To the effects of this contract, the following terms shall be interpreted
according to the definitions below:
Insurer: The Insurance company of Tourism "La Isla S.A." assuming
the risks agreed by contract.
Drawee of the Insurance: The physical or artificial person that, jointly
with the Insurer, subscribes this Policy and to whom correspond the obligations
derived from it, except those that by their nature should be fulfilled
by the Insured.
Insured: The natural person that appears in the Specific Conditions,
provided its age at the moment of contracting the Policy is less than
seventy (70) years, except by agreement in contrary and by means of payment
of the corresponding additional premium.
Domicile of the Insured: The temporary or permanent home.
Accident: An accident is any traumatic corporal lesion that can be determined
by the doctors as real, suffered by the Insured and produced direct and
independently of all other cause, due to an external, accidental, involuntary,
sudden and fortuitous event.
Limit of compensation: The amounts fixed in the Special and General Conditions
that are the maximum compensation limits to be paid by the Insurer in
case of accident.
The warrants of this insurance provide
effect in the Republic of Cuba.
3. EFFECT AND DURATION OF THE WARRANTS:know
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The warrants covered under the present Policy take effect starting from the moment in which the Insured
arrives to the Republic of Cuba and conclude upon exit of the country.
If at the moment that a loss occurs and it is protected by the present Policy, and the Insured is also covered by
another Insurance providing him the same or similar benefits, he is in
the obligation of notifying it to the Insurer.
In the event another insurance exists, the Insurer is forced to reimburse
only the proportion of the claim that he limits as of his responsibility
as agreed in this Policy and it will be representing a proportion of the
total benefits of all the concurrent Policies in force at the moment in
which it occurs.
The Insurer will be subrogated in the rights and
actions that correspond to the Insured in front of a third and that have
motivated intervention of the Insurer and up to the total cost of the
services given or reimbursed casualties. To such effects the Insured will
facilitate all the documents, tests, investigations and certifications
that will allow the Insurer to exercise the subrogation right.
Any fact that causes or can cause a reclamation, will
be notified to the Central Alarm Station of the Assistance Service of
ASISTUR or their agents within the 48 hours of the occurrence by calling:
33-8920, 33-8339 and 33-8527; Telex: 51-2905; Fax: 33-8087.
On the arising of any dispute between the Drawee
of the Insurance or the Insured and the Insurer, related to this Policy
because of its execution, interpretation, modification and/or rescission,
it shall be submitted to the competent Jurisdictional Organ in agreement
with the Law Procedure in force within the Republic of Cuba.
This Policy will be void and null and the Insured
will lack all right to compensation in the event of loss, if the Drawee
of the Insurance or the Insured makes false declarations, even if made
in good faith, if he exaggerates on the quantity of the damages, seeks
to destroy or disappear proof existing before the loss, uses as justification
inexact documents or uses fraudulent means.
The Insurer will not be responsible and will not reimburse the Insured for any damage, loss, lesion or illness when
the Insured -under his request-, asks people or professionals to attend
him as physician, pharmaceutical or legal assistance. The Insurer only
provides services when they are requested to him and without charge in
the circumstances foreseen above. In these cases, the person or people
designated by the Insurer they will be considered as Agents of the Insurer
without motion by nature or circumstance against the Insurer due to such
an appointment.
11.1 MEDICAL EXPENSES FOR ILLNESS OR ACCIDENT: The Insurer assumes the
charges, until the limit indicated in the Specific conditions for the
surgical medical expenses, dentist, pharmacists and hospitalization, incurred
as a consequence of an illness or accident during the trip and within
the period of validity of the Policy, and suited to the nature of the
illness or lesion suffered and according to the circumstances of the event.
Dentist fares are those that require a urgent treatment due to infection,
pain or trauma. In any event, this expenses are limited to 500.00 USD.
11.2 REPATRIATION OR TRANSPORTATION:
11.2.1. INJURY OR ILLNESS: In the event the Insured suffers an accident
or illness, the Insurer takes charge of the transport to the nearest hospital
having the necessary facilities to take care of him.
Also, the Insurer's medical team, in contact with the doctor that treats
the Insured, supervises that the attention given is the appropriate one.
In case the Insured were hospitalized and this condition impedes the return
in the foreseen date, the Insurer takes charge, until the limit indicated
under the Specific Conditions, of the transfer to his home country.
The means of transport used in each case will be decided by the Insurer's
medical team according to the urgency and the graveness of the case.
11.2 DEATH: In the event of death of the Insured, the Insurer takes to
his charge, until the limit indicated in the Specific Conditions, the
procedures and preparation expenses and transport of the corps from the
place of death to that of burial in his residence country. The payment
of special coffins, the burial and ceremony expenses are excluded from
this warrant.
