CignaTravel Insurance Policy booklet
We re here to help Need medical help abroad? Call us first on +44 (0) 208 763 3030 For emergencies: if you are taken by ambulance to hospital following an emergency call, you or a travelling companion should call us as soon as possible once you have been admitted to hospital. For non-emergencies: if you need a GP, or need to go to A&E or a clinic, Call Us First, before you try to locate help, so we can guide you to the safest and most appropriate source of treatment. If you are unfortunate enough to need medical help whilst abroad please Call Us First on the Assistance Helpline +44 (0) 208 763 3030 Our highly experienced multi-lingual team are available to talk 24 hours a day, to advise you or your travelling companion of what steps to take. Their aim will always be to establish the best treatment available to you in the country you are visiting. Our first steps will always be to Confirm that you re in a place of safety; Establish the best local treatment available to you; and Consider your health and best interests; Make sure that the necessary medical fees are guaranteed. Important note: it may affect your claim if you, your travelling companion or a doctor/nurse does not contact us on the number above. We do not cover any costs over 500 where prior agreement regarding treatment has not been obtained from the Assistance Helpline. Our highly experienced multi-lingual team of in-house doctors, nurses and experienced case managers will advise you, your travelling companion, and/or your treating doctor, of what steps to take. We understand how important it is to have someone who You can contact at any time of the day or night You can trust has the medical expertise to guide you to the right course of treatment Has an in-depth understanding of how and when to transfer sick and injured patients back home Will speak to you in a language you can understand. Our team is focused on trying to take some of the worry out of what can be an incredibly stressful situation so we ll keep your key contacts updated on your progress for you and if need be, we ll fly a doctor or nurse out, with specialist repatriation equipment, to accompany you home. Index Introduction 2 Definitions 3 Important conditions relating to health 7 General conditions (applicable to the whole policy) 8 Claims conditions (including making a claim) 8 General exclusions (applicable to all sections of the policy ) 10 Pre travel advice 11 Reciprocal health agreements 11 - EU, EEA or Switzerland 11 - Australia 11 Schedule of benefits 12 Section 1: Cancellation 13 Section 2: Missed Departure 15 Section 3: Travel Delay 16 Section 4: Curtailment 17 Section 5: Emergency Medical and Other Expenses 19 Section 6: Hospital Benefit 21 Section 7: Personal Accident 22 Section 8: Delayed Baggage 23 Section 9: Baggage 24 Section 10: Personal Money 26 Section 11: Loss of Passport and Other Documents 27 Section 12: Mugging 28 Section 13: Personal Liability 29 Section 14: Legal Expenses 30 Complaints procedure 32 Data protection notice 33 We actively monitor the capabilities of medical facilities throughout the world and use this knowledge to determine whether you need to be transferred to a different facility. Once we are satisfied that you are getting the appropriate treatment, we will agree a treatment plan with your treating doctor and you. If you cannot be discharged in time to continue your trip as planned, we will make arrangements to bring you home at the appropriate time. 1
Introduction This is your travel insurance policy. It contains details of cover, conditions and exclusions relating to each insured person and is the basis on which all claims will be settled. It is validated by the issue of the Schedule which must be read in conjunction with the policy. The Schedule and any endorsements are all part of the policy. The information you have supplied forms part of the contract of insurance with us. Your policy is evidence of that contract. Please note that this policy is for 12 months only subject to the age eligibility criteria set out below and will not be renewed after that time. United Kingdom residents This policy is only available to you if you are permanently resident in the United Kingdom. The law applicable to this contract It is possible to choose the law applicable to a contract of insurance in the United Kingdom. We have chosen Scottish law to apply if you live in Scotland and English law if you live elsewhere in the United Kingdom. Policy information or advice If you would like more information or if you feel the insurance may not meet your needs, please contact Customer Services. Age eligibility This policy will cease when the Life Insurance policyholder reaches the age of 66. There is no cover for anyone aged 66 and over. Policy excess Under most sections of the policy, claims will be subject to an excess. This means that you will be responsible for paying the first part of each and every claim (as shown in the Schedule of Benefits) per incident for each insured person. Geographical limits This policy covers you for worldwide travel. Pre-Existing Medical Conditions Pre-existing medical conditions or associated conditions are not covered by this policy. Please refer to Definitions section for further details. We will not pay for any claim you (or any insured person) make, that has anything to do with that medical condition. Definitions Any word or expression to which a specific meaning has been attached will bear the same meaning throughout this policy. Baggage Luggage, clothing, personal effects, valuables, and other articles which belong to you (or for which you are legally responsible) which are worn, used or carried by you during any trip but excluding personal money and documents of any kind. Bodily Injury An identifiable physical injury sustained by you caused by sudden, unexpected, external, violent and visible means. Injury as a result of your unavoidable exposure to the elements shall be deemed to have been caused by bodily injury. Carrier The ship, aircraft, train or coach operator and their employees and agents. Close Business Associate A person working for the same company as you or your travelling companion whose absence from work along with you or your travelling companion would prevent the proper functioning of the company, as confirmed by an officer of the company. Close Relative Mother, father, sister, brother, wife, husband, daughter, son, grandparent, grandchild, parent-in-law, sonin-law, daughter-in-law, sister-in-law, brother-in-law, step parent, step child, step sister, step brother, foster child, legal guardian, partner or fiancé/fiancée. Curtailment/Curtail Abandoning the trip by direct return to the United Kingdom or as a result of bodily injury or illness you have to stay in hospital for the rest of the trip. Excess The first part of any claim that you have to pay (as shown in the Schedule of Benefits). This applies to each incident for each insured person. Family You, your spouse, your civil partner (as defined in Section 1 of the Civil Partnership Act 2004) or the person (whether or not of the same sex) with whom you are permanently cohabiting in a marriage-like relationship together with your children, step children or foster children living at home aged under 16 (or under 23 if in full time education), accompanying the parents or legal guardian insured on the same policy travelling on any trip to the same destination. Under this cover either adult is also insured to travel on their own however, children are not covered when they travel independently. Cigna The policy is administered on behalf of the insurer by Cigna Insurance Services (Europe) Limited. Have a safe trip We are working with the Foreign and Commonwealth Office to do all that we can to help British Travellers stay safe overseas. Before you go overseas, check out the FCO website at www.fco.gov.uk/knowbeforeyougo. It is packed with essential travel advice and tips, and up-to-date country specific information. 2 3
