GENERAL TERMS AND CONDITIONS FOR HOME INSURANCE

Transcription

1 GENERAL TERMS AND CONDITIONS FOR HOME INSURANCE TABLE OF CONTENTS 1. CONCLUSION OF HOME INSURANCE CONTRACT AND STANDARD CONDITIONS OF CONTRACT 1 2. INSURED PLACE 1 3. INSURED ITEM 1 4. BUILDING 1 5. PART OF BUILDING 1 6. STRUCTURE 2 7. HOUSEHOLD PROPERTY 2 8. INSURANCE OF ADDITIONAL COST 2 9. INSURED EVENT CHOICE OF INSURANCE COVER SELECTED RISK PROPERTY INSURANCE ALL RISK PROPERTY INSURANCE RETENTION LIMIT INDEMNIFICATION SAFETY REQUIREMENTS AND PRUDENT CONDUCT SETTLEMENT OF DISBUTES OTHER PROVISIONS 5 1. CONCLUSION OF HOME INSURANCE CONTRACT AND STANDARD CONDITIONS OF CONTRACT 1.1. Insurer shall issue an insurance policy, based on data received from Policyholder. Insurance contract shall be considered as concluded if Policyholder pays the insurance premium in time. Insurance cover is effective from the beginning of insurance period under the conditions specified by insurance policy, even if the insurance premium has not been paid yet because of a later payment deadline If Policyholder fails to pay the insurance premium, it is assumed that s/he did not wish to conclude the contract under the policy conditions and the contract has not been concluded. In this case there is no insurance cover In case of an home insurance contract, the following standard policy conditions shall be applied: General Terms and Conditions by Salva Kindlustuse AS (KÜ-03); General Terms and Conditions for Home Insurance by Salva Kindlustuse AS (KKT-11.10). 2. INSURED PLACE Insured place shall be the address specified by insurance contract. Insurance shall cover only the insured place stated in insurance contract, unless agreed otherwise (See Section 7.5 of these General Terms and Conditions regarding the insurance of household property that is located elsewhere). 3. INSURED ITEM Insured item shall include the building, part of a building, structure, household property and additional costs specified by insurance policy. 4. BUILDING page 4.1. Building shall be a structure with a basement, walls, a roof and an interior, established on the ground Building may be a house or an outbuilding situated on the same property, e.g. garage, sauna, shed or another ancillary building. Integrated buildings, e.g. a garage integrated with the house, shall be insured as a single item. Only the building specified by the policy shall be covered Insurance of a building shall cover all existing essential parts, the lack of which would impair the integrity of the building or make the building unusable Essential parts of a building shall include the following: Any internal structures installed or waiting to be installed as well as thermal insulation and finishing elements; Technical systems situated inside or outside of the building or placed into the ground, which serve the building, e.g. water supply, sewerage, heating, ventilation, climate, communication and security systems or parts thereof; Besides the heating element also the fuel (supply for 12 months as a maximum) that is necessary for heating and is situated on the same property as the building Insurance of a building shall not cover household property, e.g. furniture (including integrated furniture), lighting fittings, household linen, kitchen and home appliances, hobby equipment, tools. Household property shall be insured as a separate item (See Section 7 of these General Terms and Conditions regarding the insurance of household property). 5. PART OF BUILDING 5.1. Part of a building may be a half of a semi-detached house, a section of a terraced house or an apartment A half of a semi-detached house and a section of a terraced house shall be ensured as a physical share. Insurance of a part of a building as a physical share shall mean in these General Terms and Conditions that the part of a building is insured as if it were a separate building Insurance shall not cover the part of the building that is not used by Policyholder and/or Insured Person and the existence/state of which has no direct effect on the part of the building to be insured An essential part of the building, which is not situated in rooms that are owned or used by Policyholder but which is situated on the same property and the good working order of which is essential for serving the insured part of the building, shall be covered proportionally to the size of insured property. Sample: In case a boiler meant for heating the whole terraced house is not situated in or is not directly adjacent to the insured part of the building and the heating of the insured part of the building is dependent on its good working order, this boiler together with the boiler room and fuel is covered to the extent of Policyholder's share of the property Half of semi-detached house and section of terraced house Sample: If Policyholder wishes to insure a section of a terraced house, the cover includes essential parts of a building situated within the boundaries of the insured section, as explained in these General Terms and Condition in respect of a building. A part of the building that is situated outside this section, e.g. the roof of the neighbouring section, is not covered and this part is or should be insured owners of neighbouring sections. Apartment Apartment is a physical share of a building, which can be separately used, altered, removed or added, without damaging another apartment or altering the external form of the building. Insurance of an apartment covers e.g. inner decoration, doors, windows, sanitary ware, power, -1-

