EXPATRIATE INSURANCE - Danish Refugee Council - Coordination SUD
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EXPATRIATE INSURANCE Danish Refugee Council (Bupa Denmark, filial af Bupa Global DAC, Irland) Valid from 2021
Contents 3 List of Reimbursements 8 Policy conditions 35 Bupa Global Privacy Notice 39 Glossary 2
List of Reimbursements
Please note that the List of Reimbursements is part of the policy conditions. It is therefore necessary to read both the List of Reimbursements and the policy conditions carefully.
Words written in italic in the List of Reimbursements and the policy conditions are "defined terms" which are specific terms relevant to your cover. Please check their meaning in the Glossary at the end of this product guide.
Valid from commencement date or policy renewal in 2021. All amounts are in DKK/EUR.
Expatriate Insurance
Business trips and vacation Insurance sum Art. 4
Expenses resulting from acute illness and injury during business trips and vacations max. 90 days, per trip Unlimited
Provisional pain-relieving dental treatment during business trips or vacations outside the country of expatriation Unlimited
Medical expenses and medical transportation Insurance sum Art. 5
Hospital, emergency room treatment, outpatient treatment, doctor and specialist Unlimited
Medically prescribed hotel accommodation and meals in connection with outpatient treatment Unlimited
Prescription medicine Unlimited
Screened blood Unlimited
Physiotherapist/Chiropractor/Reflexologist/Ergotherapy/Osteopath/Acupuncturist Unlimited
Crisis counselling/crisis psychologist if assessed necessary by the Company's medical consultant Unlimited
Telephone crisis counselling/crisis psychologist for relatives, if assessed necessary by the Company's medical consultant Unlimited
Medically prescribed treatment of mental disorders by a psychiatrist and during admission at a psychiatric department Unlimited
Medically prescribed treatment of mental disorders by a psychologist DKK 20,000/ EUR 2,700
Hospice DKK 100,000/ EUR 13,500
Medically prescripted home care DKK 40,000/ EUR 5,400
Terminal care in hospital Unlimited
Health check-ups and vaccinations in addition to the ordinary children's vaccination and health check-up programme, cf. Art. 5.1 DKK 5,000/ EUR 670
Spectacles and contact lenses DKK 1,000/ EUR 135
Hospital Cash Benefit. (cf.art. 5.b). DKK 400/EUR 50 per 24 hours at hospital for inpatient treatment. Max per
policy year DKK 800/EUR 100
3Expatriate Insurance (continued) Transport and catching up itinerary Insurance sum Art. 6 Medical transportation to an appropriate treatment facility in the event of serious illness or injury or treatment failure at the location Unlimited Repatriation in the event of death Unlimited Catching up itinerary in the event of illness. Transportation, hotel accommodation and meals will be covered if the documented scheduled itinerary cannot be kept Unlimited Next-of-kin accompaniment and compassionate emergency visit Insurance sum Art. 7 Next-of-kin accompaniment/compassionate emergency visits by max. three persons Unlimited Medical malpractice Insurance sum Art. 8 Compensation for permanent disablement occurred as a result DKK 1,000,000/EUR 135,000 of medical malpractice Pregnancy and childbirth Insurance sum Art. 9 Reasonable and necessary expenses for pregnancy and childbirth Unlimited Dental treatment Insurance sum Art. 10 Examination, tooth-cleaning, filling, root treatment, tooth extraction, pivots, bridges, gold inlay, crowns, occlusion bar, periodontitis treatment and dentures. 80 % of expenses up to DKK 15,000/EUR 2,000 Tooth adjustment up to the age of 18 Repatriation Insurance sum Art. 11 Repatriation — personal and business-related Unlimited Replacement employee Insurance sum Art. 12 Replacement employee DKK 50,000/EUR 6,750 4
Expatriate Insurance (continued)
Crisis package Insurance sum Art. 13
Evacuation in the event of war and impending war, terrorist acts, or epidemics and natural disasters Unlimited
Documented extra costs in connection with hotel accommodation, meals and local transportation DKK 1,500 / EUR 200 per insured per day
Crisis counselling/crisis psychologist if assessed necessary by the Company's medical consultant See policy conditions Art. 13.2
Telephone crisis counselling/crisis psychologist for relatives if assessed necessary by the Company's medical consultant See policy conditions Art. 13.2
Search and rescue services DKK 300,000 / EUR 40,000 per insured, however max.
DKK 600,000/ EUR 80,000 per incident
Compassionate emergency visit and home transportation, if the insured has been victim of hostage taking or kidnapping See policy conditions Art. 13.7
Flight delay and late arrival Insurance sum Art. 14
Flight delay of more than four hours, and late arrival DKK 35,000/EUR 4,725
Hotel accommodation, meals and local transportation Max. DKK 1,500/ EUR 200 per insured per day and max.