Hazardous Activities The following activities are covered: Aerobics Badminton Baseball Basketball Boogie Boarding Bowls Cricket Croquet Curling Cycling (no racing) Fell Walking Fishing Golf Hiking/Trekking (under 4,000m) Ice Skating Jogging Manual Work (at ground level involving no machinery) Marathon Running Mountain Biking (on recognised routes) Rambling Rounders Sailing (within territorial waters) * SCUBA Diving (down to 30m accompanied by a qualified diver or instructor) Snorkelling Softball Squash Surfing Swimming Table Tennis Tennis Ten Pin Bowling Volleyball Walking Water Polo Covered if professionally organised and supervised plus you wear appropriate safety equipment and take safety precautions: Abseiling Archery Banana Boating Black Water Rafting Bungee Jumping Camel/Elephant Riding Canoeing/Kayaking (no white water) Clay Pigeon Shooting * Fencing Flotilla Sailing (with professional leader) * Not Covered Base Jumping Big Game Hunting BMX Stunt Riding Bouldering Boxing Canyoning Caving/Pot Holing Coasterring Cycle Racing Flying except (as a fare paying passenger) Free/High Diving Gliding Hang Gliding Horse Jumping/ Hunting Go Karting * Gymnastics Hiking/Trekking (between 4,000m and 6,000m) Horse Riding (no jumping) Hot Air Ballooning Indoor Rock Climbing (with belays) Jet Biking* Jet Skiing* Judo/Karate/Martial Arts Kite Surfing Lacrosse Micro Lighting Motor Cycling as a driver or passenger (unless on machines of less than 125cc, you wear a helmet, and as a driver, you have held a motorcycle licence for at least 3 years and have no motoring convictions) * There is no cover under Section 13 Personal Liability Paint Balling Parascending over water Pony Trekking River Tubing (no white water) Shooting (not Big Game)* Sleigh riding (as a passenger) Swimming with Dolphins Mountaineering Organised Team Sports Parachuting Paragliding Parascending (over land) Participation in competitions unless otherwise agreed by us Polo Professional/Semi Professional Sports Quad biking Rock Climbing If there are activities that you intend to participate in that are not listed above, please call us to confirm whether cover is provided. Trampolining Water Skiing (no jumping) White Water Rafting Zipling/Zipwiring Zorbing Sailing (outside territorial waters) Scuba Diving (below 30m) Shark Diving Street Hockey Tomb Stoning Track Days involving motor vehicles including motorcycles Water Ski Jumping Weightlifting Wrestling Home Your normal place of residence in the United Kingdom. Hospital Any institution outside the United Kingdom which meets the following criteria:- It has full time facilities for overnight patients. It has facilities for surgery, medical diagnosis and treating injured and sick people. It is run by medical practitioners. It provides 24 hour nursing supervised by State Registered Nurses. It is not a medical institution, a nursing or convalescent home, a hospice or place for the terminally ill, a residential care home (as defined under the Registered Homes Act, 1984 Part 1 Section 1) or a place for drug addicts or alcoholics. Insurer CIGNA Europe Insurance Company S.A.-N.V. Legal Expenses Your representative s legal fees, expenses and other costs which we have agreed or the costs of any other parties involved in the legal proceedings if you have to pay those costs. This includes costs following an out of court settlement to which we have agreed. Loss of limb Loss by permanent severance of an entire hand or foot or the total and permanent loss of use of an entire hand or foot. Loss of sight Total and irrecoverable loss of sight. Medical Practitioner A registered practising member of the medical profession who is not related to you or any person with whom you are travelling. Mugging Theft or attempted theft (including that of a vehicle that you are in) involving an act of violence against you by someone not insured on this policy which results in your injury and hospitalisation. Period of Insurance 12 months from the date you start the policy. This is limited to 31 days per trip. Trips within the United Kingdom must be pre-booked and pre-paid for at least 2 nights away from your home. Under these policies Section 1 Cancellation cover shall be operative from the date stated in the Schedule or the time of booking any trip (whichever is the later) and terminates on commencement of any trip or expiry of this insurance (whichever is the earlier). For all other sections of the policy the insurance commences when you leave your home or in respect of a business trip, your place of business in the United Kingdom (whichever is the later) to commence the trip and terminates at the time of your return to your home or place of business in the United Kingdom on completion of the trip or expiry of this insurance (whichever is the earlier). 4 5
The period of insurance is automatically extended for the period of the delay in the event that your return to the United Kingdom is unavoidably delayed due to an event insured by this policy. Permanent total disablement A disability which entirely prevents you from attending to business or occupations of any and every kind, which exists for 12 months after the date of the incident and is beyond hope of improvement. Personal Money Bank notes, currency notes and coins in current use, postal or money orders, pre-paid coupons or vouchers, travel tickets, event and entertainment tickets, phonecards and credit/debit or charge cards all held for private purposes. Pre-Existing Medical Condition A medical condition for which: - you have been prescribed medication; you are being referred to, treated by or under the care of a Healthcare Specialist e.g. General Practitioner, Hospital Specialist/Consultant, Nurse, Osteopath, Chiropractor, Acupuncturist, Physiotherapist; you are waiting for treatment or the results of any tests or investigations whether diagnosed or not; any condition linked directly or indirectly to any form of cancer. An associated condition is a condition that can be linked to another condition for example, ischaemic heart disease and angina, heart attack and heart failure. Public Transport Any publicly licensed aircraft, sea vessel, train or coach on which you are booked to travel. Representative The solicitor or other suitably qualified person appointed to act for you. Terrorism An act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisations(s) or governments, committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear. Trip Any holiday, business or pleasure trip or journey made by you within the area of travel shown in the Schedule which begins and ends in the United Kingdom during the period of insurance but excluding one way trips or journeys. Any such trip over 31 days is not insured. There is absolutely no cover offered by the policy whatsoever for trips which are longer than 31 days per trip. This would include not insuring you for part of a trip which is longer than 31 days in duration. Each trip is deemed to be a separate insurance, each being subject to the terms, definitions, exclusions and conditions contained in this policy. Unattended When you are not in full view of and not in a position to prevent unauthorised interference with our property or vehicle. United Kingdom England, Scotland, Wales and Northern Ireland. Valuables Jewellery, gold, silver, precious metal or precious or semiprecious stone articles, watches, furs, cameras, camcorders, photographic, audio, video, computer, television and telecommunications equipment (including CDs, DVDs, tapes, films, cassettes, cartridges, headphones and mobile phones), computer games and associated equipment, telescopes, binoculars and satellite navigation equipment. We/Us/Our Cigna Insurance Services (Europe) Limited who administer the insurance on behalf of the insurer. You/Your/Insured Person The Life Insurance policyholder and their family. Important Conditions Relating to Health This policy does not cover claims arising from a pre-existing medical condition or any associated condition. For a person with whom you are travelling or have arranged to travel, a person with whom you have arranged to reside with temporarily, a close relative or close business associate, who is not insured but whose health may affect the trip If, at the time of taking out this policy or booking a trip, whichever was the later, the person with whom you are travelling or have arranged to travel, a person with whom you have arranged to reside with temporarily, a close relative or close business associate had a medical condition for which he or she: was receiving treatment at hospital (other than where they go to hospital for check-ups for a stable condition, at regular intervals which have been arranged beforehand) was waiting for a hospital consultation, investigations or treatment (other than where they go to hospital for check-ups for a stable condition, at regular intervals which have been arranged beforehand) had been given a terminal prognosis, or been told that their condition is likely to get worse in the next 12 months. We will not pay for any claim you (or any insured person) make, that has anything to do with the medical condition of that person. Any trip solely within the United Kingdom is only covered where you have pre-booked at least two nights accommodation in a hotel, motel, holiday camp, bed and breakfast, holiday cottage or similar accommodation rented for a fee. 6 7
