About Promarine
General Terms and Conditions of Travel Insurance
The terms in these Terms and Conditions shall have the following meanings:policyholder - a person who concludes an insurance contract and pays a premium;
insured person - a person whose property and/or economic interest are insured. A policyholder is also the insured person, except in the event of insurance on behalf of others;
insurance sum - the highest amount guaranteed by the insurance company;
insured person’s interest (excess) - an amount paid by a policyholder for each insurance event;
benefit - payment by the insurance company, subject to an insurance contract;
insurance event - an event resulting due to realisation of the risk insured;
disability - full or partial permanent disability.
Article 1 – RISKS
(1) Travel insurance covers the following risks to the extent specified in these Terms and Conditions:
1) costs of rescue and haulage due to a traffic accident, breakdown or theft – risk A;
2) death, permanent disability, costs of medical treatment and costs of transporting the deceased insured person – risk B;
3) theft, break-in theft, robbery, and destruction of or damage to luggage and personal belongings – risk C;
4) personal liability – risk D;
5) curtailment of the trip or holiday, or its delayed return - risk E;
6) cancellation of a holiday trip – risk F.
(2) Insurance may be concluded for all the aforementioned risks together or for any combination of two, three, four or five types of risk, except for the risk of cancellation of a holiday trip which can also be insured independently.2) death, permanent disability, costs of medical treatment and costs of transporting the deceased insured person – risk B;
3) theft, break-in theft, robbery, and destruction of or damage to luggage and personal belongings – risk C;
4) personal liability – risk D;
5) curtailment of the trip or holiday, or its delayed return - risk E;
6) cancellation of a holiday trip – risk F.
Article 2 - RESCUE AND TRANSPORT COSTS
(1) Insurance covers:
1) costs of rescuing and towing or hauling a vehicle due to a traffic accident or breakdown to the nearest suitable service;
2) costs of towing or hauling a vehicle to permanent residence, if the vehicle cannot be made ready for driving according to service - costs of towing or hauling a vehicle due to a breakdown shall be covered only if the vehicle is less than 10 years old;
3) costs of the transport of passengers and luggage from the location of a traffic accident, breakdown or theft of a vehicle to the place of destination or permanent residence with the least costly means of transport;
4) costs of a replacement vehicle until the vehicle is repaired.
(2) Insurance of the costs of rescuing, towing or transporting a vehicle, the costs of a replacement vehicle, and the costs of the transport of passengers and luggage under the first paragraph of this article shall be limited to personal vehicles, multi-purpose vehicles, motorhomes and motor vehicles with or without trailers, i.e. caravans and trailers for luggage or boats.2) costs of towing or hauling a vehicle to permanent residence, if the vehicle cannot be made ready for driving according to service - costs of towing or hauling a vehicle due to a breakdown shall be covered only if the vehicle is less than 10 years old;
3) costs of the transport of passengers and luggage from the location of a traffic accident, breakdown or theft of a vehicle to the place of destination or permanent residence with the least costly means of transport;
4) costs of a replacement vehicle until the vehicle is repaired.
(3) The insurance company covers actual loss, but not exceeding an insurance sum which is for:
1) costs of rescuing and towing or hauling a vehicle due to a traffic accident or breakdown to the nearest suitable service, in full;
2) costs of towing or hauling a vehicle to permanent residence, if the vehicle cannot be made ready for driving according to service ... EUR 560;
3) costs of the transport of passengers and luggage from the location of a traffic accident, breakdown or theft of a vehicle to the place of destination or permanent residence with the least costly means of transport ... EUR 280;
4) costs of a replacement vehicle until the vehicle is repaired ... EUR 110.
2) costs of towing or hauling a vehicle to permanent residence, if the vehicle cannot be made ready for driving according to service ... EUR 560;
3) costs of the transport of passengers and luggage from the location of a traffic accident, breakdown or theft of a vehicle to the place of destination or permanent residence with the least costly means of transport ... EUR 280;
4) costs of a replacement vehicle until the vehicle is repaired ... EUR 110.
Article 3 – CONSEQUENCES OF AN INCIDENT
(1) Insurance covers the following risks:
1) death;
2) permanent disability as a result of an incident;
3) costs of an emergency medical treatment as a result of an incident or acute illness in the guarantee period of the insurance company, and costs of transporting the deceased insured person to his/her place of residence.