DKK 3,000/ EUR 400 per household per day
Replacement purchases in the event of more than 12-hour delay on a stopover DKK 500/ EUR 70 per insured per day
Delayed baggage Insurance sum Art. 15
Replacement purchase on at least three hours baggage delay DKK 5,000 / EUR 675
Baggage Insurance sum Art. 16
Baggage — theft, loss, damage, etc. DKK 100,000 / EUR 13,500
Deductible on contents insurance and car insurance DKK 15,000 / EUR 2,000 per loss
Household contents and Special household contents Insurance sum Art. 17
Compensation for household contents in the event of fire, damage caused by storms, burglary, theft, etc. DKK 100,000 / EUR 13,500
Special household contents are covered by up to 25 % of the insurance sum, however, a maximum of DKK 70,000/ EUR 10,000
5Expatriate Insurance (continued) Personal liability - Property damage Insurance sum Art. 18 Property damage including damage to a rented holiday home/ hotel and to contents of a rented home DKK 5,000,000 / EUR 675,000 Personal liability - Bodily injury Insurance sum Art. 18 Bodily injury - If the insured is held responsible for bodily injury to a person DKK 10,000,000 / EUR 1,350,000 Legal aid Insurance sum Art. 19 Legal aid DKK 130,000 / EUR 17,550 Security/bail Insurance sum Art. 20 Security/bail DKK 100,000 / EUR 13,500 Legal assistance Insurance sum Art. 20 Legal assistance DKK 50,000 / EUR 6,750 Fulltime accident — Death Insurance sum Art. 21 Death caused by an accident DKK 1,300,000 / EUR 175,500 Death caused by an accident — Children DKK 25,000/ EUR 3,500 Fulltime accident — Disability/dental treatment caused by an accident Insurance sum Art. 21 Disability (Permanent disability) and dental treatment caused by an accident DKK 2,600,000 / EUR 351,000 Chewing injury DKK 10,000 / EUR 1,400 6
Expatriate Insurance (continued) Fulltime accident — Assault Insurance sum Art. 22 Assault DKK 500,000 / EUR 67,500 Life insurance and disability due to illness - Death Insurance sum Art. 23 Death due to illness See policy schedule Life insurance and disability due to illness - Disability Insurance sum Art. 23 Permanent disability (due to illness including tropical dility diseases) See policy schedule 7
Policy conditions Valid from commencement date or policy renewal in 2021. In accordance with the Danish Insurance Contracts Act. This version is a translation from Danish. In the event of discrepancies or ambiguity between this translation and the Danish version, the Danish version shall prevail. Index Art. 1 Acceptance of the insurance Art. 2 Commencement date Art. 3 Where cover is provided Art. 4 Business trips and vacations Art. 5 Medical expenses Art. 6 Transport and catching up itinerary Art. 7 Next-of-kin accompaniment and compassionate emergency visit Art. 8 Medical malpractice Art. 9 Pregnancy and childbirth Art. 10 Dental treatment Art. 11 Compassionate emergency repatriation Art. 12 Replacement employee Art. 13 Crisis package Art. 14 Flight delay and late arrival Art. 15 Delayed baggage Art. 16 Baggage Art. 17 Household contents and Special household contents Art. 18 Personal liability — bodily injury and property damage Art. 19 Legal aid Art. 20 Security/bail and legal assistance Art. 21 Fulltime accident, Disability, Reduced working capacity and dental treatment caused by an accident Art. 22 Fulltime accident - Assault Art. 23 Life insurance and disability due to illness Art. 24 Reimbursement Art. 25 Exceptions for reimbursement Art. 26 Claim reporting Art. 27 Cover by third parties Art. 28 Premium payment Art. 29 Assignment, termination, cancellation and expiry Art. 30 Disputes, venue, etc Art. 31 Confidentiality Glossary Art. 1 Acceptance of the insurance 1.1 Who can take out insurance The insurance can be taken out and renewed by Skandinavian and Finnish companies (the policyholder) registered with the relevant authorities in a Scandinavian country and/or Finland with an invoice address in these countries. The Company may ask the applying company to submit documentation of its registration in Scandinavia or Finland. 8
The insurance shall cover the company's employees who are assigned to work abroad in the interest of the company and any accompanying family members (the insured) including children that do not live at home and accompanying resident assistants and who are named in the policy schedule. 1.2 Health and age Employees and their accompanying family members (the insured) can take out the insurance without having to submit any medical information and will be covered for pre-existing illnesses on the cover for medical expenses and medical transportation (Art. 5) and transport and catching up itinerary (Art. 6) as policyholder has chosen Medical History Disregarded – MHD terms. Please note that exceptions apply as stated in the policy conditions. In order for new-born and adopted children to be covered by the insurance with effect from the date of birth, the Company must receive a copy of the birth certificate no later than three months after the birth. If the Company receives the birth certificate later than three months after the birth, the new-born and adopted children will be covered with effect from the date the Company receives the birth certificate. 1.3 Company acceptance The Company determines whether the insurance can be accepted, and it is a condition for the Company's liability to take effect, that the application is approved by the Company and that the premium is paid on time to the Company. 1.4 Policy schedules and claims handling All underwriting and issuance of policy schedules are made from the Company's office in Copenhagen, Denmark. The Company may choose to have data processed in or outside the EU. Art. 2 Commencement date 2.1 Insurance period Commencement date, cover, insurance sums and insurance period are stated in the policy schedule. 2.2 Duration expatriation The maximum insurance period for expatriation shall be 72 months. However, upon prior agreement with the Company it might be possible to extend the insurance period. 2.3 Right to compensation The right to compensation shall take effect as from the commencement date. 2.4 Commencement of cover Enrolments will be effective from the date the notification is received at the earliest by Bupa Global. Art. 3 Where cover is provided 3.1 Area of coverage The insurance shall provide coverage during expatriation in the geographical area indicated by the policyholder to the Company and stated in the policy schedule. The geographical area is "Scandinavia and Finland", "Europe" or the entire world. "Scandinavia and Finland" includes Denmark, Sweden, Norway and Finland. "Europe" includes Albania, Algeria, Andorra, Austria, Azores, Belgium, Belarus, Bosnia-Herzegovina, Bulgaria, Canary Islands, Croatia, Cyprus, Czech Republic, Egypt, Estonia, Faroe Islands, Finland, France, Georgia, Germany, Gibraltar, Greece, Greenland, Hungary, Ireland, Iceland, Israel, Italy, Jordan, Kosovo, Latvia, Lebanon, Libya, Liechtenstein, Lithuania, Luxemburg, Macedonia, Madeira, Malta, Moldavia, Monaco, Montenegro, Morocco, Netherlands, Palestine, Poland, Portugal, Romania, Russia (until the Urals), San Marino, Scandinavia, Serbia, Slovakia, Slovenia, Spain, Switzerland, Syria, Tunisia, Turkey, Ukraine, United Kingdom Austria Vatican City State. 3.2 Residential address abroad The insured listed in the policy schedule shall all live and be registered at the same address in the country where the employee is expatriated, in order for the insurance to be valid. 3.3 Affordable Care Act The Company's global health insurance products are non-US insurance products and accordingly are not designed to meet the requirements of the US Patient Protection and Affordable Care Act (the Affordable Care Act). The Company's insurance products may not qualify as minimum essential coverage or meet the requirements of the individual mandate for the purposes of the Affordable Care Act, and the Company is unable to provide tax reporting on behalf of those US taxpayers and other persons who may be subject to it. The provisions of the Affordable Care Act are complex and whether or not the insured is subject to its requirements will depend on a number of factors. The insured should consult an independent professional financial or tax advisor for guidance. For customers whose coverage is provided under a group insurance, the insured should speak to the group health insurance administrator for more information. 9
