ERGO 7. The Art of Choosing

Transcription

ERGO 7. The Art of Choosing
ERGO 7. The Art of Choosing
General Terms and Conditions of Non-motor Insurance
Logo Ergo 7 – dwuelementowe
Wersja: logotyp pod sygnetem, przeznaczona do umieszczania na górnej krawędzi form
Font: Fedra Serif A Pro Medium
1
a house or a flat
with fixture and fitting and with
technical facilities
roof, walls, windows, floors, wallpaper, fittings,
installations, boiler
2
furnishing
furniture (including built-in), household
appliances/electronic devices, kitchen cupboards
3
personal belongings
clothing, jewellery, books, discs, cosmetics,
computers, photo equipment, mobile phones
End of non-life insurance period
day
month
year
a house or a flat with
fixture and fitting and
with technical facilities
• fortuitous events
furnishing
• fortuitous events
• overvoltage
personal belongings
• fortuitous events
• overvoltage
• burglary
• robbery
• costs of security system replacement
• burglary
• robbery
• vandalism
• burglary
• robbery
• vandalism
• przepięcia
• koszty poszukiwania przyczyny szkody
• vandalism
• frost cracks
outbuilding
(including a detached garage)
• fortuitous events
• burglary
• robbery
• costs of security system replacement
• overvoltage
OC w życiu prywatnym
• vandalism
• frost cracks
motor hull insurance
• całkowita utrata pojazdu
motor hull insurance
• minor damage to the vehicle
Driver and Passenger’s accident insurance
motor hull insurance
• full motor hull insurance (cost estimate,
Partnership Network, Approved Repairer)
Third-party insurance for
owners of motor vehicles
OC
Car Assistance
Mini
Car Assistance
Standard
Car Assistance
Premium
Car Assistance
Prestiż
Additional
equipment
Windows
Green Card
Fix Insurance
Sum
Cover Agains
Loss of Disco
st the
ount
ERGO 7. The Art of Choosing
Choose the best insurance for your lifestyle.
antiques, works of art and collections
• fortuitous events
Logo Ergo 7 – dwuelementowe
glazing
• breaks
• cracks
Wersja: logotyp pod sygnetem, przeznaczona do umieszczania na górnej krawędzi formatu
• burglary
Font: Fedra Serif
A Pro Medium
• robbery
• vandalism
Accident insurance
Property insurance
against fortuitous
events
Property insurance
against theft
garden architecture
civil liability insurance
in private life
• fortuitous events
Personal Accidents
•
•
•
•
burglary
theft
robbery
vandalism
Motor hull insurance
Personal Accident
Insurance of Drivers
and Passengers
Third-Party
Liability
Insurance
AC
Cover Against the
Loss of Discount
Luggage
Tenant Third-Party
Liability Insurance
Home
Assistance
SOS
Assistance
Medical
Assistance
Medical Assistance
extended scope
Dear Sir/Madam,
We are pleased to welcome you to the ERGO 7 world of insurance.
We did everything to make this world simple and transparent.
The document in front of you is the General Terms and Conditions of
Insurance (the so-called OWU). It comprises among others:
• an accurate description of events that are covered and are not
covered under this policy,
• a description of the manner in which the amount of benefits paid
are determined,
• clarification of the rights and obligations of both parties
- Customers and ERGO Hestia.
We would like to draw your attention to “Definitions”. In the
provisions you can find the definitions of terms that we use herein.
The General Terms and Conditions of Insurance comprise many tips
concerning insurance, among others:
• what to take into consideration upon signing the contract, and
what to take into consideration to during its execution,
• what are the required protective measures against theft,
• how to behave when the loss occurs.
If you read the General Terms and Conditions of Insurance carefully,
you will be able to select consciously the most appropriate insurance
option, which will offer the best protection for your wealth.
Thank you for the confidence placed in our company.
Please, read the documents carefully.
EN/KM/OW092/1512
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General Terms and Conditions of
Non-Motor Insurance of ERGO 7 Line
Table of contents
I.
II.
Common Provisions and Definitions of General Terms and Conditions
of Non-motor insurance of ERGO 7 line
6
STATEMENTS OF ERGO HESTIA
8
DEFINITIONS
8
COMMON PROVISIONS
11
GENERAL EXCLUSIONS
11
INSURANCE PREMIUM
12
CONCLUDING THE INSURANCE CONTRACT ON SOMEONE ELSE’S ACCOUNT
12
INSURANCE PERIOD AND INDEMNITY PERIOD
12
CLAIM PROCEDURE
12
THE PAYMENT OF COMPENSATION OR BENEFITS
13
TERMINATION OF THE INSURANCE CONTRACT
13
INSURANCE SUBROGATION
14
FINAL PROVISIONS
14
General Terms and Conditions of Property Insurance
15
SUBJECT AND SCOPE OF INSURANCE COVER
17
EXCLUSIONS OF LIABILITY
18
SUM INSURED
18
OBLIGATIONS OF THE CUSTOMER AND THE INSURED
19
PROPERTY PROTECTION
19
MINIMUM REQUIREMENTS FOR PROTECTION OF THE PROPERTY AGAINST
BURGLARY
19
PROTECTION OF DOORS, WINDOWS AND OTHER EXTERIOR OPENINGS
19
CONSTRUCTION AND PROTECTION OF EXTERIOR DOORS
19
KEYS PROTECTION
19
ASSESSMENT OF THE AMOUNT OF LOSS AND COMPENSATION
19
FINAL PROVISIONS
21
EN/KM/OW092/1512
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III. General Terms and Conditions of Personal Accident Insurance
IV.
V.
VI.
22
SUBJECT AND SCOPE OF INSURANCE COVER
24
EXCLUSIONS OF LIABILITY
25
SUM INSURED
25
DETERMINING THE AMOUNT OF BENEFIT
25
PERSONS ENTITLED TO BENEFITS
26
FINAL PROVISIONS
26
APPENDIX 1 TO THE GENERAL TERMS AND CONDITIONS OF INSURANCE
27
General Terms and Conditions of Third-Party Liability Insurance in
Private Life
30
SUBJECT AND SCOPE OF INSURANCE COVER
32
EXCLUSIONS OF LIABILITY
32
SUM INSURED
33
LIABILITY OF ERGO HESTIA
33
FINAL PROVISIONS
33
General Terms and Conditions of Tenant Third-Party Liability
Insurance
34
SUBJECT OF INSURANCE
36
EXCLUSIONS OF LIABILITY
36
SUM INSURED
36
LIABILITY OF ERGO HESTIA
36
FINAL PROVISIONS
36
General Terms and Conditions of Assistance ERGO 7
37
SUBJECT OF INSURANCE
39
HOME ASSISTANCE
39
SOS ASSISTANCE
39
MEDICAL ASSISTANCE
40
EXCLUSIONS OF LIABILITY
42
FINAL PROVISIONS
42
VII. General Terms and Conditions of Luggage Insurance
43
SUBJECT, SCOPE AND PLACE OF INSURANCE COVERAGE
45
EXCLUSIONS OF LIABILITY
45
SUM INSURED
45
DETERMINING THE AMOUNT OF COMPENSATION
45
FINAL PROVISIONS
45
EN/KM/OW092/1512
5
Common Provisions and Definitions of
General Terms and Conditions of
Non-motor Insurance of ERGO 7 line
CODE: C-E7-PWP-01/15
EN/KM/OW092/1512
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The following table contains information about provisions of the concluded Common Provisions and Definitions of
General Terms and Conditions of Non-motor Insurance ERGO 7, which govern the issues listed in Article 17 section
1 of the Act of 11 September 2015 on the insurance and reinsurance activity.
Number of the template’s editing unit
Name of the insurance
Common for all insurance
EN/KM/OW092/1512
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
§ 3, § 10 section 3, § 13, § 14,
§ 17 section 2
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STATEMENTS OF ERGO HESTIA
§1
1. We would like to inform you that in connection with the concluded
insurance contract:
1) Sopockie Towarzystwo Ubezpieczeń ERGO Hestia SA with its
registered office in Sopot, at ul. Hestii 1, (hereinafter: “ERGO Hestia”),
is the controller of your personal data, which will be processed by
it in order to carry out its obligations under the insurance contract
and to meet legally justified purposes, such as: direct marketing
of private-label products and services and asserting claims under
the concluded insurance contract. Data is processed pursuant to:
Article 23 section 1 items 3) and 5) of the Act of 29 August 1997
on the Protection of Personal Data (consolidated text, Journal
of the Laws of 2015, item 2135) and Article 815 of the Civil Code;
2) you have the right to access and correct your personal data.
Processing the data for the purposes other than the aforesaid legally
justified purposes of ERGO Hestia or third parties to whom the data
is transferred requires your prior consent.
2. ERGO Hestia shall not be held liable for the consequences of your
failure to give it the information about the circumstances, which
were asked about in the insurance contract application form or other
communications prior to conclusion of this insurance contract or
to give circumstances at variance with the truth.
3. The Customer prior to concluding the insurance contract
should specifically refer to the contents of all General Terms and
Conditions of Insurance, paying particular attention to the sections
titled: The subject and scope of insurance, Exclusion of liability,
Sum insured and Determination of the extent of the loss and
compensation amount/Determination of the extent of the loss and
benefit amount, as well as the Common Provisions and Definitions
of General Terms and Conditions of Insurance.
4. Please note that the definitions of terms used may vary from
their typical and common meaning, as well as from the definition
contained in the generally applicable provisions of the law.
DEFINITIONS
§2
The meaning of terms used in these General Conditions of Nonmotor insurance of ERGO 7 line is determined in the following
definitions:
1) antiques - objects of the old art (works of artistic craftsmanship)
of historical value, older than 100 years;
2) garden architecture - structures located on the property
where the insured home or apartment is:
a) fences and their components,
b) swimming pools, tennis courts, side walks, roads made
of concrete slabs, concrete or asphalt paving,
c) gazebos, carports, garden lamps, wells, and statues;
d) ornamental plants growing on the property or grown in pots
on balconies, loggias, terraces,
e) playground equipment, swings, garden furniture, barbecues,
home and garden tools, pens for animals;
3) failure - a malfunction of the device caused by mechanical,
electrical, electronic or hydraulic damage, excluding: the necessity
to fill in the consumables, current and periodic maintenance,
delivery and installation of accessories;
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4) luggage - things, located outside the regular place of residence,
owned and used by the Insured or their relatives, who run household
together, in their everyday life, or things that are owned by the
Insured temporarily, if they were rented or granted for use by
the employer, legal entity or other organizational unit (excluding
individuals), provided that such rental or grant for use were
confirmed in writing by the grantor or lender;
5) construction - works comprising the erection of a house,
apartment, outbuilding or garden architecture, as well as their
reconstruction, repair, superstructure, modernization and extension.
The construction does not refer to construction works consisting
only in the fixtures and fittings and technical devices;
6) outbuilding - a building (apart from a greenhouse) which is used
for purposes other than residential purposes, as well as a detached
garage. The outbuilding comprises:
a) foundations, walls, roofs, partition walls without frame
construction, external elements: doors, windows with glazing,
and widow sills,
b) exterior plaster, façades, thermal, damp-proof and sound-proof
insulation, stairs, gutters,
c) fixtures and fittings,
d) technical devices;
7) Emergency Centre - organizer conducting assistance services
on behalf of ERGO Hestia;
8) commencement date - the beginning of insurance period on the
first insurance contract concluded with ERGO Hestia; if the insurance
period was interrupted, the commencement date is the start
date of ERGO Hestia’s liability under the new insurance contract
concluded after the interruption of insurance period;
9) house - a detached residential building, as well as a separate part
of semi-detached or terraced house (including also parts of house
belonging to the Insured constituting co-ownership of several
persons) together with garage, if it constitutes an integral part of the
house.
House also includes:
a) walls, foundations, roof, terraces, balconies, partition walls
without frame construction, external elements: doors, windows with
glazing, widow sills, roller-blinds, crates, shutters, awnings;
b) exterior plaster, façades, thermal, damp-proof and sound-proof
insulation, stairs, gutters,
c) fixtures and fittings,
d) technical devices;
10) works of art - objects of art value, such as:
a) original: paintings, collages, frescos, drawings and sculptures and
statues made of any material, provided that they are made entirely
by the artist, as well as the casts of such sculptures and statues,
the number of which is limited to 8 copies and making of them was
supervised by the artist or their heirs,
b) tapestries and wall textiles made by hand based on original
designs provided by artists, provided that their number is limited to
8 items,
c) photographs taken by the artists, printed by them or under their
supervision, signed and numbered, limited to 30 copies, all sizes and
mounts;
11) fixtures and fittings - elements mounted or embedded in
a house, apartment or outbuilding in a sustainable manner,
preventing their separation without the use of tools, in particular:
a) internal fittings, mezzanines and partition walls with frame
EN/KM/OW092/1512
construction, including plasterboard,
b) paint coating, all kinds of decorative veneers or linings of ceilings,
walls, stairs and floors,
c) shower stalls, sinks, tubs, toilet bowls, bathroom and kitchen taps,
d) internal elements: doors, windows with glazing and locks, widow
sills, shutters, roller-blinds;
12) Customer — a natural person concluding the insurance contract
(the Policyholder)
13) collections — collection of items gathered according to
specified criteria, comprising one type of works of art or other
collectibles, e.g. paintings, sculptures, coins, post stamps;
14) burglary — commitment to or attempt at seizing property
from the premises, after prior removal of security by force or
opening the entrance using tools, tailored or fake key or the original
key held by the offender obtained as a result of a crime; as well
as the destruction of the subject of insurance directly related to
commitment to or attempt at burglary;
15) theft — seizure in order to appropriate; this definition applies
only to property forming part of the garden architecture or external
elements of the house/apartment;
16) lockout — the decision of the owner to close down the
workplace, in relation to laying off employees, aimed at forcing them
to accept worse working conditions or due to strike;
17) insured place — a location of the house or apartment specified
in the insurance contract;
18) apartment — a part of a multi-family residential building
together with:
a) appurtenant premises,
b) walls, partition walls without frame construction, external
elements: doors, windows with glazing, widow sills, roller-blinds,
crates, shutters, awnings;
c) fixtures and fittings,
d) technical devices;
19) accident — a sudden event caused by external reason, as a
result of which the Insured, regardless of their will, suffered a bodily
injury or loss of bodily function, or died.