(2) Insurance shall be concluded with the following insurance sums:2) permanent disability as a result of an incident;
3) costs of an emergency medical treatment as a result of an incident or acute illness in the guarantee period of the insurance company, and costs of transporting the deceased insured person to his/her place of residence.
1) death ... EUR 2.800;
2) permanent disability as a result of an incident ... EUR 5.600;
3) costs of emergency medical treatment and costs of transporting the deceased insured person to his/her place of residence ... EUR 2.800.
(3) The insurance cover for costs of medical treatment shall be valid for additional 5 days after the expiry of an insurance policy if, owing to an incident or medically established acute illness, the insured person was forced to remain outside the place of permanent residence.2) permanent disability as a result of an incident ... EUR 5.600;
3) costs of emergency medical treatment and costs of transporting the deceased insured person to his/her place of residence ... EUR 2.800.
(4) The General Terms and Conditions of Personal Accident Insurance (PG-NE) also apply to this insurance. Where the provisions of the aforementioned General Terms and Conditions differ from the General Terms and Conditions of Travel Insurance, the provisions of the latter shall apply.
Article 4 – LUGGAGE AND PERSONAL BELONGINGS
(1) Insurance covers loss due to the damaged or destroyed insured items, which is a result of a sudden event independent of the insured person’s will, in the extent specified in these Terms and Conditions. In case of a theft, break-in theft, or robbery, the insurance also covers loss due to disappearance of insured items.(2) Insurance does not cover loss:
1) due to operation of insured items;
2) due to infringement of legal and technical requirements and the rules on technical exploitation of insured items and safeguards;
3) arising in the warranty period and which must be compensated by the manufacturer or seller;
4) due to defectiveness or faults existing at the moment of taking out insurance, and which were/should have been known to an insured person;
5) for items belonging to an employer or intended for practicing a profession.
(3) The items are insured against the risk of a break-in theft only if they are in closed and locked premises.2) due to infringement of legal and technical requirements and the rules on technical exploitation of insured items and safeguards;
3) arising in the warranty period and which must be compensated by the manufacturer or seller;
4) due to defectiveness or faults existing at the moment of taking out insurance, and which were/should have been known to an insured person;
5) for items belonging to an employer or intended for practicing a profession.
(4) Luggage and personal belongings owned by or in possession of an insured person are subject to insurance.
(5) The following shall not be considered luggage and personal belongings:
1) motor vehicles (also bicycles with an auxiliary engine) and trailers;
2) vessels (except surfboards and inflatable boats up to 3 m);
3) engines of vessels;
4) animals.
(6) The insurance company covers actual damage, however, only up to a maximum of ... EUR 1,100, and in family insurance up to a maximum of ... EUR 2,200, except for:2) vessels (except surfboards and inflatable boats up to 3 m);
3) engines of vessels;
4) animals.
1) money, securities, precious stones, precious metals and objects made of precious stones and precious metals, and real pearls up to an amount of ... EUR 75, and if they are in special closed storage (cash register or case) up to an amount of ... EUR 280;
2) art works and collections (numismatic or stamps collections, etc.) up to an amount of ... EUR 75;
3) luggage and personal belongings against the risk of theft up to the amount of ... EUR 280, in family insurance up to an amount of ... EUR 560.
2) art works and collections (numismatic or stamps collections, etc.) up to an amount of ... EUR 75;
3) luggage and personal belongings against the risk of theft up to the amount of ... EUR 280, in family insurance up to an amount of ... EUR 560.
Article 5 – PERSONAL LIABILITY
(1) The insurance company covers loss due to civil law claims made by third persons against an insured person for reasons of a sudden and surprising event (accident) for which the insured person is liable, and which results in:
1) bodily injury, illness or death of a person (injury to person);
2) destruction of, damage to or disappearance of items (damage to items).
(2) Indemnity claims for loss arising from the polluted running and stagnant waters are excluded from insurance.2) destruction of, damage to or disappearance of items (damage to items).
(3) Indemnity claims also excluded from insurance are for losses:
1) sustained by an insured person’s spouse and persons supported by the insured person in a loss event;
2) caused to items of an insured person;
3) caused by land motor vehicles, apart from losses caused by disattached caravan or freight trailers, aeroplanes, and vessels, apart from surfboards and inflatable boats up to 3 m;
4) caused by practising the profession of an insured person.
