the date that the illness has manifested itself and/or the accident has occurred, or earlier if the disability has been declared to be of a permanent nature. b. If Anker is of the opinion that the presence and/or degree of permanent disability can still not be definitely assessed after 365 days, it may postpone this assessment, however, only until the date on which 730 days have elapsed since the date the illness has manifested itself and/or the accident has occurred. Anker will pay the statutory interest rate on the amount due commencing 366 days after the date on which the illness has manifested itself and/or the accident has occurred a. Anker will determine the presence and degree of permanent disability by means of the Guides to the Evaluation of Permanent Impairment of the American Medical Association (A.M.A.). Anker applies the A.M.A.-guide edition referred to in the policy schedule. b. If the relevant A.M.A.-guide does not specify the nature of the disorder, Anker will determine the presence and degree of permanent disability by means of the report or reports drawn up by the medical and other experts to be appointed by Anker. c. In determining the degree of a loss or loss of function of part of the body, Anker will take only internal artificial appliances and aids into account and will not consider the external ones. d. In determining the degree of permanent disability Anker will not take the insured person s occupation into account a. The degree of permanent disability is expressed in a disability percentage. This disability percentage is equal to the benefit rate and is multiplied with the sum insured specified in the policy schedule. b. The insurance benefit for an insured person amounts up to a maximum of 100% of the sum insured specified in the policy schedule In the event that the insured person dies as an immediate and exclusive result of the same illness or the same accident before the degree of permanent disability has been determined by Anker, the entitlement to an insurance benefit under this module will remain in existence. Anker will determine the degree of permanent disability on the basis of the permanent disability as could be expected on the basis of the report or reports drawn up by the medical and other experts to be appointed if the insured person had not died. Article 44 Arbitration 44.1 If the policyholder disagrees with the defined disability percentage, this percentage will be determined by arbitration The policyholder will give the insured person the opportunity to have permanent disability objectively established on medical grounds by a physician in the Netherlands. With respect to the insured person s illness or injury, it is required that this physician is legally authorised to practise medicine and that he is generally recognized accordingly by the official, legally competent authorities. If the state of health, which is to be objectively and medically rated, does not allow the insured person to be transported to the Netherlands, a Dutch physician will determine the permanent disability percentage at the place where this insured person is given treatment or is being nursed. The costs involved in determining this disability percentage shall be borne by the policyholder Anker and the policyholder appoint beforehand an independent physician in the Netherlands who in the event of an irreconcilable difference, within the boundaries of the fixed percentages, determines the definite disability percentage. With respect to the insured person s illness or injury, it is required that the physician is legally authorised to practise medicine and that he is generally recognized accordingly by the official, legally competent authorities. The costs involved herein shall be jointly borne by Anker and the policyholder on a fifty-fifty basis. Article 45 Additional obligations in the event of permanent disability The policyholder is obliged: 45.1 to inform Anker in writing of an illness and/or accident which may result in permanent disability of an insured person without delay but within 30 days at the latest to inform Anker in writing of the death of the insured person in question before the insurance benefit has been granted by virtue of this module without delay but within 5 days at the latest. Article 46 Specific exclusion The policyholder cannot invoke this insurance or derive any rights therefrom: 46.1 If and to the extent the policyholder is not obliged to pay the insured person an insurance benefit in the event of permanent disability or permanent incapacity for work pursuant to the individual employment contract and/or the collective bargaining agreement If the insured person impedes his or her recovery process If the insured person fails to cooperate in determining his or her permanent disability if the permanent disability has been caused, created, worsened or stimulated by, or has arisen from an illness, a disorder, a disease or ailment which already existed or gave cause for complaints at the time the insured person signed up, while the insured person was aware thereof. vw-aci-eur-en dec-2010 page 19 of 24

