http___www.travelhorizont.com_termsandconditions_travel-insurance-terms.aspx_set-lang_hr_1.xml
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Allianz Zagreb d.d. Travel Insurance Package Terms and Conditions Introductory provisions The Terms and Conditions for the Travel Insurance Package are an integral part of the Contract concerning travel health insurance, travel accident insurance, liability insurance, luggage insurance and travel cancellation insurance concluded between the Policyholder and Allianz Zagreb d.d. In these Terms and Conditions, the following terms are taken to have the following meaning: 1) Insurer - Allianz Zagreb d.d., the insurance company with whom the Policyholder has entered into an insurance contract; 2) Policyholder - the person who has entered into an insurance contract with the Insurer and may be a natural person or a legal person; 3) Insured - the person to whom the insurance relates and may be a natural person only; 4) Beneficiary - the person to whom the sum insured or indemnity is paid in accordance with the insurance contract. In the case of death of the Insured, the beneficiaries of the insurance shall be the legal heirs of the Insured. Pursuant to the insurance contract the beneficiary of the remaining contracted coverage shall be the Insured himself/herself; 5) Third party - the person who is not the subject of the insurance contract, i.e. the person whose liability is not covered by the insurance; 6) Sum insured - the maximum amount of the Insurer's liability per single insured event; 7) Premium - the amount that the Policyholder shall pay to the Insurer under the provisions of this insurance contract; 8) Policy - the document representing the insurance contract; 9) Luggage - all items for personal use during a trip, including gifts and travel souvenirs; 10) Amateur athletes - persons who do not pursue sport as their main activity. However, they are registered members of a sports organisation at which they train and for which they compete. Any compensation they may receive on the basis of their membership does not represent their regular income; 11) Professional athletes - persons who engage in sport as their primary activity (training, participation in competitions). The compensation they receive constitutes their regular income. General provisions Conclusion of the insurance contract Article 1 (1) An insurance contract is concluded on the basis of a written policy, exclusively prior to the commencement of a trip. (2) Travel cancellation insurance may be concluded only at the time of the conclusion of the contract concerning the travel arrangement. Where travel cancellation insurance is not agreed upon at the time of the conclusion of the travel contract, the Insurer shall not be liable for the payment of indemnity. (3) An insurance contract is considered concluded upon the Policyholder's payment of the insurance premium. Commencement and validity period of the insurance contract Article 2 (1) The Insurer's liability commences at 00:00 hours on the day which is specified in the policy as the insurance commencement date, provided that the insurance premium has been paid in full by that time, and expires at 24:00 hours on the day which is specified in the policy as the insurance expiration date. (2) Travel cancellation insurance: The Insurer's liability commences at 24:00 hours on the day which is specified in the policy as the date of the insurance contract conclusion, provided that the insurance premium has been paid in full by that time, and expires at 24:00 hours on the day 50% of the planned trip duration of the Insured has passed. (3) Annual travel insurance: If annual travel insurance has been agreed upon, the insurance period shall be exclusively one year, subject to a maximum duration of a single trip of 28 days. The Insurer's liability commences at 24:00 hours on the day which is specified in the policy as the insurance commencement date, provided that the insurance premium has been paid in full by that time, and expires at 24:00 hours on the day which is specified in the policy as the insurance expiration date. Sum insured Article 3 (1) The Insurer shall per a single insured event be liable up to the limit of the sum insured reduced by the agreed-upon franchise deductibles. (2) The sum insured is agreed upon and stipulated in euros. (3) The Insurer shall pay the indemnity in HRK equivalent of the amount in EUR at the medium exchange rate quoted by the Croatian National Bank on the day when the loss is calculated. Jurisdiction Article 4 Any issues arising from the interpretation of these Terms and Conditions and the insurance policy shall be governed by the law of the Republic of Croatia. The settlement of disputes out of court and the processing of complaints Article 5 (1) The parties will seek to settle any disputes arising from the insurance relationship by amicable agreement. (2) The Policyholder, the Insured and the Beneficiary of the insurance are obliged to inform the Insurer of any matters of dispute, complaints or misunderstandings arising from the insurance relationship without delay. (3) The parties shall communicate the information referred to in the previous paragraph of this Article in writing in such form which allows the content of the communication, signature of the communicating party and the time of communication to be clearly determined. (4) The Insured, the Policyholder or the Beneficiary as defined by the insurance contract may file a complaint against a ruling or action by the Insurer. The complaint may be given orally for the record, filed by means of written submission delivered via postal service, telefax or e-mail to the following addresses: freephone 0800 5000 e-mail: osiguranje@allianz.hr in person at the Insurer's sale office in writing to the mailing address: Allianz Zagreb d.d. Služba za kontakte s klijentima, Heinzelova 70, Zagreb The complaint shall contain: a) for natural persons the complainant’s full name and address or the name of their legal representative, while for legal persons their registered name, registered office address, and full name of their legal representative, b) the reasons for the complaint and the claims, c) the evidence confirming particulars of the claim when they are available for the submission, as well as documents that had not been available at the time of the proceedings that led to the disputed ruling and proposals for the presentation of evidence, d) complaint submission date and signature of the complainant or representative, e) written power of attorney when the complaint is filed by an authorised representative. The complaint must be filed no later than 15 days from the date of receipt of the ruling that is subject to the complaint or from the date on which the complainant came to knowledge of the action that is subject to complaint. The