Art. 4 Business trips and vacations 4.1 Business trips and vacations The insurance shall cover business trips and vacations worldwide, lasting no more than 90 days per trip. The travel insurance shall provide coverage from the moment the insured leaves his/her residence or workplace to begin his/her trip. The coverage shall cease when the insured returns to his/her residence or workplace or when the insurance period expires, if this occurs before the insured's return. The insurance provides unlimited cover for the insured's medical expenses in case of acute illness or accident during business or leisure trips worldwide. 4.2 Existing conditions Existing conditions, or conditions that were present before departure from the country of expatriation, are covered by the insurance to the extent that it could not be reasonably expected, that the condition would require treatment during the business or leisure trip. 4.3 Pregnancy During business trips and vacations the insurance shall cover the insured's medical expenses in case of any sudden and unforeseen illness and/or complication in connection with maternity before the 8th month (36th week) of pregnancy, however cf. Art. 25.1 d) 4.4 Temporary pain-stilling dental treatment when travelling Coverage is provided for temporary pain-stilling dental treatment, when the insured is travelling outside his/her country of expatriation, Coverage is subject to an original statement from the locally authorised dentist being submitted to the Company. The statement shall specify which part of the dental treatment is temporary and pain-stilling. The insurance shall not cover dental conditions that did not arise during the insured's travel and where dental treatment is not temporary, pain-stilling and can await the insured's arrival at home. Dentures and treatment as a result of a chewing injury or a dental injury is not included in this coverage. Art. 5 Medical expenses 5.1 Cover medical expenses The Company assesses and decides whether the expenses are reasonable and relevant to establish whether the insured suffers from an illness, is in need of treatment or check-up of treatment received. The insurance comprises the following services: a) treatment of somatic (physical) diseases during hospitalisation or as outpatient treatment, b) Hospital Cash benefit: the benefit applies when the insured has received eligible inpatient treatment for a covered medical condition at a public hospital/with no charge, c) organ transplant is covered per diagnosis and course of treatment, all inclusive max. DKK 1,000,000/EUR 140,000. Only transplant of human organs is covered, and both the transplant and the procurement of the organ must be pre-approved by the Company, d) expenses for treatment and accommodation when medically necessary hospitalisation, e) delivery of screened blood can take place in connection with planned surgeries where the Company's medical consultants estimate that the local blood has not been screened according to international standards. The screened blood will be transported and delivered to the place of treatment by a medical consultant approved by the Company. It is a condition that the local authorities allow the Company to bring the screened blood into the country. Furthermore, the Company must be notified at least 48 hours before the planned surgery, f) reasonable and necessary additional expenses for medically prescribed accommodation and meals are covered provided that treatment normally requiring hospitalisation can be carried out as outpatient treatment, g) reasonable and necessary accommodation expenses regarding outpatient treatment in a hospital is covered with the maximum of DKK 40,000/EUR 5,400 per person per insurance year, maximum daily rate of DKK 1,000/EUR 135. h) medically prescribed treatment of mental disorders by a psychologist, psychiatrist and during hospitalisation at a psychiatric department. The treatment must be pre-approved by the Company's medical consultants. 10
Treatment by a psychologist shall be covered to a maximum amount of DKK 20,000/EUR 2,700 per insured per policy year. i) physicians and specialists, j) crisis counselling/crisis psychologist, if assessed necessary by the Company's medical consultant. For treatment by a psychologist cover see Art. 5.1 h), k) telephone crisis counselling/crisis psychologist for relatives, if assessed necessary by the Company's medical consultant, l) speech therapist, m) prescription medicine. The Company shall cover a maximum of 3 months' expected consumption of eligible prescribed medicine per condition at the time, and only after the consumption of the purchased medicine, the Company will again cover for a maximum period of 3 months. However, the Company shall never cover an expected consumption after the end of the insurance period, n) medically necessary physiotherapy, ergotherapy, reflexology, chiropractic/osteopathic treatment, and/or acupuncture, o) medically necessary rehabilitation approved by the Company; cf. Art. 25.1.1 b, p) external orthopaedic aids, prostheses or other medical aids in connection with surgery for a period of up to four months after final treatment, in cases where the aids are ordered by a doctor and necessary for further improvement of surgery results or for preventing deterioration of surgical results, q) health check-ups and vaccinations are covered up to a max. of DKK 5,000/EUR 670 per insured per policy year. Furthermore, ordinary children's vaccinations and health check-ups are covered, cf. the current recommendation from the Danish National Board of Health or WHO (cf also art. 5.4), r) glasses and contact lenses are covered up to a max. of DKK 1,000/EUR 135 per insured per policy year. Sunglass lenses without prescription strength and frames are not covered, s) admission to a hospice to a maximum amount of DKK 100,000/EUR 13,500 for one course of illness. The admission should be recommended by the attending physician and must be approved in advance by the Company's medical consultants, t) reasonable and necessary expenses for medically prescribed home care by a nurse in the insured's own home up to maximum DKK 40,000/EUR 5,400 per insured per policy year. The treatment must be approved in advance by the Company's medical consultants, u) terminal care in hospital. For hospice see Art. 5.1 s). v) medical expenses in connection with HIV and AIDS (including prescription medicine, incl. tools for ingestion / injection of medicine) See Exceptions for reimbursement in Art. 25. 5.2 Quality of treatment The Company only approves treatment which takes place after methods approved by the public health authorities in the country where treatment takes place. It is also a condition that there schould be a likely possibility that the treatment substantially and long-term can cure the illness or injury, or substantially and long-term can improve the health after the illness or injury. Physicians, specialists, dentists, etc. performing treatment must have authorisation in the country of practise. 5.3 Special conditions for physiotherapy, ergotherapy, reflexology, chiropractic/osteopathic treatment and acupuncture The Company's liability to pay compensation is conditional upon the Company receiving an original certificate from both the local general practitioner and the attending physiotherapist, ergotherapist, reflexologist, chiropractor, osteopath or acupuncturist. All treatment must be given by an approved therapist within each form of treatment. 5.4 General health check up 11