20) malignant prostate cancer — the neoplasm which presents
as a malignant tumor (in the prostate gland) with uncontrolled
growth and dissemination of malignant neoplastic cells as well as
infiltration of the tissues. Classification of malignant prostate tumor
needs to be verified by histopathological examination;
21) malignant breast cancer — the neoplasm which presents
as a malignant tumor (in the mammary gland) with uncontrolled
growth and dissemination of malignant neoplastic cells as well
as infiltration of the tissues. Classification of the malignant breast
cancer needs to be verified by histopathological examination;
22) relatives — spouse, unmarried partner, siblings, ascendants,
descendants, in-laws, sons-in-law and daughters-in-law, stepfather,
stepmother, stepson, adopted and adoptive parent;
23) third parties — all persons not involved in the insurance
relationship under the insurance contract concluded with ERGO
Hestia;
24) entitled person — person specified by the Insured or a person
specified herein who is entitled to receive the insurance benefit due
to the death of the Insured;
25) glazing:
a) glass windows and doors, interior and exterior,
b) glass elements which are a component parts of the furniture or
EN/KM/OW092/1512
fixtures and fittings,
c) fireplace glass,
d) mirrors and stained glass windows, affixed in a permanent
manner,
e) glass, ceramic or stone wall and ceiling cladding,
f) kitchen hobs — ceramic or glass,
g) aquaria or terrariums with the capacity of over 100 litres;
26) frost cracks — cracking of elements, located outside the
insured home, apartment or outbuildings, due to frost;
27) appurtenant premises — premises appurtenant to the
apartment, which can be a separate property, and which can only be
used by the Insured or their relatives, running household together,
or a person authorized by them; the appurtenant premises include
also the parking space inside the building, where the apartment is;
28) loss investigation — carrying out necessary activities to
explicitly identify the element, the fault or defect of which was the
direct cause of bodily injury or damage to property under the liability
insurance.
29) flood — flooding of areas as a result of rising water of flowing
and standing water, or as a result of rise of sea level of coastal
waters;
30) overvoltage — a sharp change in voltage in electricity network;
31) criminal offence — act of a person prohibited under penalty by
the law binding at the time a given act was committed, as a crime or
offence, illegal, at fault and socially harmful at a degree higher than
infinitesimal;
32) robbery — seizure of property by threat of immediate use of
force to a person or after making them unconscious or helpless;
robbery is also the seizure of property by force in relation to the
subject of seizure, which has remained in direct contact, or was
related to the Insured;
33) personal belongings — things used by the Insured or their
relatives, running household together, in their everyday life, or
things that are held by the Insured temporarily, if they were
rented or granted for use by the employer, legal entity or other
organizational unit (excluding individuals), provided that such rental
or grant for use were confirmed in writing by the grantor or lender,
including:
a) clothing and other personal effects,
b) equipment: photo, electronic, computing devices and mobile
phones,
c) musical instruments,
d) sports equipment,
e) non-registrable wheelchairs and medical and rehabilitation
equipment,
f) owned in line with the provisions of law, batch production weapon
of all kinds,
g) computer software,
h) jewelry, watches, products made of gold, silver, precious stones
and pearls, as well as platinum and other metals of platinum group,
cash;
34) extreme sports — base jumping, canyoning, heli body flying,
skiing and snowboarding outside of blazed trails, parkour, freediving,
cave diving, wreck diving, under ice diving, scuba diving (below
40 m), rafting, speleology, skeleton, full-contact martial arts
(including boxing), all air and motor sports, all sports performed
in mountain rivers, mountain climbing, zorbing, high-sea sailing;
The definition of extreme sports comprises also participation in
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expeditions to the following places, which are known for their
extreme climatic and natural conditions: desert, high mountains
(above 5300 m above sea level), bush, pole, jungle, as well as glacial
and snowy areas requiring the use of safety or security equipment;
35) high-risk sports — aerodrium, cross country skiing, biathlon,
bmx, bob sleigh, grass boarding, heliskiing, ice hokey, house
running (rap sliding), hydrospeed, american football, canoeing,
kite surfing, mountain cycling, body building, athletics (apart from
running), asphalt surfing, water skiing — barefoot skiing, alpine
skiing, technical diving, football, water polo, sled dog racing, paintball, parasailing, scuba-diving (up to 40 m), rugby, rock boarding,
sandboarding, scad diving, jet skies, luge, snowboard, skijoering,
ski jumping, squash, equestrian sports, water jumping, bungee
jumping, contactless martial arts (including boxing), tree climbing,
rock climbing, sailing (excluding high-sea sailing);
36) sailing equipment — rowing boats, racing rowing boats, canoes,
water bicycles, surfing and windsurfing boards, jet skis, rubber
dinghies, sailing yachts with sail area of 10sq m, motor yachts with
engine of 5 kW of power;
37) loss — caused directly by a peril covered by the insurance
contract: non-pecuniary consequence of an event or damage to
property;
38) terrorism — illegal actions organized due to ideological or
political reasons, individual or group, directed against people
or objects in order to bring in chaos, to intimidate people and
disorganize the public with the use of violence in order to achieve
political or social objectives;
39) Insured — the natural person to whose account the Customer
has concluded the insurance contract;
40) stroke — cerebrovascular accident that was diagnosed and
confirmed with such medical imaging techniques as: CT (computer
tomography), MRI (Magnetic Resonance Imaging), PET (Positron
Emission Tomography), consisting of:
a) infarct of cerebral tissue or
b) intracranial or subarachnoid hemorrhage, or
c) embolism from extracranial sources, and that caused the
sustained neurological deficits lasting for longer than 3 months (the
existence of permanent neurological defects should be confirmed by
specialist in neurology);
41) excess — amount specified in the insurance contract, by which
ERGO Hestia decreases the compensation;
42) technical devices — devices enabling the use of house,
apartment or an outbuilding, installed or in-built in a permanent
manner and consistent with their destined use:
a) utility connections, heaters of any kind, completed installations,
b) devices used for treatment and collecting trash and sewage,
c) air conditioning and ventilation systems,
d) solar batteries and panels, photovoltaic cells, lightning protector
installation,
e) alarm and monitoring devices and systems, water supply and
sewage systems, electricity, gas or heating (including fireplaces),
f) antennas, intercoms, videophone, cameras;
43) vandalism — the deliberate destruction of or damage to insured
property by third parties;
44) cash values — gold and silver coins that do not constitute
means of payment, non-utility items: silver, gold, platinum in scrap
and bars, precious, semi-precious, synthetic stones, pearls, amber,
coral, as well as checks, bills of exchange, bonds, shares, bills of
10
lading, letters of credit, payment cards and other documents,
replacing cash;
45) replacement value — the value reflecting the costs of
reproducing the property to a new yet not improved state, that is:
a) for the houses, outbuildings, garden architecture — the
construction cost on the same site, including comparable
technology, structure and finishing standard, using existing
dimensions and materials;
b) for an apartment, furnishing, personal belongings, glazing,
luggage — the purchase price or sales cost of a new item of the
same or a comparable brand, the same or most comparable brand
and installation costs;
46) market value — value corresponding the purchase price on the
local market;
47) market value of apartment — the value corresponding to the
product of the floor area of an apartment multiplied by the average
market price of 1 sq m, occurring in a given town or city or district
in relation to homes of similar characteristics and standard of finish;
48) actual value — replacement value less technical wear and tear;
49) competitive sports — practicing of a sport discipline in
a registered section, sports club or sports organization in order to
achieve maximum results, consisting of regular participation in
training, competitions and tournaments;
50) furnishing — decorative elements and household appliances
and other property necessary to run household, such as:
a) furniture (including built-in),
b) mechanized equipment and household appliances,
c) audiovisual equipment and electronics,
d) household items,
e) household supplies;
51) electronic lock — locking enabling the access to a room
with a smart card or code, used only for entrance to the place of
residence of the Insured, made available only to the Insured and to
people residing with them, and authorized domestic staff;
52) multipoint lock — a lock which bolts the door into the frame in
several distant places
53) multi-tumbler lock — lock which has more than one groove
perpendicular to the shaft on the blade;
54) riots — violent demonstrations or hostile actions directed
against the government aimed at the change of existing legal
framework;
55) myocardial infarction — explicitly diagnosed partial myocardial
necrosis resulting from acute ischemia, which caused the coinciding
symptoms such as:
a) typical angina identified in the patients medical history;
b) new changes in electrocardiography, previously not diagnosed,
typical of recent myocardial infarction;
c) increase in the activity of heart biomarkers typical of recent
myocardial infarction;
d) significant decrease in ejection fraction of the left ventricle
(according to the measurement within at least 3 months of the date
of event) or new segmental disturbances in the contractility of heart
wall in the imaging examinations;
56) dangerous professions — work in the military formations
(except for office work), work in the uniformed services (except for
office work), construction works associated with demolition, work
at the height above 15 m, work at the construction of scaffolding,
underwater works, fishing, work on ship, in mining industry (workers
EN/KM/OW092/1512
employed at platforms, mining) as well as stunt, acrobat, circus
artists, fire fighter, mountain rescuer, secret service worker, cash
transport guard;
57) increased risk professions — professions involving physical
works, that is: industrial worker, operator or machine and device
assembly worker, farmer, gardener, forester, driver, construction
and repair worker; performing activities with dangerous tools such
as: hammer drill, mechanical saws, jackhammers, sawing machines
and mechanical grinders, machining tools; performing activities at
the height above 5 m and the activities with paints, lacquers, liquid
fuels and dissolvents, technical and fuel gases, hot technical oils or
technical liquids;
58) fortuitous event:
a) rescue operations — actions taken to prevent loss threatening
directly or to mitigate its effects, provided that these measures were
appropriate to the circumstances,
b) smoke and soot — suspension of particles in gas being a direct
result of:
1/ combustion, which suddenly emerged from devices placed in
the insured location, used according to their intended purpose and
technical regulations;
2/ fire, explosion, overvoltage caused by lightning, and overvoltage
regardless of the site of their origin;
c) hail,
d) sonic bang,
e) hurricane — wind of at least 15 m/sec., causing massive damage,
f) avalanche — a sudden slipping or sliding of masses of snow,
ice or rocks from the mountain slopes,
g) snow pressure — direct pressure of snow or ice on the insured
property and falling down of a neighbouring property as a result
of the pressure of snow or ice causing the damage or collapse
of property,
h) landslide,
i) fire,
j) overvoltage caused by lightning,
k) surface water flow,
l) earthquake,
m) lightning,
n) vehicle collision,
o) falling tree,
p) falling mast,
q) falling aircraft,
r) explosion,
s) flooding — the presence of liquids in an apartment,
a house or a building being a result of:
1/ precipitation,
2/ escape of water, steam or liquids due to damage to the water
supply, sewerage or heating systems,
3/ escape of water from household appliances as a result of their
failure,
4/ withdrawal of water or sewage from public sewerage facilities,
5/ accidental and inadvertent taps or other valves in other devices in
the system left open, specified in item 2/,
6/ operation of third parties,
7/ escape of water from a broken or cracked aquarium,
8/ automatic restart of the sprinkler or spray systems except for
EN/KM/OW092/1512
cases resulting from fire, testing, repairs, reconstruction, upgrading
of the installation or building,
In Luggage Insurance, flooding is the liquid damage to insured
luggage and cash resulting from the aforementioned causes;
t) ground subsidence — reduction of ground level due to the
collapse of empty space in the ground occurring without human
intervention;
59) event:
a) destruction or damage — in the Property Insurance against Fire
and Fortuitous Events and in SOS Assistance Insurance,
b) loss, destruction or damage — in the Property Insurance
against Burglary, in insurance of garden architecture against theft,
in Luggage Insurance, in Home Assistance Insurance
c) accident — in Personal Accident Insurance,
d) death, bodily injury or loss of bodily function, or destruction
of or damage to property — in the Third-party Liability Insurance,
e) loss of bodily function or bodily injury — in Medical Assistance
Insurance;
60) domestic animals — animals usually bred by people and kept
at home or in the backyard: dogs, cats, birds, rodents, aquarium
fish, horses, apart from animals bred for commercial and economic
purposes.