2 heating, water supply, and sewerage systems (installed or to be installed) Insurance of an apartment covers balconies and loggias, with the exception of any unauthorized reconstruction that has not been approved by authorities As an exception, the insurance of an apartment covers the part of technical equipment that services the whole building, if it is situated in or crosses through the apartment and is essential for the functioning of the whole building. Sample: Insurance of a building covers also the central heating pipeline that is located in and crosses through the apartment and carries the heating water to other apartments In case of a dwelling that is an object of common ownership, the insurance of an apartment covers the part of the building that is administered and/or used by Policyholder or Insured Person independently from the other co-owner and pursuant to the specific agreement In case of a dwelling that is an object of common ownership, the insurance does not cover the part of the building which forms the bases for the security or functioning of the building, e.g. basement, load bearing walls, roof, and residencies for communities that should be insured jointly by co-owners. Sample:In case of a house that is an object of common ownership and where Policyholder buys an insurance cover only for rooms situated on the second floor and used by Policyholder, this insurance does not cover the roof, load bearing walls, the basement, the common hallway and other such parts of the building Insurance of an apartment does not include the following: Structural elements that are necessary for the life of a structure or securing its safety; Part of the building used jointly by all owners or co-owners of the apartment, e.g. basement, load bearing structures, roof, internal decoration in residencies for communities, external decoration of the building, public heating, power and ventilation systems, etc.; Household property (See Section 7 of these General Terms and Conditions regarding the insurance of household property) Insurance of a part of a building covers besides the heating element also the fuel (supply for 12 months as a maximum) that is necessary for heating and is situated on the same property as the building. 6. STRUCTURE 6.1. Structure is a construction work, which is not a building or a part of a building. Structure includes e.g. the following constructions: fence, exterior lighting settings, flagpole, barbeque house, shelter, pool Insurance of a house or a half of a semi-detached house or a section of a terraced house (hereinafter: the dwelling) covers all terrestrial and underground structures belonging to that dwelling The indemnification limit for structures shall be up to 10% of the sum insured of the dwelling, but not exceeding 32,000 euro. Structures are insured against same hazards and with the same retention limit as the dwelling Structures may also be mentioned separately on the insurance policy as insured items; structures that have been insured in such a way are no longer insured together with the dwelling Insurance of an apartment covers also a structure only if the structure is mentioned separately on the insurance policy as an insured item. 7. HOUSEHOLD PROPERTY 7.1. Household property shall include movables that are traditionally situated in the house/apartment, e.g. furniture, lighting fittings, household linen, clothes, footwear, sport equipment, kitchen and home appliances, tools, jewels, accessories that have been temporarily removed from a motor vehicle (roof storage, roof racks, bicycle carrier, spare wheels) If the insurance covers jewels, articles of value and artistic works, the insurance policy shall specify the maximum amount of insurance for these items Insurance of household property shall not cover the following: Foodstuff and beverage; Tobacco; Cash, securities or other documents, excluding driver's license, bank cards, passport and personal identification card (See Section 8.2 of these General Terms and Conditions regarding the indemnification for the issuance fee of documents); Motor vehicles and vessels, excluding mowers Household property kept in a storeroom (e.g. cellar storeroom) that is situated in an apartment house and belongs to the apartment or has been made available for the apartment owner is insured up to the amount specified by the insurance policy. Insurance shall cover household property that is situated outside the insured place only if specifically provided by the insurance policy. Insurance shall cover only the items listed under special terms and conditions of the policy (See Section 15.7 of these General Terms and Conditions regarding the ruled for keeping of household property). 