insurer must respond to the complaint in writing within 15 days after the receipt of the complaint. (5) Should the complainant submit an appeal to the decision on the complaint, the Insurer shall forward the appeal to the Insurer's Committee of Appeal. The Insurer's Committee of Appeal consists of two (2) members, of which at least one (1) must be a law school graduate. Decision of the Committee of Appeal will be communicated to the complainant in writing without delay, or eight days of receipt of the complaint at the latest. (6) Any disputes arising from the insurance relationship or in connection therewith, including any disputes referring to the questions of validity of its coming into existence, breach or termination, as well as any legal effects thereof, may be referred for conciliation to one of the conciliation organizations in the Republic of Croatia (e.g. at the Croatian Insurance Bureau, at the Croatian Chamber of Commerce in Zagreb or the Croatian Employers Association). Jurisdiction in case of a dispute Article 6 If the efforts to reach an amicable settlement of a dispute remain unsuccessful, the matter will be referred for decision to the competent court in Zagreb having subject-matter jurisdiction over the matter in dispute. Scope of the insurance Insured persons and risks Article 7 The scope of the coverage shall encompass only those insured persons and risks that are listed in the insurance policy. Travel health insurance The Insured Article 8 (1) In accordance with these special provisions concerning travel health insurance, an eligible Insured person during travel and stay abroad may be a person who is a citizen of the Republic of Croatia and a foreign national who, pursuant to the Croatian Act on the Movement and Residence of Aliens, has the following status in Croatia: an extended stay, a stay based on a business visa or a permanent residence. (2) Any foreign visitor during a stay in the Republic of Croatia is eligible to be an Insured person. A foreign visitor is a person resident outside Croatia who travels in the capacity of a tourist outside his/her usual environment for a period shorter than 12 months, for any purpose other than engaging in a lucrative activity in the visited destination. Territorial limits of the insurance coverage Article 9 Under these Terms and Conditions, the insurance coverage shall be valid for the countries listed in the insurance policy, excepting the countries in which the Insured has a permanent residence and the right to public health insurance and those countries of which the Insured is a citizen. Scope of the Insurer's liability Article 10 (1) The services provided by the Insurer in respect of which he pays expenses are as follows: a) If the Insured is ill or injured, the Insurer shall: provide the Insured with advice and instruction on how to reach a general practitioner, medical facility, X-ray or scanning centre or another medical institution; in the event that the Insured requires hospitalisation, the Insurer shall select a medical institution which best suits the nature and the course of the lnsured's illness, book a room at the hospital, arrange transportation to the hospital and inform the hospital on the manner in which the invoice shall be settled; as necessary, the Insurer shall enquire about the Insured at the hospital to ensure that the treatment is progressing correctly; in the event that the Insured at his own initiative opts for hospitalisation at an institution which is not suitable for the nature and the course of his/her illness, the Insurer shall arrange that the Insured is transferred to an institution which better suits the nature and the course of the Insured's illness. b) In case the Insured's health condition requires repatriation, the lnsurer shall organize repatriation of the Insured from the place of stay to his/her residence, or to a hospital in the country of domicile, which shall be selected by the Insurer's medical personnel. If the need arises, the Insured shall be accompanied by a medical team. Additional costs of the transportation of a person accompanying the Insured shall be covered if the medical staff deems such escort necessary. Only the Insurer’s physicians may decide whether repatriation is recommendable and decide on the method of repatriation. If, in the opinion of the physicians, the Insured’s repatriation is possible and the Insured decides against it, the Insurer’s services shall be instantly terminated, in particular with regard to the medical or hospital expenses which may be incurred in the event of future return of the Insured to his/her home country. The Insurer assumes financial liability for the total amount of the listed costs up to the limit of 50% of the travel health insurance sum as it is determined in the insurance policy. c) If the Insured must remain hospitalized abroad for more than 7 days beyond the planned end of the trip and if the Insured is accompanied by an insured family member, the Insurer shall cover the costs of hotel accommodation of the person accompanying the Insured until the time of the repatriation of the Insured. The Insurer shall pay an amount not exceeding EUR 50 per night for no more than 7 nights. d) Costs of rescue up to the limit of EUR 10 000 In the event of rescue of the Insured by means of a helicopter or an air plane, the Insurer shall reimburse only the necessary and proven costs incurred by the Insured while being rescued from an inaccessible place or while receiving the necessary and urgent medical help. e) If the Insured has incurred the costs of treatment according to a physician's prescription or the costs of hospitalization, the Insurer shall provide for: stationary treatment (first medical aid pending hospitalisation); a medical visit in the place where the Insured has gotten ill; the compensation for the medicine and medical supplies prescribed by a physician; necessary medical aids and walking aids which constitute an integral part of the treatment of broken limbs and injuries, as prescribed by physicians; X-ray, scanner and laboratory diagnostics; clinical treatment, including use of scientifically proven methods, in a hospital at the place of the Insured’s stay or the nearest suitable hospital; the costs of transportation by formally approved emergency services for the purpose of admitting the Insured at the nearest hospital or with the nearest available physician, exceptionally by a taxi; the costs of transferral to a specialist clinic when medical indications require it and according to a physician's referral; surgeries, including any surgery-related expenses; dental treatment exclusively for the purpose of relieving acute toothache up to the limit of 2% of the travel health insurance sum as it is determined in the insurance policy. f) In the case of death of the Insured: the Insurer shall