COMMON PROVISIONS
GENERAL EXCLUSIONS
§3
1. ERGO Hestia shall not be liable:
1) for losses caused intentionally by the Insured or a person with
whom the Insured lives in the same household;
2) for losses caused by the Insured due to gross negligence, unless
the payment of compensation is equivalent to the circumstances
of equity;
3) for loss caused by landslides, earthquakes, falling trees or masts,
resulting from human activities;
4) if the Insured caused the loss under the influence of alcohol or
intoxicated, under the influence of drugs or other intoxicants or
medication with a similar effect, unless the Insured’s condition had
no bearing on the loss;
5) for events caused by acts of war, martial law, state of emergency,
riots, revolts, civil unrest, strikes, lockouts or acts of terrorism and
sabotage, as well as confiscation, nationalization, requisition or
detention of property by the authorities and events resulting from
the nuclear or radioactive contamination, laser and maser rays and
magnetic and electromagnetic fields.
2. The exclusions mentioned in section 1 item 1)–3) do not apply to
Personal Accident Insurance.
3. Exclusion of losses caused due to gross negligence and referred
to in section 1 item 4) do not apply to Personal Liability Insurance in
a private life.
4. Insurance coverage does not comprise damage to property, which
became the possession of the Insured or their relatives as a result of
crime.
11
INSURANCE PREMIUM
INSURANCE PERIOD AND INDEMNITY PERIOD
§4
1. The amount of the premium shall be determined on the basis
of ERGO Hestia’s tariff in force on the date of conclusion of the
insurance contract.
2. The amount of the premium depends, subject to the provisions
of § 5–6 below, on:
1) risk level assessed in the application scope of insurance,
2) premium payment method (i.e. whether it is a single or recurring
premium),
3) insurance period and variant,
4) the amount of sum insured,
5) the record of insurance contracts concluded in ERGO Hestia.
3. The dates of payment of subsequent instalments and their
amounts are determined in the insurance contract.
§7
1. Liability of ERGO Hestia starts on the date and time specified in
the insurance contract as the commencement of insurance period,
provided that the premium or its first instalment is paid on the
date specified in the insurance contract, subject to the risk of flood,
in which case the coverage commences as per § 3 section 2 of the
General Terms and Conditions of Property Insurance.
2. If Ergo Hestia is liable before the payment of premium or first
instalment, and the premium is not paid in a timely manner,
ERGO Hestia terminates the insurance contract with immediate
effect and demands payment of premium for the period in which the
insurance coverage was provided.
In the absence of termination, the insurance contract shall be
surrendered at the end of the period for which the premium was not
paid.
3. Liability of ERGO Hestia is limited to the end of insurance period,
unless the insurance contract is terminated earlier.
4. The Personal Accident Insurance Contract may be concluded for
a period of one year, as well as for less than one year (short-term
contract).
§5
In addition to the provisions of § 4:
1) in Property Insurance, the amount of additional premium depends
on:
a) the extension of coverage over flood, taking into account the
period of insurance coverage and the probability of flooding in the
insured location,
b) the regional area, where insured location is situated, and
discounts for anti-theft systems;
2) in the Personal Liability Insurance, the amount of premium
depends on the number of insured adults;
3) in Personal Accident Insurance, the amount of premium depends
on the age of the Insured, type of sport they play or profession they
practice and the number of insured persons.
CONCLUDING THE INSURANCE CONTRACT ON SOMEONE ELSE’S
ACCOUNT
§6
1. The Customer may enter into a insurance contract on someone
else's account (on the account of the Insured).
2. ERGO Hestia may request premiums only from the Customer,
but it may raise the allegation affecting its liability also against the
Insured.
3. The Insured has the right to request a due payment directly
from ERGO Hestia, unless the Parties agreed otherwise. Such an
arrangement cannot be made, if the event has already occurred.
4. The Insured may request ERGO Hestia to provide them with
information about the provisions of the concluded insurance
contract and General Terms and Conditions insofar it refers to their
rights and obligations.
5. If the insurance contract is concluded on someone else’s account,
the Customer undertakes to provide the General Terms and
Conditions of Insurance to the Insured. If the Insured consents to
pay for a premium, the Customer shall provide the Insured with the
General Terms and Conditions of Insurance prior to obtaining their
consent. The Insured shall confirm the receipt of General Terms and
Conditions of Insurance in writing. The Customer shall provide the
document comprising such confirmation to ERGO Hestia.
12
§8
1. Payment of the amount lower than the one specified in the
insurance contract shall not be considered as payment of the
premium or subsequent premium instalment.
2. If premiums are paid in instalments, failure to pay subsequent
instalment within the specified deadline leads to cessation of
ERGO Hestia’s liability only when ERGO Hestia sends to the Customer,
after the lapse of that deadline, a notice for payment of the
premium in the specified amount, warning that failure to pay the
amount within 7 days from the date of receipt of the notice shall
result in cessation of liability.
3. If payment is made via bank transfer or postal order, the payment
date is the date when the payment was ordered in the bank or at
the post office, provided that, when paying with a bank transfer,
there were enough funds on the Customer’s account; otherwise the
payment date is the date when specified transfer amount is credited
to ERGO Hestia bank account.
§9
In Personal Accident Insurance, the Customer may terminate the
insurance contract at any time with immediate effect.
CLAIM PROCEDURE
§ 10
1. The Insured is obliged to notify ERGO Hestia about the event
immediately after it occurred or upon learning about it.
2. Notification may be made:
1) through an online form available at: www.ergohestia.pl or
2) by calling on: 801 107 107 or 58 555 5 555.
3. In the case of intentional breach or gross negligence in relation
to the obligation of immediate notification referred to in section 1,
ERGO Hestia may reduce the compensation or benefit by relevant
EN/KM/OW092/1512
amount, only if the breach contributed to extending the scope of
loss or prevented ERGO Hestia from determining the circumstances
and consequences of the event.
4. The obligations of the Insured comprise:
1) providing ERGO Hestia with documentation necessary to
investigate claim listed by ERGO Hestia in the notification sent to the
applicant or notifying ERGO Hestia immediately about inability to
provide such documentation;
2) informing the local Police immediately about every event which
could occur as a result of a crime or offence (including vandalism)
and receiving written confirmation of submitting such notification;
3) inform immediately the building administrator about any event
of flooding of the apartment;
4) leaving the site where the event occurred untouched until the
representative of ERGO Hestia arrives, unless it is necessary to
safeguard the remainder property or to decrease the extent of loss;
ERGO Hestia cannot refer to this provision if, for reasons attributable
to it, it did not start claim adjustment process within 7 days upon
receipt of the notification about the event,
5) adherence to ERGO Hestia recommendations and providing
information and authorizations to the extent necessary for the
proper claim adjustment.
5. ERGO Hestia shall verify the submitted receipts, cost estimates
and other documents and consult experts.
6. If criminal proceedings were initiated against the person who
caused the event, or if the aggrieved party pursues claims for
compensation in court, the Insured is obliged to notify ERGO Hestia
immediately.
§ 11
Notwithstanding the obligations set forth in § 10, in the case of
Personal Accident Insurance, if the event occurs, the Insured is also
required to:
1) undergo treatment and follow recommendations to mitigate the
effects of an accident;
2) undergo examination carried out by physicians or undergo
possible clinical monitoring;
3) release physicians, public and private health care establishments
and Social Insurance Institution (ZUS), to the extent necessary to
investigate the claim, from the confidentiality obligation and agree
to provide ERGO Hestia with the documentation of treatment.
§ 12
1. Regardless of the obligations specified in § 10 of Personal Liability
Insurance, the Insured is obliged to refrain from activities aimed
at the satisfaction of the aggrieved party, acceptance of claim or
reaching a settlement, until a written approval is received from
ERGO Hestia.
2. If criminal proceedings were initiated against the person who
caused the event, or if the aggrieved party pursues claims for
compensation in court, the Insured is obliged to notify ERGO Hestia
immediately.
3. The Insured is obliged to submit the court decision to ERGO Hestia
within a period enabling ERGO Hestia to make a statement with
regard to lodging an appeal.
EN/KM/OW092/1512
§ 13
If the Insured, due to willful misconduct or gross negligence, fails
to meet obligations specified in § 10 sections 4 and 6 and §§ 11–12,
ERGO Hestia will refuse to pay full or partial compensation for
the resulting loss, provided that such failure had a bearing on the
occurrence or extent of loss, determination of causes of event, its
circumstances and the amount of compensation and it is connected
to the resulting loss.
THE PAYMENT OF COMPENSATION OR BENEFITS
§ 14
1. The sum insured determined in the insurance contract is the
liability cap of ERGO Hestia with respect to all events occurring
in the insurance period.
2. If the sum insured is exhausted, the insurance contract is
terminated with respect to the given risk.
3. With the permission of ERGO Hestia, the Customer may
supplement the sum insured by completing new insurance
application and paying additional premium.
§ 15
1. ERGO Hestia pays the compensation or benefit within 30 days
from the date of receiving notification about the event.
2. If it is impossible to clarify the circumstances necessary to
establish liability of ERGO Hestia or the amount of compensation
or benefit within the period indicated in section 1, the compensation
and benefit should be paid within 14 days from the date when these
circumstances may be clarified with due diligence. ERGO Hestia pays
the indisputable part of compensation or benefit within 30 days.
3. If the Insured has benefited from advance compensation
specified in the General Terms and Conditions Assistance ERGO 7,
the compensation due will be paid less the advance compensation.
4. The compensation paid by ERGO Hestia may not be higher than
loss incurred.
TERMINATION OF THE INSURANCE CONTRACT
§ 16
1. If the insurance contract is concluded for a period exceeding
6 months, the Customer shall have the right to withdraw from
the insurance contract within 30 days, and if the Customer is
an entrepreneur — within 7 days from the date of conclusion
of the insurance contract. If ERGO Hestia does not provide the
Customer, who is a consumer, with an information about his right to
withdrawal at the latest as at the date of conclusion of the contract,
the 30-day period shall commence on the date when the Customer,
who is a consumer, learns about such right.
2. A consumer who concluded a distance insurance contract may
withdraw from the contract within 30 days from date of notification
about the conclusion of the insurance contract or from the date of
confirmation of the information referred to in Article 39 section 1 of
Act of 30 May 2014 on Consumer Rights, whichever date is later.
The time limit is considered observed, if the declaration is sent
before the lapse thereof.
3. Withdrawal from the insurance contract shall not release the
Policyholder from the obligation to pay the premium for the period,
during which ERGO Hestia provided the coverage.
13
4. The Customer may file the withdrawal notice as specified in § 19.
5. In the event that the subject of insurance is sold, rights arising
from the insurance contract may be transferred to the transferee
of the subject of insurance. The transfer of such rights requires
ERGO Hestia’s consent.
6. In the event of transfer of the rights referred to in section 5,
the obligations of the transferor shall also be transferred to the
transferee of the subject of insurance. Despite the transfer of
obligations, the transferor is jointly and severally liable for the
payment of the premium allocated by the time the insurance subject
is transferred to the transferee.
7. If the rights referred to in section 5 were not transferred to the
transferee of the subject of insurance, the insurance relationship
shall be terminated upon the transfer of the subject of insurance to
the transferee.
8. The provisions of sections 5–6 do not apply to transfer of liabilities
that arose or may arise as a result of the occurrence of an accident
stipulated in the insurance contract.
6. A person entitled under the insurance contract, which is an
individual, may refer the matter to be examined by the Financial
Ombudsman.
INSURANCE SUBROGATION
§ 20
1. Insurance contracts are concluded under the provisions of Polish
law.
2. Disputes arising from the insurance contract are heard under the
Polish law and claims may be sought before courts competent with
respect to their general competence, or courts competent for place
of residence or registered office of the Customer, the Insured or the
person entitled under the insurance contract. A legal action may
also be brought either in accordance with the provisions on general
jurisdiction or to the court competent for the place of residence of
an heir to the Insured or an heir to beneficiary under the insurance
contract.
3. The parties may decide to refer disputes to arbitration court.
§ 17
1. The Insured is obliged to secure the possibility to assert claims for
damages against persons responsible for the loss.
2. If the Insured waives all or part of their rights against the person
who caused the loss without the consent of ERGO Hestia, ERGO
Hestia may refuse to pay compensation in whole or in the part
subject to the waiver, and if the compensation was already paid,
it may seek reimbursement of the amount corresponding to the
whole or to the part with respect to which the Insured has waived
those rights, respectively.
§ 19
1. Notices and statements of the Customer and ERGO Hestia should
be made in writing, subject to section 3.
2. The Customer and ERGO Hestia shall be obliged to inform each
other about the change of the address of place of residence or
registered office.
3. In the insurance contract, the Customer and ERGO Hestia may
decide that their notices and statements can be delivered also
by e-mail, text messages, fax or telephone to the addresses and
telephone numbers specified in the insurance contract. Delivery
of notices and statements in these forms may be introduced at
any time, at the request or with the consent of the Customer and
together, along with the information about their address and
telephone number.
