130925-60800014201 -42-81784945-0 YOUR PARTICULAR CONDITIONS

130925-60800014201 -42-81784945-0 YOUR PARTICULAR CONDITIONS

These are the Particular Conditions of your policy: Sanitas Previsión Every time you wish to consult something, here you will find all the details of the policy and conditions you have contracted. Information on your policy no. PERSONAL DETAILS Who is the Policyholder? Who are the insured parties in your policy? Policy address for notification purposes: DNI of the Policyholder: Broker: METHOD OF PAYMENT INFORMATION ABOUT THE INSURANCE YOU HAVE CHOSEN Which product have you contracted? Sanitas Previsión 3

When did you register the insured parties and what is their premium? What is the maximum contracting age for these products? Sanitas Previsión: 100 years old VALIDITY PERIOD FOR YOUR POLICY From 00.00 hrs on 01/09/2013 until the death of the Insured. PREMIUM METHOD CONTRACTED The premium method contracted is: SINGLE Described below is the premium contracted, together with other premium methods which might apply during the life of the policy. Single premium: premium based on single premium life insurance. The amount of the single premium determined in the contracting and paid in the first year of the policy includes the automatic annual revaluation scheduled for the next 10 years. If, when 10 years have elapsed, it is found that there is a need to increase the capital insured above what was scheduled in the initial premium to adapt the cost of the guarantees, this increase in capital must feature tariffs which take into account the age of the Insured Party at that moment, and will be communicated to the Policyholder for consent. AUTOMATIC CAPITAL REVALUATION In order to keep the insured capital up to date, it will be revalued automatically at 2.5% for every year of insurance. This revaluation will depend on the premium method contracted, as stipulated in the previous section. THE AMOUNT OF YOUR PREMIUM PREMIUMS 4

Net Premium: Discount/Extra premium: Discount/Rec.Method of Payment: Additional premium: Legally specified taxes (CCS): Tax on Premiums: Total annual premium: First payment amount (1): Remaining amounts payable (2): Frequency: (1) Corresponding to net premium (including Extra Premiums) according to payment method plus all the legally specified taxes. (2) Corresponding to net premium (including Extra Premiums) according to payment method. The information contained in this document is confidential and is protected according to Organic Law 15/1999 of 13 December, on Protection of Personal Data, and additional regulations. The insurance premium for this policy and the scope of the insured coverage have been established taking into consideration that the policy will have at all times at least a minimum number of insured which is the same as the figure when it was contracted. If the number of insured on the policy is lower than the aforementioned minimum number at any time during its life, Sanitas may suggest to the policyholder that the contract be modified. The policyholder will have 15 days to accept or reject it. If the policyholder rejects it, or gives no answer, Sanitas may, once the aforementioned period has elapsed, terminate the contract after informing the policyholder in advance, with a new fifteen-day deadline for a reply; after this period has elapsed, and within the following eight days, it will communicate to the policyholder the final termination, which will occur at the end of the calendar month in which the communication is made. The premium must be paid within the 30 days following the policy inception date, or 30 days after each month, quarter or semester has expired, depending on the premium payment breakdown agreed between the parties. 5

GUARANTEES CONTRACTED INTERNATIONAL REPATRIATION OF THE DECEASED TO SPAIN 8,000.00 NATIONAL FUNERAL SERVICE 4,000.00 DESCRIPTION OF THE SERVICE The national funeral service includes the following coverage: Coffin Shroud Embalming Religious or lay ceremony Condolence book Funeral parlour room Hearse Accompanying car Wreath of flowers Flower arrangement Obituary or notice in the press, as chosen by the Insured s family Burial or cremation costs, as chosen by the Insured s family Rental of temporary niche (10 years) Headstone and inscription Urn for ashes in case of cremation Documentary procedures necessary for the provision of the service 6