organise and bear the costs of the transportation of the body from the place where the death occurred to the deceased’s home or bear the costs of a funeral at the place of death, including the costs of a coffin, up to the limit of 50% of the travel health insurance sum as it is determined in the insurance policy; if the family of the Insured organises the transport of the Insured’s body before the Insurer has approved it, the Insurer shall reimburse the costs up to the amount equalling the sum which would have been charged to the Insurer by a person who would have provided the transportation service to the Insurer if it was the Insurer who had originally organised it; if the Insured is not a citizen of the country from which he/she has come and his/her family wants to repatriate the body to the deceased’s homeland, the Insurershall organise the transportation of the body and assume financial liability up to the limit of 50% of the travel health insurance sum as it is determined in the insurance policy. Exclusion of the Insurer’s liability Article 11 (1) The Insurer’s liability shall be excluded in the following cases: a) losses due to chronic diseases and consequences thereof, as well as the consequences resulting from earlier accidents, if these consequences were pre-existing and known at the time of the insurance contract conclusion or should have been recognized at the time, even if no treatment had been received to address them; likewise, losses due to consequences of illnesses which had been treated in the 6 months prior to the inception of the insurance, except in those cases when medical assistance has been rendered to save the Insured's life or provide relief from acute pain; b) trips for therapeutic purposes; c) costs exceeding reasonable and customary costs for the same type of medical services in the place where the service is provided; d) treatment or care which is not a consequence of an emergency medical intervention or accident; e) all costs incurred in connection with the treatment of malignant and cancerous diseases, except for the expenses incurred while urgent measures were being undertaken to rescue the Insured's life or provide relief from acute pain; f) costs incurred as a consequence of illness or accident in the event of war or as a result of wartime events (whether the war has been declared or not), riots, mass movements, terrorist acts and sabotage, attacks, riots, civil unrest or similar events, radioactive contamination of any description and cause; g) any losses or costs caused by epidemics, pollution or natural disasters which were known about prior to the departure; h) losses caused by unnecessary exposure to danger on one's own initiative (except in case of saving someone's life, but not including participation in search and rescue missions) or by involvement in criminal and illegal acts, or as a result of intoxication or addiction (alcohol, drugs, medications) of the Insured; i) losses as a consequence of performing any paid manual labour or physical activity. Manual or physical labour is work that requires increased physical activity, such as construction and installation works, working outdoors, working with machinery, work in the service industry (waiters, cooks, maids, etc.); j) use of drugs or narcotics; k) the costs of any medical services and assistance in the country of permanent residence; l) costs of any surgical or medical procedures which can safely be postponed until the return of the Insured to the homeland; m) costs of any medical services or medications previously known to be necessary, which are required during the trip or staying abroad; n) costs of rehabilitation and physiotherapy, as well as the costs of artificial substitutes or similar aids (dentures, dental and orthopaedic devices, hearing aids, lenses, visual aids, etc.) o) costs incurred as a consequence of an accident deliberately caused by the Insured or a consequence of a committed or attempted suicide; p) costs incurred as a result of mental illnesses or depression; q) pregnancy and consequences or complications thereof, in particular: deliberate termination of pregnancy, birth and miscarriage. However, in case of acute complications during pregnancy, the Insurer shall in accordance with the provisions of the insurance policy pay for the costs of the first medical intervention which may be necessary in order to eliminate the risk for the life of the mother and/or the child; r) artificial insemination or another infertility treatment as well as the costs of contraception; s) sexually transmitted diseases, AIDS; t) accidents arising from engagement in sports at the amateur or professional level whether in terms of participating in competitions or attending training exercises; u) accidents arising from engagement in extreme sports, parachute jumps or the like, extreme mountain climbing without a certified alpine guide and climbing tours above 6,000 m of altitude as well as expeditions and sporting activities in the wild waters; v) accidents arising from operating motor vehicles, watercrafts or aircrafts if the Insured does not hold the required official documents; w) accidents resulting from diving if the person does not possess a valid diving certificate; x) accidents arising from participation in bets or occurring during or as a consequence of a criminal act or a fight (except in case of self-defence); y) costs incurred as a result of thermal treatment, radiotherapy, phototherapy, heliotherapy, cosmetic surgery; z) costs of vaccination and costs of dental treatment (except for the costs of emergency dental interventions); aa) treatment or care provided by a physician who is a family member; bb) medical costs which are already indemnifiable on the basis of another contract or right. (2) However, the Insurer always guarantees assistance to the Insured person in any situation of immediate mortal danger. A situation of mortal danger is deemed to be a situation for which it may be established that the Insured would have died if there had been no medical intervention. Exercising rights under the insurance Article 12 (1) In the case of occurrence of the insured event, the Insured is obliged to comply with the Insurer’s instructions which form an integral part of the insurance policy. (2) If the Insured complies with the instructions referred to in paragraph 1 of this Article, then he/she does not have to pay in a foreign country the costs referred to in Article 10 of these Terms and Conditions. (3) If the Insured does not comply with the instructions referred to in paragraph 1 of this Article, he/she shall notify the Insurer of the reasons therefor. After the establishment of the liability, the Insurer shall reimburse to the Insured the costs referred to in Article 10 of these Terms and Conditions, including the costs of house calls and the