Policy Number: Insured(s): Broker: NZGPAG02299 Fiji National University Aon Fiji Address: PO Box 16960 Period of Insurance: Suva - From: To: 30 June 2014 (at 4:00pm) 30 June 2015 (at 4:00pm) Both dates inclusive including any subsequent period for which we accept a Renewal Premium Premium: Goods & Services Tax: Total Payable: As Agreed As Agreed As Agreed Renewal to be reassessed for any subsequent Period of Insurance Authorised by: Chanelle Luatua, A & H Account Manager On behalf of: ACE Insurance Limited at Wellington on 30 June 2014
Description Of Cover Insured Person(s)/Categories: 1. -200 Students whilst on Campus and whilst commuting between the various campus's in Fiji only -25% are Part-Time students 2. -Students are covered while they are on Campus and during their commuting between the campus's in and around Fiji Scope of Cover: Policy Wording: 3. -Students are during field trips this includes commuting between islands in and around Fiji 1,2,3. 24 hours per day while on the business of the Insured, including direct travel to and from normal business address ACE Group Personal Accident Policy
Schedule Of Benefits Sum Insured as per table of conditions - each Insured Person SECTION 1 - Personal Accident and Sickness Categories Table Of Events Part A - Lump Sum Benefits 1 Event 1 - Accidental Death 10,000 0 0 2 Event 1 - Accidental Death 10,000 0 0 3 Event 1 - Accidental Death 10,000 0 0 Part A - Injury Resulting in Surgery Part C - Sickness Resulting in Surgery 1 0 0 2 0 0 3 0 0 Part B - Weekly Benefits Injury Part C - Weekly Benefits Sickness % of Salary - Part C Excess Period (Days) - Part C 1 0 0.00 0 2 0 0.00 0 3 0 0.00 0 Part D - Injury Resulting In Fractured Bones - Lump Sum Benefits Part E - Injury Resulting In Loss of Teeth or Dental Procedures 1 0 0 2 0 0 3 0 0 Funeral Benefit % of Salary - Part B Loss of Enjoyment of Life Excess Period (Days) - Part B 1 0 0.00 0 2 0 0.00 0 3 0 0.00 0 Bed Confinement Ambulance Cover 1 2,000 25,000 50 2,500 2 2,000 25,000 50 2,500 3 2,000 25,000 50 2,500 Rehabilitation Benefit Trauma Counselling AIDS/HIV Benefit Residence Alteration Benefit 1 500 5,000 10,000 2,000 2 500 5,000 10,000 2,000 3 500 5,000 10,000 2,000
Replacement Staff/Recruitment costs Education Fund Benefit 1 10,000 5,000 2 10,000 5,000 3 10,000 5,000 Aggregate Limit of Liability: Any One (1) Period of Insurance (A): 2,000,000 Non-Scheduled Aircraft (B): 2,000,000
Endorsements: Endorsement General Exclusion applicable to all sections of this policy: We will not pay benefits with respect to any loss, damage, liability, Event, Bodily Injury or Sickness which: 6. would result in the provision of cover, payment of such claim or provision of such benefit that would be a violation of any sanction, prohibition or restriction including under United Nations resolutions or the trade or economic sanctions, laws or regulations of the United States of America or New Zealand as applicable. HAZOURDOUS PURSUITS ENDORSEMENT Notwithstanding General Exclusion 1.1, this endorsement is applicable to all sections of this policy. We shall not pay benefits with respect to any loss, damage, liability, Event, Injury or Sickness which results from You engaging in or taking part in: a) hunting of any sort, racing of any sort (other than on foot), playing polo, rodeo, contact sports, mountaineering or rock climbing using ropes or climbing equipment (other than hiking), pot holing, caving, abseiling, BASE jumping, kite surfing; or b) travel in international waters in a private sailing vessel or privately registered sail vessel; or c) ballooning, bungee jumping, parasailing, white-water rafting, black-water rafting or white-water kayaking unless carried out with a licensed operator; or d) parachuting, paragliding or hang-gliding unless carried out in tandem under licensed instruction; or e) diving underwater using an artificial breathing apparatus unless You hold a recognised diving qualification and You are diving within the limits of that qualification, or You are diving under the direct supervision of a qualified diving instructor; or f) motorcycling, if the driver does not hold a valid license for the country the motorcycle is being operated