5.4.1 Health check-up after expatriation The insurance has been extended to cover one health check-up within the first month, beginning from the first day after the end of the expatriation period, and after permanent return to the home country, with the purpose of clarifying if the insured has contracted any diseases during the expatriation. The insurance covers max. DKK 3,750/EUR 500 per person, including the expatriated employee and any accompanying family memebers. Furthermore, the insurance has been extended to cover treatment of the diseases that the above mentioned health check-up may detect, for up to 3 months, counting from the first day after the end of the expatriation period, and on the condition that the return to the home country is permanent. The insurance covers max. DKK 375,000/EUR 50,000 per person for the whole period of 3 months. Any treatment of detected diseases must be pre-approved by the Company's medical consultants before treatment can take place. Exceptions to cover: a) If the insured is covered for health check-ups and/or treatment in the social security system of the home country, or other public or private medical insurance, or similar. b) Treatment in a private system, including private hospitals, if the possibility of treatment in a public system exists. This despite the fact that there might be waiting periods for treatment in the public system. c) Transportation expenses to and from treatment is not covered by the insurance. d) If the insured is a resident of an EU/EEA country, cover is not provided for treatment outside the EU/EEA. e) Cover is not provided for treatment of diseases and conditions which occurred, and/or for which symptoms have been present, before the start of the expatriation period, regardless if these have worsened during the period of expatriation. f) If the group agreement for expatriation for the Organization is terminated, the cover ends as per the agreement expiry date, even if the period of 1 or 3 months respectively, has not passed since the end of expatriation of the insured. Art. 6 Transport and catching up itinerary 6.1 Cover medical evacuation The Company shall cover all reasonable expenses incurred for the insured's medical evacuation to nearest centre where treatment is available or to the Home country determined by the Company, including ambulance transportation in case of: a) acute illness or b) serious injury or c) treatment failure at the location. The insurance shall cover only one medical evacuation in connection with one course of illness/injury/treatment failure. Transport expenses will only be covered if the illness or injury is covered by the insurance. Reimbursable expenses include transportation costs, reasonable and necessary expenses for accommodation and meals. If the insured uses his/her own car, the transport costs to and from the place of treatment by the shortest route are covered up to a maximum of DKK 1.50/EUR 0.20 per km. 6.1.1 Company rights in the event of transport for treatment The Company is entitled to demand repatriation of the insured for treatment in the country of expatriation or the home country and delay treatment until the insured's return. Furthermore, the Company is entitled to demand that the insured be transferred to another suitable place of treatment. The Company's medical consultant, perhaps in consultation with the attending physician, decides whether the transport is necessary and/or safe. 6.2 Transport in connection with necessary hospitalisation Transport to a hospital is covered with a maximum amount of DKK 40,000/EUR 5.400 per person per policy year provided that it is reasonable, necessary and safe and has been pre-approved by the Company's medical consultant, perhaps in consultation with the attending physician. It is a condition that the treatment is covered by the insurance cover for medical expenses. 6.3 Repatriation and statutory arrangements on death In the event of death, reasonable and necessary expenses for home transportation of the deceased and for statutory arrangements, such as embalming and a zinc coffin, shall be reimbursed. The next-of-kin have the following options: 12
a) cremation of the deceased and home transportation of the urn or b) home transportation of the deceased or c) funeral in the country of expatriation. 6.4 Catching up itinerary The Company shall provide coverage for the expenses of obtaining an itinerary if the insured's trip has begun and the documented scheduled itinerary cannot be kept. Coverage is subject to the delay being due to an illness or injury and the attending physician having prescribed bed confinement, hospital care or emergency outpatient treatment. Reimbursable expenses include an aeroplane ticket (business class), expenses for reasonable and necessary accommodation and meals while catching up on the scheduled and documented itinerary. 6.5 Delays or restrictions The Company cannot be held liable for any delays or restrictions in connection with the transportation caused by weather conditions, mechanical problems, restrictions imposed by public authorities or the pilot or any other condition beyond the control of the Company. Art. 7 Next-of-kin accompaniment and compassionate emergency visit 7.1 Conditions for next-of-kin accompaniment and compassionate emergency visit The Company shall provide coverage for next-of-kin accompaniment and compassionate emergency visit, if the insured dies, is hospitalised or evacuated as a result of serious injury or acute serious illness. Expenses for next-of-kin accompaniment or compassionate emergency visit will only be covered if the illness or injury is covered by the insurance. Compassionate emergency visit Coverage is provided when, in the opinion of the attending physician and the Company's medical consultant, the insured is to be hospitalised for at least three consecutive days, or the condition of the insured is life threatening. The insurance shall cover only one compassionate emergency visit in connection with one course of illness. Coverage for compassionate emergency visit shall cease when the insured is discharged from hospital. Next-of-kin accompaniment Next-of-kin accompaniment is not dependent on the length of a hospital stay, or that the condition of the insured is life-threatening. 7.2 Number of accompanying persons and/or persons on compassionate emergency visit The insured may choose a maximum of three persons to accompany him/her. The compassionate emergency visits shall be made from the insured's country of expatriation or home country. 7.3 Children Co-insured children under the age of 18 are always entitled to cover under next-of-kin accompaniment provided that the child's parents or all of the child's travelling companions have become accompanying persons due to a covered injury. 7.4 Covered expenses Coverage is provided for the maximum of three accompanying person's return flight, only one trip per person (business class max.) and reasonable and necessary expenses for accommodation, meals and local transportation. Art. 8 Medical malpractice 8.1 Cover medical malpractice The insurance includes cover for compensation due to medical malpractice where an authorised physician carries out suboptimum treatment compared to the normal standard of care in the country where treatment is provided. Coverage is limited to treatment during admission or out-patient treatment, which entitles the insured to compensation according to the Danish law of Liability for Damages Act and article 3 in Danish "Lov om klage og erstatningsadgang indenfor Sundhedsvæsenets." It is a condition that the treatment is covered by the insurance cover for medical expenses, that it is pre-approved by the Company and that the treatment has taken place at a medical facility referred to by the Company. 13
