Business Travel Insurance

Transcription

1 T E R M S K 69:4 Business Travel Insurance Finalized in Jan Supersedes K 69:4 Moderna Försäkringar AB Göteborg Stockholm

2 General insurance terms from 1999 for Business Travel Insurance This being a translation of the Swedish original, the Swedish wording shall always prevail. The scope of the insurance is indicated in the insurance policy. General Contractual Conditions and Definitions and Explanations (AB-DF), respectively, have been collated in an offprint and apply to the text of these terms. Where the insurance policy, AB-DF and these terms contain conflicting commitments or provisions, the insurance policy shall have preferential right of interpretation over the Business Travel Terms, which in turn shall have preferential right of interpretation over AB-DF. An asterisk (*) indicates when words, expressions or concepts are defined under Definitions. Contents page 1 Validity and scope of the insurance 3 2 Insurance amount. Maximum indemnification 3 3 Illness and accident Indemnification in the event of disablement and death What is not covered by the insurance Discontinuing a journey/compensatory travel due to illness or accident 7 7 Crisis insurance 8 8 Luggage protection (all risk) Delays to luggage Liability as a private individual Legal protection as a private individual Assault protection (personal injury) General conditions Definitions 15 In the event of severe illness, disease, accidents or the Insured requiring assistance abroad, please contact: SOS-International A/S, Denmark. Please quote the insurance number when contacting SOS-International. Address and telephone number: SOS International A/S Nitivej 6 DK-2000 Frederiksberg DENMARK Phone Fax Telex SOS DK. Telegram SOSINTER

3 1 Validity and scope of the insurance 1.1 Who is covered by the insurance The insurance covers - all employees - spouse, cohabitee and any children accompanying the Insured on the journey, unless otherwise specified in the insurance policy and providing that the insurance agreement has been entered into by the employer. The Insured person is the owner of the insurance pertaining to him. Limitation Unless otherwise agreed, the insurance shall apply only to persons permanently resident in and covered by insurance from a national social insurance office in a Nordic country. For persons not insured with a regional social insurance office in a Nordic country, the insurance shall apply except in the event of illness and accident as set out below. 1.2 When the insurance provides coverage 1.3 Where the insurance provides coverage Unless otherwise agreed, the insurance covers business travel* from the time the Insured leaves his home or workplace until he returns to either place, subject however to a maximum period of 210 days calculated from the time of departure. The geographical scope of the validity for the insurance is set out by the insurance agreement. Note All references to Sweden in these terms shall also apply to any other country in which the Insured is resident. 2 Insurance amount. Maximum indemnification Modern Insurances s liability to pay indemnification is limited, unless otherwise agreed, to MSEK 20 for all claims during the insurance period. 3 Illness and accident 3.1 What is covered by the insurance The insurance shall otherwise apply with the insurance amount specified in the insurance policy or under the relevant clause. If the Insured falls ill or is befallen by an accident, compensation shall be granted for necessary and reasonable costs in accordance with the provisions below. Medical treatment Indemnification shall be granted for nursing and medical costs as well as treatment and facilities prescribed by a registered physician. 1

4 Dental care Dental care reimbursement shall be granted for the cost of any provisional treatment of emergency dental complaints required while travelling and carried out by dentists away from the place of residence. If the Insured s teeth are injured in an accident, indemnification shall also be granted for treatment carried out by dentists in Sweden. Both the treatment and the cost are subject to the prior approval of Modern Insurances. Certificates and other documentation In the event of dental injury arising from chewing or biting, indemnification shall be granted only for such temporary treatment as was administered away from the place of residence. Indemnification shall be granted for doctor s certificates and other documents required by Modern Insurances to settle the claim. Travel expenses If the Insured needs to travel in order to obtain medical attention or dental care, indemnification shall be granted for reasonable local travel expenses. Additional expenses for the home journey Repatriation of a deceased person If a qualified doctor at the place of stay deems that the Insured needs to return to home in Sweden, compensation shall be paid for additional expenses incurred on the journey home. Both the necessity of the journey home and the mode of travel shall be stipulated by the doctor and approved beforehand by Modern Insurances or SOS International in Copenhagen. If the Insured dies outside away from the place of residence in Sweden, Modern Insurances shall pay the cost of repatriating the deceased. Modern Insurances shall also pay the cost of such arrangements as are necessary to implement such transportation. Burial abroad If the Insured dies abroad, Modern Insurances may, instead of effecting transportation home to Sweden, pay the costs of burial at the location. Travel by close relatives* to a severely ill or deceased person If the Insured falls severely ill or is befallen by an accident abroad, and if the authorized physician deems his condition to be life threatening, Modern Insurances shall pay necessary and reasonable costs for tickets, board and accommodations of no more than 60 days for two close relatives return travel from Sweden. The above also applies if the Insured dies abroad and burial takes place at the location. Return travel from a country other than Sweden can be paid for but is subject to a maximum equal to the cost of equivalent return travel from Sweden. 2