in, or You are not wearing a helmet, or where the motorcycle has an engine capacity more than 200cc; g) snow skiing/boarding outside designated commercial ski field areas, or in areas within designated commercial ski fields that are closed due to adverse conditions. SPORTING ENDORSEMENT Notwithstanding General Exclusion 1(b) cover is extended Under Sections 1, 4 & 5 of the Policy to include losses arising from Insured Persons training for and/or partaking in any sport, provided such sports are not otherwise excluded within the Hazardous Pursuits endorsement as detailed above. The following conditions apply for any claims arising directly or indirectly from such activities: 1. Under Section 1, Personal Accident & Sickness; the sum insured is reduced to $100,000; and 2. Under Section 1, Personal Accident and Sickness; (a) Event 2, Permanent Total Disablement, is deleted and replaced by Permanent Paraplegia and/or Permanent Quadriplegia; (b) There is no cover under Section 1 Part B Weekly Benefits Injury, Events 25 & 26; and (c) Part D, Injury Resulting in Fractured Bones is deleted; and 3. Under Section 4, Medical & Additional Expenses and Cancellation & Curtailment Expenses, the sum insured is reduced to $250,000. The Excess applicable is $500 each and every claim; and 4. Under Section 7, Baggage/Business Property, there is no cover for sporting equipment; and 5. Under Section 8, Alternative Employee / Resumption of Assignment Expenses, We will not indemnify any expenses that arise as a result of an Insured Person sustaining an Injury; 6. There is no cover under Section 9, Personal Liability. PART A - Lump Sum Benefits It is hereby noted and agreed that in the event of an Insured Person being covered for the same loss under the following policy held by the Insured with ACE Insurance Limited, only the policy with the highest sum insured shall apply. Policy No. AGAT391687
PRIVACY STATEMENT ACE Insurance Limited ( ACE ) is committed to protecting your privacy. ACE collects, uses and retains your personal information in accordance with the principles in the Privacy Act 1993. ACE collects your personal information (which may include health information) when you are applying for, changing or renewing an insurance policy with us or when we are processing a claim. We collect the information to assess your application for insurance, to provide you or your organisation with competitive insurance products and services and administer them and to handle any claim that may be made under a policy. If you do not provide us with this information, we may not be able to provide you or your organisation with insurance or to respond to any claim. We may disclose the information we collect to third parties, including contractors and contracted service providers engaged by us to deliver our services or carry out certain business activities on our behalf (such as actuaries, loss adjusters, claims investigators, claims handlers, professional advisers including doctors and other medical service providers, credit reference bureaus and call centres), other companies in the ACE group, insurance and reinsurance intermediaries, other insurers, our reinsurers, and government agencies (where we are required to by law). These third parties may be located outside New Zealand. You agree to us using and disclosing your personal information as set out above. This consent remains valid unless you alter or revoke it by giving written notice to our Privacy Officer. From time to time, we may use your personal information to send you offers or information regarding our products that may be of interest to you. If you do not wish to receive such information, please contact our Privacy Officer using the contact details provided below. If you would like to access a copy of your personal information, or to correct or update your personal information, please contact our Privacy Officer on +64 (9) 3771459 or email Privacy.NZ@acegroup.com. If you have a complaint or want more information about how ACE is managing your personal information, please contact the Privacy Officer, ACE Insurance Limited, PO Box 734 Auckland, Tel: +64 (9) 3771459 or email Privacy.NZ@acegroup.com.