purchase of medicines. (4) The Insurer must be notified within 5 days of the occurrence of the insured event at the latest, except in the case of unforeseen circumstances or an act of God. (5) In the course of undertaken interventions, the Insurer shall always comply with national and international legislation and legislative provisions. (6) The Insurer shall not be liable for: delays or unexpected developments during the provision of the contracted services in case of strikes, explosions, demonstrations, mass movements, traffic restrictions, sabotage, terrorism, civil or interstate war, consequences of radioactivity or in any other event of an act of God, unforeseen circumstances or restrictions to the Insurer’s operations. (7) The Insurer is liable for the payment of a claim only if the evidence of the insurance coverage (original policy) is accompanied by the following documents: a) original invoices which must contain the name of the treated person, type of illness, information about individual items of the administered medical treatment, as well as dates thereof. Where the costs relate to the purchase of medicines, the invoice shall be understood to be the prescription issued by a physician which mustclearly show the prescribed medicines, their price and the confirmation by the pharmacy (stamp) that the medicine has been paid; in case of dental treatment, the information about the treated tooth and the administered treatmentmust be specified in the invoice; b) in the case of reimbursement of costs of transportation of the Insured’s body or his/her funeral at the place of death, the invoices must be substantiated by an official certificate of death and a coroner’s report showing the cause of death; c) in the case of transportation to the place of residence, the invoices must be substantiated by a medical report verifying the necessity of transportation. The Insured is obliged to forward to the Insurer without delay all invoices sent to his/her home address for the purpose of payment. If he/she acts contrary to this provision, the Insurer shall reimburse only the costs relating to medical services that have been provided, whereas the costs of reminders and penalty interest shall be borne by the Insured him/herself. (8) The Insurer may request a translation of the invoices and accompanying medical documents in which case the costs of the translation shall be borne by the Policyholder. If the costs of the translation are borne by the Insurer, these will be deducted from the claim amount. Claim Article 13 (1) In order to exercise the rights under the insurance, claims shall be submitted to the Insurer no later than one month after the completion of the medical treatment (at the travel destination) or after transportation to the place of residence, or, in the case of death, after transportation of the body or after the funeral at the place of death. (2) The Policyholder, the Insured or the Beneficiary of the insurance shall at the request of the Insurer submit all pieces of information necessary for the establishment of the cause of the occurrence of the insured event or the scope of the Insurer’s liability for the payment of the indemnity, including evidence on the actual commencement of the trip. (3) At the Insurer’s request, the Insured shall undergo a medical examination by a physician of the Insurer’s choice. (4) The Policyholder and the Insured shall authorise the Insurer to obtain from third parties who are providers of medical and other services within the meaning of these Terms and Conditions any information necessary for the establishment of the Insurer’s liability. Travel personal accident insurance Eligibility for insurance Article 14 The persons insured under these Terms and Conditions shall be included in the full liability of the Insurer regardless of their health condition and general working ability, except for mentally ill persons and persons completely deprived of business capacity who are in any case excluded from the insurance. Definition of personal accident Article 15 (1) Within the meaning of these Terms and Conditions a personal accident is considered to be a sudden and unexpected event that is generally caused by an external source without the Insured’s intention which affects the Insured's body and results in the Insured's death or a suffered bone fracture. (2) For the purposes of the preceding paragraph, the following cases are considered to be a personal accident: being run over by a vehicle, being victim of a vehicle crash, an impact by or into an object, an electric shock, a lightning stroke, falling, slipping, tumbling down, being wounded by weapons, a sting or a bite by animals, a sting by insects, except where such a sting causes an infectious disease or an anaphylactic reaction to insect venom. (3) The following cases are also deemed to be a personal accident: poisoning by chemical agents due to the Insured's ignorance, except in case of an occupational disease; infection of a wound caused by an accident; poisoning due to inhalation of gases or poisonous vapours, except in case of an occupational disease; burns caused by fire or electricity, hot objects, liquids or vapours, acids, alkalis etc.; choking and drowning; smothering or suffocation due to the Insured’s being trapped (under soil, sand etc.); pulling of muscles, dislocation, spraining, bone fracture due to abrupt bodily movements or sudden exertions caused by unforeseen external events insofar as, after the injuries have been sustained, this is diagnosed by an appropriate specialist physician; influence of light, sun rays, temperature or bad weather if the Insured has been directly exposed to these due to an accident which had occurred before such exposure or if he/she has found himself/herself in such unforeseen circumstances which could not have been prevented or if he/she has been exposed to such influences because of him/her saving a human life; effects of x-rays or radiation if arising abruptly or suddenly, except in case of an occupational disease; (4) According to these Terms and Conditions, the following cases are not deemed to be a personal accident: contagious, occupational and other diseases, congenital or acquired diseases and/or deformations, as well as the consequences of psychological afflictions; abdominal hernia, umbilical hernia, hydroceles or other hernias; infections and diseases developed because of various allergies, cutting or tearing off blisters or other excrescences of thickened skin; anaphylactic shock, except when it occurs during a medical treatment due to a sustained accident; hernia disciintervertebralis, all types of lumbagoes, discopathy, sacralgia, coccydynia, ischialgia and myofascitis, fibrositis, fascitis and all pathoanatomic changes in the region of loins and the lower spine defined by analogous terms; ablatio retinae of a