Expenses covered by the insurance: Compensation for permanent disablement which has occurred as a direct consequence of the medical malpractice. The compensation consists of the difference between the disablement in question and the disablement that would have occurred even after correct medical treatment, 8.2 Exceptions The insurance does not cover: a) medical malpractice conducted by other medical staff than trained and on location authorised physicians, b) permanent disablement occurring as a direct and expected consequence of illness or injury, c) if the insured has accepted the treatment even if The Company has warned the insured that the treatment offered does not fulfil the requirements for acknowledged, authorised principles for treatment, which have been approved by the Company, d) compensation for failure or malfunction of technical equipment etc., e) compensation if the damage from a subsequent assessment could have been avoided by using another available type of treatment or process which, from a medical point of view, would have been just as effective in treating the patient's disease, f) compensation if damage occurs, as a result of the investigation, including diagnostic interventions or treatment in the form of infections or other complications that are more comprehensive than what the patient should reasonably tolerate. Hereby, both the severity of the damage and the patient's sickness and general health must be taken into account. Also the rarity of the damage and the possibilities for taking into account the risk of it occurring, g) compensation for treatment that has not been pre-approved by the Company and/or where the Company has not referred to a medical facility. Art. 9 Pregnancy and childbirth 9.1 Covered expenses for pregnancy and childbirth The Company shall cover reasonable and necessary expenses for pregnancy and childbirth. The insurance shall not provide coverage for any form of fertility test/treatment, including hormone treatment, insemination or other related treatments. 9.2 Waiting period pregnancy examinations The right to reimbursement for outpatient pregnancy examinations shall take effect four weeks after commencement date of the coverage. 9.3 Waiting period delivery and postnatal check-ups The right to reimbursement for expenses in connection with delivery and postnatal check-ups shall be covered 10 months after commencement date of the coverage. 9.4 Coverage new born children Children born no sooner than 10 months after the commencement date of the mother's pregnancy cover are covered for medical expenses up to DKK 1,5 mil/ EUR 195,000 in the country of expatriation in the first month, regardless of the child's state of health. 9.5 Transportation in connection with childbirth The insurance covers expenses for one transportation of the insured pregnant person in connection with one course of childbirth from the country of expatriation to the home country and return to the country of expatriation. Though transport expenses will only be covered if the childbirth is covered by the insurance and the transportation must be preapproved by the Company. This cover only applies for the pregnant insured. Art. 10 Dental treatment 10.1 Covered dental treatment The Company shall reimburse the following treatments up to the annual limit stated in the List of Reimbursements: 14
a) examination, tooth-cleaning, filling, root treatment, tooth extraction, pivots, bridges, gold inlay, crowns, occlusion bar, periodontitis treatment and dentures. b) tooth adjustment up to the age of 18. 10.2 Waiting period dental cover The right to reimbursement shall take effect three months after commencement of the coverage, however, dental examinations and tooth cleaning shall be covered four weeks after the commencement aand temporary pain-stilling dental treatment in the country of expatriation is covered from the commencement of the coverage. Treatment needs arising before commencement of cover or before the expiry of the waiting period are not covered by the insurance. 10.3 The dentist's assessment of the insured's dental health The Company has the right to reduce or omit reimbursement of expenses for dental treatment and adjustment if the insured's teeth based on a dentist's assessment are in a much worse state than with people of the same age, who attend regular examinations and undergo recommended treatment in this connection. Art. 11 Compassionate emergency repatriation 11.1 Conditions for compassionate emergency repatriation Coverage is provided upon prior approval by the Company if the covered trip has to be interrupted for one of the following reasons: a) a member of the immediate family in the insured's home country or country of expatriation dies after the insured's departure or becomes seriously and acutely ill or is seriously injured and subsequently hospitalised or suffers a life- threatening acute deterioration of an existing condition, b) burglary, fire or flooding of the insured's private dwelling or in his/her business if a police report or other similar documentation is available and the presence of the insured is required, c) fraud in the business by an employee, if a police report or other documentation is available and the presence of the insured is required, d) strikes in contravention of collective agreements or bankruptcy of the business requiring the presence of the insured. The insurance shall cover only one repatriation in connection with one event, including one course of an illness. Repatriation shall only be covered if the time of return is more than 12 hours earlier than the insured's scheduled time of return. No reimbursement is paid if the member of the immediate family who is the reason for the repatriation is an accompanying traveller who was repatriated at an earlier stage of the trip. If the insured does not reside permanently in the same country as the member of the immediate family who is the reason for the repatriation the insurance shall cover reasonable and necessary transport costs in connection with the repatriation that are equivalent to the transport costs to the insured's country of expatriation. 11.2 Travelling companion The insured may choose one person as his/her travelling companion. Repatriation shall be carried out from the place of sojourn of the insured. 11.3 Children Co-insured children under the age of 18 are entitled to cover under compassionate emergency repatriation provided that the child's parents or all of the child's travelling companions are compassionate emergency repatriated due to a covered injury. 11.4 Covered additional expenses Additional expenses for aeroplane tickets to home country or the country of expatriation in the same class category as the outward journey are covered (max. business class), and so are reasonable and necessary extra travel expenses incurred by the insured and travelling companion in connection with curtailment of a covered trip. Expenses for hotel accommodation, meals and local transport while staying in the home country shall not be covered by the insurance. Furthermore, coverage is provided for a return journey to the point of departure of repatriation if the insured at the time of repatriation had at least one month left of the scheduled duration of the original journey. The return journey must be effected no later than four weeks after repatriation. 15
11.5 Travelling by motor vehicle in Europe If travelling by a motor vehicle, the insured may use other means of transportation if agreed with the Company. In that event, the insurance shall also cover the expenses of returning the vehicle. 11.6 Company pre-approval Emergency repatriation shall only be covered if pre-approved by the Company. Art. 12 Replacement employee 12.1 Covered replacement employee Benefits shall be payable if the insured cannot carry out the purpose of the trip as a result of one or more of the following events: a) the insured is hospitalised or the attending physician has prescribed bed confinement for at least four consecutive days on account of covered acute illness or injury, or b) the insured is medically evacuated due to a covered illness/injury, or c) the insured interrupts his/her pre-arranged travel itinerary to return home due to covered repatriation, or d) the insured accompanies a co-insured travelling companion due to a covered illness/injury, e) the insured dies. 12.2 Covered additional expenses Additional expenses for the replacement employee's return aeroplane ticket one time (max. business class), hotel accommodation, meals and local transportation are covered. The insurance cover a maximum of one replacement employee per incident/illness/injury. Art. 13 Crisis package 13.1 Evacuation The insurance provides cover for evacuation in case of: a) epidemics in the region where the insured is staying, if the Ministry of Foreign Affairs of Denmark, the Danish embassy or a similar institution recommends evacuation, b) war, invasion, acts of a foreign enemy, hostilities (whether war has been declared or not), civil war, terrorist acts, rebellion, revolution, insurrection, civil commotion, military or usurped power, martial law, riots or the acts of any lawfully constituted authority, or army, naval or air services operations (whether war has been declared or not), in the region where the insured is staying, if the Ministry of Foreign Affairs of Denmark, the Danish embassy or a similar institution recommends evacuation, and has arisen after the insured left for the region, c) natural disasters provided that the Ministry of Foreign Affairs of Denmark, a Danish embassy or a similar institution recommends evacuation. 