FINAL PROVISIONS
§ 18
1. The Customer, the Insured or the entitled person under the
insurance contract, who is an individual, may raise objections as to
the services provided by ERGO Hestia (a complaint):
1) through an online form available at: www.ergohestia.pl;
2) by calling: 801 107 107 or 58 555 5 555;
3) in writing — at the address of the registered office of Sopockie
Towarzystwo Ubezpieczeń ERGO Hestia SA, ul. Hestii 1, 81-731 Sopot;
4) orally or in writing — during a visit at a business unit of Sopockie
Towarzystwo Ubezpieczeń ERGO Hestia SA.
2. Complaints shall be processed by an organisational unit
established for this purpose by ERGO Hestia Management Board.
3. A reply to a complaint shall be sent within 30 days from receiving
the complaint in writing or via any other permanent data carrier,
or by e-mail if so requested by the complainant.
4. In particularly complex cases which prevent the investigation
of a complaint and reply within the time limit determined above,
the reply will be sent within 60 days from the date of its receipt.
5. Persons listed in section 1, in non-standard cases, may refer
to ERGO Hestia’s Customer Ombudsman through the online form
available at: www.ergohestia.pl.
14
§ 21
Common Provisions shall enter into force as of 24 January 2016 and
shall apply to insurance contracts concluded as of this date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
EN/KM/OW092/1512
II. General Terms and Conditions of Property
Insurance
CODE: C-E7-M-01/15
The insurance contract is concluded on the basis of the General Terms and Conditions of Property Insurance and Common Provisions
and Definitions for Non-motor Insurance ERGO 7 (Common Provisions).
EN/KM/OW092/1512
15
The following table contains information on which provisions of the concluded General Terms and Conditions of
Property Insurance govern the issues listed in Article 17 section 1 of the Act of 11 September 2015 on insurance
and reinsurance activity.
Number of the template’s editing unit
Name of the insurance
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
Property
§ 1, § 2, § 3, § 4
§ 5, § 6, § 11, § 12 section 5,
§ 14, § 15
16
EN/KM/OW092/1512
SUBJECT AND SCOPE OF INSURANCE COVER
§1
1. The subject, option and scope of insurance are selected by the Customer.
2. Depending on the choice, the insurance covers the loss, destruction or damage to property resulting from the events given in the table
below:
Insurance option
I
•apartment
•house
•outbuilding
Object of insurance
II
•apartment
•house
•outbuilding
•furnishing
• personal belongings
III
•apartment
•house
•outbuilding
•furnishing
• personal belongings
• antiques, works of
art, collections
• garden architecture
Insurance against Fire and Other Fortuitous Events — causes of events
Fortuitous events
yes
yes
yes
Overvoltage
no
yes
yes
Frost cracks, includes:
•house
•apartment
•outbuilding
no
no
yes
Breakage or cracking, concerns glazing
no
no
yes
Burglary
yes
yes
yes
Robbery
yes
yes
yes
Vandalism
no
yes
yes
Theft relates to:
• garden architecture
• external elements of the house/apartment
no
no
yes
Loss investigation — in Insurance against Fire and
Fortuitous Events
no
yes
yes
Changes of security devices — in Insurance against Theft
yes
yes
yes
Removing the loss remainder
yes
yes
yes
Appointment of appraisers
yes
yes
yes
Insurance against Burglary — causes of events:
Additional benefits — costs coverage
EN/KM/OW092/1512
17
§2
1. The outbuilding and garden architecture can be covered by
insurance if:
1) at the same time the house or apartment is covered and
2) the outbuilding and parts of garden architecture are on the same
property, where the insured home or apartment is located.
2. Antiques, works of art, collections catalogued and valued by the
appraiser at the Customer cost may be covered only if they are
located in the insured house or apartment in which the furnishings
and personal belongings are insured.
3. Personal belongings and furnishings are covered by insurance
if they are located in the house or apartment indicated in the
insurance contract, including in the appurtenant premises, except
for the parking space.
§3
At the Customer’s request and upon payment of additional
premium, the coverage under Property Insurance against Fire and
Fortuitous Events shall be extended to losses resulting from floods.
The insurance period and the period of coverage start on the 31 day
starting from the date of conclusion of the insurance contract.
This provision shall not apply in cases of uninterrupted continuation
of insurance in Ergo Hestia with respect to floods.
§4
1. ERGO Hestia shall reimburse the cost of loss investigation only if it
is liable for the loss under the insurance contract.
2. The costs of loss investigation comprise the costs of labour and
materials necessary to identify and reach the damaged component,
and to remove the effects of these actions (to restore the state
before the loss).
3. If the Insured or their relative running a household together with
the Insured lose their keys used for opening securities, ERGO Hestia
shall refund the documented costs incurred to replace these
securities.
EXCLUSIONS OF LIABILITY
§5
1. Except for § 3 of the Common provisions, the insurance does not
cover losses:
1) in facilities under construction: houses, apartments, outbuildings,
garden architecture, as well as nearby fixtures and fittings,
furnishing or personal belongings, if the loss was a result of the
construction works;
2) in furnishing, personal belongings or antiques, works of art and
collections, located in loggias, on balconies and terraces;
3) in buildings, equipment and installations subject to demolition;
4) due to defects in the electrical system, without commissioning
confirmed by technical condition assessment of the installations in
buildings not older than 5 years;
5) as a result of flooding with water from precipitation, if the
occurrence of the loss was due to bad technical condition of the roof
or other elements of the building;
6) resulting from improper installation or manufacturing defect in
the subject of insurance.
2. Moreover, the insurance does not cover losses:
1) occurring in monetary values, documents, manuscripts, plans,
18
archives, stamp collections, coin collections;
2) hunting trophies;
3) data on carriers of all types;
4) in property acquired for resale;
5) in property used for the purposes of commercial, service or
production activity, apart from property purchased by the Insured,
who is a sole trader, and property lent to the Insured by their
employer;
6) antiques, works of art and collections, computer, audio-visual,
photo and electronic equipment stored in appurtenant premises and
outbuildings;
7) garden architecture and technical devices of value lower than
PLN 200;
8) losses occurring during installation or dismantling of the subject
of insurance, conducting maintenance or repair works, as well as
resulting from a manufacturing defect.
3. Additionally, the insurance does not cover losses occurring as
a result of:
1) systematic (i.e. regular and repetitive) influence of noise,
vibration, smoke, temperature, water or other weather conditions;
2) freezing of water in devices and installations, including flooding
caused by the freezing of water;
3) emission, leaking or other form of penetrating the air, water or soil
by hazardous substances;
4) ground settlement and influence of underground waters, unless
they are the result of flood and additional cover against flood has
been taken into account;
5) damp or flooding caused by leaks from water and sewage system,
windows, roof, walls or devices discharging water from the roof,
walls, terraces and balconies, if their maintenance was one of the
obligations of the Insured, who with ordinary care should have
known about leaks resulting from it or if, knowing about the existing
negligence in this regard, did not refer in writing to the owner
or administrator of the building to request its removal.
4. The insurance does not cover losses due to dry/wet rot or property
freezing, regardless of the cause.
5. The glazing insurance does not cover losses consisting in stains,
change of colours, scratches, scrapes or surface chip-offs of the
subject of insurance.
SUM INSURED
§6
1. It is the Customer who determines the sum insured and gives it to
Ergo Hestia.
2. The basis for its determination is:
1) the market value as at the insurance contract date — for works
of art, antiques and collections, plants covered as parts of garden
architecture;
2) replacement value — for furnishing, personal belongings, garden
architecture and apartment, subject to § 12 section 4;
3) replacement value — for homes or outbuildings, subject to item
4) replacement value — for:
a) house not older than 50 years or in the case of which the roof,
as well as façades were replaced or underwent major renovation
within the last 50 years;
b) outbuilding not older than 30 years or in the case of which
the roof, as well as façades were replaced or underwent major
EN/KM/OW092/1512
renovation within the last 30 years; otherwise, the sum insured is
determined on the basis of actual value.
3. Sum insured for outbuildings is determined jointly for all
outbuildings situated on the property.
4. If during the period covered by the insurance contract there is an
increase in value of the covered property, the Customer may report
it by Ergo Hestia and upon the reception of permission increase the
sum insured by paying an additional premium.
OBLIGATIONS OF THE CUSTOMER AND THE INSURED
PROPERTY PROTECTION
§7
1. The Insured is obliged to ensure proper safeguarding of the
property, which shall include compliance with applicable provisions
concerning the protection, storage and use of the property and
aiming at the prevention of loss.
2. The Insured shall comply with applicable provisions concerning
fire protection, construction and use of technical devices and
performance of technical supervision, with recommendations and
requirements of manufacturers or suppliers of such devices and
with other provisions aiming at the prevention of loss, as well as to
requirements set forth in the insurance contract, subject to section
3. The Insured is obliged to take care of maintenance of cables and
devices supplying and discharging water, steam or liquids and use
appropriate protective measure timely as to secure these cables and
devices against frost.
4. For buildings not older than 5 years, the Customer shall have
commissioning confirmed with technical condition assessment
of the electrical system.
2. All entrances to the apartment (including appurtenant premises),
house or outbuilding are secured with full exterior doors (or doors
containing glass elements, provided that the lock cannot be opened
or the apartment, house or building cannot be entered as a result of
damage to such glass elements).
3. Exterior doors to the apartment, house or building are locked with
at least:
1) two multi-tumbler locks or one multi-tumbler lock in the case of
doors with increased burglar-resistance confirmed with a certificate
of manufacture in accordance with burglar-resistance class
(certificates must be issued by an institution authorised by the Polish
Centre for Accreditation) or
2) one certified lock, or
3) multipoint lock, or
4) two multi-tumbler padlocks, or
5) one multi-tumbler lock or one lock opened by means of a complex
access code other than a key (a magnetic card, digital code,
biometrical reader, e.g. finger prints, iris, etc.) — only in the case
where the insured property is located in the apartment or house
in which continuous supervision is performed or in an apartment
equipped with active anti-theft signal and alarm system.
4. If a garage is located in the body of the building, a multi-tumbler
padlock, electric locking system or other security system with
burglar-resistance class shall be considered sufficient protection of
the garage gate.
5. In the event that entrance to the outbuilding or appurtenant
premise is secured by doors locked with:
1) one multi-tumbler lock;
2) a multi-tumbler padlock;
3) an electric locking system or other security system with burglarresistance class; liability of ERGO Hestia for theft in such buildings or
premises shall be limited to 20% of the sum insured in respect of the
given category of items.
MINIMUM REQUIREMENTS FOR PROTECTION OF THE PROPERTY
AGAINST BURGLARY
KEYS PROTECTION
PROTECTION OF DOORS, WINDOWS AND OTHER EXTERIOR
OPENINGS
§ 10
The keys to the locks and padlocks are in sole possession of the
Insured, their relatives and other authorized persons.
§8
Windows, balcony doors, patio doors of balcony door design and
other exterior openings are properly mounted and secured as to
prevent theft, with the exception of openings on the storeys above
the ground floor, where they cannot be accessed from balconies,
roofs, extensions, patios, stairways and fixed ladders below or
next to them, neither from the roof located above — in the case of
openings situated on top storey.
ASSESSMENT OF THE AMOUNT OF LOSS AND COMPENSATION
§ 11
If the Insured, due to willful misconduct or gross negligence, fails
to meet obligations specified in §§ 7–10, ERGO Hestia will refuse to
pay full of partial compensation for the resulting loss, provided that
such failure had an influence on the occurrence or extent of loss,
determination of causes of event, its circumstances and the amount
of compensation, and it is connected to the resulting loss.
CONSTRUCTION AND PROTECTION OF EXTERIOR DOORS
§9
1. Doors, windows and other exterior openings are properly mounted
and secured as to prevent theft, with the exception of openings on
the storeys above the ground floor, where they cannot be accessed
from balconies, roofs, extensions, patios, stairways and fixed ladders
below or next to them, neither from the roof located above — in the
case of openings situated on top storey.
EN/KM/OW092/1512
§ 12
1. In the case of damage to property insured, the extent of loss
and the amount of compensation are determined by ERGO Hestia
according the prices binding as at the date of occurrence of loss,
according to the costs of renovation or repair, based on:
a) receipt (invoice) of contractor together with the cost estimate
attached to the receipt (invoice), or
b) calculation of the aggrieved party, who has removed or intends to
19
remove the loss with his own resources, or
c) calculation by ERGO Hestia on the basis of publicly available
contractor estimators used in property maintenance and repairs.
2. ERGO Hestia verifies receipts, invoices, calculations and other
documents confirming that the repair costs were incurred by the
Insured, with respect to the scope of works and the amount of costs,
based on publicly available contractor estimators used in renovation
and repairs.
3. In the event of damage to the property insured (except for
apartment), if it cannot be renovated or repaired, the amount of
loss is determined based on guideline adopted in § 6 section 2 for
determination of sum insured.
4. If the apartment was damaged in a way that irreversibly prevents
from living in it, ERGO Hestia shall determine the amount of
compensation as at the date of occurrence of the loss in accordance
with the market value of the apartment.