General Conditions General conditions applicable to the whole policy. You must comply with the following conditions to have the full protection of your policy. If you do not comply we may at our discretion cancel the policy or refuse to deal with your claim or reduce the amount of any claim payment. 1. Reasonable precautions You must take all reasonable precautions to avoid injury, illness, disease, loss, theft or damage and take and cause to be taken all practicable steps to safeguard your property from loss or damage and to recover property lost or stolen. 2. Statutory Cancellation Rights You may cancel the policy within 14 days of receipt of the policy documents by contacting us. 3. Fitness to Travel It is a condition of this policy that when booking your trip or taking out this policy whichever is later that you are fit to travel. Cancellation outside the Statutory Period We reserve the right to cancel the policy by providing 21 days notice by registered post to your last known address. Claims Conditions You must comply with the following conditions to have the full protection of your policy. If you do not comply we may at our discretion cancel the policy or refuse to deal with your claim or reduce the amount of any claim payment. 1. Making a claim To make a claim please call us by phone or contact us at the address given below depending on the type of claim. All claims except Legal Expenses Cigna Travel Insurance Claims PO Box 1037 Oakleigh House Cardiff CF11 1HU Telephone: 0844 579 0021 Legal Expenses only Chancery House St Nicholas Way Sutton Surrey SM1 1JB Telephone: 0208 652 1313 The notification must be made within 31 days or as soon as possible after that following any bodily injury, illness, disease, incident, event, redundancy or the discovery of any loss, theft or damage which may give rise to a claim under this policy. You must also inform us if you are aware of any writ, summons or impending prosecution. Every communication relating to a claim must be sent to us without delay. You or anyone acting on your behalf must not negotiate, admit or repudiate any claim without our written consent. You or your representatives must supply at your own expense all information, evidence, details of household insurance and medical certificates as required by us. We reserve the right to require you to undergo an independent medical examination at our expense. We may also request and will pay for a post-mortem examination. You must retain any property which is damaged and if requested, send it to us at your own expense. If we pay a claim for the full value of the property and it is subsequently recovered or there is any salvage then it will become our property. We may refuse to reimburse you for any expenses for which you cannot provide receipts or bills. 2. Subrogation We are entitled to take over any rights in the defence or settlement of any claim and to take proceedings in your name for our benefit against any other party. 3. Fraud You must not act in a fraudulent manner. If you or anyone acting for you: a) makes a claim under the policy knowing the claim to be false or fraudulently exaggerated in any respect or b) makes a statement in support of a claim knowing the statement to be false in any respect or c) submits a document in support of a claim knowing the document to be forged or false in any respect or d) makes a claim in respect of any loss or damage caused by your wilful act or with your connivance. Then we a) shall not pay the claim b) shall not pay any other claim which has been or will be made under the policy c) may at our discretion declare the policy void d) shall be entitled to recover from you the amount of any claim already paid under the policy e) shall not make any return of premium f) may inform the police of the circumstances. 8 9
General Exclusions General Exclusions applicable to all sections of the policy. We will not pay for claims arising directly or indirectly from: 1. War, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, terrorism (except under Section 5 - Emergency Medical and Other Expenses and Section 7 - Personal Accident), revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power. 2. Ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste, from combustion of nuclear fuel, the radioactive, toxic, explosive or other hazardous properties of any nuclear assembly or nuclear component of such assembly. 3. Loss, destruction or damage directly occasioned by pressure waves caused by aircraft and other aerial devices travelling at sonic or supersonic speeds. 4. The failure or fear of failure or inability of any equipment or any computer programme, whether or not you own it, to recognise or to interpret correctly or process any date as its true calendar date, or to continue to function correctly beyond that date. 5. Your participation in winter sports activities such as skiing, snow boarding, snow mobiling and bob sleighing. 6. Your participation in or practice of any other sport or activity unless: a) shown as covered under hazardous activities. b) shown as covered in your schedule. 7. Any pre-existing medical condition and associated condition. 8. Your use of a motorised vehicle unless a full United Kingdom driving licence is held permitting the use of such vehicles in the United Kingdom. 9. Your wilful, self-inflicted injury or illness, suicide or attempted suicide, solvent abuse, the use of drugs (other than drugs taken in accordance with treatment prescribed and directed by a medical practitioner but not for the treatment of drug addiction) or self-exposure to needless peril (except in an attempt to save human life). 10. Any form of alcohol abuse including alcohol withdrawal or you drinking too much alcohol where it is reasonably foreseeable that such consumption could result in a serious impairment of your faculties and/or judgement resulting in a claim. We do not expect you to avoid alcohol on your trip but we will not cover any claim arising because you have drunk so much alcohol that your judgement is seriously affected and you need to make a claim as a result. 11. Your own unlawful action or any criminal proceedings against you. 12. Losses that are not directly associated with the incident that caused the claim for example, loss of earnings due to being unable to return to work following injury or illness happening while on a trip or the cost of replacing locks in the event that keys are lost while on a trip. 13. Operational duties of a member of the Armed Forces. 14. Your travel to a country or specific area or event to which the Travel Advice Unit of the Foreign and Commonwealth Office has advised the public not to travel. 15. Any liability arising from any goods, services advice, or arrangements supplied by us or any of our agents. 16. Claims where there is another insurance policy covering the same risk. 17. Costs recoverable elsewhere. 18. Any trip that had already begun when you purchased this insurance will not be covered. 19. Claims arising from the unauthorised use of a swimming pool outside the specified times of opening. 20. You climbing on top of, or jumping from a vehicle or jumping from a building or balcony, or climbing or moving from any external part of any building to another (apart from stairs) regardless of the height, unless your life is in danger or you are attempting to save human life. 21. You not wearing a helmet whilst on a motorcycle (this includes mopeds and motorised scooters). 22. You not wearing a seatbelt when travelling in a motor vehicle, where a seatbelt is available. Pre-Travel Advice For advice about visas and vaccinations you may need for your trip or for general information such as the safety of drinking water, tipping, opening hours of banks and shops at your destination and reciprocal health arrangements, contact our 24 hour pre-travel advice line on 0208 763 3030. Reciprocal Health Agreements EU, EEA or Switzerland If you are travelling to countries within the European Union (EU), the European Economic Area (EEA) or Switzerland, you are strongly advised to obtain a European Health Insurance Card (EHIC). This will entitle you to benefit from the reciprocal health care arrangements which exist between countries within the EU/EEA or Switzerland. In the event of liability being accepted for a medical expense which has been reduced by the use of either a EHIC or private health insurance, we will not apply the deduction of a policy excess under Section 7 Emergency Medical and Other Expenses. Australia If you require medical treatment in Australia, you must enrol with a local MEDICARE office. You do not need to enrol on arrival but you must do this after the first occasion you receive treatment. In-patient and outpatient treatment at a public hospital is then available free of charge. If you are admitted to hospital, contact must be made with the Assistance Helpline as soon as possible and their authority obtained in respect of any treatment not available under MEDICARE. 10 11