13.2 Covered additional expenses The insurance provides cover for: a) Transportation to the nearest safe destination, the home country or to the country of expatriation, and a maximum amount of DKK 1,500/EUR 200 per day for documented additional expenses for accommodation, meals and local transportation per evacuation/repatriation per person. Furthermore the insurance shall cover reasonable expenses for the purchase of essential items of clothing with a maximum of DKK 5,000/EUR 670 per person. The Company shall determine if the insured is to be evacuated to the nearest safe destination, the home country or to the country of expatriation. In the event that the insured is evacuated to the nearest safe estination, documented necessary additional expenses in connection with the return journey to the home country or the country of expatriation shall be covered. b) Crisis counselling/crisis psychologist when the Company's medical consultant determines that crisis counselling should be initiated on the basis of the circumstances pertaining to the reason for the evacuation. c) Telephone crisis counselling/crisis psychologist for relatives, if assessed necessary by the Company's medical consultant. 16
13.3 Special aspects in the event of war or impending war If the insured is detained by the authorities in a country due to war or impending war, the insurance shall provide coverage for up to three months for reasonable and documented extra expenses for accommodation and meals, plus the costs of necessary domestic transportation. 13.4 Search and rescue The insurance provides cover for search and rescue. The insurance provides cover for expenses in connection with a search for up to 14 days and for rescue/recovery when the insured's location has been determined. The insurance sum amounts to DKK 300,000/EUR 40,000 per person. However, the insurance sum amounts to a maximum of DKK 600,000/EUR 80,000 per incident per policy. It is a condition for compensation: a) that the insured has been reported missing for at least 24 hours to the police or other public authority, b) that the insured has been seen within 120 hours before the notification, c) that the local authorities require payment or guarantee of payment before a search is being initiated, and d) that the Company pre-approves the parties in charge of the search and rescue and the scope. 13.5 Exceptions The insurance does not cover expenses related to search or rescue: a) in connection with kidnapping or hijacking, b) which the Company would not have had if the Company had arranged the search or rescue, c) in cases where public authorities provide cover for such expenses for individuals who do not have this cover, d) in cases where the search has been initiated by relatives because the insured has omitted to inform where the insured is or because the relatives or other persons want to get in contact with the insured, regardless of the reason. 13.6 Reporting missing person When the insured has been reported missing, this must be notified immediately to the Company. The Company cooperates with its international network in the area in question and the Ministry of Foreign Affairs of Denmark and approves the parties in charge of the search. 13.7 Hostage taking and kidnapping When preapproved by the Company's the insurance provides cover for the following, if the insured has been the victim of hostage taking and/or kidnapping a) Reasonable and necessary expenses for home transportation of the insured to the country of expatriation or home country after release. b) Reasonable and necessary expenses for local transportation, meals and hotel accommodation in the period from the time release until the insured is able to return home. c) Compassionate emergency visit of maximum three persons, if the insured is admitted to hospital after release. Coverage is provided when, in the opinion of the attending physician and the Company's medical consultant, the insured is to be hospitalised for at least three consecutive days. The compassionate emergency visits shall be made from the insured's country of expatriation and/or home country. Coverage for compassionate emergency visit shall cease when the insured is discharged from hospital. Coverage is provided for the accompanying persons' return flight tickets one time, (business class max.) and reasonable and necessary expenses for accommodation, meals and local transportation. 13.8 Exceptions The insurance does not cover: 17
a) Expenses related to ransom. b) Expenses related to investigation of a hostage taking/kidnapping. 13.9 Ministry of Foreign Affairs of Denmark recommendations Coverage is subject to the insured not previously having neglected to follow an evacuation recommendation from the Ministry of Foreign Affairs of Denmark. 13.10 Company liability The Company cannot be held liable for the extent to which transportation/search/rescue can be carried out may be carried out, but will cooperate with the Ministry of Foreign Affairs of Denmark, the Danish embassy or a similar institution, in such cases where assistance is necessary. Art. 14 Flight delay and late arrival 14.1 Covered flight delay and late arrival The insurance shall provide cover: a) in case of delays of more than four hours of a booked flight, in case of flight cancellations or in case of overbooking which results in the insured not getting on a booked flight, or b) in case the insured unforeseeably and through no fault of his/her own arrives late to a public means of transportation or a means of transportation arranged by the travel agent and subsequently must catch up on his/her planned itinerary For the tickets to be covered, it is a condition that the means of transportation have been booked and paid at least 24 hours before departure. The insurance shall not provide cover if the late arrival is due to a connecting flight not having allowed for the official minimum transit time. 14.2 Covered additional expenses The insurance shall provide compensation for documented, necessary and reasonable additional expenses for hotel accommodation up to DKK 1,500/EUR 200 per insured, though max. DKK 3,000/EUR 400 per day, per household. The insurance shall provide compensation for documented, necessary and reasonable additional expenses for local transportation and meals up to DKK 500/ EUR 70 per insured per day. The insurance shall also provide compensation for an aeroplane ticket (max. business class). Additional expenses shall only be covered if they are not covered by the carrier or by another party. The insurance sum amounts to the maximum compensation per trip per family. 14.3 Additional expenses covered in connection with stopovers In the event of a delay in connection with a stopover during which the insured at no point has access to checked baggage, in addition to the coverage described in Art. 14.2, the insurance shall cover documented, necessary and reasonable additional expenses for articles of clothing, toiletries and vital medicines. Coverage requires that the delay lasts a minimum of 12 hours. The insurance coverage is up to DKK 500/EUR 70 per day per insured. Art. 15 Delayed baggage 15.1 Covered replacement purchases The insurance shall cover reasonable expenses for the purchase of essential items of clothing, toiletries and essential medicine and perambulator/stroller in cases where registered baggage (proof must be submitted) is delayed for more than three hours after the estimated time of arrival at the destination outside the country of expatriation, on the first journey to the country of expatriation, and on the return journey to the home country after the end of expatriation. The insurance sum amounts to the maximum compensation per claim. This benefit will be provided only if: a) the insured provides an original claims report from the carrier. 18
We recommend that the delay is reported to the arrival service at the airport immediately upon arrival at the destination. They will prepare and issue the claims report to you.