8. INSURANCE OF ADDITIONAL COST Lock replacement cost shall be indemnified if the household property is covered by All Risk property insurance or if criminal offence risk has been selected for household property If a key of a front/back door has been stolen or lost, the replacement of the lock or lock mechanism with a similar lock or lock mechanism or the cost of recoding the lock shall be indemnified up to 320 euro Insurance of household property situated in storeroom Insurance of household property situated outside the insured place Lock replacement cost Document issuance fee If Policyholder has covered his/her home and household property with All Risk (See Sections 10.2 and 12 of these General Terms and Conditions regarding All Risk property insurance) property insurance, then in case the wallet of a person permanently residing in the insured place has been stolen, lost or destroyed unexpectedly, the Insurer shall indemnify the fee for issuing a new document (bank card, driver's license, passport, personal identification card). Living cost Insurance may cover only essential expenses necessary for renting an equivalent dwelling or moving, in case the dwelling has become uninhabitable due to a damage caused by insured event Living cost shall be insured if specifically mentioned on the insurance policy Indemnification limit for living cost shall be stated on the insurance policy Living cost shall be indemnified until the moment when the dwelling becomes inhabitable after restoration, but for -2-

3 no more than 24 months after the occurrence of loss and only up to the indemnification limit specified by the insurance policy. Living cost shall be indemnified also in case the insurance period has expired after the occurrence of loss Insurance shall not cover expenses that Policyholder should have made irrespective of the loss occurred, e.g. expenses made for utilities, power supply, communication. 9. INSURED EVENT Insured event shall mean a sudden and unforeseeable single event defined in the insurance contract, upon the occurrence of which the Insurer is obliged to pay insurance indemnity as provided by insurance terms and conditions. 10. CHOICE OF INSURANCE COVER Policyholder can choose between the cover of Selected Risk property insurance and that of All Risk property insurance In case of Selected Risk property insurance, Policyholder can choose risks he/she wishes the property to be insured against. The list of risks under Selected Risk property insurance is provided in Section 11 of these General Terms and Conditions In case of Selected Risk property insurance, the risk shall be insured to the extent specified in the insurance contract Insurance shall cover the risk after which there is the word "yes" written on the insurance policy in respect of the relevant insurable interest Pursuant to contractual limitations, All Risk property insurance provides cover against several risks and the coverage is wider than in case of Selected Risk property insurance All Risk property insurance shall cover all risks and hazards that are not mentioned in Section 12 of these General Terms and Conditions All Risk property insurance has been selected, if there is the word "yes" written on the insurance policy in respect of the relevant insurable interest Risks that may be covered by Selected Risk property insurance are fire, pipe leak, flood, storm damage and criminal offence Fire shall mean any loss caused by fire spread outside the specific firebox, smoke, grime and fire extinction actions If the insured item has been damaged or destroyed by a shockwave caused by an explosion of a boiler, tank or other pressure vessel, direct lightning strike or falling down of an aircraft, this loss shall also be insured under the insured risk 'fire', even if such an event has not caused any direct burning process Insurance shall not cover the loss caused by short-circuit, overcharge or other power-related reasons, if this has not caused any burning process Selected Risk property insurance All Risk property insurance 11. SELECTED RISK PROPERTY INSURANCE Fire Pipe leak Pipe leak shall mean a sudden leaking of water from the utility system that is servicing the house or from a device attached to this system Pipe leak insurance covers the loss caused by water, but does not compensate for expenses made for repairing the utility system. These risks can be covered by All Risk property insurance. Sample: If a water