Schedule of Benefits Section Limit Excess * Cancellation 5,000 50 Missed Departure 1,000 Nil Travel Delay 250 Nil Curtailment 5,000 50 Emergency Medical and Other Expenses 10,000,000 50 Hospital Benefit 1,000 Nil Personal Accident 25,000 Nil Delayed Baggage 200 Nil Baggage 1,500 50 Single article limit 300 50 Valuables 500 50 Personal Money 500 50 Loss of Passport and Other Documents 600 50 Mugging 1,000 Nil Personal Liability 2,000,000 50 Legal Expenses 25,000 250 *per person person incident Section 1: Cancellation We will pay you up to the amount shown in the Schedule of Benefits for your share of any irrecoverable unused travel and accommodation costs (including excursions) and other pre-paid charges which you have paid or are contracted to pay together with any reasonable additional travel expenses incurred if the cancellation of the trip is necessary and unavoidable as a result of any of the following events occurring: 1. The death, bodily injury or illness of: a) you b) any person with whom you are travelling or have arranged to travel with c) any person with whom you have arranged to reside temporarily d) your close relative e) a close business associate. 2. Compulsory quarantine, jury service attendance or being called as a witness (except as an expert witness) at a Court of Law of you or any person with whom you are travelling or have arranged to travel with. 3. Redundancy (provided employment has been on a continuous basis with the same employer for at least 24 months, you qualify for payment under current UK redundancy payment legislation, and at the time of booking the trip or purchasing this policy, whichever is the later, there was no reason to believe anyone would be made redundant) of you or any person who are travelling or have arranged to travel with. 4. The Police requesting you to remain at or return to your home due to serious damage to your home caused by fire, aircraft, explosion, storm, flood, subsidence, malicious persons or theft. You may claim only under Section 1 Cancellation or Section 4 - Curtailment for the same event, not both. 1. If you fail to notify the travel agent, tour operator or provider of transport/accommodation immediately upon finding it necessary to cancel the trip, our liability shall be restricted to the cancellation charges that would have applied had failure not occurred. 2. If you cancel the trip due to bodily injury or illness you must provide a medical certificate from a medical practitioner stating that this necessarily and reasonably prevented you from travelling. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. The cost of Air Passenger Duty or other airport departure taxes. 3. Any claims arising directly or indirectly from: a) redundancy caused by or resulting from misconduct leading to dismissal or from resignation or voluntary redundancy or where a warning or notification of redundancy was given prior to the date this insurance is purchased by you or the time of booking any trip (whichever is the later). b) circumstances known to you prior to the date this insurance is purchased by you or the time of booking any trip (whichever is the later) which could reasonably have been expected to give rise to cancellation of the trip. 12 13
4. Travel tickets paid for using any airline mileage reward scheme, for example Air Miles or Avios points, or other similar reward schemes. 5. Accommodation costs paid for using any Timeshare, Holiday Property Bond or other holiday points scheme. 6. Stress, anxiety, depression or any other mental or nervous disorder that you are suffering from unless it has been investigated and diagnosed as such by a consultant specialising in the relevant field. 7. Your pregnancy or childbirth where pregnancy has exceeded 28 weeks. 8. Any claim if at the time of taking out this policy or booking a trip, whichever was the later, the person with whom you are travelling or have arranged to travel, a person with whom you have arranged to reside with temporarily, a close relative or close business associate had a medical condition for which he or she: a) was receiving treatment at hospital (other than where they go to hospital for check-ups for a stable condition, at regular intervals which have been arranged beforehand) b) was waiting for a hospital consultation, investigations or treatment (other than where they go to hospital for check-ups for a stable condition, at regular intervals which have been arranged beforehand) c) had been given a terminal prognosis, or been told that their condition is likely to get worse in the next 12 months. 9. Any loss where the treatment for which you have been on a waiting list or where you were aware of the need for treatment, at the time of purchasing this insurance or booking your trip whichever was the later, results in you making a claim. For example, where the date of your treatment results in the cancellation of your trip. 10. Anything mentioned in the General Exclusions. You should also refer to the Important Conditions Relating to Health section. Section 2: Missed Departure We will pay you up to the amount shown in the Schedule of Benefits for reasonable additional accommodation (room only) and travel expenses necessarily incurred in reaching your overseas destination or returning to the United Kingdom if you fail to arrive at the international departure point in time to board the public transport on which you are booked to travel on the initial international journey of the trip as a result of: a) scheduled public transport services failing to get you there in time due to strike, industrial action, adverse weather conditions or mechanical breakdown b) an accident to or breakdown of the vehicle in which you are travelling. 1. In the event of a claim arising from any delay occurring following an accident to or breakdown of the vehicle in which you are travelling you must obtain written confirmation from the Police or emergency breakdown services of the location, reason for and duration of the delay. 2. You must allow sufficient time for the public transport or other transport to arrive on schedule and to deliver you to the departure point. 1. Claims arising directly or indirectly from: a) strike or industrial action existing or declared publicly by the date this insurance is purchased by you. b) an accident to or breakdown of the vehicle in which you are travelling for which a professional repairer s report is not provided. c) breakdown of any vehicle in which you are travelling if the vehicle is owned by you and has not been serviced properly and maintained in accordance with the manufacturer s instructions. d) withdrawal from service (temporary or otherwise) of an aircraft or sea vessel on the recommendation of the Civil Aviation Authority or a Port Authority or any similar body in any country. 2. Additional expenses where the scheduled public transport operator has offered reasonable alternative travel arrangements. 3. Anything mentioned in the General Exclusions. 14 15
Section 3: Travel Delay The benefit provided under 1. below is intended to provide compensation if you are delayed at your point of departure and is only applicable if you have travelled there and checked-in. If you have not travelled to your departure point you will not be covered even if you have checked-in online. If departure of the public transport on which you are booked to travel is delayed at the final departure point from or to the United Kingdom for at least 12 hours from the scheduled time of departure due to: a) strike b) industrial action c) adverse weather conditions d) mechanical breakdown of or a technical fault occurring in the public transport on which you are booked to travel We will pay you: 1. 30 for the first completed 12 hours delay and 20 for each full 12 hours delay thereafter up to the amount shown in the Schedule of Benefits for the cover level you have selected or 2. Up to the amount shown in the Schedule of Benefits for the cover level you have selected under Section 1 Cancellation for your share of any irrecoverable unused travel and accommodation costs and other pre-paid charges which you have paid or are contracted to pay if after a minimum 12 hours has elapsed, you choose to cancel your trip. You may claim only under subsection 1. or 2. above for the same event, not both. You may claim only under this section or Section 3 Missed Departure for the same event, not both. You may claim only under this section or Section 1 Cancellation for the same event, not both. 1. You must check in according to the itinerary supplied to you. 2. You must obtain confirmation from the carriers (or their handling agents) in writing of the number of hours of delay and the reason for the delay. 3. You must comply with the terms of contract of the travel agent, tour operator or provider of transport. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all applies for claims under 2 above where you choose to cancel your trip following a 12 hour delay. 2. Claims arising directly or indirectly from: a) strike or industrial action or air traffic control delay existing or publicly declared by the date this insurance is purchased by you. b) withdrawal from service (temporary or otherwise) of an aircraft or sea vessel on the recommendation of the Civil Aviation Authority or a Port Authority or any similar body in any country. 3. Anything mentioned in the General Exclusions. 16 Section 4: Curtailment We will pay you up to the amount shown in the Schedule of Benefits for your share of any irrecoverable unused travel and accommodation costs (including excursions) and other pre-paid charges which you have paid or are contracted to pay together with any reasonable additional travel expenses incurred if the trip is curtailed before completion as a result of any of the following events occurring: 1. The death, bodily injury or illness of: a) you b) any person with whom you are travelling or have arranged to travel with c) any person with whom you have arranged to reside temporarily d) your close relative e) a close business associate. 2. Compulsory quarantine, jury service attendance or being called as a witness (except as an expert witness) at a Court of Law of you or any person with whom you are travelling or have arranged to travel with. 3. The Police requesting you to return to your home due to serious damage to your home caused by fire, aircraft, explosion, storm, flood, subsidence, malicious persons or theft. 