EXCLUSIONS
The warrants 11.1 and 11.2 do not cover the expenses originated by:
a) The rendering of services that have not been requested to the Insurer
and that have been made without his agreement, except in the event of
force majeur or being of demonstrated material impossibility.
b) The catastrophes caused by deceit of the Insured, of the Drawee of
the Insurance, or by people traveling with the Insured.
c) The catastrophes occured in the event of war (declared or not), manifestations
and popular riots, acts of terrorism and sabotage, strikes, detentions
on behalf of any authority for other reasons than traffic accidents, restrictions
to free circulation or any other case of force majeur, unless the Insured
proves that the catastrophe doesn't have relationship with such events.
d) Participation in dangerous competitions of any nature, as well as
trainings or competition, the bets and the consequences that happen by
the practice of dangerous pastime, such as: hunting, under-water activities,
delta-flynig, mountaineering, etc. This exclusion can be withdrawn by
special agreement with the Drawee of the Insurance.
e) The catastrophes that have for cause the irradiations coming from
the transmutation or nuclear disintegration or radioactivity.
f) The rescues in the sea or in mountain sites.
g) Chronic or previously existing illnesses, congenitally recurrent,
known or not by the Insured, as well as their getting worse and their
consequences.
h) Suicide or illnesses and resulting lesions from suicide intent or
those inflicted intentionally by the Insured to himself.
i) Treatments, illnesses and pathological states, as well as any consequence
taken place by the intentional ingestion or administration of toxics (drug),
alcohol, narcotics or for the use of medications without medical prescription.
j) Any type of protesis, such as, contact eye lenses, earphones, glasses,
etc., even in the case in which the Insurer takes to his charge the assistance
in all its facets.
k) Pregnancies, childbirths and abortions, independently of their nature,
as well as any derived consequence of a gestation state.
l) Any fact derived from a mental alteration, for any cause and even
if transitory.
11.3. CIVIL RESPONSIBILITY: The Insurer takes to his charge, according
to that indicated under the Special Conditions, the monetary compensations
foreseen by the Cuban legislation, if the Insured is obliged to satisfy
them as civic responsibility for corporal or material damage caused unwittingly
to third in persons or their belongings.
The payment of the quota, expenses and professionals' honorarium are
included when they are in defense of the Insured and he has civil responsibility.
In the event of catastrophe of Civil Responsibility, the Drawee of the
Insurance or the Insured should not accept, to negotiate or to reject
any reclamation without the Insurer's expressed authorization.
The Insurer will be responsible only if he has given his consent in a
writing, before any admitted responsibility or any legal expense incurred
by the Insured Person.
The Insured will hand to the Insurer in written a detailed report of
the facts, and will facilitate all the documents finding him guilty and
presented by those harmed, indicating their names and addresses.
EXCLUSIONS
The warrant of CIVIL RESPONSIBILITY (11.3) does not include the corporal
lesions or deaths and/ or material damages caused by:
a) Voluntary participation in mutinies, popular riots, attacks, fights
(except in legitimate defense), commission or intent of exercising a criminal
act.
b) By responsibility arisen by the practice of a profession or occupation,
supply of goods, services or, contractual or employer's responsibility.
c) Due to private, hired, borrowed or entrusted animals under any concept
to the Insured.
d) By intentional ingestion or administration of toxic (drugs), alcohol,
narcotics or for the use of contraindicated medications.
e) By driving aircrafts or ships, also the use of firearms.
11.4 ADVANCE PAYMENT OF JUDICIAL BOND: The Insurer will advance, without
any overcharge, upto the limit fixed under the Special Conditions, the
bond that can be demanded to the Insured by the judicial authorities inside
a process undertaken against him by accusing him of criminal responsibility
in an accident.
To be able to be entitled to this warrant, a previous bond will be made
in favor of the Insurer.
11.5 ASSISTANCE: The Insurer puts at disposition of the Insured a 24
hour-service to assist him in the event of necessity.
STEPS FOR THE ASSISTANCE:
a) The Insured will request the assistance by telephone, he is to give
his first and last names, series and number of the voucher and the its
term of validity, the place and telephone number where he is, and describe
the problem he has.
The phone calls will be call-collect and in the places where this service
is not available, the Insured will be able to recover the cost of the
calls during the trip for the amount spent by presentation of the justificatory
notes.
b) In the supposition that the Insured suffers an accident or a sudden
illness and he cannot fulfill that indicated in point a), he will go to
the nearest clinic or hospital and should carry the voucher to be able
to receive the services without cost.
c) The Insurer does not assume the responsibility for delays or nonfulfillments
due to force majeur.
In any case, if the Insurer's direct intervention were not possible, the
Insured will be reimbursed - upon arrival to his residence country, or
if it were necessary, as soon as he is in a place where the previous circumstance
does not converge- for the expenses incurred and that are warranted, under
presentation of the corresponding justificatory notes.
d) The medical services and health transport, are to be made in agreement
with the doctor in charge of the Insured and the Insurer's medical team.
e) If the Insured were entitled to the refund of the part of the ticket
not used - when making use of the repatriation or transport- this refund
will revert on the Insurer. Also, regarding the expenses of assured people's
transport, the Insurer will only take charge of the complementary expenses
required in case the costs exceed those foreseen initially by the Insureds.
The payment of the indemnity will take place within the following forty (40) days after receival of the necessary
documents and after the opportune verifications are made. The Insurer
will determine the compensations that are due, he shall communicate it
to those concerned and will proceed to the payment.
NOTES
This is not the official translation of SEGURO & ASISTENCIA
VIAJE de "La Isla" S.A.