pipe situated in bathroom and installed into the wall is damaged and water pouring out ruins the bathroom floor, the pipe leak insurance covers expenses made for restoring the insured floor, but does not cover works necessary for repairing the damaged pipe Insurance shall not cover the water damage caused by melting snow, rain or other natural flood, if the sewerage system servicing the house cannot cope with the flood. This risk is insured under the insured risk 'flood' or under All Risk property insurance Insurance shall not cover the loss caused by a long-term process, e.g. corrosion, decay, excessive moisture, fungus or other equivalent phenomena Flood shall mean high water level caused by rain, melting snow, backwater, including backwater caused by storm, or groundwater, and water damaged caused by such high water level. Flood shall also include damage caused by water that enters the building through the sewerage system due to reasons stated above. Sample: If the central sewerage system cannot cope with the water pouring down due to heavy rain and the water enters the building through the sewerage system, the resulting loss is insured under the insured risk 'flood' Storm damage shall mean any loss caused by strong wind, hail, an item (excluding ice and water) carried by wind, or direct impact of a tree or pole falling down due to the wind. Strong wind shall be at least 20 m/s as measured by the closest weather station. Insurance covers the direct loss caused by storm If the structure of a building has been damaged by storm and rain or water from melting snow entering the building because of that causes additional damage, this is also covered under the insured risk 'storm damage' Insurance does not cover the loss accompanying the storm, e.g. damage caused by the loss of power supply due to storm Flood Storm damage Criminal offence Criminal offence shall mean theft of an insured item, if the theft is performed by destroying, breaking in or dismantling a block or a fastening Criminal offence shall also include the following: Vandalism where an insured item is deliberately damaged or destroyed by a third person; Deprivation of property through a violent act or by directly threatening with violence. 12. ALL RISK PROPERTY INSURANCE All Risk property insurance does not cover the following: Loss caused by sinking, rising or shifting of a building and/or parts of a building; Loss caused by excessive weight of ice or snow; Loss caused by precipitation (snow, ice, rain) to roof and wall structures; Loss caused by the low quality of construction or repair works; If the low quality of construction or repair works cause damage to flawless parts of a building, insurance shall indemnify this part of the loss subject to prior rectification of low-quality work that caused the loss. Provisions of these Section shall not be applied if the low quality of construction or repair works causes the loss mentioned in Sections ; Sample: An underfloor heating pipe that was incorrectly installed during the construction ruptures and causes water -3-

4 damage. This water damage shall be indemnified after the ruptured pipe is repaired or replaced. The cost of repairing or replacing the underfloor heating pipe that was incorrectly installed shall not be indemnified Loss caused due to using low-quality or unsuitable materials; If low-quality or unsuitable materials cause damage to flawless parts of a building, insurance shall indemnify this part of the loss subject to prior replacement or repair of materials that caused the damage. Provisions of these Section shall not be applied if the usage of low-quality or unsuitable materials causes the loss mentioned in Sections ; Sample:Loss caused by peeling the paint is not indemnified for, if the peeling was caused because of unsuitable exterior paint Loss caused by errors in design; Loss caused by vibration, except in case where vibration causes a collapse in the building and makes the building uninhabitable; Sample: Excavation and pile-driving works on the neighbouring property cause fissures in outer walls of the building. This damage is not insured Loss caused by long-term process, e.g. amortization, corrosion, decay, excessive moisture, fungus or other equivalent reasons; Aesthetic damage, e.g. scratches, paint variations, smudges, tear and other such damage that does not hinder the use of an item; Repair and maintenance cost; Loss due to damaging the sport equipment during the use; Loss caused by losing an item, except when insurance covers additional cost (See Section 8 of these General Terms and Conditions regarding the insurance of additional cost); Loss that shall be indemnified under a guarantee or any other contract; Intentional loss caused by Policyholder or a person under Policyholder's responsibility who is mentioned in Section 6 of General Terms and Condition of Salva Kindlustuse AS KÜ-03; also cases when a property is damaged due to actions caused by mental disorder of Policyholder or a person under Policyholder's responsibility; Embezzlement of the insured item by a fraudulent conduct of or extortion by a third person; Expropriation or legal demolition. 