b) the compensatory purchases were made before the baggage was returned to the insured,
c) the original documentation of the expenses defrayed in the form of dated receipts, vouchers or the like, where it clearly is indicated what the defrayed expenses concern, is submitted to the Company, and
d) the insured's baggage has been checked in at the same carrier as the insured.
15.2 Exceptions
The insurance shall not cover rental/purchase of sports equipment. In addition, indirect losses, e.g. expenses for taxi, hotel and telephone, are not covered.
15.3 Cover upon arrival in country of expatriation
Coverage is not provided upon the insured's arrival in the country of expatriation, unless baggage has been delayed for more than 48 hours and the insured needs to embark upon a new journey abroad within 72 hours after expected
arrival home. The new journey must have been booked prior to the delay.
Art. 16 Baggage
16.1 Covered baggage
The following items belonging to the insured or the policyholder will be covered on his/her travel outside his/her country of expatriation.
Baggage, electronic equipment, cash, tickets, credit cards, securities and passports.
Photo equipment, video equipment, computer equipment, mobile phones and other electronic equipment, jewellery and watches, as well as keys to a private all-year residence, are only covered if they are brought as hand luggage.
The total maximum reimbursement for photo equipment amounts to DKK 15,000/EUR 2,100 and the total maximum reimbursement for jewellery amounts to DKK 15,000/EUR 2,100. PC equipment is covered at 50 % of the amount
insured, max. DKK 15,000/EUR 2,100. The insurance sum amounts to the maximum compensation per claim.
16.2 Limitations
As described in the following table, the following limits apply:
Cause / Item Baggage and electronic equipment Cash, tickets and securities
1 Fire, theft, theft from a locked hotel room, a locked home abroad or a locked safety box Up to the sum insured Replacement of keys and 10 % of the sum insured
locks for the insured's private all-year residence,
up to DKK 1,500/EUR 200
2 Theft, observed when being committed, of valuables carried on or by the insured Up to the sum insured Replacement of keys and 10 % of the sum insured
locks for the insured's private all-year residence,
up to DKK 1,500/EUR 200
3 Theft from a boot or locker separate from the passenger compartment of a locked boat or motor vehicle Up to the sum insured 10 % of the sum insured
Replacement of keys and locks for the insured's
private all-year residence, up to DKK 1,500/EUR
200
4 Loss of registered baggage (proof must be submitted) Up to the sum insured (electronic equipment, Not covered
however, not covered)
5 Damage to registered baggage (proof must be submitted) Up to the sum insured (electronic equipment, Not covered
however, not covered)
19Art. 16 Baggage (continued)
Cause / Item Baggage and electronic equipment Cash, tickets and securities
6 Theft from the passenger compartment of a locked boat or motor vehicle Not covered Not covered
7 Forgotten, lost or mislaid items Not covered Not covered
8 Theft of baggage left without effective supervision Not covered Not covered
9 Theft from motor vehicle, boat, trailer, hotel room, home or safety box that bear no visible signs of forced entry Not covered Not covered
10 Damaged to baggage caused by food, bottles, glass, etc. packed in insured's own baggage Not covered Not covered
11 Loss in connection with abuse of credit card or traveller's cheques Not covered Not covered
12 Loss of or damage to baggage freighted separately Not covered Not covered
13 Indirect loss Not covered Not covered
14 Simple theft Not covered Not covered
However, In case of simple theft of luggage which However, In case of simple theft of luggage which
is left standing next to/behind the insured, the is left standing next to/behind the insured, the
insurance covers up to the sum of DKK 5,000/EUR insurance covers up to the sum of DKK 5,000/EUR
670. 670.
15 Minor damage to the exterior of baggage (scratches, stains, dents) Not covered Not covered
Exceptions for cover:
a) Baggage and electronic equipment of any nature for commercial use, including travellers samples, dealers stock and collections.
b) Bicycles, sports equipment and accessories for such items.
c) items that cannot be documented and where it is customary that the insured can document their loss.
16.3 Calculation of compensation
Compensation for the insured's lost or damaged valuables is calculated according to the following principles:
a) the insurance shall cover the replacement cost of comparable new items if the lost/damaged items are less than two years old (proof must be provided),
b) for items more than two years old, purchased second-hand or already damaged, compensation will be fixed at the replacement cost of comparable new items less a fair deduction for deterioration due to age, wear and tear,
reduced usability or any other circumstance. This also applies to items for which no documentation of age and value can be provided,
c) the Company may choose to have damaged items repaired or pay an amount corresponding to the costs of repair,
d) the Company is entitled, but not obliged to provide compensation in kind,
e) coverage for film and video recordings and the like is limited to the cost of the raw materials,
f) the insurance shall cover the costs of replacing tickets, credit cards, securities and passports. The costs include necessary transportation charges, fees, photos, etc., but not compensation for the time involved in replacing the items.