1. You must obtain a medical certificate from the medical practitioner in attendance and prior approval of the Assistance Helpline to confirm the necessity to either: a) return home prior to curtailment of the trip due to death, bodily injury or illness, or b) remain in hospital for the rest of the trip due to bodily injury or illness. 2. You must contact the Assistance Helpline for assistance if you need to curtail your trip for an insured reason. 3. If you fail to notify the travel agent, tour operator, or provider of transport or accommodation as soon as you find out it is necessary to curtail the trip the amount we will pay will be limited to the charges that would have applied otherwise. 4. If you are curtailing your trip payments will be calculated on a pro-rata basis taking into consideration unused accommodation and excursions. If you are unable to revalidate your return ticket we will pay for your repatriation costs up to the same class of travel as on your outward journey but not any unused portion of your original ticket. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. The cost of Air Passenger Duty or other airport departure taxes. 3. Any claims arising directly or indirectly from circumstances known to you prior to the date this insurance is purchased by you or the time of booking any trip (whichever is the later) which could reasonably have been expected to give rise to curtailment of the trip. 4. Travel tickets paid for using any airline mileage reward scheme, for example Air Miles or Avios points or other similar reward schemes. 17
5. Accommodation costs paid for using any Timeshare, Holiday Property Bond or other holiday points scheme. 6. Stress, anxiety, depression or any other mental or nervous disorder that you are suffering from unless it has been investigated and diagnosed as such by a consultant specialising in the relevant field. 7. Your pregnancy or childbirth where pregnancy has exceeded 28 weeks. 8. In respect of curtailment expenses incurred as a result of a tropical disease where you had not had the recommended inoculations and/or taken the recommended medication. 9. Any claim if at the time of taking out this policy or booking a trip, whichever was the later, the person with whom you are travelling or have arranged to travel, a person with whom you have arranged to reside with temporarily, a close relative or close business associate had a medical condition for which he or she: a) was receiving treatment at hospital (other than where they go to hospital for check-ups for a stable condition, at regular intervals which have been arranged beforehand) b) was waiting for a hospital consultation, investigations or treatment (other than where they go to hospital for check-ups for a stable condition, at regular intervals which have been arranged beforehand) c) had been given a terminal prognosis, or been told that their condition is likely to get worse in the next 12 months. 10. Any loss where the treatment for which you have been on a waiting list or where you were aware of the need for treatment, at the time of purchasing this insurance or booking your trip whichever was the later, results in you making a claim. For example, where the date of your treatment results in the cancellation of your trip. 11. Anything mentioned in the General Exclusions. You should also refer to the Important Conditions Relating to Health section. Section 5: Emergency Medical and Other Expenses This section provides insurance for emergency medical costs not covered under a reciprocal health agreement between the government of the United Kingdom and that of your country of loss including costs covered by the European Health Insurance Card (EHIC). This is not Private Medical Insurance. We will pay you up to the amount shown in the Schedule of Benefits for the following expenses which are necessarily incurred as a result of your suffering bodily injury or illness: 1. Emergency medical, surgical, hospital, ambulance and nursing fees and charges incurred outside the United Kingdom. 2. Emergency dental treatment for the immediate relief of pain (to natural teeth only) up to a limit of 750 incurred outside the United Kingdom. 3. In the event of your death outside the United Kingdom the reasonable additional cost of funeral expenses abroad up to the amount shown in the Schedule of Benefits plus the reasonable cost of conveying your ashes to your home, or the additional costs of returning your body to your home. 4. Reasonable additional transport (economy class) or accommodation expenses incurred, up to the standard of your original booking. This includes, with the prior authorisation of the Assistance Helpline, reasonable additional transport or accommodation expenses for a friend or close relative to remain with you or travel to you from the United Kingdom or escort you and additional travel expenses to return you to your home if you are unable to use the return ticket. 5. With the prior authorisation of the Assistance Helpline, the additional costs incurred in the use of air transport or other suitable means, including qualified attendants, to repatriate you to your home if it is medically necessary. Repatriation expenses will be in respect only of the identical class of travel utilised on the outward journey unless the Assistance Helpline agree otherwise. 1. You must give notice as soon as possible to the Assistance Helpline or us of any bodily injury or illness which may lead to you incurring medical expenses over 500 or before any arrangements are made for your repatriation. 2. If you are injured or become ill during your trip, the Assistance Helpline may: a) move you from one hospital to another and /or b) arrange for you to return to the United Kingdom at any time. They will do this if they and the treating doctor think that it is safe for you to be moved or returned to the United Kingdom. If you choose not to, our liability will end on the date it was deemed safe for you to be moved or returned to the United Kingdom. For travel to the United States of America emergency medical, surgical, hospital, ambulance and nursing fees and charges means costs that are incurred for approved, eligible medical services or supplies up to 150% of the published medical rates for the same or similar treatment as payable by US Medicare. 18 19
1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. Any claims arising directly or indirectly in respect of: a) costs of telephone calls, other than: i. calls to the Assistance Helpline notifying and dealing with the problem for which you are able to provide receipts or other evidence to show the cost of the calls and the numbers you telephoned ii. any costs incurred by you when you receive calls on your mobile from Assistance Helpline for which you are able to provide receipts or other evidence to show the cost of the calls. b) the cost of treatment or surgery, including exploratory tests, which are not directly related to the bodily injury or illness which necessitated your admittance into hospital. c) any expenses which are not usual, reasonable or customary to treat your bodily injury or illness. d) your pregnancy or childbirth where pregnancy has exceeded 28 weeks. e) any form of treatment or surgery which in the opinion of the medical practitioner in attendance and the Assistance Helpline can be delayed reasonably until your return to the United Kingdom. f) expenses incurred in obtaining or replacing medication, which at the time of departure is known to be required or to be continued outside the United Kingdom. g) additional costs arising from single or private room accommodation. h) treatment or services provided by a health spa, convalescent or nursing home or any rehabilitation centre unless agreed by the Assistance Helpline. i) any expenses incurred after you have returned to the United Kingdom. j) expenses incurred as a result of a tropical disease where you have not had the recommended inoculations and/or taken the recommended medication. k) your decision not to be repatriated after the date when in the opinion of the Assistance Helpline it is safe to do so. l) claims where you do not comply with the treatment agreed by the treating doctor and the Assistance Helpline doctor. m) the cost of taxi fares, other than those for your travel to or from hospital relating to your admission, discharge or attendance for outpatient treatment or appointments or for collection of medication prescribed for you by the hospital. However, any costs incurred by you to visit another person or by another person visiting you in hospital are not covered. n) for any sums which can be recovered by you and which are covered under any National Insurance Scheme or Reciprocal Health Agreement. Section 6: Hospital Benefit We will pay you 50 for every complete 24 hours you have to stay in hospital as an in-patient outside the United Kingdom up to the amount shown in the Schedule of Benefits as a result of bodily injury or illness you sustain. We will pay the amount above in addition to any amount payable under Section 5 Emergency Medical and Other Expenses. You must give notice as soon as possible to the Assistance Helpline or us of any bodily injury or illness which necessitates your admittance to hospital as an in-patient. 