5. The amount of compensation shall be decreased by the salvage
value of the damaged or destroyed property that may be suitable for
further use, processing or sale.
§ 13
With regard to the part of house constituting co-ownership of
several persons (with the exception of joint property of spouses), the
amount of compensation is a share in loss determined on a pro rata
basis to the share of the Insured in the ownership of entire house.
§ 14
1. Liability cap of ERGO Hestia amounts to:
1) for decorative plants insured within the framework of property
architecture — PLN 10,000,
2) for the cost of loss investigations — PLN 10,000, provided that
due to the costs of repair of the item, the failure of which was the
cause of the damage, ERGO Hestia is liable within the limits of the
aforementioned sum insured up to PLN 500 for each damaged item,
3) for costs of replacement of securities — PLN 500.
2. The compensation is paid up to amount corresponding:
1) in Variant II:
a) to 5% of the sum insured for personal belongings, but not more
than PLN 1,000 — for cash,
b) to 40% of sum insured for personal belongings — for jewelry,
products made of gold, silver, gems and pearls, as well as platinum
and other platinum-group metals,
c) to 10% of the sum insured in respect of a given item in case of
losses caused by vandalism in all subjects of insurance,
d) in the case of Insurance against Fire and Fortuitous Events
— to 5% of the sum insured for furnishing, personal belongings
— for property stored in the appurtenant premises,
2) in Variant III:
a) to 10% of the sum insured for personal belongings, but not more
than PLN 1,500 — for cash,
b) to 50% of sum insured for personal belongings — for jewelry,
products made of gold, silver, gems and pearls, as well as platinum
and other platinum-group metals,
c) to 20% of the sum insured in respect of a given item in case of
losses caused by vandalism in all subjects of insurance,
d) for losses in glazing caused by cracking or breaking — 5% of sum
insured of house, apartment, outbuilding or furnishing insurance,
e) in the case of Insurance against Fire and Fortuitous Events
20
— to 10% of the sum insured for furnishing, personal belongings
— for property stored in the appurtenant premises,
f) for damage due to frost cracks — 10% of sum insured of house,
apartment, outbuilding,
3) to 50% of the sum insured in respect of a given item in case of
losses caused by overvoltage in all subjects of insurance,
3. Within the sums insured in respect of particular items the
insurance covers:
1) the costs of appointing the insurance appraisers
— if ERGO Hestia agreed to such appointment,
2) costs of post-loss clean-up — in the range of up to 5% of the
amount of loss. 4. For plants forming a part of garden architecture,
the market value of the same species of plant, however not older
than 10 years.
§ 15
If the Customer makes use of discount for anti-burglary securities
and this security was malfunctioning when the loss occurred, it was
removed earlier or it was not turned on due to willful misconduct
or gross negligence of the Insured, the compensation shall be
decreased by excess of 10%, if lack of the security had a bearing on
the occurrence or the extent of loss.
§ 16
While determining the amount of loss, the following is not taken into
account:
1) scientific, collector’s, historical or memorial value, however, this
exclusion does not cover works of art, antiques, collections;
2) costs resulting from unavailability of spare parts and materials
necessary to restore the condition existing before the loss, if repair
can be made with the use of other replacement parts or materials
available on the market;
3) costs incurred for disinfection of the remainder after loss, removal
of soil, water and air contamination and soil rehabilitation.
§ 17
If after the payment of compensation the Insured received the lost
items back, they are obliged to return immediately to ERGO Hestia
the payment made as compensation or renounce the title to them
on behalf of ERGO Hestia.
EN/KM/OW092/1512
FINAL PROVISIONS
§ 18
The method of determining and payment of premium, period of
insurance and the period of liability of ERGO Hestia, rights and
obligations of each Party to the insurance contract, method
of payment of compensation are determined in the Common
Provisions.
§ 19
General Terms and Conditions of Insurance shall enter into force
as of 24 January 2016 and shall apply to the insurance contracts
concluded as of that date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
EN/KM/OW092/1512
21
III. General Terms and Conditions of Personal Accident
Insurance
CODE: C-E7-NNW-01/15
The insurance contract is concluded based on the General Terms and Conditions for Personal Accident Insurance and Common Provisions
and Definitions for Non-motor Insurance ERGO 7 (hereinafter referred to as the General Provisions).
22
EN/KM/OW092/1512
The following table informs which provisions of the General Terms and Conditions of Personal Accidents Insurance
govern the issues listed in Article 17 section 1 of the Act of 11 September 2015 on insurance and reinsurance
activity.
Number of the template’s editing unit
Name of the insurance
Personal Accidents
EN/KM/OW092/1512
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
§ 1 sections 1, § 1 sections
3–4, § 4 section 1, § 4
sections 6–8
§ 1 section 2, § 2, § 3, § 4
sections 3–4, § 4 section 9, §
5, § 6 section 2, § 7 section 2
23
SUBJECT AND SCOPE OF INSURANCE COVER
§1
1. The scope of insurance includes personal accidents suffered by the Insured, subject to exclusions specified on the General Terms and
Conditions and § 3 of Common Provisions.
2. The Insured may only be a natural person, who on the first day of the insurance period is less than 65 years of age.
3. Depending on the variant selected by the Customer, Ergo Hestia pays benefits specified in the table below:
Options
I
II
III
Death of the Insured
yes
yes
yes
Permanent disablement by the Insured
yes
yes
yes
Daily hospital allowance
no
yes
yes
Medical and rehabilitation expenses
no
yes
yes
Total and permanent incapacity to work
no
no
yes
Myocardial infarction or cerebral stroke
no
yes
yes
Occurrence of breast or prostate cancer
no
no
yes
Personal accident benefits
Illness benefits
Extension of insurance scope
Competitive sports
payment of additional premium
High-risk sports
payment of additional premium
Increased risk professions
payment of additional premium
4. Benefits specified in the table are paid in the following manner:
1) benefit upon the death of the Insured — payment of 100% of
sum insured;
2) benefit due to permanent disablement of the Insured — lumpsum payment corresponding to a percentage of sum insured
determined in accordance with Table 1, constituting Appendix 1 to
the General Terms and Conditions of Insurance;
3) daily hospital allowance — payment of PLN 100 for each day of
stay of the Insured in the hospital.
This payment applies to the cases of uninterrupted stay longer than
4 full days, however not longer than 90 days, if the stay started and
continued over ERGO Hestia liability period. The date of admission
to the hospital is calculated as a full day regardless of the time
of admission to the hospital. ERGO Hestia shall not pay benefits
for days during which there was a break in the stay in hospital as
a result of the granting pass;
4) treatment and rehabilitation costs — refund of documented,
necessary from the medical points of view, costs incurred within
the territory of the Republic of Poland with respect to a personal
accident, for which the due compensation for permanent
disablement was up to 20% of sum insured, but no more than
PLN 10 000.
24
These costs comprise:
a) advice, physicians visits, tests, outpatient procedures and
surgeries, stay at a healthcare facility;
b) transport by public means (excluding aviation) or specialized
transport if its use is necessary for medical reasons;
c) essential medicines, dressings;
d) rehabilitation in specialized medical facilities and rehabilitation
wards in hospitals;
e) aids, prostheses, rehabilitation equipment (except for household
appliances/audio-video devices), wheelchairs, orthopaedic items
and costs of dental reconstruction of permanent teeth, implants and
implant placement;
f) vocational training for the disabled;
5) the benefit for total and permanent incapacity to work —
a lump-sum of 100% of the sum insured, however no more than
PLN 100 000;
6) payment for myocardial infarction or cerebral stroke — lumpsum payment of 30% of the sum insured, however no more than
PLN 30 000;
7) benefit for the occurrence of the breast or prostate cancer
— depending on the clinical progression of the disease, lump-sum
payment corresponding to the percentage of the sum insured
determined according to Table 2, however, not more than PLN 30 000.
EN/KM/OW092/1512
EXCLUSIONS OF LIABILITY
§2
1. The insurance does not cover the personal accidents and illnesses
suffered by the Insured:
1) as a result of committing a crime or an attempt, stated by legally
binding court decision;
2) as a result of self-inflicted injury or suicide;
3) as a result of alcoholic disease or other mental disturbances and
behavioral disturbances resulting from the use of psychoactive
agents;
4) as a result of driving without required license, if it affected the
occurrence of loss;
5) as a result of playing sports in order to earn money or playing
extreme sports;
6) in relation to performing high-risk professions.
2. Moreover, the insurance shall not cover:
1) infections, the insurance cover is applied if the Insured was
infected with a micro-organism as a result of injuries suffered in
a personal accident covered by the scope of insurance;
2) damage to intervertebral disc and its consequences;
3) poisoning of gastrointestinal tract;
4) consequences of personal accidents being a result of bodily injury
or loss of bodily function of the Insured due to treatment, regardless
of who performed the treatment, unless the treatment was directly
associated with a personal accident;
5) effects of accidents being the consequence of or arising in
connection with any disease, apart from accidents resulting from
myocardial infarction, cerebral stroke, malignant breast cancer or
prostate cancer (if they are covered under given insurance variant);
6) myocardial infarction and cerebral stroke in persons, in which
before the commencement date or within 90 days from the
commencement date, a cardiac vascular disease (including arterial
hypertension or coronary disease) or diabetes was diagnosed and
treated;
7) developing malignant breast cancer or prostate cancer:
a) which was diagnosed or treated before the commencement date
or within 90 days from the commencement date,
b) resulting from chronic illnesses (including benign neoplasm),
which were diagnosed or were treated before the commencement
date.
3. As regards benefits due for cerebral stroke, cerebral symptoms
caused by traumatic factors or resulting from vascular reasons
resulting from the brain disease are excluded from the scope of
insurance coverage.
4. Daily hospital allowance shall not be applicable, if the stay of the
Insured is in the rehabilitation facilities and health care facilities, the
primary purpose of which is care or health resort or rehabilitation
treatment, also in specialist mental health hospitals.
SUM INSURED
§3
1. The sum insured shall be determined in the insurance contract,
individually for each Insured.
2. The sum insured is determined by the Customer, however, it
cannot be lower than PLN 10,000 and higher than PLN 500 000.
EN/KM/OW092/1512
3. The sum insured shall be the liability cap of ERGO Hestia, both in
relation to one event and to all events that occur during the period
of the insurance contract.
DETERMINING THE AMOUNT OF BENEFIT
§4
1. ERGO Hestia shall pay the benefit for death, only if it occurred
within a year from the date of accident.
2. The determination of causal relationship and the type of
permanent disablement shall be done based on proofs and medical
documentation gathered by ERGO Hestia.
3. In the case of loss or damage to organ or system, the function of
which were damaged before the accident, the disablement degree
shall be determined as the difference between the disablement
before and after the accident.
4. If the Insured suffers several disablements, ERGO Hestia pays out
the benefits for all disablements covered by insurance, at maximum
up to the sum insured, and with respect to disablements specified in
Table 1. Chapter II in Appendix 1, up to PLN 100 000.
5. ERGO Hestia asks for the opinion of medical consultants so as to
determine the degree of permanent disablement.
6. Medical and rehabilitation expenses are paid:
1) if they were incurred in the period shorter than a year from the
date of accident;
2) on the basis of receipts — to the Insured, and if the
aforementioned expenses were incurred by the third party — to the
party;
3) in the amount, which shall not be covered by general health and
social insurance.
7. ERGO Hestia shall pay the benefit for the total and permanent
incapacity to work:
1) if it occurred in the period no longer than a year from the date of
accident;
2) if the Insured on the date of conclusion of the insurance contract
and over 6 months prior to the conclusion of the insurance contract
was employed or worked professionally as sole trader in accordance
with the provisions of law.
8. Assessment of the total and permanent incapacity to work
shall be done by ERGO Hestia in cooperation with the physicians
appointed by it, on the basis of the evidence and medical records,
after at least 6 months after the occurrence of the incapacity. Total
and permanent incapacity to work means the inability of the Insured
to perform in the future the professional work to which they are
qualified by virtue of his or her background and experience, which
has been the main source of income for the past 6 months preceding
the date of the personal accident covered by insurance.
9. If the Insured performed a number of professions which meet the
criteria referred to section 6 item 2), in order to be covered under
total and permanent incapacity to work liability, it is necessary to
select one profession, in respect of which ERGO Hestia is to pay the
benefit.
10. ERGO Hestia shall also refund to the Insured the documented
costs of additional medical exams required by it for the purposes of
justifying the claim.
25
§5
If the Insured received benefit for permanent disablement or total
and permanent incapacity to work, and then died due to the same
personal accident, the death benefit is paid only if it is higher than
the already paid. In such situation, the benefit paid is reduced by the
amount already paid.
§6
1. Determination of the amount of benefits for the occurrence of
malignant breast cancer or prostate cancer and the payment of
the benefit due is based on the results of the histopathological
examination, hospital discharge summaries and other necessary
medical documentation.
2. Total payment for occurrence of malignant breast cancer or
prostate cancer for all events within the period of insurance may not
exceed PLN 30,000.
PERSONS ENTITLED TO BENEFITS
§7
1. The benefits shall be paid to the Insured, subject to section 2.
2. Payment for death of the Insured shall be made to an eligible
person, unless such person intentionally contributed to the death
of the Insured.