ACE Insurance Limited QUALIFYING FINANCIAL ENTITY (QFE) DISCLOSURE STATEMENT ABOUT THIS DISCLOSURE STATEMENT Prepared 22 May 2013 The purpose of this Disclosure Statement is to help you make a decision about choosing a financial adviser. It contains information on, amongst other matters, who we are and how we can be contacted or given instructions and how complaints and disputes are dealt with. It is important that you read this information. We invite you to contact us if you would like to obtain further information, provide us with instructions, or if you have any queries about the products and services we are authorised to provide. Please retain this document along with your current policy documentation in a safe place for your future reference ABOUT ACE INSURANCE LIMITED ACE Insurance Limited (ACE) is an insurer and provides financial advice in connection with its general insurance products and life insurance products. ACE s details are: Company Number: 104656 Financial Services Provider Number: 35924 Head Office: CU1-3, Shed 24, Princes Wharf, Auckland 1010, New Zealand Postal address: PO Box 734, Shortland Street, Auckland 1140, New Zealand Telephone: 0800 422 346 or (+64 9) 377 1459 Facsimile: (+64 9) 303 1909 E-mail: CustomerServices.AUNZ@acegroup.com Website: www.aceinsurance.co.nz ACE is a Qualifying Financial Entity (QFE) under the Financial Advisers Act 2008 and takes responsibility for the financial advice provided by its QFE advisers. ACE also underwrites certain classes of sickness and accident insurance products under its Combined Insurance brand. authorises its QFE advisers to provide financial advice in connection with these products directly to the public. The relevant QFE Disclosure Statement may be accessed via www.combinedinsurance.co.nz. You may check ACE s QFE status and whether other entities are a member of the QFE group on the Financial Service Providers Register at www.fspr.govt.nz. HOW WE ARE RATED ON FINANCIAL STRENGTH At the time of print, ACE Insurance Limited has an AA - insurer financial strength rating given by Standard & Poor s (Australia) Pty Limited. The rating scale is: AAA - Extremely Strong BBB - Good CCC - Very Weak SD or SD - Selective Default or Default AA - Very Strong BB - Marginal CC - Extremely Weak R - Regulatory Action A - Strong B - Weak NR - Not Rated Plus (+) or minus (-): the rating from AA to CCC may be modified by the addition of a plus or minus sign to show relative standings within the major rating categories. A full description of the rating scale is available on the website of Standard & Poor's (Australia) Pty Limited.
ACE S COMPLAINTS AND DISPUTE PROCEDURES ACE takes the concerns of its customers very seriously and has detailed complaint handling and dispute resolution procedures that you may access, at no cost to you. To assist ACE with your enquiries, please provide us with your claim or policy number (if applicable) and as much information you can about the reason for your complaint or dispute. ACE s complaints and dispute procedures are as follows: Stage 1 - Complaint Handling Procedure If you are dissatisfied with any of ACE s products or services and you wish to lodge a complaint, please contact us at: Complaints.NZ@acegroup.com The Complaints Officer ACE Insurance Limited Postal address: PO Box 734, Shortland Street, Auckland 1140 Telephone: 0800 422 346 or (+64 9) 377 1459 Facsimile: (+64 9) 303 1909 Stage 2 Dispute Resolution Procedure If you are dissatisfied with ACE s response to your complaint, you may ask that your complaint be treated as a dispute and referred to ACE s dispute resolution team at: DisputeResolution.NZ@acegroup.com Internal Dispute Resolution Service ACE Insurance Limited Postal address: PO Box 734, Shortland Street, Auckland 1140 Telephone: (+64 9) 377 1459 Facsimile: (+64 9) 303 1909 Stage 3 - External Dispute Resolution ACE is a member of an independent external dispute resolution scheme operated by the Financial Services Complaints Limited (FSCL) and approved by the Ministry of Consumer Affairs. If you are dissatisfied with our dispute determination or if we are unable to resolve your complaint or dispute to your satisfaction within 40 days you may contact the FSCL at: Financial Services Complaints Limited Postal address: PO Box 5967, Lambton Quay, Wellington 6145 Telephone: 0800 347 257 (Call Free for consumers) or (+64 4) 472 FSCL (472 3725) Facsimile: (+64 4) 472 3728 E-mail: Web: HOW WE ARE REGULATED info@fscl.org.nz www.fscl.org.nz As a QFE, ACE is licensed and regulated by the Financial Markets Authority (FMA). You may obtain information about financial advisers from the FMA. You may also report information about ACE and our QFE advisers to the FMA at:
Financial Markets Authority Street address: Level 5 Ernst & Young Building 2 Takutai Square Britomart Auckland Postal address: PO Box 1179, Wellington 6140 Telephone: (+64 4) 472 9830 Facsimile: (+64 4) 472 8076 Web: www.fma.govt.nz Version: 12QFEDDACE01