1. Any claims arising directly or indirectly from: a) any additional period of hospitalisation relating to treatment or surgery, including exploratory tests, which are not directly related to the bodily injury or illness which necessitated your admittance into hospital. b) hospitalisation relating to any form of treatment or surgery which in the opinion of the medical practitioner in attendance and the Assistance Helpline can be delayed reasonably until your return to the United Kingdom. c) any additional period of hospitalisation relating to treatment or services provided by a convalescent or nursing home or any rehabilitation centre. d) hospitalisation as a result of a tropical disease where you have not had the recommended inoculations and/or taken the recommended medication. e) any additional period of hospitalisation following your decision not to be repatriated after the date when in the opinion of the Assistance Helpline it is safe to do so. 2. Any claims not covered under Section 5 - Emergency Medical and Other Expenses. 3. Anything mentioned in the General Exclusions. 3. Claims where you do not comply with the treatment agreed by the treating doctor and the Assistance Helpline doctor. 4. Anything mentioned in the General Exclusions. You should also refer to the Important Conditions Relating to Health section. 20 21
Section 7: Personal Accident If during the trip you sustain a bodily injury and within 12 months you become disabled or die because of the injury, and the injury is the sole cause of death or permanent total disability, we will pay you or your dependants up to the amount shown in the Schedule of Benefits if you: a) die b) suffer loss of limb or loss of sight in one or both eyes c) suffer permanent total disability from all gainful employment. We will only pay one of the above benefits for each insured person if it related to the same accident. If an insured person is under 16 or 65 or over we will only pay 2,500 for benefit a), b) and c). Our medical practitioner may examine you as often as they deem necessary in the event of a claim. Provisions Benefit is not payable to you: i) under more than one of items a), b) or c). ii) under item c) until one year after the date you sustained your bodily injury. iii) under item c) if you are able or may be able to carry out any gainful employment or gainful occupation. Section 8: Delayed Baggage We will pay up to the amount shown in the Schedule of Benefits for each insured person for the cost of buying essential items if your baggage has been delayed or misplaced by the carrier for more than 12 hours during the outward part of your trip. If we pay your claim under this section we will deduct the amount from the final settlement of any claim you make under Section 9 - Baggage, if the baggage is found to be permanently lost. 1. If your baggage is delayed whilst in the care of your carrier you must report to them, in writing, details of the loss whilst in their care. In the case of an airline, you must: a) obtain a Property Irregularity Report from the airline. b) give formal written notice of the claim to the airline within the time limit contained in their conditions of carriage (please retain a copy). c) retain all travel tickets and tags for submission if a claim is to be made under this policy. 2. You must keep detailed receipts for all essential replacement items purchased. 1. Anything mentioned in the General Exclusions. 1. Anything mentioned in the General Exclusions. 22 23
Section 9: Baggage We will pay you up to the amounts shown in the Schedule of Benefits for the accidental loss of, theft of or damage to your baggage. The amount payable will be the value at today s prices less a deduction for wear, tear and depreciation or we may at our discretion replace, reinstate or repair the lost or damaged baggage. The maximum we will pay for: 1. Any one article, pair or set of articles 2. The total for all valuables is the amount shown in the Schedule of Benefits. In respect of prescription spectacles the limit is 300 and for the cost of replacement keys (house and/or car only) the limit is 250. 5. Loss, theft of or damage to unset precious stones, contact or corneal lenses, hearing aids, dental or medical fittings, antiques, musical instruments, deeds, manuscripts, securities, perishable goods, bicycles, and damage to suitcases (unless the suitcases are entirely unusable as a result of one single incidence of damage). 6. Loss or damage due to cracking, scratching, breakage of or damage to china, glass (other than glass in watch faces, cameras, binoculars or telescopes), porcelain or other brittle or fragile articles unless caused by fire, theft, or accident to the aircraft, sea vessel, train or vehicle in which they are being carried. 7. Loss or damage due to breakage of sports equipment or damage to sports clothing whilst in use. 8. Loss, theft of or damage to business goods, samples, tools of trade, motor accessories and other items used in connection with your business, trade, profession or occupation. 9. Loss or damage caused by wear and tear, depreciation, deterioration, atmospheric or climatic conditions, moth, vermin, any process of cleaning, repairing, or restoring, mechanical or electrical breakdown. 10. Anything mentioned in the General Exclusions. 1. You must report to the local Police within 24 hours of discovery or as soon as possible after that and obtain a written report of the loss, theft or attempted theft of all baggage. 2. If baggage is lost, stolen or damaged while in the care of a carrier, transport company, authority or hotel you must report to them, in writing, details of the loss, theft or damage and obtain written confirmation. If baggage is lost, stolen or damaged whilst in the care of an airline you must: a) obtain a Property Irregularity Report from the airline. b) give formal written notice of the claim to the airline within the time limit contained in their conditions of carriage (please retain a copy). c) retain all travel tickets and tags for submission if a claim is to be made under this policy. 3. Receipts for items lost, stolen or damaged must be retained as these will help you to substantiate your claim. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. Loss, theft of or damage to valuables left unattended at any time (including in a vehicle or in the custody of carriers) unless deposited in a hotel safe, deposit box or left in your locked personal, private accommodation. 3. Loss, theft of or damage to baggage contained in an unattended vehicle: a) overnight between 9 p.m. and 9 a.m. (local time) or b) at any time between 9 a.m. and 9 p.m. (local time) unless it is in the glove compartment or the locked boot which is separate from the passenger compartment for those vehicles with a boot, or for those vehicles without a separate boot locked in the vehicle and covered from view. 4. Loss or damage due to delay, confiscation or detention by customs or other authority. 24 25
Section 10: Personal Money We will pay you up to the amount shown in the Schedule of Benefits for the accidental loss of, theft of or damage to your personal money. In respect of foreign currency, cover is also operative during the 72 hours immediately preceding your departure on the outward journey. The maximum we will pay if you are under the age of 16 for bank notes, currency notes and coins is 50. 1. You must report to the local Police within 24 hours of discovery or as soon as possible after that and obtain a written report of the loss, theft or attempted theft of your personal money. 2. Receipts for items lost, stolen or damaged must be retained as these will help you to substantiate your claim. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. Loss, theft of or damage to personal money left unattended at any time (including in a vehicle or in the custody of carriers) unless deposited in a hotel safe, safety deposit box or left in your locked personal, private accommodation. 3. Loss or damage due to delay, confiscation or detention by customs or other authority. 4. Loss or damage due to depreciation in value, variations in exchange rates or shortages due to error or omission. 5. Anything mentioned in the General Exclusions. Section 11: Loss of Passport and Other Documents We will pay you up to the amount shown in the Schedule of Benefits following the accidental loss of, theft of or damage to your passport (including visas), travel tickets, green cards, driving licences, and business documents and records for: 1. Reasonable additional travel and accommodation expenses necessarily incurred abroad to obtain a replacement of your lost or stolen passport or visa or driving licence. 2. A temporary travel permit whilst you are on your trip. 3. A replacement passport or driving licence when you are back in the United Kingdom. 1. You must report to the local Police within 24 hours of discovery or as soon as possible after that and obtain a written report of the loss, theft or attempted theft of your passport or driving licence. 2. If your passport, travel tickets, green cards, driving licences, and business documents and records are lost, stolen or damaged while in the care of a hotel you must report to them, in writing, details of the loss, theft or damage and obtain written confirmation. 3. Receipts for items lost, stolen or damaged must be retained as these will help you to substantiate your claim. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. Loss, theft of or damage to your passport, travel tickets, green cards, driving licences, and business documents and records left unattended at any time (including in a vehicle or in the custody of carriers) unless deposited in a hotel safe, safety deposit box or left in your locked personal, private accommodation. 3. Loss or damage due to delay, confiscation or detention by customs or other authority. 4. Anything mentioned in the General Exclusions. 26 27