(4) The insurance company is also obliged to reimburse for loss in the cases from the preceding paragraph, if this is covered by some other type of risk specified in this insurance.2) caused to items of an insured person;
3) caused by land motor vehicles, apart from losses caused by disattached caravan or freight trailers, aeroplanes, and vessels, apart from surfboards and inflatable boats up to 3 m;
4) caused by practising the profession of an insured person.
(5) The insurance company covers personal liability for each insurance event up to an amount of ... EUR 5,600.
Article 6 – CURTAILMENT OR DELAYED RETURN
(1) Insurance covers the loss incurred to an insured person due to early return from a holiday, because the travel or hotel organisation, in accordance with a mutual agreement, does not reimburse costs for unused part of the holiday.(2) Loss shall only be covered in the event of death of the insured person during a holiday,, if the insured person has been injured, or has fallen ill due to medically established acute illness, or his/her spouse or another close relative has died who is related to the insured person up to and including the second generation.
(3) In the event of organised and paid transport for an insured person’s return from a holiday, costs of the same type of transport means shall also be covered by insurance.
(4) Insurance covers costs of prolonged stay if an insured person is forced to remain outside the place of permanent residence after the end of a holiday, because he/she has been injured or fallen ill due to medically established acute illness. The insurance company must reimburse accommodation expenses to the maximum of the accommodation category of the insured person’s stay during the holiday. Expenses shall be reimbursed for emergency medical treatment, however, to a maximum of 5 days. In the event of organised and paid transport of the insured person’s return from a holiday, costs of the same type of transport means shall also be covered by insurance.
(5) If an insured person is injured or falls ill, the stay of another person in the same accommodation category as the one by the insured person, and for the same period, shall be covered by insurance. In the event of death of an insured person, the costs of accommodation for one person shall be covered by insurance until the person is taken to the burial site.
(6) Insurance also covers travel expenses for the person referred to in the preceding paragraph for travelling from the place of permanent residence to the place where the injured, ill or deceased insured person is, with the least costly transport means. The return costs shall be covered only if the insured person also has the right to the cover of return costs, that is, in the same extent.
(7) The insurance company covers actual costs, however, in a total amount up to a maximum of ... EUR 2,800.
Article 7 – CANCELLATION OF A HOLIDAY TRIP
(1) Insurance covers costs which an insured person must settle with the organiser of a holiday trip in the event of cancelling or not taking the trip for the reasons arisen after taking out insurance, as follows:
1) an incident, death or unexpected deterioration of the insured person’s health making him/her unable to travel;
2) an incident, death or unexpected deterioration of the close relative’s health (spouse, children, parents, grandparents, grandchildren, brothers, sisters) not allowing the insured person to travel;
3) an official call where the insured person’s presence is obligatory;
4) elementary accidents that do not allow the insured person to travel.
(2) The costs covered by the insurance company in the event of cancellation of a trip, also include the insurance premium for other risks insured within the scope of a holiday trip.2) an incident, death or unexpected deterioration of the close relative’s health (spouse, children, parents, grandparents, grandchildren, brothers, sisters) not allowing the insured person to travel;
3) an official call where the insured person’s presence is obligatory;
4) elementary accidents that do not allow the insured person to travel.
(3) Insurance covers the cost of cancellation of a trip even when an insured person’s co-travellers who are stated on the same insurance policy cancel the trip and/or cannot take the trip due to one of the aforementioned reasons. The legitimacy of such cancellation must be evident from the claim documentation (joint application and joint policy, indemnity claims of co-travellers).
(4) The insurance of cancellation of the holiday trip should be taken out at the same time as the conclusion of the holiday trip contract,
(5) As soon as an insured person finds out he/she will not be able to travel, he/she must notify the organiser of the trip in writing thereof. If the insured does not take action immediately, the insurance company shall cover only the proportion which should have been paid by the insured person in case of immediate written notification to the trip. organiser.
(6) The insurance company shall cover cancellation costs which an insured person would have to pay to the trip organiser when cancelling or not taking the holiday trip, as specified in the holiday trip contract, and these depend on the value of an arrangement and on the time of submission of the traveller’s cancellation.