5 3.2 The indemnification period In the event of illness, indemnification shall be granted only for such costs as relate to care and treatment within 60 days of the first visit to a doctor. In the event of an accident, the indemnification period has been set at a maximum of three years from the time of the accident. 3.3 Insurance amount, Maximum indemnification Modern Insurances s liability to pay indemnification under 3.1 is limited, unless otherwise agreed, to the insurance amount set out below. 4 Indemnification in the event of disablement and death Indemnification shall be granted for necessary and reasonable medical and nursing costs dental care costs travel expenses relating to additional expenses for travel home repatriation of the deceased burial abroad up to a maximum of 1 base amount* (Swedish official amount) close relatives travel to a severely ill or deceased person. 4.1 What is covered by the insurance The insurance covers accidental injury* and includes indemnification in the event of a lasting impairment in bodily function (medical disability*) when future working capacity is reduced by at least 50% as a result of the injury (financial disability*) in the event of death. The degree of disability shall be assessed according to the rules for medical and financial disability. 4.2 Indemnification rules Indemnification in the event of medical disability In the event of accidental injury resulting in financial disability, indemnification shall be paid out instead, calculated according to the degree of medical disability, where this results in greater indemnification. Indemnification can never be granted for both medical and financial disability. Such injuries and symptoms as are caused by the accident and are objectively determinable shall be taken as a basis for determining the degree of disability. The determination will be made irrespective of the degree to which the claimant s working capacity has been reduced owing to the accidental injury. If a lost body part can be replaced by an artificial limb or prosthesis, the degree of disability shall also be determined taking prosthetic function into account. 3

6 Medical disability is calculated in accordance with a table used jointly by the insurance industry Indemnification in the case of financial disability Where the same accident has given rise to injuries to several body parts, indemnification shall be awarded in accordance with a maximum calculated disablement rate of l00%. Only such injuries and symptoms as are caused by the accident and are objectively determinable shall be taken as a basis for determining the degree of financial disability. Determination of such financial disability shall be guided by the loss of working capacity brought about by the accidental injury, making reasonable allowance for age, previous education, training and level of activity, retraining or other such initiatives as well as housing situation. Where the accidental injury has brought about a permanent reduction of at least 50% in the Insured s working capacity and the national insurance office has awarded early retirement pension in pursuance of the Swedish General Insurance Act, disability compensation shall be paid out as follows: Level of early retirement Disability compensation as a pension percentage of the insurance amount 100% 100% 75% 75% 50% 50% If early retirement pension is granted from the completion of the 60th year, inclusive, or later, indemnification shall be granted for financial disability only if the degree of medical disability resulting from the accidental injury is at least 50%. Similar conditions shall apply if the Insured has also been awarded less than full early retirement pension and receives full early retirement pension on completion of his 60th year. If the Insured is drawing a partial temporary disability pension or partial early retirement pension at the time of the claim, the maximum amount of financial disability compensation awardable shall be equal to the loss of residual working capacity. If the Insured is drawing full temporary disability pension or full early retirement pension at the time of the claim, no indemnification for financial disability shall be granted. An insured party who has completed his 60th year at the time of the accident shall be granted indemnification for medical disability only. 4.3 Disability capital Indemnification shall be paid out by a proportion of the insurance amount equivalent to the degree of disability at the age attained by the Insured at the time of the accident The right to disability capital The right to disability capital shall accrue if the accidental injury results in disablement within three years of the accident and at a remove of at least 12