previously sick or degeneratively changed eye, and, on an exceptional basis, ablatio retinae of a previously healthy eye will be considered an accident if there are signs of direct external injury of the eyeball diagnosed in a medical institution; consequences of delirium tremens and the influence of narcotics; consequences of medical, particularly surgical interventions which are undertaken for the purpose of a medical treatment or prevention of illness, except where such consequences are caused by a proven mistake of medical staff (vitiumartis); pathological changes of bones and pathologic fractures, as well as stress fractures; neuromuscular diseases and endocrine diseases; accidents due to heart failure (heart attack); heart failure (heart attack) in any event shall not be considered the result of an accident; accidents due to stroke, a mind or consciousness disorder, unless these are directly caused by an accident which may be understood as such in accordance with the Insurer's accepted definition of an accident. Scope of the Insurer's liability Article 16 (1) When a personal accident occurs in accordance with these Terms and Conditions, the Insurer shall pay the sum insured under the insurance policy. (2) In the case of death of an insured person under 14 years of age, the Insurer is only liable for the payment of actual funeral expenses which are documented by relevant invoices and up to the sum insured under the insurance policy. (3) In the event of a personal accident causing a bone fracture to the Insured, the Insurer shall pay the sum insured under the insurance policy, regardless of the number of fractured bones. Exclusion of the Insurer’s liability Article 17 (1) All Insurer’s liabilities shall be completely excluded if a personal accident occurs as a result of: a) earthquake; b) war or wartime events (whether the war has been declared or not), riots, mass movements, terrorist acts and sabotage, attacks, riots, civil unrest or similar events, radioactive contamination of any description and cause; c) engagement in sports at the amateur or professional level whether in terms of participating in competitions or attending training exercises; d) engagement in extreme sports, parachute jumps or the like, extreme mountain climbing without a certified alpine guide and climbing tours above 6,000 m of altitude as well as expeditions and sporting activities in the wild waters; e) operating motor vehicles, watercrafts or aircrafts if the Insured does not hold the required official documents; f) diving if the person does not possess a valid diving certificate; g) participation in bets or occurring during or as a consequence of a criminal act or a fight (except in the cases of self-defence); h) an attempted or committed suicide; i) the Policyholder, the Insured or the Beneficiary having caused the accident deliberately; j) the influence of alcohol and/or narcotics on the Insured, regardless of any liability of a third party for the occurrence of the accident. A personal accident is deemed to have occurred as a result of influence of alcohol if the level of alcohol in the blood, measured immediately after the occurrence of the accident, is higher than that which is permitted by law regulating the operation of vehicles, and in other cases higher than 0.80 g/kg. The Insured is deemed to be under the influence of alcohol if after a traffic accident he/she refuses to subject him/herself to a breath alcohol test, as well as if he/she leaves the place of accident before the arrival of the police, or if he/she fails to call the police or inform the nearest police station of the accident, or if he/she otherwise avoids undergoing a breath alcohol test; k) as a result of active engagement in a fight, except in a proven case of self-defence. (2) The insurance contract shall be null and void if at the time of the conclusion of the contract the insured event had already occurred or was occurring or it was obvious that itwould occur, and the already paid premium shall be returned to the Policyholder in the amount reduced by the Insurer’s expenses. Notification of personal accident Article 18 (1) The Insured who is injured in a personal accident shall: a) immediately see a physician or call a physician in order to be examined and receive medical assistance and promptly take any necessary measures for the purpose of medical treatment, as well as comply with medical advice and instructions regarding the manner and course of the medical treatment; b) notify the Insurer of the accident; c) when notifying the Insurer of the accident, submit all necessary reports and information, in particular those about the place and the time of the occurrenceof the accident, a full description of the event, the name of the physician who had examined the Insured and referred him/her for a medical treatment or who was treating him/her, the medical report on the type and degree of the injury, possible consequences, as well as the information on physical handicaps, defects or illnesses which the Insured may have sustained before the occurrence of the accident, and also relevant X-ray images. (2) If the personal accident results in the death of the Insured, the insurance Beneficiary shall inform the Insurer thereof in writing, as well as obtain all necessary medical andother documents, including the evidence that he/she is entitled to receiving the sum insured. (3) The costs of the medical examination and reports (the initial and final medical reports, further medical examination and a specialist’s opinion), and other costs incurred in the course of establishing the circumstances in which the accident had occurred and exercising the rights under the insurance contract shall be borne by the claimant. (4) The Insurer is authorised and has the right to request from the Insured, the Policyholder, the Beneficiary, a medical institution or any other legal entity or a natural person additional explanation and evidence, and to take action at his own cost so that the Insured might undergo a medical examination by the Insurer's physicians or medical boards in order for the relevant circumstances in connection with the reported accident to be established. Liability insurance Scope of the Insurer's liability Article 19 (1) Travel insurance policy may be agreed upon to include the following liability insurance: a) Private liability insurance: The insurance covers civil non-contractual liability of the Insured for any claims arising from death, bodily injury or deterioration of health and damage to or destruction of property of third parties. b) Property damage private liability insurance: The insurance covers civil non-contractual liability of the Insured for any claims arising from damage to or destruction of property of third parties. (2) The insurance shall apply to the following losses: a) engendered