PROTECTION OF PERSONAL INFORMATION The Policyholder guarantees that all the information given to the Insurer, both when applying for the insurance and during the lifetime of this policy, is true and that no detail has been omitted regarding the health of each of the insured parties included in the policy. Nevertheless, the Policyholder authorises the Insurer to request information from doctors, clinics, hospitals, etc. and consequently authorises the latter to provide the Insurer with details of the health of any persons included in the policy which it deems necessary for management of the insurance, to offer any integrated health care programmes the Insurer may have to improve the health care process, better knowledge and evaluation of the risks to be covered, for fraud prevention and to attend to any claims presented by the insured. In addition, and in compliance with Law 15/1999 of 13 December on Protection of Personal Information and Royal Decree 1720/2007 of 21 December which approves the Regulation for Development of organic law 15/1999, the Insurer informs the policyholder and the insured parties, who hereby consent, that all their personal information is incorporated in files held by the Insurer; the purpose of this is to assist the activities carried out by the company, to ensure effective contractual relations, offer integrated health care programmes for health improvement, to ascertain the reasons for de-registering the policy, to prevent fraud and to send, by any means, advertising or other offers which might be of interest regarding the company and third parties with which it has cooperative links, and authorise SANITAS to handle these details to send information most appropriate for their specific needs. In order to prevent fraud, the insured parties expressly consent to the Insurer retaining the information necessary for this purpose, even after the contractual relationship has ended. If the Policyholder /Insured do/does not consent to the inclusion of their details in these files, and the subsequent handling thereof, the insurance contract cannot be implemented. In addition, the insured parties and the policyholder expressly authorise the transfer of this information to companies in the Sanitas group, which are identified in www.sanitas.es, related to products and financial services, insurance, socio-health and/or health and welfare services, and for reasons of co-insurance or re-insurance of the risk, and any other organisation with which it establishes cooperative links, to ensure effective contractual relations with the insured and to send related commercial information. The policyholder is responsible for communicating to all the insured parties included in the policy that their details have been included in the abovementioned files and the intended use to be made of them by the Insurer, so that they can exercise any rights they deem appropriate. The policyholder will inform the aforementioned insured parties that the details relating to services covered by the policy will be communicated to the policyholder, unless the policyholder releases the Insurer from its legal duty to provide information or this is requested by any of the beneficiaries. 7

The policyholder declares that he/she has the consent of the insured both for the policyholder to provide their personal details to the Insurer and for the latter to provide to the policyholder the information on the insured party services covered by the policy. Rights of opposition, access, rectification and cancellation of these details in the aforementioned legislation may be exercised at the registered address of the Insurer, at street Ribera del Loira 52, 28042 Madrid, Customer Relations Department. If the policyholder and/or the insured do not wish to receive commercial information from the Insurer or, where relevant, from other organisations with which the Insurer has established links of cooperation, or do not wish their details to be given to other companies other than for the effectiveness of the contractual relations, must inform Sanitas of this by sending a communication to the following e- mail address: relacionesconclientes@sanitas.es. If no communication is received within a period of 45 days after the date on which the policyholder was made aware of the provisions in the preceding paragraphs, this will be taken to mean that he/she agrees to the sending of advertising and transfer of details to other companies in the terms indicated. The information contained in this document is confidential and is protected according to Organic Law 15/1999 of 13 December, on Protection of Personal Data, and additional regulations. The Policyholder and/or Insured Party expressly accept each of the clauses contained in these particular conditions and in the general conditions received together with this document, which they state they are aware of.they state, in particular, that they accept the restrictive clauses contained in these general conditions and, if relevant, in these particular conditions, which are duly emphasised in accordance with the terms of 3 of the Insurance Contract Law. According to Art. 107 of the Regulation for Planning and Supervision of Private Insurance, the Policyholder and the Insured declare that they have received on today s date and prior to the signing of the contract all the information referred to in article 104 of the aforementioned Regulation (i.e. legislation applicable to the insurance contract, claims and the procedure to follow), and that it also appears in this insurance policy. 8

Made in duplicate in Madrid, on 25 September 2013 On behalf of the Insured/Policyholder On behalf of the Insurer Sergio de Andrés Osorio Sanitas, S.A. de Seguros 9