7 months from the time of the accident. As soon as the definitive degree of disability has been ascertained, the disability capital will be paid out. 4.4 Option of having indemnification reviewed if disability increases Ascertainment of the definitive degree of disability shall be made within three years of the accident, if possible, but may be deferred for as long as necessary on the grounds of medical experience or with reference to the rehabilitation facilities available at the time. If treatment has been fully completed and the definitive degree of disability can be ascertained within the first twelve months to have elapsed since the accident, the right to indemnification shall accrue and indemnification shall be paid out once the degree of disability has been ascertained. If the accidental injury results in substantial and permanent impairment of the Insured s bodily function or if the Insured loses additional working capacity after final settlement has been made, the Insured shall be entitled to revert and have the degree of disability reviewed. 4.5 Anticipatory indemnification* 4.6 Technical aids in the event of disablement 4.7 Indemnification in the case of death However, no review will be granted once more than 10 years has passed from the time of the occurrence of the accident. If the definitive degree of disability is not ascertained when the right to indemnification accrues, anticipatory indemnification shall be paid out from this point until such time as it is ascertained. At the beginning of each 12-month period (indemnification year), calculated up to the point when the right to indemnification accrued, the degree of disability to be applied during the indemnification year shall be ascertained. The degree of disability is the minimum degree to which the accident is deemed to give rise. Anticipatory indemnification during the indemnification year constitutes 6% of the one-off sum corresponding to the degree of disability ascertained for the indemnification year. In addition to the indemnification triggered by disablement, as determined on the basis of the degree of disability, indemnification shall be awarded for such technical aids as are prescribed by a doctor as necessary to alleviate the state of disability and not reimbursable by any other party under Swedish law or any special statute. Indemnification shall be granted to a maximum total of SEK 50,000 and only for expenses approved beforehand by Modern Insurances. The right to indemnification in the case of death exists if the accidental injury occasions the death of the Insured within three years of the accident. Indemnification constitutes the insurance amount for death. If a one-off amount for disablement has already been paid out for the same accident by Modern Insurances or if entitlement exists to such indemnification but it has not yet been paid out, compensation for death shall be reduced by the disability compensation. Beneficiary Unless some other provision has been notified in writing to Modern Insurances, the beneficiary is the Insured s spouse/cohabitee/registered partner and child or, where no such relatives exist, legal heirs. 5

8 4.8 Insurance amount, Maximum indemnification Modern Insurances s liability to pay indemnification is limited, unless otherwise agreed, to MSEK 20 in total where several persons are injured by the same cause and in the same instance. Capital amount in the event of an accident If the Insured is affected by an accident and the accident results in disablement or death, indemnification shall be granted as follows: The insurance amount the one-off amount for disablement and death is - death amount 5 base amounts - capital amount assuming 100% disablement, before completion of 65th year, 10 base amounts - capital amount assuming 100% disablement, after completion of 65th year 5 base amounts 5 What is not covered by the insurance Higher amounts can be agreed, in which case they will be indicated in the insurance policy. 5.1 Exceptions 5.2 Hazardous activities Accidental injury does not cover - injury arising due to infections from bacteria, germs, viruses or any other infectious matter; - injury arising as a result of using a medical preparation or from operations, treatments or investigations not due to accidental injury covered by this insurance; - conditions which in the light of medical experience cannot, even where ascertained after an accident, be regarded as due to the accident but are connected with illness, physical defect or deformity, or pathological changes. Where such physical infirmity can be assumed to have resulted in a worsening of the consequences of the injury, indemnification shall be granted only for those consequences arising independently of the physical infirmity; - injury where the event that caused the injury was due to the Insured being under the influence of alcohol, other intoxicants, sedatives, drugs, narcotics or due to abuse of medicines. Indemnification shall not be granted for costs associated with or accidental injury sustained by the Insured when taking part in: - parachuting, kite surfing, hang gliding, paragliding, mountain climbing, mountaineering, bungee jumping, white water rafting, off-piste skiing and comparable activities - previously advertised sporting and athletics competitions or training specially arranged for such and organized by anyone other than an inter-company athletic association. 6