Section 12: Mugging This section does not apply to trips within the United Kingdom. We will pay 50 per 24 hours up to the limit shown in the Schedule of Benefits for the cover level you have selected, in addition to any medical expenses incurred under Section 5 Emergency Medical and Other Expenses of this policy if you are mugged and, as a result of your injuries received from the mugging, are admitted as an in-patient to a hospital abroad. 1. You must report to the local Police within 24 hours or as soon as possible after that and obtain written confirmation of your injuries and period of in-patient treatment from the hospital. 2. Any claims arising from trips taken within the United Kingdom. 3. Anything mentioned in the General Exclusions. Section 13: Personal Liability We will pay up to the amount shown in the Schedule of Benefits (inclusive of legal costs and expenses) against any amount you become legally liable to pay as compensation for any claim or series of claims arising from any one event or source of original cause in respect of accidental: 1. bodily injury, death, illness or disease to any person who is not in your employment or who is not a close relative or member of your household. 2. loss of or damage to property that does not belong to and is neither in the charge of or under the control of you, a close relative, anyone in your employment or any member of your household other than any temporary holiday accommodation occupied (but not owned) by you. 1. You must give us written notice as soon as possible of any incident, which may give rise to a claim. 2. You must forward every letter, writ, summons and process to us as soon as you receive it. 3. You must not admit any liability or pay, offer to pay, promise to pay or negotiate any claim without our written consent. 4. We will be entitled if we so desire to take over and conduct in your name the defence of any claims for indemnity or damages or otherwise against any third party. We shall have full discretion in the conduct of any negotiation or proceedings or in the settlement of any claim and you shall give us all necessary information and assistance which we may require. 5. In the event of your death, your representative(s) will have the protection of this cover provided that such representative(s) comply(ies) with the terms and conditions outlined in this policy. 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. Compensation or legal costs arising directly or indirectly from: a) liability which has been assumed by you under agreement unless the liability would have attached in the absence of such agreement. b) pursuit of any business, trade, profession or occupation or the supply of goods or services. c) ownership or use of aircraft, horse-drawn or mechanical/motorised vehicles, bicycles, watercraft (other than rowing boats, punts or canoes), animals (other than horses, domestic dogs or cats), or firearms (other than guns being used for sport). d) the transmission of any communicable disease or virus. e) ownership or occupation of land or buildings (other than occupation only of any temporary holiday accommodation). 3. Anything mentioned in the General Exclusions. 28 29
Section 14: Legal Expenses We will pay the legal expenses incurred by you or your representative, up to the amount shown in the Schedule of Benefits, in the pursuit of compensation and/or damages against a third party arising from or out of your personal injury or death as a direct result of an accident. 1. Notification You must inform us by filling in a claim form within 90 days of the commencement of the event giving rise to the claim. You must give us a full and truthful account of the details of your claim. Until you have told us about the claim and we have given our agreement, we will not be responsible for any legal expenses. 2. Selection of Appointed Representative You are free to choose a representative (by sending us a suitably qualified person s name and address) if: a) we agree to start court proceedings and it becomes necessary for a lawyer to represent your interests in those proceedings; or b) there is a conflict of interest. We will consider your choice of representative and will approve your choice if you can satisfy us that your nominated representative has the appropriate skills and experience to handle your claim. If we cannot agree with your choice of representative we will explain why and you may choose another suitably qualified person. If we and you cannot reach agreement then Special Condition 3 will apply. 3. Arbitration If there is a dispute between you and us about this section of the policy, it can be taken to an independent arbitrator. The arbitrator will be a solicitor or barrister whom you and us agree to. If we cannot agree with you on an arbitrator, the President of the Law Society (or similar organisation) will choose the arbitrator. The side that loses the arbitration will pay the costs of the arbitration. If the decision is not totally in favour of one side, the arbitrator will decide who pays the costs. If you lose or are asked to pay a share of the costs, those costs will not be covered under this policy. 4. Co-operation We must be able to contact the appointed representative. You and the appointed representative must co-operate with us and tell us about developments concerning your case. We must be able to have access to the appointed representative s files if we request this. 5. Settlement You must tell us if an offer is made to settle the legal proceedings. You must not negotiate or agree to settle the dispute without having our agreement beforehand. If you do not accept a reasonable offer, we may not continue to support your claim. 6. Payment of Bills You must send us all bills for the appointed representative s legal expenses as soon as you receive them. You must confirm to us that any charges you have to pay are acceptable and that we may pay the bill for you. 7. Recovery You and your representative must take every step to recover legal expenses. If we pay legal expenses up to the maximum for any one claim and you pay more legal expenses to end your case, You and us will share any legal expenses that are recovered. You and us will each receive the same percentage as was paid. 8. Claims Evidence We will require the following evidence: A doctor s certificate in respect of accidental personal injury or death certificate in respect of accidental death. Any independent witness statements. Any available supporting documentary evidence (including photographs if possible). We will not pay for: 1. The excess of each and every claim per incident for each insured person but limited to two excesses in all. 2. Legal expenses incurred prior to the granting of support by us. 3. Any claim reported more than 90 days after the start of the event giving rise to such a claim. 4. Any claim where, in our opinion, there is insufficient prospect of success in obtaining a reasonable benefit. 5. Damages or fines you have to pay. 6. Claims arising from a trip solely within the United Kingdom. 7. Any claim arising from your business or professional activities. 8. Legal expenses incurred in relation to a dispute between you and us other than as detailed under the Arbitration clause. 9. Any legal expenses which are dependent upon the successful outcome of the case. 10. Anything mentioned in the General Exclusions. 30 31