in the capacity of a private person while engaging in his/her daily activities other than trade activities or any other profitable activity; b) due to possession and use of bicycles without motors; c) due to pursuing sports other than hunting on an amateur basis; d) due to keeping domestic animals, except where animals are kept for the purpose of making money. Exclusions from the insurance Article 20 (1) The insurance shall not apply to: a) losses sustained by the Policyholder, the Insured, his/her married or common-law spouse, the Insured's family members or other persons who live with the Insured in the same household; b) losses caused deliberately; c) losses arising from the possession and use of: aircrafts and watercrafts, motor vehicles and other vehicles which must be registered according to the legislation in force; d) losses caused by cold steel weapons and weapons in general; e) losses incurred due to damage to objects or completed works which have been performed or delivered by the Insured or any other person on the Insured's orders or for the account of the Insured, if the loss has been caused by the workmanship or delivery; f) losses caused by defective products; g) losses incurred due to damage to a third party’s property caused during the performance of professional activities by the Insured involving this property (e.g. processing, repair, transportation, testing etc.); h) losses arising from acting contrary to legal regulations; i) losses arising from effects on the environment, and especially those caused by pollution (to water, soil and air), as well as harmful effects on plant and animal species and/or protected natural habitats; j) pure financial losses, i.e. the losses not arising from causing bodily injury or health deterioration to a third party, or causing damage to or destruction of their property; k) losses arising from an infringement of personality rights (non-pecuniary damage) which are not a direct result of injury to body or health and particularly all claims arising from infringements of rights to dignity, reputation, honour, trade secrets, freedom of economic activity and similar. l) losses occurring gradually. (2) In addition to this, the insurance shall not apply to: a) losses incurred as a consequence of war or as a result of wartime events (whether the war has been declared or not), riots, mass movements, terrorist acts and sabotage, attacks, riots, civil unrest or similar events; b) liability for losses directly related to use of nuclear energy, losses directly or indirectly related to high-energy ionizing radiation (e.g. alpha, beta and gamma rays that are emitted by radioactive substances and neutrons or rays produced in particle accelerators or laser rays and other similar rays); c) liability for losses directly or indirectly caused by asbestos, products or materials made of asbestos of any kind or that are in any way related to asbestos; d) liability for losses resulting directly or indirectly from influence of magnetic, electromagnetic fields or nuclear radiation, regardless of their source or occurrence; e) liability of the Insured based on contractual extension of his/her liability in cases in which he/she is normally not liable by law; f) losses for which the Insured is liable in the capacity of an investor; however, losses for which the Insured is liable in the capacity of a party contracting the works and/or a party performing the works on his/her own real estate are covered. Insured event Article 21 (1) The insured event is a future, uncertain loss event which is independent of the exclusive will of the Insured and on the basis of which a third party could claim indemnity. The insured event shall be deemed to have occurred at the time when it began to occur. (2) Several consecutive losses, where such losses ensue from the same cause, shall be deemed to be a single insured event. Insurance validity period Article 22 (1) The Insurer shall be liable for the payment of a claim only if the insured event in question has occurred during the insurance validity period. (2) In the case of claims arising from health deterioration which has been developing gradually, a loss event shall be deemed to have occurred at the time when the health deterioration was for the first time diagnosed by a physician and documented by a physician’s report. Sum insured and the Insured's participation in claims (deductible) Article 23 The Insured shall participate in each claim with a deductible in the amount of EUR 100. The Insurer shall per a single insured event be liable up to the limit of the sum insured, as it is determined in the insurance policy, reduced by any agreed-upon deductibles. The Insured’s obligations upon the occurrence of an insured event Article 24 (1) The Insured is obliged to notify the Insurer of the occurrence of the insured event within three days of gaining the knowledge thereof, as well as of the respective claim that has been submitted. (2) The Insured is also obliged to notify the Insurer when a claim against him/her has been filed before court, when he/she has been taken into custody and when the proceedings for the submission of evidence have been instituted. (3) In the case when an investigation has been carried out, an indictment raised or a decision on instigating criminal proceedings has been issued, the Insured is obliged to immediately notify the Insurer thereof, even in the case when he/she has already notified the Insured of the occurrence of the loss event. The Insured is also obliged to submit the report on the loss event prepared by a competent body of authority. (4) The Insured is not authorised, without prior consent of the Insurer, to make any statements in respect of the claim, and in particular to admit it either in part or in whole, agree on a settlement or the payment of the claim, unless the facts implicate that the refusal to admit, settle or pay the claim would have been an obvious injustice. In the case when the Insured mistakenly believes that his/her liability exists or that the established facts are true, this shall not be considered a valid excuse. (5) If a claimant lodges a claim against the Insured, the Insured is obliged to submit to the Insurer the summons or writ and all the files related to the insured loss event and the claim and allow the Insurer to take over the conduct of the lawsuit. (6) If the Insured refuses to consent to any settlement recommended by the Insurer, then the Insurer shall not be liable for any amount in excess of the indemnity or interest or costs incurred due to such refusal. (7) If the claimant addresses the Insurer directly with the claim, the Insured is obliged to provide the Insurer with all evidence and information he/she has at disposal and which are necessary for the establishment of the liability for the damage which has been done and for