9 5.3 Costs excluded Indemnification according to 3 Illness and accident shall not be granted for costs - based on the presence of a need for care when the Insured started travelling. Note: If the state of health worsens unpredictably during travel, indemnification shall be granted only for the additional expense entailed by such deterioration of health. - relating to a stay at a public bath or spa and associated travel - for injuries occurring when the Insured was mentally ill, under the influence of alcohol, other intoxicants, sedatives, drugs, narcotics or due to abuse of medicines. Note: This limitation does not apply if the offending party can show that there is no connection between the injury and the factor herewith mentioned. - incurred because a ship or aeroplane having had to alter its timetable owing to the Insured s injury or illness - brought about by childbirth or illness in connection with pregnancy after the seventh month of pregnancy - of private nursing (in the Nordic countries) - of preventive health care, pregnancy testing and routine dental care - of repatriation or other transportation brought about solely by the Insured s fear/ worry about the risk of infection - reimbursable by another party under Swedish law, another statute, convention or other insurance. 6 Discontinuing a journey/compensatory travel due to illness or accident 6.1 Additional costs of travel home 6.2 New outward journey or compensatory travel If the Insured is forced to discontinue his business travel before the appointed time on account of a close relative in Sweden falling seriously ill or being befallen by an accident and a doctor deeming their condition to be life threatening, indemnification shall be granted for - necessary and reasonable additional costs for the return journey by a means of transport in regular service to the place of residence in Sweden - travelling and/or hotel expenses that cannot be repaid by the travel company, hotel or suchlike. If the Insured is forced to discontinue his business travel before the appointed time on account of illness or accident and if, according to a statement from an authorized doctor, the Insured cannot carry out his work, indemnification shall be granted for - travel for a substitute (return ticket) if for business reasons the employer has had to substitute another person for the Insured - the cost of a new outward journey if repatriation occurred at a time when the Insured was set to resume work following recovery, as well as the cost of any substitute returning home - unspent actual travel costs in cases where no substitute was sent out or when the Insured was not set to resume work at the location, provided that such costs cannot be reimbursed by any other party, airline company, tour operator, hotel or suchlike. 7

10 6.3 Insurance amount. Maximum indemnification Modern Insurances s liability to pay indemnification is limited, unless otherwise agreed, to the insurance amount stated below. 7 Crisis insurance Indemnification shall be granted for necessary and reasonable - additional costs for the journey home - travel and hotel expenses up to a maximum of SEK 25,000 - cost of a new outward journey or home journey - unspent travel expenses up to a maximum of SEK 15, What is covered by the insurance This insurance provides crisis therapy for an insured party subjected during the exercise of his duties to any of the events below, resulting in an acute psychological crisis: - Robbery, assault or threats - Accidents - Fire, explosion or burglary at the workplace - Traffic accidents The insurance covers crisis therapy (consultation with a psychologist) limited to ten sessions of treatment per insured and per claim. The period during which treatment is provided is limited to 12 months from the claim event. Treatment shall be administered by an authorized psychologist and subject to approval by Modern Insurances prior to treatment. Travel expenses Indemnification shall be granted for the Insured s necessary and reasonable travel expenses for travel within the country of residence. 7.2 Insurance amount. Maximum indemnification Modern Insurances s liability to pay indemnification under these special terms is limited, unless otherwise agreed, to 10 official base amounts in connection with each claim event, including travel expenses. 7.3 Excess The insurance applies without an excess. 7.4 Action in the event of a claim Any crimes shall be reported to the police. 8

11 8 Luggage protection (all risk) 8.1 What is covered by the insurance Insured property The insurance covers property (luggage), including property especially liable to be stolen* and travel documents* belonging to the Insured or rented or borrowed by him in the country of residence and taken along on the journey. The insurance also covers effects belonging to the employer that have been taken along, though only to the extent that indemnification cannot be obtained through any other insurance or agreement Theft and other material damage Indemnification shall be granted for such damage to or loss of luggage travelling with the Insured as is caused by sudden and unforeseen events Additional costs Indemnification shall be granted for necessary and reasonable additional costs arising as a direct consequence of a claim in accordance with the above that provides grounds for compensation. Such additional costs, which must be attested, may be costs incurred in blocking charge, banking or credit cards, travel expenses for making a report to the police or any other similar costs. 8.2 What is not covered by the insurance Property excepted Exceptions The insurance does not cover - motor-driven vehicles, caravans or any other towed vehicle, boat or aircraft, and parts and equipment for such property - goods intended for sale, nor drawings, manuscripts, archives and data media - animals and furniture and other items in the process of being moved between localities - tools and sample collections. Indemnification shall not be granted for - property kept at night in a parked car or any other vehicle. Nor will property especially likely to be stolen be indemnified if left unattended in a car or other vehicle - damage to cash, travel documents or objects made partly or entirely of precious metal, real pearls and precious stones, as well as cameras with accessories, where such property is checked in for transit or luggage registration - damage as a result of abrasion or wear and tear - external damage to suitcases and similar, such as denting, scoring or the like, without any major effect on its serviceability - damage as a result of defective or unsuitable packaging - damage as a result of the leakage of any fluid or sticky items taken along - damage that can be indemnified through some other insurance, transport company, hotel or suchlike - damage to sports appliances when in use. 9