(7) In the event of cancellation of a holiday trip due to the aforementioned reasons, the insurance company is obliged to reimburse the premium for other risks insured under these Terms and Conditions in full at the request of an insured person.
Article 8 – INSURED PERSONS
(1) An insured person may be any person taking a trip or holiday and a business trip.(2) This insurance can be concluded also as family insurance.
(3) In addition to policyholder in the family insurance his/her spouse and children, stepchildren or adopted children until the age of 18 years, or 24 years if they are still in full-time education, and travel together, are insured as well.
Article 9 - INSURANCE VALUE
Insurance value is the purchase price of a new item less the value of amortisation, age and economic outdatedness.Article 10 – INSURANCE AREA
Insurance shall apply in the territory of ... EURope (in the geographical sense of the word) unless otherwise agreed in the insurance contract.Article 11 – CLAIMS PAYMENTS
(1) The loss covered by insurance shall be accounted in the event of:
1) destruction of an insured item – after insurance value of an item when determining the payment of the insurance company, less the value of remains;
2) damage to an insured item – after the repair and materials costs, the extent to which they would amount when determining the payment of the insurance company, less the value of remains.
(2) It shall be considered that an item is destroyed, and the loss shall therefore be accounted as referred in point 1 of the preceding paragraph, if repair work reach the insurance value of the item on the date of determining the payment of the insurance company, less the value of remains.2) damage to an insured item – after the repair and materials costs, the extent to which they would amount when determining the payment of the insurance company, less the value of remains.
(3) The remains of destroyed and damaged items are kept by an insured person and are accounted for according to their market price on the date of determining the payment of the insurance company and pursuant to their condition immediately after the insurance event.
(4) The loss in the personal liability claims shall be accounted pursuant to the criteria applied in indemnity law.
Article 12 – PAYMENT BY THE INSURANCE COMPANY (BENEFIT)
(1) In each insurance event the insurance company pays the accounted loss in full, however, to a maximum of the insurance sums specified in these Terms and Conditions. In personal accident insurance, the insurance company must pay the insurance sum for death or the insurance sum for disability, depending on the level of disability of an insured person. If the insurance company guarantees for claims of several insured persons with one insurance sum, and this does not meet the requirements for their cover, the insured persons are paid a proportional part of a benefit so that the sum of amounts paid does not exceed the insurance sum. The same principle also applies in personal liability insurance, if claims of several insured persons exceed an insurance sum.(2) Insurance only covers material loss caused to insured items due to insured risks, while indirect loss or loss due to an insurance event is covered only by personal liability claims.
(3) In each insurance event, an insured person has a 10% interest of the said components of payment of the insurance company, but not less than ... EUR 38 (excess), except in the personal liability cover due to medical treatment or transport of the deceased insured person, in the event of death or permanent disability of an insured person, and in the event of cancellation of a holiday trip.
Article 13 – RISK CIRCUMSTANCES
(1) In concluding an insurance contract a policyholder must inform the insurance company of all the circumstances relevant to risk assessment (gravity of risk) and which were/should have been known to him/her. The circumstances relevant to risk assessment shall be considered, in particular, circumstances known to a policyholder and on the basis of which a premium is determined and accounted, as well as those which are stated in an insurance contract. These circumstances may be determined by a policyholder and the insurance company together.(2) A policyholder must enable the insurance company the review and revision of risk, as well as the determination of the highest possible loss.
Article 14 – CONCLUSION OF AN INSURANCE CONTRACT
(1) An insurance contract shall be concluded on the basis of an oral or written offer.(2) The insurance company may require modifications or explanations after receiving an offer. It shall be considered that the insurance company has received an offer, when it receives the required modifications or explanations.
(3) The provisions on conclusion of an insurance contract shall also be applied when the existing insurance contract changes, except in the event of changes to the insurance terms or premium pricelist.
Article 15 – INSURANCE GUARANTEE PERIOD
(1) Insurance shall be concluded for a minimum of 8 days, however, if so agreed, also for a longer period.(2) If not agreed otherwise, the guarantee of the insurance company commences at midnight of the date stated in a policy as the commencement of insurance, on condition that the premium was paid and that an insured person left permanent residence in order to travel, go on a holiday or take a business trip.
(3) If an insured person postpones the start of travel or a holiday, he/she may change the insurance contract in agreement with the insurance company before the commencement of guarantee so that new commencement of insurance shall be determined.