the assessment of the validity of the claim, the scope and level of the indemnity. (8) If, due to changed circumstances, the Insured gains such a right which may result in a reduction or a cancellation of the annuity which is being paid to the claimant, the Insured is obliged to notify the Insurer thereof. If the Insured does not comply with the obligations set forth in this Article, he/she will bear any adverse consequences which may result from such non-compliance, unless these consequences would have occurred even if he/she had complied with the obligations. The Insurer’s duties upon the submission of a claim by an injured party Article 25 (1) The following are the duties of the Insurer in respect of the claim submitted by the injured party: a) together with the Insured to conduct the defence against invalid or excessive claims (Legal protection - Article 26); b) comply with the valid claims (Payment of indemnity - Article 27); c) reimburse the costs of legal proceedings (Reimbursement of costs of legal proceedings- Article 28). Legal protection Article 26 (1) The Insurer’s duty to provide legal protection includes: a) investigation of the Insured’s liability for the loss that has occurred; b) conducting the lawsuit when the claimant endeavours to exercise his/her right to indemnity in a lawsuit directly against the Insurer; c) making statements on behalf of the Insured which the Insurer deems useful for the purposes of meeting the claims or defending against any invalid or excessive claims. (2) The Insurer may participate in the lawsuit in the capacity of a party interested in the outcome of the lawsuit. (3) The Insurer is authorized to refuse to conduct the lawsuit or leave the conducting of the lawsuit to the Insured if an assessment has been made that legal protection may no longer be extended considering the amount of claim as it relates to the sum insured. (4) In the event that the Insurer deposits the sum insured as indemnity prior to the commencement of the proceedings, his obligation to extend legal protection becomes void. Payment of indemnity Article 27 (1) The Insurer shall pay the indemnity under the insurance on the basis of: a) an acknowledgement he has made or approved of; b) a settlement he has made or approved of; c) court award, but up to and not exceeding the limit of liability under the insurance contract. (2) The Insurer has the right to pay to the Insured the amount equal to the sum insured reduced by the amount of the agreed-upon franchise deductibles, in which case the Insurer is free from all obligations and procedures in regard to the insured event. (3) Should the Insured be obliged to submit an indemnity deposit for purposes of security according to legal regulations or court award, the Insurer shall participate in the depositing, but not in excess of the level of his liability for the payment of the indemnity. (4) In the case when the Insured is liable for the payment of annuity as indemnity, and the paid-up value of the annuity exceeds the sum insured or the balance after the deduction of other payments in respect of this insured event, the annuity due will only be compensated in such proportion as the sum insured or balance bears to the paid-up value of the annuity. The paid-up value of the annuity for the purpose of calculating the ratio shall be calculated on the basis of the life insurance mortality tables used in the Republic of Croatia. (5) If the Insurer objects to the proposal of the Insured to agree upon an out-of-court settlement, he shall be liable for the payment of the indemnity and the ensuing interests and expenses, even when these exceed the sum insured. Reimbursement of costs of legal proceedings Article 28 (1) The Insurer shall reimburse all costs of legal proceedings regardless of whether he is conducting the lawsuit on his own or the claimant is seeking to exercise the right to indemnity in proceedings directly against the Insured, if the sum of the costs of the lawsuit and the indemnity (with applicable interest) do not exceed the sum insured. (2) The Insurer shall pay the costs of the defence attorney in a criminal proceedings instituted against the Insured due to an event which could give rise to a claim for the compensation of loss on the basis of liability covered by the insurance only in the following exceptional case: if he has been informed of the chosen defence attorney and if he has agreed to pay the costs. The Insurer shall not compensate the costs of criminalproceedings and the representation of the claimant. (3) When the Insurer pays out the sum insured, the Insurer shall be free from further payments in respect of the indemnity and costs per single insured event. Insurance of luggage Scope of the Insurer's liability Article 29 (1) The insurance covers loss of, damage to or destruction of luggage, both hand-carried by the Insured throughout the trip and checked luggage, during travel to and from, as well as during the stay in the place of destination in the following cases: traffic accident, natural disasters (earthquake, flood, storm etc.), fires and explosions, a criminal act of a third party (e.g. theft, robbery) and when entrusting the luggage to the carrier. (2) In terms of these Terms and Conditions, a place of stay at the travel destination is considered to be the place where the insured person is staying for the duration of a trip, with no intention to settle in this place. (3) The Insurer shall cover the costs of purchasing new luggage (strictly necessary replacement clothes, basic toiletries and other necessities) up to a maximum of EUR 250 in case that personal luggage which has been handed over to the carrier for the purpose of transportation does not on the same day as the Insured reach the travel destination outside his/her place of residence or stay due to a delay in transportation. (4) The insurance does not cover indemnity for the purchase of new luggage on the return trip to the place of residence. Exclusions and limitations of the Insurer’s liability Article 30 (1) Jewellery, watches, furs, devices and appliances of every kind with accompanying equipment (e.g., a camera, video camera, mobile phone, tablet, laptop), as well as musical instruments, are insured only up to one third of the luggage insurance sum as it is determined in the insurance policy and only if they are carried on the person. Under no circumstances does the insurance cover such objects when they are placed in checked luggage or during the time they are being used. (2) Bicycles, kayaks, sporting folding boats and inflatable boats, as well as other sports equipment with associated equipment, are insured only during transportation to and from the travel destination and while secured at the site of the tourist accommodation in a locked room, but they are not insured during the time they are being