12 8.3 Insurance amount. Maximum indemnification The insurance provides coverage by the insurance amount specified below. - personal property 1 official base amount including property especially likely to be stolen and effects belonging to the employer 50% of the official base amount - travel documents 30% of the official base amount - money 10% of the official base amount - additional costs as per % of the official base amount 8.4 Standard of negligence Apart from the normal prudence requirements to prevent theft or damage: - means of transport and temporary dwellings like a bungalow, apartment, hotel room, passenger cabin and similar must not be left unlocked or with windows open - money, travel documents and property especially likely to be stolen must be locked inside a suitcase, cupboard, locker, drawer or suchlike when the Insured leaves the residence, hotel room, means of transport, etc. This also applies to any property especially likely to be stolen that can be locked up Failure to observe standard of negligence 8.5 Damage assessment rules If the standard of negligence has not been met, the indemnification can be reduced unless such negligence has been minor or of slight importance to the insurance case. In the event of gross neglect, indemnification may be forfeited altogether Books, antiques, etc. For books, antiques, works of art, coins, notes, stamps and collections or objects of value to a collector, damage shall be assessed as the cost on the ordinary free market of purchasing property of equal value in the state in which it was at the time of the claim event. If property of equal value is not available to buy secondhand, the property will be assessed at what it is likely to have cost, had it been available. Collections will be assessed in their entirety Photographs and other items Other property especially prone to theft For photographs, films, records and tape recordings, the damage will be assessed at market value, where available, and failing that, at the cost of replacing the raw material. Damage shall be assessed at the cost of buying a new item as identical as possible to the object damaged. If the Insured does not replace the item within six months or if the article declines in value by more than 50% of the price of a new object, Modern Insurances shall pay the current cash value. The current cash value (market value) is the as-new replacement value less the reduction in value due to age, wear, obsolescence, diminished usability and other considerations Other assessment rules Assessment of a claim is based on the price level at the earliest point when the Insured can determine his indemnification claim, though no later than two months from the day of the claim. 10

13 Where damaged property can be repaired, damage shall be assessed at the repair cost that is reasonable. The repair cost may never exceed the indemnification the Insured is entitled to receive in accordance with the above rules Indemnification rules for personal property Note: Cheques, bankbooks, charge cards and suchlike will be indemnified only by the costs that may arise for the purpose of freezing the account in question. If an unauthorized person makes use of the account and this results in a financial loss for the Insured, this cost is not indemnifiable through the insurance. Modern Insurances is entitled to decide whether a claim is to be indemnified in cash or in accordance with the assessment rules above, or with new, second-hand or repaired property. If property in accordance with is not repurchased, only the financial value will be indemnified, i.e. what the policyholder would have received if the object had been sold. 9 Delays to luggage If property for which indemnification has been awarded turns up again, such property shall be made available to Modern Insurances as soon as possible. However, the Insured shall be allowed to retain the property if the indemnification received for it is repaid without delay. 10 Liability as a private individual 10.1 Who is covered by the insurance 10.2 What is covered by the insurance If registered luggage is delayed more than 8 hours after the estimated arrival at a destination outside of the country of residence, indemnification shall be paid for necessary and reasonable extra costs up to 10% of the official base amount. The liability protection covers the Insured as a private individual in his capacity as a traveller outside of the Nordic region Scope Damage to hired premises Exceptions The insurance shall apply when someone requires the Insured to pay damages for personal injury or material damage occurring during the insurance period. Modern Insurances shall pay indemnification for damage to a hotel room or other hired or rented accommodation away from the place of residence, together with effects therein, though only to the extent that the damage cannot be indemnified through some other insurance. Damage due to wear and tear or mismanagement will not be indemnified. 11