The Company shall only be liable to pay compensation if the insured items are handled and stored safely, and if the insured exercises due care. Not exercising due care means for example leaving baggage
unsupervised in a public place to which the public has access
in any place where it can be taken without insured's knowledge
in such a distance that insured is unable to prevent it being taken
2016.4 Reporting
Any theft or robbery must be reported to the nearest police authority. Loss of or damage to registered baggage (proof must be submitted) must be reported to the airline company or the like. If, in exceptional circumstances, it is not
possible to notify the relevant local authority, e.g. due to imminent departure, such notification must be made to the Company as soon as possible upon the insured's return home. Copy of the police report, airline report or the like
must be submitted to the Company at the latest together with the claim.
16.5 Deductible on contents insurance and car insurance
While travelling outside the country of expatriation, the insurance covers the deductible that affects the insured in the event of reimbursable damage according to the insured's contents, house or car insurance terms.
The damaged car must be a private passenger car belonging to the insured or the household and must have been brought along on the business trip. Reimbursement is even given for the deductible that affects the insured in the
event of reimbursable damage to a private short-time rented, insured passenger car hired by the insured, which has been used for or been parked unused due to an official business trip. The damage must first be dealt with by the
insurance provider according to the insured's contents/house or car insurance terms. The highest reimbursement amount is DKK 15,000/ EUR 2,000 per loss.
Art. 17 Household contents and Special household contents
17.1 Covered household contents
The insurance will cover ordinary private household contents and special household contents owned by the persons stated in the policy schedule, plus contents for which they bear the risk. Cover is restricted to the country of
expatriation.
17.2 Ordinary household contents
Ordinary private household contents comprises private belongings, including all usual contents of a private home, unless mentioned separately in Art. 17.3 or excluded in the cover chart.
17.3 Special household contents
Special household contents are defined as antiques, works of art, paintings, genuine carpets and rugs, musical instruments, fur coats, gold, silver, platinum, pearls, precious stones, jewellery and watches. Special household contents
are covered by up to 25 % of the insurance sum, however, a maximum of DKK 70,000/EUR 10,000 per policy year applies.
As described in the cover chart, the following limits apply:
All amounts ar in DKK/EUR
Cause / Item Ordinary household contents Special household contents
1 Fire, including damage caused by heat, smoke, soot or measures used in connection with extinguishing a fire Up to the sum insured 25 % of the sum insured, max. DKK 70,000/EUR 10,000 per policy year
2 Damage by fire that cannot be classified as an uncontained fire Not covered Not covered
3 Damage to items exposed to fire or heat in order to be heated, cooked, ironed, dried or the like, and thereby Not covered Not covered
catch fire or are damaged as a result of this
4 Damage to electrical machinery, wires, cables, equipment, including radio and TV sets and the like caused by Not covered Not covered
a hot circuit or any other purely electrical phenomenon – including induction caused by electric storms – which
do not result in fire
5 Damage caused by explosion and direct strikes of lightning Up to the sum insured 25 % of the sum insured, max. DKK 70,000/EUR 10,000 per policy year
6 Damage caused by air crashes or falling debris from an aircraft Up to the sum insured 25 % of the sum insured, max.
DKK 70,000 / EUR 10,000 per policy year
7 Damage caused by explosives carried by an aircraft Not covered Not covered
8 Damage caused by water, oil, radiator coolants or the like suddenly escaping from installations, aquaria or Up to the sum insured 25 % of the sum insured, max. DKK 70,000/EUR 10,000 per policy year
other containers with a capacity of 20 litres or more (i.e. not seeping and dripping)
21Art. 17 Household contents and Special household contents (continued)
Cause / Item Ordinary household contents Special household contents
9 Damage from gutters and downspouts or damage caused by rising groundwater or sewage Not covered Not covered
10 Damage incurred when filling oil tanks or other containers Not covered Not covered
11 Damage due to building and repair work Not covered Not covered
12 Damage caused by frost bursts in an inadequately heated building, unless caused by temporary failure of the Not covered Not covered
heating supply
13 Damage caused by storms, including loss or damage caused by rain if the building where the insured items Up to the sum insured 25 % of the sum insured, max. DKK 70,000/EUR 10,000 per policy year
are kept is also damaged by a storm
14 Reasonable expenses for damage incurred by salvaging and preserving the insured items Beyond sum insured Beyond sum insured
15 Burglary and vandalism Up to the sum insured, cash max. DKK 2,000/EUR 280 25 % of the sum insured, max.
Replacement of keys and locks at the insured's residence, maximum DKK DKK 70,000/EUR 10,000 per policy year.
1,500/EUR 200
16 Theft from a home where the burglar has gained access through open or unfastened windows, unclosed and Not covered Not covered
unlocked doors showing no visible signs of forced entry
17 Theft where access is obtained by means of a correct or a false key Not covered Not covered
17 Theft where access is obtained by means of a correct or a false key Not covered Not covered
18 Simple theft Not covered Not covered
19 Theft from a home that has been unoccupied for more than 2 months Not covered Not covered
20 Theft from a locked luggage compartment or box separate from the passenger compartment of a motor Max. 10 % of the sum insured Not covered
vehicle
21 Theft from a locked luggage compartment or box separate from the passenger compartment of a motor Not covered Not covered
vehicle with no visible signs of forced entry
22 Robbery and theft, observed when being committed, of valuables carried on or by the insured Max. 10 % of the sum insured. Cash: max. DKK 2,000/EUR 280 Max. 10 % of the sum insured. Cash: max. DKK 2,000/EUR 280.
Replacement of keys and locks at the insured's residence, maximum DKK
1,500/EUR 200
23 Theft of bicycles which are carefully locked Max. 10 % of the sum insured Not covered
24 Motor vehicles (including mopeds), motorised garden implements of more than 5 HP, caravans, aircrafts and Not covered Not covered
boats as well as spare parts and accessories
25 Cash, money substitutes and securities, see item 22 Not covered Not covered
26 Coins and stamp collections Not covered Not covered
27 Special household contents stored in lofts, cellars, outhouses and garages Not covered Not covered
28 Forgotten, lost, mislaid or left items Not covered Not covered
29 Indirect loss Not covered Not covered
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