3. Insured may at any time change the eligible person.
§8
If by the time of death of the Insured, the Insured failed to indicated
the person entitled to receive the benefit, the benefit is granted to
family members of the deceased in the following order:
1) spouse — in full,
2) children — in equal parts,
3) parents — in equal parts,
4) other heirs of the deceased — in equal parts.
FINAL PROVISIONS
§9
The method of determining and payment of premium, period of
insurance and the indemnity period of ERGO Hestia, rights and
obligations of the parties, method of payment of the benefit are
determined in the Common Provisions.
§ 10
The General Terms and Conditions of Insurance shall enter into
force as of 24 January 2016 and shall apply to insurance contracts
concluded as of that date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
26
EN/KM/OW092/1512
APPENDIX 1 TO THE GENERAL TERMS AND CONDITIONS
OF INSURANCE
Table 1. Assessment of disablement resulting from accident
Damage to rectum and anus
10%
Brain contusion
10%
Brain concussion
1%
Post-traumatic loss/ damage of: an organ or body part
Chapter I. The events for which ERGO Hestia
shall pay benefits in the amount specified as
the percentage of the sum insured.
The sum insured is the liability cap of ERGO
Hestia, both in relation to one event and to
all events that occur during the period of this
insurance contract.
Wypłacany
procent sumy
ubezpieczenia
POST-TRAUMATIC TOTAL INJURY
Lung (partial)
10%
Spleen
10%
One kidney
10%
Two kidneys
50%
Pancreas (partial)
15%
Liver (partial)
15%
Tetraplegia
100%
Uterus/Phallus
30%
Hemiplegia
100%
Testicle/Ovary
15%
Paraplegia
100%
Two testicles/two ovaries
40%
Hemiparesis limiting the aptitude of limbs with
global aphasia
100%
Cranium bone loss
6%
Extrapyramidal syndrome significantly limiting
the aptitude of organism and requiring third
party care
Nose in its entirety (including the nasal bones)
30%
100%
Loss of maxilla
40%
Loss of mandible
50%
Disequilibrium of cerebellar or origin, making it
impossible to walk
100%
Total loss of vision in one eye
30%
Epilepsy with psychic disturbances,
characteropathy, dementia and epileptic
equivalents preventing from performing any
work or requiring individual/special education
Total hearing loss, unilateral
30%
Total loss of one auricle
15%
100%
Total loss of both auricles
25%
Total loss of breast (mammary gland)
25%
Severe psychic disturbances requiring
constant third party care (dementia-like
changes, psychoses, frequent and long-lasting
psychiatric hospitalization)
Partial loss of breast (mammary gland)
15%
100%
Major amputation of one upper extremity
(above elbow)
65%
total loss of vision in two eyes
100%
60%
Total hearing loss in both ears
100%
Minor amputation of one upper extremity
(below elbow)
total anarthria Total aphasia with agraphia and
alexia, regardless of 12-month speech-therapy
Total amputation of one hand (palm)
50%
100%
Total loss of upper extremity function
50%
Amputation of two upper/lower extremities
100%
Total amputation of five fingers on one hand
40%
Major amputation of lower extremity (at knee
joint)
60%
POST-TRAUMATIC PARTIAL INJURY
Post-traumatic injuries of internal organs
Heart or pericardium damage
15%
Minor amputation of lower extremity (below
knee)
50%
Damage to aorta, vena cava and the main
branches
10%
Total amputation of foot
40%
Damage to stomach
5%
Total post-traumatic loss of lower extremity
function
40%
Rupture of the spleen without necessity to
remove it
5%
Total amputation of five fingers on one foot
25%
Damage to diaphragm
5%
Loss of extremity in shoulder
75%
Loss of extremity together with scapula
80%
Loss of extremity in brachial area
65%
Loss of extremity in antebrachial area
55%
Damage to liver requiring a transplant (final
hepatic failure)
80%
Damage to the small or colon intestine
10%
EN/KM/OW092/1512
27
Chapter II. The events for which ERGO Hestia
shall pay benefits in the amount specified as
the percentage of the sum insured.
Where the sum insured set forth in the
insurance contract exceeds PLN 100,000, the
benefits shall be paid as the percentage of the
amount of PLN 100,000.
Percentage
of the sum
insured or of
the amount of
PLN 100 000
paid
POST-TRAUMATIC PARTIAL INJURY
Post-traumatic loss/damage of: body part or total torn of
muscles
Caudal bone
2%
Femoral bone
7%
Fibula
2%
Tibia
6%
Humeral bone
5%
Radial bone, ulnar bone, carpus bone
4%
Spinal column
8%
Other fractures
1%
Loss of hallux
8%
Dislocations
Total loss of toes II, III, IV and V of foot
3%
5%
Total loss of the thumb
10%
of spinal column without neurological
consequences as paralyses and pareses
Total loss of index finger
8%
In the mandibular joint area
2%
Total loss of fingers III to V — for each finger
2%
Ilium
10%
Total rupture of quadriceps muscle
6%
Knee joint
8%
Total rupture of biceps femoris (lower
extremity)
In the tarsus area
5%
4%
Hallux
3%
Complete rupture of the biceps and triceps
(upper extremity)
3%
Joints of toes III to V (for each finger)
2%
Clavicular and shoulder joint or clavicular and
sternal joint
3%
Humeral and scapula joint
4%
Elbow joint
5%
Wrist
3%
Thumb joints
3%
Index finger joints
2%
Joints of fingers III to V (for each finger)
1%
Sutured wounds, frostbite or burn
incised would or III degree frostbite of face,
neck, forearms and palms
2%
Lacerated would (e.g. as a result of dog bite) of
face, neck, forearm and palm
3%
Incised would of other body parts, including
hairy skin on head
1%
Lacerated wound of other parts of body,
including hairy skin on head
2%
Frostbite III degree
3%
burn III grade (calculated for each percent of
body surface)
2%
Fractures
Rotations
Of backbone in cervical section
2%
Of backbone in thoracic and/or lumbar section
1%
Of illac joint
3%
Knee joint with damage to ligamentous
apparatus
3%
Knee joint with damage to ligamentous
apparatus and after surgery
5%
Of tarsal joint or in the foot section or in tarsal
joint and in foot section
2%
Of shoulder joint
3%
Elbow
2%
Wrist
3%
of cranium
4%
Facial skeleton — mandible, maxilla
6%
of jugular bone
3%
Nasal bones — without disfigurement of the
nose shape
1%
Nasal bones — with disfigurement of the nose
shape, though the operation
3%
Sternum
4%
One rib
1%
Two or more ribs
2%
Thumb joints
2%
Pelvis
6%
Index finger joints
1%
28
EN/KM/OW092/1512
Joints of fingers III to V (for each finger)
1%
Post-traumatic complete loss of permanent teeth
(for each tooth)
Incisor or canine
1%
The remaining teeth, starting from two
0.5%
Partial loss of incisor or canine
0.5%
Complete ankylosis
Pseudarthosis of the bone
10%
Post-traumatic aneurysm
10%
Intoxication with gasses and inhalatory
substances
5%
Chronic osteomyelitis
10%
Table 2. Breast or prostate cancer
Occurrence of breast cancer
The pre-invasive tumors (together
with Paget’s disease of the mammary
gland) and the largest invasive tumors
of less than 2 cm without metastases
to regional ancillary lymph nodes:
Stage 0 — Tis, N0, M0
Stage I — T1, N0, M0
Percentage of the sum
insured paid
10%,
up to PLN 10 000
Other invasive tumors: Stage IIA:
• T0-1, N1, M0
• T2, N0, M0 Stage IIB
• T2, N1, M0
• T3, N0, M0 Stage IIIA:
• T0-2, N2, M0
• T3, N1-2, M0 Stage IIIB:
• T4, N0-2, M0 Stage IIIC:
• T (all), N3, M0 Stage IV:
• T (all), N (all), M1
30%, up to PLN 30 000
Occurrence of prostate cancer
Percentage of the sum
insured paid
T1 (including T1a, T1b and T1c)
tumor non-detectable per rectum and
invisible in imaging examinations
10%,
up to PLN 10 000
T2 — tumor is within the prostate
gland
T3 — tumor infiltrating outside the
sheath of the prostate gland T4 — stiff
tumor infiltrating outside other organs
than spermatic follicles (bladder neck,
rectum, elevator muscle of anus,
pelvic wall)
30%,
nie więcej
niż 30 000 zł
EN/KM/OW092/1512
29
IV. General Terms and Conditions of Third-Party
Liability Insurance in Private Life
CODE: C-E7-OCWŻP-01/15
The insurance contract is concluded based on the General Terms and Conditions for Third-Party Liability Insurance and Common Provisions
and Definitions for Non-motor Insurance ERGO 7 (hereinafter referred to as the Common Provisions).
30
EN/KM/OW092/1512
The following table informs which provisions of the General Terms and Conditions of Third-Party Liability Insurance
govern the issues listed in Article 17 section 1 of the Act of 11 September 2015 on insurance and reinsurance
activity.
Number of the template’s editing unit
Name of the insurance
Third-party liability insurance
in private life
EN/KM/OW092/1512
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
§ 1 section 1
§ 1 section 3, § 2, § 3
31
SUBJECT AND SCOPE OF INSURANCE COVER
§1
1. Subject to the exclusion of § 2 of these General Terms and Conditions of Insurance and § 3 of the Common Provisions, the insurance covers
the liability for damage to property or bodily injury caused to third parties by persons covered by insurance, in the course of activities of
private life, resulting from events that took place during the period of insurance, according to the table below:
Options
Sum insured
I third-party liability
insurance
II third-party liability
insurance
III
PLN 200 000
PLN 500 000
PLN 2 000 000
Persons covered by insurance
1) The Insured
2) minor children of the Insured
3) domestic staff and other persons carrying out work in the household, employed by
the Customer in connection with the performance of work for persons covered by
insurance — regardless of the legal basis of employment and the form of agreement
4) relatives of the Insured, including adult children, residing together with the Insured
— for payment
Scope of insurance
1) losses caused in relation to the use or possession of house or apartment (including
rented house and apartment)
2) losses resulting from flooding not attributable to the Insured
3) losses caused in relation to the possession and use of property, including the property
used by the persons covered by the insurance benefit under rental, tenancy, loan,
lease agreement or other related legal relationship
4) losses caused in relation to care of minor children
5) losses resulting from practicing sports, using sailing equipment
6) losses resulting from owning domestic animals (including when under the care of the
Insured)
7) other losses caused to third parties in connection with private life activities
Territorial limits
worldwide
2. All losses that are the result of the same event or result from the
same cause, regardless of the number of aggrieved parties, are
considered to be formed on the same date.
3. ERGO Hestia shall also cover, within the sum insured, the
necessary costs:
1) for which the person covered by insurance is responsible, as they
have contractually assumed liability of a third party, or expanded
the scope of their liability under generally applicable provisions of
law;
2) judicial defense, if criminal proceedings are initiated against the
Insured, provided that ERGO Hestia expressed written consent to
cover such costs, up to 20% of the sum insured at maximum;
3) necessary actions taken by the Insured after an accident in order
to reduce the extent of loss.
EXCLUSIONS OF LIABILITY
§2
1. Insurance does not cover third-party liability for loss:
1) for which the person covered by insurance is responsible, as they
have contractually assumed liability of a third party, or expanded
the scope of their liability under generally applicable provisions of
law;
32
2) caused to relatives of the people covered by insurance or people
employed by them;
3) resulting from practicing extreme sports;
4) involving the occurrence of financial loss unrelated to damage to
property or bodily injury;
5) related to the infringement of copyrights, patents, trademarks
and trade names;
6) occurring in monetary value, documents, plans, archives, stamp
collections, coin collections, antiques, works of art and collections;
7) resulting from the transmission of infectious diseases, the
existence of which the person covered by insurance knew or on the
best effort basis could learn this information;
8) being the consequence of a systematic (i.e. regular and
repetitive) influence of noise, vibration, temperature, water, weather
conditions;
9) covered under geological and mining laws;
10) caused by emission, leaking or other form of penetrating the air,
water or soil by hazardous substances;
11) caused by subsidence, landslides, flooding by standing or flowing
water, as well as the withdrawal of liquid in sewer systems;
12) arising in connection with the construction of houses,
apartments, outbuilding and buildings forming the garden
architecture, if the permit was required to carry out these works;
EN/KM/OW092/1512
13) caused by animals other than domestic animals;
14) resulting from the possession or use of any motor vehicles or
aircraft;
15) covered by obligatory third-party liability insurance policies
which are required of the Insured.
2. Insurance does not cover losses to all kinds of vessels.
3. Insurance shall not cover fines and administrative or legal
penalties and other financial penalties.
4. Insurance does not cover third-party liability for loss covered
under Tenant Third-Party Liability Insurance, under General Terms
and Conditions of the Tenant Third-Party Liability Insurance.
SUM INSURED
§3
1. The sum insured is determined in the insurance contract.
2. Sum insured is the liability cap of Ergo Hestia with respect to all
events and all aggrieved parties in the insurance period.
3. After payment of compensation, sum insured shall be reduced
by the amount of compensation paid. If the guarantee sum is
exhausted, the insurance contract is terminated.