14 Undertaking 10.3 What is not covered by the insurance If indemnification is demanded from the Insured for a claim that may be covered by the insurance, Modern Insurances undertakes vis-à-vis the Insured to - investigate whether liability to pay damages is present - negotiate with the party demanding damages - represent the Insured in legal or arbitration proceedings and in that connection pay court costs and arbitration expenses which the Insured incurs or is instructed to pay and which cannot be obtained from the opposite or another party - pay the damages the Insured is liable to pay. The insurance does not cover - liability to pay indemnification above and beyond current damages law - damage to property which the Insured or anyone else to whom the insurance applies has hired, rented, borrowed, treated, processed, repaired or had any other kind of more than casual dealings with (regarding hired dwellings, see above) - damage for which the Insured can be held liable as owner of real estate, an apartment or as the proprietor of site-leasehold rights - damage for which the Insured can be held liable as owner, user or driver of a: motor-driven vehicle not designed to be operated by a pedestrian, where the damage occurred as a result of traffic involving the vehicle 10.4 Insurance amount. Maximum indemnification Note: This exception does not refer to an electrically powered wheelchair. - a steam, motor or sailing boat (except for windsurf board), hovercraft or hydrocopter Note: The insurance shall cover personal injury, however, if the vessel is fitted with an outboard motor of at most 10 HP (7.36 kw) or with a sail area of at most 10 m2. aircraft - damage arising in connection with the Insured or someone else to whom the insurance applies committing a deliberate act that can lead to imprisonment under Swedish law. Modern Insurances s liability to pay indemnification in connection with each claim event in the event of personal injury or damage to property, respectively, is 150 official base amounts. These amounts also apply where multiple parties covered by the insurance agreement are liable to pay damages. This also applies if several claims have arisen from the same cause and in connection with the same event. If a person whose place of residence is in the country of residence is liable to pay damages, fair indemnification for personal injury shall be determined in accordance with Swedish law. 12

15 10.5 In the event of a claim for damages If damages are obtained from the Insured and, without Modern Insurances s permission, the Insured admits liability to damages, approves an indemnification claim or pays out indemnification, Modern Insurances shall be exempt from liability. If the case goes to court, the Insured shall immediately notify Modern Insurances and follow the instructions given. If the Insured fails to observe these obligations, no judgement of indemnification liability can be brought against Modern Insurances. 11 Legal protection as a private individual 11.1 Who is covered by the insurance 11.2 What is covered by the insurance 11.3 What is not covered by the insurance 11.4 Rules for compensatory damages Which representative the Insured is entitled to choose The insurance covers the private individual insured in his capacity as a traveller outside of the Nordic region. The insurance covers disputes that can be heard in a Swedish district court or that, once heard there, can be heard by the court of civil appeal or the Swedish Supreme Court, or an equivalent court abroad. Note: The insurance does not cover criminal cases, therefore, nor disputes that can only be heard by administrative authorities or special courts of law. The insurance does not cover disputes - connected with employment or the performance of the Insured s occupation - that apply by virtue of their nature or scope to financial commitments of an unusual nature for a traveller or that apply to surety commitments - that apply to demands or claims that have been assigned to the Insured, if it is not evident that assignment took place prior to the dispute arising - that apply to the Insured in his capacity as owner, user, driver or operator of a motor-driven vehicle, caravan or other towed vehicle, aircraft, steam, motor or sailing boat. The insurance does apply, however, in the case of temporary borrowing, rental or hire of a motor vehicle, caravan, towed vehicle or pleasure craft. - that apply to damages or some other demand on the Insured based on an act that has attracted suspicion or indictment for offences requiring criminal intent, if the Insured does not have a well-founded interest in having his case dealt with. Such interest is not deemed to be present, for instance, if a court or legal-aid commission has rejected an application for legal aid or ruled that legal aid must be discontinued. In order for the insurance to be valid, the Insured must engage a representative who has been approved by Modern Insurances and is appropriate in consideration of the nature of the matter and the location at which the case will be heard. 13