(4) Insurance shall be terminated when an insured person returns from travel or a holiday to permanent residence, however, at midnight of the date stated in a policy as the end of insurance period at latest. If reasons arise for prolonging the stay under these Terms and Conditions, the validity of insurance shall be extended for a maximum of 5 days.
Article 16 – PREMIUM PAYMENTS
(1) The first or single premium must be paid by a policyholder when he/she receives the insurance document, and the following premiums on the first day of each insurance year.When paying the first premium, the payment of the premium on the basis of a receipt or another document where usually the payment deadline is determined shall be considered as an agreement that the premium is to be paid at the conclusion of an insurance contract.
If it is agreed that a premium shall be paid in instalments, all premium instalments in the insurance year become due when an insurance event arises.
(2) If it is agreed that a premium shall be paid in instalments or retroactively, regular interests may be charged on the amount of the premium for which the suspension of payment has been agreed. If a premium instalment has not been paid by the date of maturity, interests on late payment may be charged.
(3) If a premium is paid by post, the date of payment shall be considered the day when the amount of the premium was delivered correctly to the post. If a premium is paid by a payment order, the date of payment shall be considered the day when the order arrives to the bank of the insurance company.
(4) With regard to the agreed period of insurance, if a lower premium was determined in an insurance contract and the insurance was terminated prior to the end of this period due to whatever reasons, the insurance company has a right to claim the difference up to the premium which should have been paid by a policyholder if the insurance contract had been concluded only for the period it actually lasted.
(5) In the event of termination of the validity of an insurance contract because of an unpaid due premium, a policyholder must pay the premium for the unpaid period by the date of termination of the validity of the contract, or an entire premium for the current insurance year, if by the date of termination of the validity of the contract an insurance event has arisen for which the insurance company must pay a benefit.
Article 17 – CONSEQUENCES OF NON-PAYMENT OF A PREMIUM
(1) Obligation of the insurance company to pay out a benefit shall cease if a policyholder does not pay an insurance premium by its maturity, which became due after conclusion of a contract, and this is not done by another person interested, after 30 days from the date when the policyholder received the registered mail of the insurance company with the notification of maturity of the premium, whereby this deadline cannot expire prior to the 30-day period from maturity of the premium.(2) After expiration of the deadline referred to in the first paragraph of this article, if a policyholder is late with payment of a premium which should be paid after conclusion of a contract, or the second and following premiums, the insurance company may cancel the insurance contract without notice, where cancellation of the insurance contract commences with expiration of the deadline referred to in the first paragraph of this article, and with termination of insurance cover, if the policyholder was notified by registered mail of maturity of the premium and termination of insurance cover.
(3) If a policyholder pays a premium after expiration of the deadline referred to in the first paragraph of this article, but within one year of maturity of the premium, the insurance company is obliged to pay a benefit, if an insurance event arises from midnight onwards after payment of the premium and interests on late payment. If the policyholder does not pay the premium within this deadline, the insurance contract shall cease to be valid after the end of the insurance year.
Article 18 - INSURED PERSON’S OBLIGATION AFTER AN INSURANCE EVENT
(1) An insured person must notify the insurance company of an insurance event without delay, that is, at latest within 3 days after returning from travel, or when his/her health allows that.(2) An insured person must immediately notify the relevant police of an insurance event arised due to a traffic incident, fire, explosion, theft, break-in theft and robbery, or an attempt of the last three actions, and state which items disappeared, were destroyed or damaged.
(3) An insured person must submit the personal liability claim to the insurance company, inform it about possible legal action or action of the state authorities and about the proceedings lodged, and let it be in charge of the case. An insured person must not admit liability for damages and settle with the plaintiff without explicit prior approval of the insurance company.
(4) If an insured person breaches the aforementioned obligation, the insurance company is not oblied to reimburse for the part of loss arisen due to this default.
Article 19 – EXPERT AND APPEAL PROCEEDINGS
(1) Each contracting party may request that specific disputable facts be assessed by experts.(2) Each party designates one expert from among the persons not in employment relationship with the parties. Prior to the start of work, the designated experts appoint the third expert who shall give an opinion only in case findings of the first two experts differ, and only within the limits of their findings.