LIABILITY OF ERGO HESTIA
§4
1. ERGO Hestia is required to assess the factual
1 and legal circumstances and take a decision on the recognition of
claim and payment of compensation, or defend the Insured against
an unjustified claim.
2. ERGO Hestia shall pay due compensation to the aggrieved party in
accordance with the rules of third party liability of a person covered
by the insurance.
3. ERGO Hestia shall have the right to pay compensation amounting
to the sum insured, which can satisfy claims arising out of the event,
releasing itself from the obligation to continue to defend and incur
other costs.
FINAL PROVISIONS
§5
The method of determining and payment of premium, period of
insurance and the period of liability of ERGO Hestia, rights and
obligations of each Party, method of payment of benefit are
determined in the Common Provisions.
§6
General Terms and Conditions of Insurance shall enter into force
as of 24 January 2016 and shall apply to the insurance contracts
concluded as of that date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
EN/KM/OW092/1512
33
V. General Terms and Conditions of Tenant
Third-Party Liability Insurance
CODE: C-E7-OCN-01/15
The insurance contract is concluded based on the General Terms and Conditions of Tenant Third-Party Liability Insurance and Common
Provisions and Definitions for Non-motor Insurance ERGO 7 (hereinafter referred to as the Common Provisions).
34
EN/KM/OW092/1512
The following table informs which provisions of the General Terms and Conditions of Tenant Third-Party Liability
Insurance govern the issues listed in Article 17 section 1 of the Act of 11 September 2015 on insurance and
reinsurance activity.
Number of the template’s editing unit
Name of the insurance
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
Tenant Third-Party Liability
§ 1 section 1
§ 1 section 3, § 2, § 3
EN/KM/OW092/1512
35
SUBJECT OF INSURANCE
SUM INSURED
§1
1. Subject to the exclusions set forth in § 2 of these General Terms
and Conditions of Insurance and § 3 of the Common Provisions, the
insurance shall cover third-party liability for losses caused within the
insurance period by the Tenant and their relatives residing therewith
to third parties, in relation to the possession or use under lease or
loan agreement of the apartment, single-family house, detached
garage, outbuilding and garden architecture being the subject of
insurance against fire and other fortuitous events under ERGO 7 line.
2. All losses that are the result of the same event or result from the
same cause, regardless of the number of aggrieved parties, are
considered to be formed on the same date.
3. ERGO Hestia shall also cover, within the sum insured, the
necessary costs:
1) fee of the appraiser appointed upon written consent of
ERGO Hestia in order to determine the circumstances of the
accident, reasons and extent of loss, up to 20% of the sum insured
at maximum;
2) judicial defense, if criminal proceedings are initiated against the
Insured, provided that ERGO Hestia expressed written consent to
cover such costs, up to 20% of the sum insured at maximum;
3) necessary actions taken by the Insured after an accident in order
to reduce the extent of loss.
§3
1. The sum insured shall amount to PLN 100 000.
2. Sum insured is the liability cap of Ergo Hestia with respect to all
events and all aggrieved parties in the insurance period.
3. After payment of compensation, sum insured shall be reduced by
the amount of compensation paid. If the sum insured is exhausted,
the insurance contract is terminated as at the date of exhausting
the sum insured.
LIABILITY OF ERGO HESTIA
§4
1. ERGO Hestia is required to assess the legal and factual situation
and take a decision on the recognition of claims and payment of
compensation, or defend the Insured against unreasonable claim.
2. ERGO Hestia shall pay due compensation to the aggrieved party in
accordance with the rules of third party liability of a person covered
by the insurance.
3. ERGO Hestia shall have the right to pay compensation amounting
to the sum insured, which can satisfy claims arising out of the event,
releasing itself from the obligation to continue to defend and incur
other costs.
FINAL PROVISIONS
EXCLUSIONS OF LIABILITY
§2
1. Insurance does not cover third-party liability for loss:
1) for which the person covered by insurance is responsible, as they
have contractually assumed liability of a third party, or expanded
the scope of their liability under generally applicable provisions of
law;
2) caused to relatives of the people covered by insurance or people
employed by them;
3) involving the occurrence of financial loss unrelated to damage to
property or bodily injury;
4) occurring in monetary value, documents, plans, archives, stamp
collections, coin collections, antiques, works of art and collections;
5) being the consequence of a systematic (i.e. regular and
repetitive) influence of noise, vibration, temperature, water, weather
conditions;
6) covered under geological and mining laws,
7) caused by emission, leaking or other form of penetrating the air,
water or soil by hazardous substances;
8) caused by subsidence, landslides, flooding by standing or flowing
water, as well as the withdrawal of liquid in sewer systems;
9) arising in connection with the construction of houses,
apartments, outbuilding and buildings forming the garden
architecture, if the permit was required to carry out these works;
10) caused by animals other than domestic animals;
11) covered by obligatory third-party liability insurance policies
which are required of the Insured.
2. Insurance does not cover losses to all kinds of vessels.
3. Insurance shall not cover fines and administrative or legal
penalties and other financial penalties.
36
§5
1. The method of determining and payment of premium, period
of insurance and the period of liability of ERGO Hestia, rights
and obligations of each Party, method of payment of benefit are
determined in the Common Provisions.
2. General Terms and Conditions of Insurance shall enter into force
as of 24 January 2016 and shall apply to the insurance contracts
concluded as of that date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
EN/KM/OW092/1512
VI. General Terms and Conditions of Assistance ERGO 7
CODE: C-E7-A-01/15
The insurance contract is concluded based on the General Terms and Conditions for Assistance ERGO 7 Insurance and Common Provisions
and Definitions for Non-motor Insurance ERGO 7 (hereinafter referred to as the Common Provisions).
EN/KM/OW092/1512
37
The following table informs which provisions of the General Terms and Conditions of ERGO 7 Assistance Insurance
govern the issues listed in Article 17 section 1 of the Act of 11 September 2015 on insurance and reinsurance
activity.
Number of the template’s editing unit
Name of the insurance
ERGO 7 Assistance
38
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
§ 1 section 1, § 1 section 3,
§ 3 section 1, § 4 section 1
§ 1 section 2, § 3 section 2,
§ 4 section 2, § 5, § 6
EN/KM/OW092/1512
SUBJECT OF INSURANCE
§1
1. The insurance covers the costs of the providing immediate
Assistance services through Emergency Centre.
2. The benefits are exercised within 4 hours from the event covered
by the insurance being reported, subject to section 3.
3. Computer equipment/ household appliances/ audio-video devices
under Home Assistance shall be repaired at the latest within 48
hours of notification.
HOME ASSISTANCE
§2
1. The ability to use the service is contingent on the occurrence or
threat of occurrence of damage or destruction of the property in the
insured location, resulting from fortuitous events, floods or faults,
subject to section 3.
2. The sum insured and limits for each type of service within the
insurance period are determined in the table below:
the insured location is impossible, the cost of repair in the center is
covered by the Insured,
3) information services — provision of information on public services
and service providers telephone numbers.
SOS ASSISTANCE
§3
1. The condition to use the service is damage or destruction of
house or apartment specified as the insured location, resulting from
fortuitous events and floods, preventing from further habitation.
2. The sum insured and limits for each type of service within the
insurance period are determined in the table below:
Type of service
Limit of services
Property safeguarding
Property transportation
Type of service
Sum insured
PLN 5 000
Limit of services
Emergency assistance of a specialist
(plumber, electrician, locksmith, heating
and air conditioning specialist, carpenter,
2 times
glazier, electronic specialist, alarm and
intercom specialist)
Repair of computer equipment/household
appliances/electronic equipment
1 time
Information service
no limit
Additional services — arrangement
within the framework of legal norms and
generally accepted good practice
no limit
3. The condition for use of Assistance service consisting in:
1) emergency assistance of a locksmith provided in the event of
damage, locking-in or loss of keys or damage of locks in exterior
doors to the house or apartment,
2) repair of computer equipment, office equipment, household
appliances, electronic equipment — performed in the event of
failure.
4. Assistance services specified in the table comprise the conduct of
the following activities:
1) specialist intervention assistance — the arrangement and
coverage of costs of services when immediate action is necessary to
prevent the increase of loss or cause further damage;
2) repair of computer equipment/household appliances/electronic
equipment:
a) the arrangement and coverage of costs of a specialist or IT
specialist, in order to repair it in insured location,
b) the arrangement and the coverage of costs of transport of the
equipment to and from the nearest repair center, if the repair in
EN/KM/OW092/1512
Sum insured PLN
15 000
up to 3 days
1 time
Property storage
up to 90 days
Substitute premises
up to 90 days
A visit to a psychologist for the Insured
and their relatives
up to 5 visits
Transportation of the Insured and their
relatives
1 time
Transport of children to school,
kindergarten, nursery school
1 time
Care of domestic animals
up to 3 days
Immediate return home
1 time
Information service
no limit
Advance compensation
up to PLN 5 000
3. Assistance services specified in the table comprise the conduct of
the following activities:
1) property safeguarding — the arrangement and the coverage of
necessary costs of safeguarding of the property belonging to the
Insured or their relatives in the insured location against occurrence
of any further loss;
2) property transportation — the arrangement and the coverage
of costs of transportation of property belonging to the Insured or
their relatives carried out in order to secure or use the property
outside the insured location. The transportation is carried out by a
passenger car or a truck from the insured location to the location
within the territory of the Republic of Poland specified by the
Insured;
3) property storage — the arrangement and the coverage of costs
of storage of property belonging to the Insured or their relatives;
4) substitute premises — the arrangement and coverage of costs
to provide premises for the period when the house or apartment of
the Insured is uninhabitable. The premises made available to the
Insured ensure the satisfaction of basic housing needs.
5) transportation of the Insured and their relatives — organizing
39
and covering the costs of transportation of people and their hand
luggage to the location within the territory of the Republic of Poland
specified by the Insured, as well as the subsequent return to the
insured location;
6) transportation of children to school, kindergarten, nursery
school — the arrangement and the coverage of costs of transport of
minor children of the Insured to school, kindergarten, nursery school
and back;
7) care of domestic animals — arrangement and coverage of costs:
a) of care of domestic animals left at the Insured’s place of stay or
b) transportation of domestic animal to and from the person
indicated by the Insured, within the territory of the Republic of
Poland or to an animal hotel;
8) immediate return home — arrangement and coverage of costs
of return of the Insured and their relatives to the insured location
within the territory of the Republic of Poland;
Type of Assistance service
9) information services — provision of information on public
services and service providers telephone numbers;
10) advance compensation — payment of advance compensation
under contract of insurance of the house or apartment against fire
and fortuitous events concluded in the framework of ERGO 7. In the
event that ERGO Hestia refuses to pay compensation, the Insured
shall return the advance payment.
MEDICAL ASSISTANCE
§4
1. The occurrence of sudden illness or accident requiring the
immediate medical assistance within the territory of the Republic of
Poland for the Insured or their relative residing together with them,
is the condition to make use of this service.