16 What costs are reimbursed by the insurance The Insured can obtain indemnification for the following costs, where they are necessary and reasonable, and the Insured cannot secure their payment by the opposing party, the government or a similar body or authority abroad. One of the implications of this is that Modern Insurances will not pay if the Insured relinquishes, in or out of court, his possibilities of receiving indemnification from the opposing party. The costs referred to are - representative s fees and costs - investigating costs prior to the legal action, provided that the report has been commissioned by the Insured s representative - costs of arguing the case in court and of arbitration proceedings - handling costs in court - legal costs which the Insured has been ordered to pay the opposing party or the government after the dispute has been tried by a court or arbitrator - legal costs which the Insured has undertaken to pay the opposing party in connection with mediation during legal proceedings, provided that it is evident that the court would have instructed the Insured to pay legal costs amounting to a greater sum if the dispute had been tried Costs excepted The insurance does not award indemnification for - own work, lost earnings, travel and subsistence or other costs for the Insured or any other insured party - execution of a judgement, ruling or agreement - additional costs arising if the Insured engages several representatives or changes his representative - indemnification for arbitrators 11.5 Maximum indemnification amount Modern Insurances s commitment to pay indemnification is limited in the case of each claim to 2 official base amounts. A dispute is deemed to exist if the Insured and any other insured party represent the same side. Even if the Insured has several disputes, they shall be reckoned as one dispute if the demands are based on essentially the same grounds Excess The excess for each claim is 20% of the costs, though no less than 2% of the official base amount Recourse To the extent that indemnification is awarded by virtue of the insurance, Modern Insurances shall assume the Insured s right to claim indemnification. 14

17 12 Assault protection (personal injury) 12.1 What is covered by the insurance The insurance covers personal injury as a result of assault and battery or any other wilful outrage if the offence is committed by a person with whom the Insured involuntarily comes into contact. Limitation The insurance does not provide coverage to the extent that the perpetrator is capable of paying the damages What is not covered by the insurance Modern Insurances does not normally pay for injury inflicted upon the Insured - when the Insured was under the influence of alcohol, sedatives, abuse of medicines, drugs or narcotics, unless the Insured can demonstrate that there is no link between such influence and the injury - when the Insured has subjected himself to the risk of injury without due cause - owing to the Insured having been guilty of a wilful act which can result in fines or greater punishment under Swedish law What the Insured must observe if injured 12.4 Maximum indemnification amount Nor is indemnification awarded for - damages based solely on consent - damages based on assignment from the party directly entitled to indemnification. In the event of injury the Insured must show that he is entitled to damages and that the party responsible is unknown or unable to pay damages. Injury that may trigger an indemnification claim must be reported to Modern Insurances as soon as possible. Furthermore, the Insured must file a police report at the scene of the injury and send the police certificate to the company. In order for Modern Insurances to be able to award indemnification, the Insured must prove on the balance of probabilities that the Insured cannot obtain indemnification from the perpetrator. If it is uncertain whether he can pay, the Insured if so requested by Modern Insurances must plead the case against him. If Modern Insurances requests that the Insured plead the case, Modern Insurances shall pay the legal costs that cannot be indemnified through general legal aid. In order for Modern Insurances to be able to determine whether or not the Insured needs to plead the case in a lawsuit, it is of the utmost importance that the Insured provide Modern Insurances with all information of relevance as promptly as possible. Modern Insurances s commitment to pay indemnification is limited in the case of each claim to 15 official base amounts. Indemnification is determined in accordance with the rules in Section 5 of the Swedish Tort Liability Act. Courts sometimes adjust damages on the basis of the perpetrator s personal circumstances (e.g. being a minor, mental illness or financial circumstances). In such cases Modern Insurances shall pay damages in full without adjustment, within the framework of the maximum indemnification. If, on the grounds of 15