13. RETENTION LIMIT Retention limit shall mean an amount of money or another value specified in the insurance contract that is subtracted from the Insurer's performance obligation Insurer shall not indemnify the loss under the retention limit stated on insurance policy If the insured event causes damage to insured items with different retention limits, only the highest retention limit shall be taken into account Retention limit shall not be applied in the following occasions: The indemnification of door or window glasses of the insured building or part of the insured building that was damaged due to the occurrence of insured event; When the alarm signal was forwarded to an authorised security company by the alarm system in case of fire, water damage or breaking-in; The indemnification of lock replacement cost (See Section 8.1 of these General Terms and Conditions regarding the indemnification of lock replacement cost); The indemnification of document issuance fee (See Section 8.2 of these General Terms and Conditions regarding the indemnification of document issuance fee). 14. INDEMNIFICATION The objective of loss indemnification is to compensate reasonable repair, restoration or replacement cost that was necessary for restoring roughly the situation prior to the occurrence of an insured event. Additional cost due to insured event should also be compensated, if provided by insurance contract Sum insured shall mean the amount of money that is specified in the insurance contract and is the maximum amount of payment to be made by Insurer during the insurance period Underinsurance shall mean that the sum insured is lower than the value of insured item. Insurer shall not consider provisions on possible underinsurance when indemnifying for the loss and the limit of indemnification for loss shall be the sum insured Insurable value of a building shall mean the sum of expenditure necessary for the reinstatement of the equivalent building in its initial form and quality, less depreciation Depreciation shall mean a reasonable amount that reflects the state of the building, especially its age and amortization, and can be expressed as a percentage of its reinstatement cost. Relevant experts shall be used, if it is necessary to determine the depreciation of a building. Each party to the contract may use its own experts and shall pay for ordered services Normal price shall mean the price of an item, which has been insured as household property, on a local market, taking into account its age, physical depreciation and change in intangible value In case of an insured event related to a building, Insurer shall indemnify for the loss within the extent of insurable value of the building, but no more than the sum insured stated on the insurance policy In case of partial damage to a building, Policyholder shall not be entitled to request the indemnification for the whole building If depreciation of a building is less than 40% and Policyholder shows its interest towards restoring the destroyed or damaged building and organizes restoration works of the building on the same site in 2 years after the occurrence of loss at the latest, Insurer shall indemnify besides the insurable value also for depreciation, as well as for demolition and site clearance expenses necessary for restoration, up to the sum insured stated on the insurance policy If depreciation of a building is over 40% and Policyholder shows its interest towards restoring the destroyed or damaged building and organizes restoration works of the building on the same site in 2 years after the occurrence of loss at the latest, Insurer shall indemnify besides the insurable value also for demolition and site clearance expenses necessary for restoration, up to the sum insured stated on the insurance policy Core definitions Indemnification for loss resulting from damage to a building Indemnification for damage of household property If the damaged property can be repaired and reparation is economically justified, the repair cost shall be indemnified If the damaged property cannot be repaired or reparation is not economically justified, monetary compensation shall -4-