20 CONTRACTUAL PAYMENT OBLIGATION MODULE IN THE EVENT OF PERMANENT DISABILITY OR PERMANENT INCAPACITY FOR WORK The terms and conditions of this module will only apply if the policy schedule expressly shows that this module has been included under the insurance policy. Article 47 Essence of the module The purpose of this module is in the event of permanent disability or permanent incapacity for work of an insured person on the instructions and on behalf of the policyholder to determine his contractual payment obligation and to provide an insurance benefit in connection with this disability or incapacity for work. The policy schedule expressly shows whether the policy provides cover for permanent disability or permanent incapacity for work caused by: a. an illness, or; b. an accident, or; c. an illness and an accident. Article 48 Extent of the cover for a contractual payment obligation in the event of permanent disability or permanent incapacity for work 48.1 If the insured person has become permanently, wholly or partially, disabled as an immediate and exclusive result of an illness which has manifested itself and/or an accident which has occurred during the period referred to in articles 5 and 6 herein, the policyholder will be entitled to the following services and insurance benefit: a. determination of the policyholder s contractual payment obligation on the basis of his individual employment contract and collective bargaining agreement concluded with the insured person; b. a benefit in accordance with the payment obligation stipulated by contract Irrespective of the policyholder s actual contractual payment obligation, the insurance benefit will not exceed the sum determined pursuant to articles 49, 50 and 51 herein Anker determines the policyholder s contractual payment obligation and the related insurance benefit on the basis of the latest individual employment contract and collective bargaining agreement provided by the policyholder to Anker on which the payment obligation is based. If on the basis of a more recent individual employment contract and collective bargaining agreement, which have not been provided by the policyholder to Anker, the policyholder has a higher contractual payment obligation, this obligation will not be covered. Article 49 Determination of permanent disability or permanent incapacity for work and extent of the insurance benefit 49.1 Anker will assess the presence and degree of permanent disability or permanent incapacity for work after the lapse of the period as referred to in the individual employment contract and the collective bargaining agreement on which the payment obligation is based, however at the latest after 365 days, counting from the date that the illness has manifested itself and/or the accident has occurred, or earlier if the disability or incapacity for work has been declared to be of a permanent nature On the instructions and on behalf of the policyholder Anker will determine the presence, the degree of permanent disability or permanent incapacity for work and the extent of the insurance benefit by means of the report or reports drawn up by the medical and other experts appointed by Anker. This determination will take place on the basis of the criteria referred to in the individual employment contract and the collective bargaining agreement on which the contractual payment obligation is based If the individual employment contract and/or the collective bargaining agreement on which the payment obligation is based do not provide any criteria for determining the nature of the disorder of the insured person, the disability criterion will be applied. Anker will determine the presence and the degree of permanent disability by means of the Guides to the Evaluation of Permanent Impairment of the American Medical Association (A.M.A.). Anker applies the A.M.A.-guide edition referred to in the policy schedule a. If the relevant A.M.A.-guide does not specify the nature of the disorder of the insured person, Anker will determine the presence and degree of permanent disability by means of the report or reports drawn up by the medical and other experts to be appointed by Anker. b. In determining the degree of a loss or loss of function of part of the body Anker will take only internal artificial appliances and aids into account and will not consider the external ones. c. In determining the degree of permanent disability Anker will not take the insured person s occupation into account. d. In the event that the insured person dies as an immediate and exclusive result of the same illness or the same accident before the degree of permanent disability has been determined by Anker, the entitlement to an insurance benefit under this module will remain in existence. Anker will determine the degree of permanent disability on the basis of the permanent disability as could be expected based on the report or reports drawn up by the medical and other experts to be appointed by it if the insured person had not died a. The degree of permanent disability or permanent incapacity for work is expressed in a disability or incapacityfor-work percentage. b. The insurance benefit amounts to the benefit rate related to the defined disability or incapacity-for-work percentage on the basis of the individual employment contract and/or the collective bargaining agreement on which the payment obligation is based, multiplied with the sum insured specified in the policy schedule. c. If the individual employment contract and/or the collective bargaining agreement on which the payment obligation is based do not provide any criteria for determining the benefit rate, the insurance benefit will amount to a percentage of the sum insured specified in the policy schedule, which is equal to the defined disability or incapacity-for-work percentage. d. The insurance benefit for an insured person amounts up to a maximum of 100% of the sum insured specified in the policy schedule. vw-aci-eur-en dec-2010 page 20 of 24