18 consent or some other reason, the court imposes an amount higher than that dictated by damages law practice, however, indemnification shall be granted to a maximum of the amount that would be imposed according to the rules for damages. 13 General conditions 13.1 Settling a claim Reporting and indemnification claims 13.2 Air crash and war risks A claim must be reported to Modern Insurances without delay and within six months at the latest. If the claim is lodged after that, Modern Insurances shall be exempt from liability. The claim report must be signed by the employer and the party requesting indemnification. In addition, the party requesting indemnification shall - in the event of theft, burglary, robbery or assault, make out a police report at the site where the claim occurred and submit a certificate to this effect to Modern Insurances - in the event of a claim that has occurred in transit or at a hotel, report the claim to the transport company or hotel, respectively - in the event of a delay to registered luggage, attach a certificate from the transport company - issue an itemized claim for indemnification - where the same claim is covered by some other insurance, notify Modern Insurances to this effect - at the request of Modern Insurances, issue information and furnish verifications, testimonies, doctor s certificates and other documentation required by Modern Insurances in order to settle the claim Air crash Injury sustained in war Exception The insurance applies when flying, as long as the Insured is a passenger on an aircraft of designated nationality. Passengers are considered to be only such persons on board as do not have or perform a task unrelated to the conveyance of the aeroplane or in-flight service. If the Insured stays in or travels to an area affected by war, warlike events, civil war, revolution or uprising, the insurance shall apply subject to payment of the higher premium requested by Modern Insurances and called for by the increased risk involved. The insurance does not cover: - injury arising as a result of the Insured taking part in war or other violent disturbances or becoming involved in such as a reporter or similar - injury that would be indemnified under 12. Assault protection (personal injury). Limitation 16

19 The insurance amount for injury sustained in war is limited to a combined maximum annual amount for claims for disablement or death of 15 official base amounts each, subject to a limitation of 5 official base amounts for each person to have been killed or injured Injury resulting from radioactivity If the Insured has several accident insurance policies with one or more insurance companies, the insurance amount under this insurance for disablement and death as a result of war or other disruptions listed here is limited so that, together with equivalent amounts under the other insurances, it shall not exceed the amount set out in 4.8. The amount shall be divided between the various insurances in relation to their liability in accordance with the relevant insurance clause. Accidental injury as a result of radioactivity is covered by the insurance. Limitation The same limitation as for injury sustained in war as noted in applies to injury resulting from radioactivity. DEFINITIONS Financial disability Disability/disablement Medical disability Financial disability refers to a reduction with permanent implications for the future of at least 50% of the injured party s working capacity due to the accident. Working capacity is regarded as being permanently reduced when all opportunities for working in a different occupation have been tried and the national insurance office has awarded early retirement pension in accordance with the Swedish General Insurance Act. Disability means that the accidental injury has resulted in a permanent reduction in bodily function (medical disability) or that future working capacity has been reduced by at least 50% as a result of the injury (financial disability). Assessment of the degree of disability is done in accordance with the rules for medical and financial disability (see points and 4.2.2). In the event of accidental injury entailing financial disability, indemnification shall be paid out instead, calculated on the basis of the medical degree of disability, where this results in greater indemnification. Indemnification can never be awarded for both medical and financial disability. Medical disability is the impairment of physical and mental functions ascertained irrespective of the Insured s occupation and working conditions or leisure interests. Such functional impairment must be objectively ascertainable. Medical disability is also deemed to include permanent aches and pains, and loss of a sensory or internal organ. 17

20 Close relative Accidental injury Travel documents Close relative refers here to a spouse, child, grandchild, sibling, parent, maternal or paternal grandparent, parent-in-law and any other person with whom the Insured is cohabiting. Accidental injury refers to physical injury or bodily harm involuntarily befalling the Insured as a result of a sudden external event (an insult on the body originating externally) and involving medical consultation. Physical injury arising as a result of frostbite, heat stroke or sunstroke is ranked in the same category as accidental injury. The day on which such injury manifested itself is then regarded as the time of the accidental injury. Travel documents refer to - travellers cheques, petrol coupons and restaurant vouchers, tickets, passports, lift and green-fee cards. Property especially likely to be stolen Property especially likely to be stolen refers to - objects made partly or entirely of precious metal, real pearls and precious stones - antiques and works of art, hand-woven rugs and carpets, pocket and wristwatches, furs and fur coats - computers, including software and communications equipment (e.g. telephones, telefaxes, mobile phones and pagers) - cameras, projectors, binoculars and telescopes, musical instruments, taperecorders, record-players, amplifiers, loudspeakers and PA systems, radio, TV and video sets, and accessories for the objects listed here (also tapes, cassettes, records and discs) - weapons, wines and spirits. Business travel Business travel also refers to travel within the employee s area of permanent posting. The travel must have been ordered and/or defrayed by the employer. Travel between the Insured s dwelling and the workplace is not considered business travel. Anticipatory indemnification Anticipatory indemnification refers to the indemnification paid out annually up to the time when the definitive degree of disability has been finalized. *Base amount A base amount is a Swedish official amount that varies from year to year. In 2002 the base amount is SEK 37,