5 be paid. Where monetary compensation is paid, it shall be equal to the purchase price of a new equivalent item in case of items that are not older than 2 years, or normal price i.e. the price of an equivalent used item in case of items that are older than 2 years. In case of a work of art, jewellery or antique, the normal price of the item shall be indemnified Insurer shall pay the indemnification for loss caused by the occurrence of insured event within 14 days at the latest of the moment when he became aware of the cause and extent of loss, method of indemnification as well as the receiver of indemnification, and the beneficiary has given her/his consent if such a person has been named in the insurance contract Insurer shall send his decision to diminish or refuse indemnification to Policyholder within 14 days after the submission of all required evidence, documents and applications. 15. SAFETY REQUIREMENTS AND PRUDENT CONDUCT Besides requirements and recommendations listed in Sections , general safety requirements stated in Section 13 of General Terms and Conditions of Insurance of Salva Kindlustuse AS (KÜ-03) shall be applied If Policyholder should infringe a safety requirement stated in Insurance Terms and Conditions, increasing the occurrence risk of insured event or aggravation of loss, Insurer shall be entitled to decrease its contractual obligation to pay the insurance indemnity up to 50%, depending on the gravity of infringement Switched-on heat blowers, heated fireboxes, burning candles or other sources of fire shall not be left unsupervised It shall be forbidden to use an open fire for purposes not intended, e.g. for melting a frozen water pipe Safety precautions shall be taken when performing hot works or fire-risk works, in order to avoid the ignition of property during or after the performance of such work Rubbish and waste may be burnt only in a prescribed place and time It shall be forbidden to smoke in bed Chimneys shall be cleaned at least once a year Only a person of respective qualification may install electrical installations and equipments If a chimney for a furnace, fireplace or a sauna furnace is constructed by Policyholder or under his/her responsibility, minimum distance requirements foreseen for combustible material and smoking chimney shall be met. Only certified metal chimneys may be used Fire safety Safety of construction or repair work Utility systems If a building is not used and heated in winter in a permanent basis, all utility systems filled with freezing liquids shall be emptied If the heating is switched on in winter in a building that is not in permanent use, the power of the heating appliance shall be controlled in such a way that a sudden aboveaverage temperature would not cause any freezing damage When leaving home, all windows and doors shall be closed and locked. If the key is lost, the front/back door lock or the lock mechanism shall be replaced as soon as possible In case of an alarm system, the system shall be activated. If an alarm system has been installed to a building or an apartment, an expert shall service it at least once a year in order to guarantee its operating reliability Rooms, doors, windows, locks, keys, alarm system Keeping of household property Household property shall be kept in such a way that any third person has no free or simplified access to it. E.g. household property shall not be left in front of the front/back door of an apartment house or into a public hallway; also, it is not appropriate to keep the household property on ground-floor balconies Property shall not be left outside the building when leaving the house or for the night. E.g. bicycles, baby carts and mowers should be kept in a locked room Property that is designed for outside purposes and cannot be placed into a locked room on a daily basis due to its weight and/or measures may be kept in the yard on a permanent basis Household property shall not be left in a vehicle to be seen. E.g. sport equipment shall be placed in such a way into a vehicle that it cannot be seen or put into a locked compartment or attached to the vehicle with a locking device If a bicycle is temporarily kept e.g. in front of a school or a shop, it shall be locked using a bicycle lock. It is not necessary to lock a baby carriage or cart. 16. SETTLEMENT OF DISBUTES All disputes arising from insurance contracts shall be settled under these General Terms and Conditions as well as according to legislation of the Republic of Estonia If these General Terms and Conditions have been translated into another language, the settlement of disputes shall be based on the Estonian version of these General Terms and Conditions In order to settle the insurance disputes out of the court, the parties to a dispute shall be entitled to turn to the insurance dispute settlement body that is operating under the authority of the Estonian Insurance Association. If an agreement cannot be reached, the dispute shall be settled in Harju County Court (Harju Maakohus) Financial Supervision Authority supervises the compliance of Insurers with legislation. Financial Supervision Authority does not settle any contractual disputes between Insurers and Policyholders/Insured persons. 17. OTHER PROVISIONS Insurer shall be entitled to abstain from concluding an insurance contract without providing any justification. -5-