Complaints Procedure You have the right to expect the best possible service and support. If we have not delivered the service that you expected or you are concerned with the service provided, we would like the opportunity to put things right. If you feel we have fallen short of our standards, please contact the Customer Relations Team. Post: Cigna Travel Insurance Customer Relations Department 1 Drake Circus Plymouth, PL1 1QH Telephone: 0844 412 4683 For your protection calls may be recorded and may be monitored. E.mail: customerrelations.plymouth@cignainsurance.co.uk What to do if you are still not satisfied. If you are still not satisfied then you may be able to refer your complaint to the Financial Ombudsman Service. You must approach the Financial Ombudsman Service within six months of our final response to your complaint. We will remind you of the time limits in the final response. Financial Ombudsman Service South Quay Plaza 183 Marsh Wall London E14 9SR Telephone 0800 0 234 567, free for people phoning from a fixed line (for example, a landline at home) or 0300 123 9 123, free for mobile-phone users who pay a monthly charge for calls to numbers starting 01 or 02 Email: complaint.info@financial-ombudsman.org.uk Website: www.financial-ombudsman.org.uk We must accept the Ombudsman s final decision, but you are not bound by it and may take further action if you wish. Your rights as a customer to take legal action remain unaffected by the existence or use of our complaints procedure. However the Financial Ombudsman Service may not adjudicate on any cases where litigation has commenced. Is CIGNA Europe Insurance Company S.A.-N.V. covered by the Financial Services Compensation Scheme (FSCS)? CIGNA Europe Insurance Company S.A.-N.V. is covered by the Financial Services Compensation Scheme. This provides compensation in case any of its members go out of business or into liquidation and are unable to meet any valid claims under its policies. Further information can be obtained from the Financial Services Compensation Scheme (www.fscs.org.uk) or by contacting the FSCS at 10th Floor, Beaufort House, 15 St Botolph Street, London EC3A 7QU or by calling 0800 678 1100 or 020 7741 4100. Data protection notice Introduction Please make sure that you read and understand this Data Protection notice as it explains to you what we will do with the information that you give us in respect of this travel insurance policy. If you apply for our products and/or services it is highly likely that we will need both personal and sensitive data about yourself and anyone else who is covered by the application form in order to administer the insurance policy and any claims which may arise. You should show this notice to any other person covered under your insurance policy. If your application includes other individuals you should obtain their consent to us using their personal information as described in this notice before you give their information to us. When we use the terms we, our or us in this Data Protection notice, we mean Cigna Insurance Services (Europe) Limited. The ways in which we use the personal information you give to us are described below. Your insurance policy is administered by Cigna Insurance Services (Europe) Limited. We will sometimes use the personal information you give to us for different purposes to Confused.com. The data controller Cigna Insurance Services (Europe) Limited is the data controller of all information collected and processed in the context of the insurance policy. Protection and uses of your personal data The security of your personal information is very important to us. All personal information that you supply to us either in respect of yourself or other individuals in connection with our products and/or services will be treated in confidence by us and will be used by us for the purpose of providing and administering our products and services. This may involve the collection and processing of sensitive data (as defined in the Data Protection Act 1998) and if you complete an application form for our products and/or services you will be giving your consent to such information being processed by us (which may include other companies within the Cigna corporate group) or our agents. Certain information has been passed by Confused.com in relation to this insurance policy, and we may collect your personal information from other third parties where this is necessary in order to provide insurance services to you. We may analyse the personal information you provide in combination with any other information that we lawfully hold or receive for the purposes of reviewing, tailoring and improving our products and services. We may also engage the services of third parties to perform any such analysis on our behalf, however in doing so we will ensure that all such activities are carried out in compliance with the applicable data protection legislation. In order to protect your privacy, we will anonymise any information we analyse as far as possible. Your personal and sensitive data may also be shared with the underwriter of our insurance products. It may be necessary to pass your personal and sensitive data to other companies for processing on our behalf, or to organisations with which we work to provide the benefits under your policy (for example, to a hospital which is responsible for any treatment you receive through your policy). Some of these companies or organisations may be based outside Europe in countries which may not have the laws to protect your personal data, but in all cases we will ensure that it is kept securely and only used for the purposes described in this notice. 32 33
Customer satisfaction surveys Inaccurate data If you believe that we are holding inaccurate information about you in relation to your insurance policy, please contact us who will be happy to correct any errors. Telephone calls Please note that for your and our mutual protection telephone calls to us may be monitored and/or recorded for the purposes of: establishing facts relevant to our business; checking that we comply with laws, regulations and self-regulatory procedures; checking and/or demonstrating the standards that we should be meeting, for example, for quality control and staff training purposes; preventing or detecting crime; investigating or detecting the unauthorised use of our systems, to secure our system and to ensure the effective operation of our systems. Fraud prevention, detection & claims history In order to prevent and detect fraud we may at any time: Share information about you with other organisations and public bodies including the Police, loss adjustors and other third parties that we engage to investigate claims; Check and/or file your details with fraud prevention agencies and databases, and if you give us false or inaccurate information and we suspect fraud, we will record this. We, and other organisations involved in the administration of your policy, may also search these agencies and databases to: - Help make decisions about the provision and administration of insurance, credit and related services for you and members of your household; - Trace debtors or beneficiaries, recover debt, prevent fraud and to manage your accounts or insurance policies; - Check your identity to prevent money laundering, unless you furnish us with other satisfactory proof of identity; - Undertake credit searches and additional fraud searches. We can supply on request further details of the databases we access or contribute to. We aim to continuously improve the services we offer to our customers. Occasionally we carry out customer satisfaction surveys which may be for our own benefit or for more general interest, and we may need to collect further information about you in connection with them. Surveys will usually be carried out by us but in some circumstances we will use an external firm. Your participation in such a survey is entirely optional but your help and feedback would be appreciated. Contact us If you have any questions about the way in which we use your personal information, please contact the Customer Services helpline or our Data Protection Officer. Useful contact numbers 24 Hour Assistance Helpline +44 208 763 3030 Lines open: 24 hours a day, 7 days a week An on-line new case notification form is available at www.firstassist.co.uk Click on Assistance services/claims information. For ongoing enquiries you can e-mail direct on international.ops@firstassist.co.uk Claims Helpline 0844 579 0021 Lines open: 8am - 8pm Monday to Friday excluding Bank Holidays Legal Expenses Claims Helpline 0208 652 1313 Lines open: 9am - 5pm Monday to Friday Customer Services 0844 579 0021 Lines open: 8am - 8pm Monday to Friday, 9am - 5pm Saturday Fax: 01752 258496 Email: travelqueries@cignainsurance.co.uk [When we investigate claims, we may conduct searches of publicly accessible information about you available on the internet, including using sources such as search engines and social media.] 34 35
Notes Notes 36 37
Cigna Insurance Services (Europe) Limited is registered in England & Wales No. 4617110. Registered Office: Chancery House, St Nicholas Way, Sutton, Surrey SM1 1JB Cigna Insurance Services (Europe) Limited is authorised and regulated by the Financial Conduct Authority. Financial Services Register number 310671. CIGNA Europe Insurance Company S.A.-N.V., registered in Belgium with limited liability (Brussels trade register no. 0474624562), Avenue de Cortenbergh 52, 1000 Brussels, Belgium. Subject to the prudential supervision of the National Bank of Belgium, Boulevard de Berlaimont 14, 1000 Brussels (Belgium) and to the supervision of the Financial Services and Markets Authority (FSMA), rue du Congrès 12-14, 1000 Brussels (Belgium), in the field of consumer protection and subject to limited regulation by the Financial Conduct Authority. Details of the extent of our regulation by the Financial Conduct Authority are available on request. You can check this information on the Financial Services Register by visiting the website www.fsa.gov.uk/register/home.do or by phoning 0845 606 1234. CNFTIPD (01-14)