2. The sum insured amounts to PLN 5,000 for one event and for all
events, while limits for each type of service and benefit within the
insurance period are set forth in the table below:
Insurance option
Insurance event
Benefits due
Basic
Extended
Limits of benefits
Medical aid
Physician visit:
• arranged 24/7
2 times
4 times
2 times
4 times
2 times
4 times
-
1 time
2 times
4 times
-
2 times
2 times
4 times
1 time
2 times
Care of children, elderly and dependents
2 times
4 times
Care of domestic animals
2 times
4 times
2 times
4 times
Transport of children to school, kindergarten, nursery school
2 times
4 times
Domestic staff
2 times
4 times
-
1 time
• arranged between 8:00 p.m. and 6:00 a.m. and 24h during
weekends and on public holidays
Nurse visit
Sudden illness
Delivery of medications and small medical equipment
Personal
accidents
Vaccination
Medical transport
Psychological assistance
Rehabilitation:
• visit of a physiotherapist or
• visit in rehabilitation facility
Rehabilitation equipment
Care assistance
Delivery:
• of basic food products or
• personal belongings to the hospital
Assistance in funeral arrangements
40
Sudden illness
Personal
accidents
EN/KM/OW092/1512
Type of Assistance service
Benefits due
Insurance option
Insurance event
Basic
Extended
Limits of benefits
Information assistance
Telephone information about health care facilities and services
no limit
Notification of the family or the employer
no limit
Telephone medical/hospital information
no limit
Medical assistant
no limit
3. Assistance services specified in the table comprise the conduct of
the following activities:
1) physician’s visit — the arrangement and coverage of costs of
primary care physician’s visit and transportation to the place of stay
of the Insured or their relative; In the basic option, the physician’s
visit is arranged only between 8:00 p.m. and 6:00 a.m. during
weekdays and 24h during weekends or on public holidays;
2) nurse’s visit — the arrangement and coverage of costs of nurse’s
visit and transportation to the place of stay of the Insured or their
relative for the purpose of providing nurse care in accordance with
the instructions of the physician of the Emergency Centre;
3) delivery of medications and small medical equipment — the
arrangement and coverage of costs of delivery of medications,
dressings and similar small medical equipment to the place of stay
of the Insured, in accordance with the instructions of the physician
of the Emergency Centre; The service is provided in the event
that the Insured, according to the opinion of the physician of the
Emergency Centre, is unable to leave their place of stay. The service
shall not include the cost of purchase of the above mentioned items;
4) vaccination — the arrangement and coverage of costs of visit of
a physician or nurse for the purpose of vaccination. The service shall
not include the cost of purchase of the vaccination;
5) medical transportation — arrangement and coverage of costs:
a) of transport to or from a medical facility — in case of events which
do not require emergency care intervention;
b) transport to a follow-up visit or from such visit to a place of stay
— provided that the Insured was hospitalized and, in accordance
with the written recommendations of the attending physician,
should attend a follow-up visit at a medical facility and is not able to
travel to the visit by means of public transportation or by their own
car due to their health condition confirmed with medical records;
c) transport in order to appear before the medical board;
d) transport from the hospital to the place of stay;
e) transport between medical facilities — the service is performed
at the written recommendation of the attending physician upon
consultation with the Emergency Centre and is carried out with the
means of transport adapted to the health condition of the Insured;
6) psychological care — the arrangement and coverage of costs of
a visit to a psychologist. The benefit applies within 180 days after
the date of the accident;
7) rehabilitation — the arrangement and coverage of costs of one of
the following benefits, provided that the Insured, in accordance with
the written recommendations of the attending physician, requires:
a) a visit of a physiotherapist at the Insured’s place of stay or
EN/KM/OW092/1512
b) a visit in the nearest rehabilitation facility;
8) rehabilitation equipment — the arrangement and coverage of
costs of rental and transport to the place of stay of the Insured
of rehabilitation equipment, if such was recommended by the
attending physician or the physician of the Emergency Centre in
writing, on the basis of medical records;
9) care of children, elderly and dependents
- arrangement and coverage of costs:
a) of care at the Insured’s place of stay or
b) of transport of the person to be taken care of or the transport to
the person to be taken care of (purchase of first-class train, bus or
airline tickets, provided that the cost of such tickets is comparable
to the cost of train or bus tickets), in the event of hospitalization
of the Insured who is the caretaker of a minor child, an elderly or
dependent person;
10) care of domestic animals — the arrangement and coverage
of costs of care of domestic animals of the Insured in the place of
stay of the animal, if the period of expected hospitalization of the
Insured is longer than 48 hours. After exhausting the liability limit
determined in the table in section 2, ERGO Hestia shall arrange
for and cover the cost of transport of the domestic animals to a
specified person or to the nearest animal shelter;
11) delivery of basic food products — the arrangement and
coverage of costs of delivery of basic food and sanitary products to
the Insured or their relative who, according to the physician of the
Emergency Centre, unable to leave their place of stay. The insurance
shall not include the cost of purchase of the above mentioned items;
12) delivery of personal belongings to the hospital — the
arrangement and coverage of costs of delivery of basic necessities
to the Insured or their relative who were taken into the hospital
and are unable to seek assistance of their household members
with respect to the above. The service shall not include the cost of
purchase of the above mentioned items;
13) transportation of a child to school, kindergarten, nursery
school — the arrangement and the coverage of costs of transport
of minor children of the Insured to and from school, kindergarten,
nursery school;
14) domestic staff — the arrangement and coverage of costs of
domestic staff services for the Insured or their relative, who cannot,
in the opinion of a physician of Emergency Center, perform domestic
tasks;
15) assistance in funeral arrangements — in the event of death
of the Insured or their relative, the arrangement, with the help of
specialized service providers, of funeral-related services, including
41
transportation of the body, the purchase and delivery of the coffin or
urn, delivery of flowers or wreaths. The cost of the arranged services
shall be borne by the Insured;
16) telephone information about health care facilities and
services — information concerning the contact details, addresses
and working hours of medical facilities (physicians, hospitals, clinics,
medical cooperatives) operating on the territory of the Republic
of Poland, which are suitable to the needs of the Insured and are
recommended by the Emergency Centre;
17) notification of the family or the employer — provision, at the
Insured’s request, of necessary information concerning the Insured’s
situation to the Insured’s relatives or their employer.
The information can be provided by telephone, by fax or by e-mail;
18) telephone medical/hospital information — information:
a) on what to bear in mind, when going to a hospital;
b) on what to bear in mind, when leaving a hospital;
c) on what preparation to a surgical procedure consists in;
d) on examinations to be carried out on the Insured or their relative
during hospitalization, along with information on what each
examination consists in, what to pay attention to when visiting
relatives in a hospital;
19) Medical assistant — arrangement:
a) of the visit of primary care physician or pediatrician in the place of
stay of the Insured,
b) of transport to or from a medical facility of between medical
facilities,
c) of nurse care,
d) of assistance of a midwife or nurse in the care of a new-born child,
e) of rehabilitation,
f) of delivery of medications, dressings, rehabilitation equipment
available without prescription to the place indicated by the Insured,
g) of psychological assistance,
h) of stay of the guardian in the hospital in the event of
hospitalization of a child,
i) of help and assistance of a person in the event of admission to and
discharge from the hospital,
j) of a visit of a specialist.
The cost of the arranged services shall be borne by the Insured.
§5
Upon the provision of Assistance service, the sum insured is reduced
by an amount equal to the costs incurred by ERGO Hestia in this
respect. When the sum insured is exhausted, the insurance contract
shall be terminated as at the date of exhausting of the sum insured.
EXCLUSIONS OF LIABILITY
less than PLN 200 or older than 5 years;
6) losses resulting from the necessity to replenish consumables,
on-going and periodic maintenance, delivery and installation of
accessories and lack of necessary resources to handle equipment or
vehicle;
7) costs incurred by the Insured or another person entitled to
the benefit individually, unless the service is not rendered within
4 hours, and provided that other arrangements have not been made
between the Insured and the Emergency Centre.
2. The Home Assistance option shall also not cover:
1) services related to the maintenance of technical equipment,
furnishing, fixtures and fittings;
2) losses resulting from disconnection or interruption of the
functioning of water and sewer equipment, the repair of which is the
obligation of appropriate public utilities or building administrator.
3. Liability of ERGO Hestia under Medical Assistance option is
excluded, if the necessity of medical intervention or hospitalization
is related to:
1) rehabilitation or disease under treatment, which has not been
cured yet;
2) sudden deterioration of health or complications arising during an
ongoing treatment of diseases that require continuous treatment or
medical care.
FINAL PROVISIONS
§7
The method of determining and payment of premium, period of
insurance and the period of liability of ERGO Hestia, rights and
obligations of each Party, method of payment of benefit are
determined in the Common Provisions.
§8
General Terms and Conditions of Insurance shall enter into force
as of 24 January 2016 and shall apply to the insurance contracts
concluded as of that date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
§6
1. ERGO 7 Assistance insurance shall not cover:
1) costs of materials and parts necessary to render service or make
repair;
2) costs related to the use of substitute premises (rent, utilities,
telephone payments);
3) medical transportation, if the cost of transportation can be
covered by health insurance;
4) failure of equipment under warranty or for which, under generally
applicable law, the vendor is liable;
5) repair of household appliances or electronic devices of a value of
42
EN/KM/OW092/1512
VII. General Terms and Conditions of Luggage
Insurance
CODE: C-E7-B-01/15
The insurance contract is concluded based on the General Terms and Conditions of Luggage Insurance and Common Provisions, and
Definitions for Non-motor Insurance ERGO 7 (hereinafter referred to as the Common Provisions).
EN/KM/OW092/1512
43
The following table contains information on provisions of the concluded General Terms and Conditions of Luggage
Insurance which govern the issues listed in Article 17 section 1 of the Act of 11 September 2015 on the insurance
and reinsurance activity.
Number of the template’s editing unit
Name of the insurance
Prerequisites of payment of
damages and other benefits
or the value of insurance:
Limitations and exclusions
of liability of the insurance
company allowing it to refuse
the payment of damages and
other benefits or to decrease
their amounts:
Luggage
§1
§ 2, § 3, § 4 section 2
44
EN/KM/OW092/1512
SUBJECT, SCOPE AND PLACE OF INSURANCE COVERAGE
§1
Insurance covers the loss, destruction of or damage to luggage located in a place covered by insurance and resulting from the events given
in the table below:
Place of insurance coverage
Causes of events
Direct care of the Insured or their relatives
•robbery
• Entrusting to a professional carrier on the basis of appropriate freight
documents,
• Handing over against receipt to the left luggage office.
•loosing
•burglary
Leaving:
• in premises closed on multi-tumbler lock or multipoint lock, or electronic lock, in
the place of accommodation of the Insured (excluding tents),
• in trunk of a motor vehicle closed on lock or trailer or cabin on a vessel closed on
lock, provided that the luggage was not visible from outside.
•burglary
• fortuitous events
Transporting in a vehicle and on racks or in external cargo carriers, including pickup truck load beds, if they were locked according to its construction at the moment
of damage.
Including also damage to racks and external cargo carriers.
• collision of vehicles
• damage caused by the sudden contact of the car with
persons, animals or objects outside the vehicle
• sudden influence of thermal or chemical agent from the
outside of the vehicle
Territorial limits
worldwide
Sum insured
PLN 5 000
EXCLUSIONS OF LIABILITY
§2
1. The insurance shall not cover:
1) monetary values;
2) medications;
3) property acquired for resale;
4) property used for the purposes of commercial, service or
production activity, apart from property purchased by the Insured,
who is a sole trader, and property lent to the Insured by their
employer;
5) loss in the amount of more than PLN 200.
2. ERGO Hestia shall not be held liable for losses caused by robbery,
the occurrence of which was reported to the police unit by the
Insured no later than within 24 hours of its occurrence, unless for
reasons beyond the control of the Insured it is impossible to meet
this obligation; in such case, the Insured is obliged to report the
event immediately after the termination of the obstacles preventing
it.
2. After payment of compensation, sum insured shall be reduced by
the amount of compensation paid. If the sum insured is exhausted,
the insurance contract is terminated as at the date of exhausting
the sum insured.
DETERMINING THE AMOUNT OF COMPENSATION
§4
1. The amount of compensation is determined according to the
replacement value, except for:
1) cash — which is determined based on its nominal value (nominal
value of foreign currency is translated into PLN based on A table
or B table of the average foreign exchange rate announced by the
National Bank of Poland, applicable as at the date of loss event);
2) loss of keys, which is determined based on the costs of changing
the locks.
2. In the case of cash and jewelry, the amount of compensation may
not be higher than PLN 1,000.
FINAL PROVISIONS
SUM INSURED
§3
1. The sum insured shall be the liability cap of ERGO Hestia, both in
relation to one event and to all events that occur during the period
of the insurance contract.
EN/KM/OW092/1512
§5
The method of determining and payment of premium, period of
insurance and the period of liability of ERGO Hestia, rights and
obligations of each Party, method of payment of benefit are
determined in the Common Provisions.
45
§6
General Terms and Conditions of Insurance shall enter into force
as of 24 January 2016 and shall apply to the insurance contracts
concluded as of that date.
President of
the Management Board
Member of
Management Board
Piotr Maria Śliwicki
Adam Roman
46
EN/KM/OW092/1512
What to do when the loss event occurs
1. Please secure the location where the loss event occurred and take care of the things that were not
damaged. If you know or suspect that the event is a result of crime, you should notify the police.
If necessary, call emergency ambulance service or fire brigade.
2. Then, the loss should be reported to ERGO Hestia as quickly as possible.
You will need:
• the address, telephone number, e-mail address
• description of circumstances of the event
• date and hour of the event
Important!
• Please provide us with your phone number — it will facilitate and speed up subsequent contact
with ERGO Hestia.
• A special number will be given to the loss — please write it down and use it in subsequent
contacts with ERGO Hestia.
The loss can be reported:
a) via Internet
• via the electronic form available at: www.ergohestia.pl
• by email at: szkody@ergohestia.pl
b) by calling
• + 48 58 555 5 555 — from a mobile phone or from abroad
• + 48 801 107 107
c) by fax
• + 48 58 555 6 001
d) by mail at the address
STU Ergo Hestia SA BLS-Likwidacja
ul. Hestii 1
81-731 Sopot
3. The claim adjuster will contact you within 48 hours from the notification (2 business days)
and will arrange a convenient date and place of loss investigation
4. If necessary, the claim adjuster will provide you with documents to be completed. The complete
documentation can be provided to the claim adjusted by e-mail or by mail to the address specified
above. The claim adjuster will provide you with all information concerning further claim adjustment
procedure.
5. After that, you will receive a written decision concerning the award of compensation. Ergo Hestia pays
the benefit within 30 days from the date of receiving notification about the loss. If, despite the highest
due diligence, it is impossible, you will receive the compensation within 14 days from the time of
gathering all documents necessary to complete the claim adjustment procedure.
EN/KM/OW092/1512
47
Would you like to contact us?
It is simple:
contact form available at: www.ergohestia.pl
e-mail for claim notification: szkody@ergohestia.pl
company e-mail: poczta@ergohestia.pl
Sopockie Towarzystwo Ubezpieczeń ERGO Hestia SA
ul. Hestii 1, 81-731 Sopot