(3) Each party bears the costs for the designated expert, while for the third expert each party bears half of the costs.
(4) Findings of the experts are binding for both sides.
(5) A written appeal may be lodged against the settlement offer of the insurance company or rejection of a claim at the appeals commission. The appeal must be filed at the organisational unit of the insurance company which dealt with the claim.
(6) The insurance company also deals with appeals in which breaches of business ethics are reported. The appeal must be filed at the organisational unit of the insurance company where the breaches should arise.
Article 20 – TRACING STOLEN ITEMS
(1) In the event of theft and other forms of unlawful acquisition of insured items, the insurance company is obliged to reimburse for the loss only after 30 days from the day the disappearance was reported to the police.(2) If an insured person finds out in any way where the stolen items are, he/she must immediately take the necessary steps to determine the identitiy of the items, to receive them as soon as possible, and notify the insurance company thereof at once.
(3) If an insured person received a benefit prior to finding out where stolen items are, he/she may request them back if they are found. In so doing, he/she must return the benefit received for items which were found undamaged. If the items found are damaged, the insured person may request them back at an agreed value, and return a corresponding part of the benefit to the insurance company.
Article 21 – EXCLUSION FROM INSURANCE AND LOSS OF INSURANCE RIGHT
(1) The loss events are excluded from insurance, if they are:
1) caused by an insured person on purpose;
2) in direct relation to uprising, internal unrest, war or earthquake;
3) a result of a nuclear reaction, radiation or contamintion;
4) a result of active participation in races and other sports competitions, as well as in their preparations.
(2) An isured person looses insurance protection, if he/she causes an insurance event as a driver without a relevant driving licence, under the influence of alchohol, illegal drugs or other narcotics. It shall be considered that an insured person is under the influence of alcohol, if as a driver of a motor vehicle he/she has more than 0.5‰ of alcohol in blood, and in other insured risks more than 1‰.2) in direct relation to uprising, internal unrest, war or earthquake;
3) a result of a nuclear reaction, radiation or contamintion;
4) a result of active participation in races and other sports competitions, as well as in their preparations.
(3) The loss events excluded from travel insurance are also those which are stated in individual insured risks.
Article 22 – TERMINATION OF INSURANCE
An insured person may terminate the insurance at the business units of the insurance company or by registered mail, however, at latest by the time the insurance company's guarantee commences. In this case, the insurance company is obliged to refund the insurance premium in the amount of 80% of the paid insurance premium at the request of an insured person.Article 23 – CHANGES TO INSURANCE TERMS OR PREMIUM PRICELIST
(1) If the insurance company makes changes to the insurance terms or premium pricelist, it must notify the insured person of the changes at latest 60 days prior to the end of the insurance year.(2) A policyholder has a right to cancel the contract within 60 days after the receipt of notification. The contract shall cease to be valid after the end of the insurance year.
(3) If a policyholder does not cancel an insurance contract, it shall change in accordance with new insurance terms and premium pricelist at the beginning of the following year.
Article 24 – CHANGE OF ADDRESS
(1) A policyholder must notify the insurance company of changes to his/her name or residence, or the company or head office, within 15 days of the day of a change.(2) If a policyholder made changes to his/her name or residence, or the company or head office, and did not inform the insurance company thereof, it shall be sufficient that the insurance company sends the notification which must be communicated to the policyholder to his last known address or head office, or addresses it to the last known name or company.
Article 25 – METHOD OF NOTIFYING
(1) Agreements on the content of an insurance contract shall only apply, if they are concluded in writing.(2) All notifications and statements which should be given pursuant to the provisions of an insurance contract must be in writing.
(3) A notification or statement shall be considered in good time, if it has been sent by registered mail prior to the deadline.
(4) A statement which should be given to another person shall become valid only when he/she receives it.
Article 26 – APPLICATION OF LAW
The provisions of the Code of Obligations shall apply to the relation between a policyholder and insured person on the one hand and the insurance company on the other.Article 27 – JURISDICTION IN CASE OF DISPUTE
Disputes between a policyholder or insured person on the one hand and the insurance company on the other shall be resolved by the court with jurisdiction in the place of conclusion of an insurance contract, or by the Arbitration at Zavarovalnica Triglav under special agreement, or by the Mediation Centre at the Slovene Insurance Association under special agreement.