used. (3) Luggage in a parked vehicle, mobile home or a watercraft is insured against theft only if the vehicle, mobile home or a watercraft in question is locked, or it is stored in a locked factory equipment carrier exclusively between 6:00 and 22:00 hours. Exceptionally, if the layover is no longer than 2 hours, the insurance shall be in effect continuously. (4) Cash, securities, jewellery, travel tickets, credit cards and all personal identification documents (passport, driver's licence etc.), artworks and animals are exempt from the insurance. Glasses, contact lenses and dentures, except in the event of a traffic accident are also not covered by the insurance. (5) The Insurer shall not be liable for: a) losses arising from the properties or the condition of the luggage itself, its internal flaws or the common properties of the contents of the luggage; b) losses due to destruction of clothing and footwear due to trying it on and wearing it and of the personal luggage due to testing it and carrying it; c) losses resulting from the destruction of fragile objects (ceramics, glass, etc.); d) damage causing scratches on luggage, especially scratches on travel bags, suitcases, etc.; e) theft of luggage left in a place without supervision and oversight; f) loss of luggage due to forgetting it during travel, at the place of destination or at the place of departure on a trip; g) losses as a consequence of loss, destruction or damage to personal cosmetics; h) any loss arising from use, malfunction or destruction caused by insects or other vermin, climatic and atmospheric conditions, mechanical or electrical failures, staining or any method of dyeing or cleaning, or damage caused by water in any way; i) losses in those cases when the Insured has brought about the insured event intentionally or negligently or if upon the occurrence of the insured event, in particular in a loss notification report, he/she deliberately states untrue information; j) losses incurred as a consequence of war or as a result of warfare (whether the war has been declared or not), riots, mass movements, terrorist acts and sabotage, attacks, riots, civil unrest or similar events, radioactive contamination of any description and cause. Notification of the insured event Article 31 (1) Upon occurrence of the insured event the Insured is obliged to immediately report the losses and/or damages sustained as a result of a criminal act of a third party to a competent or nearest police station. A police report including a list of all lost or damaged items should be submitted to the Insurer along with a written loss notification within 30 (thirty) days of the date of occurrence of the insured event at the latest. (2) Losses of and/or damages to checked luggage must be reported without delay to the carrier or the organisation providing accommodation services. A loss certificate must be submitted to the Insurer along with a written loss notification within 30 (thirty) days of the date of the occurrence of the insured event. (3) If the damage is fully recovered from the carrier or the organisation providing accommodation services, the same can not be recoverable from insurance. Indemnity Article 32 (1) The indemnity shall be paid in the amount of the purchase value of the lost item reduced by the estimated amount of depreciation because of its age or wear and tear (present value), but the paid amount shall not exceed the stipulated sum insured. (2) If the insured items are totally destroyed or stolen and the Insured cannot prove their present value within the meaning of the preceding paragraph, the Insurer shall be liable for a payment to a maximum of 50% of the purchase value of a new item. (3) For damaged items the Insurer is obligated to reimburse the necessary repair costs, up to the amount of the present value of the insured items. (4) For movies, image, audio and data carriers (media in short), the Insurer shall reimburse the present value of the lost medium. The material stored on the lost media is not subject to indemnity and are in all cases excluded from the insurance. (5) In the case of loss of and/or damage to the luggage which is hand-carried by the Insured, the Insured shall participate in the claim in the amount of EUR 50 per loss event. Travel cancellation insurance Sum insured Article 33 The sum insured equals the price of the travel agreed upon and paid by the Insured in respect of which he/she has concluded an insurance contract with the Insurer. Scope of the Insurer's liability Article 34 (1) If the Insured cancels the contracted trip due to unforeseen obstacles or obstacles which could not have been prevented or avoided by the Insured, and which may have arisen between the time of the conclusion of the contract concerning the trip and the commencement of the trip, or if for these reasons the Insured is forced to interrupt a trip which has already commenced, providing that he had not used more than 50% of the planned trip, the Insurer shall indemnify the costs of travel cancellation if the trip in question has been cancelled because of any of the following events: a) sudden acute illness (except for mental illness) which requires urgent medical care; pregnancy disorders; death or severe bodily injury of the Insured, the Insured's spouse or co-resident common-law spouse, children, parents, siblings, or persons entrusted to the Insured's care; b) the intolerance to vaccination which the Insured was obliged to take according to valid legal regulations of the country of destination; c) greater damage to the property of the Insured caused by a natural disaster, fire or a deliberate criminal act of a third party; d) military exercise; e) theft or total damage to the vehicle of the Insured, if he/she is travelling by this vehicle. Indemnity Article 35 (1) In the case of occurrence of an insured event the Insurer is liable to pay the indemnity in the amount of 90% of the price of the trip agreed upon and paid for by the Insured. (2) If the trip is cancelled prior to the planned commencement of the trip, the Insurer shall indemnify the full amount of the already paid premium for the remaining unused coverage as it is agreed upon in the travel insurance contract which stipulates the indemnity in the event of travel cancellation. Notification ofthe insured event Article 36 (1) The Insured is obliged to within 3 (three) working days of the occurrence of any reason for travel cancellation as specified in Article 36 of these Terms and Conditions cancel the trip at the travel agency with which he/she has entered into the travel agreement or to cancel the arrangements with the provider of accommodation and transport during the trip in question. (2) If the Insured has to cancel the agreed upon or commenced trip for any of the reasons specified in Article 36 of these Terms and Conditions, he/she is obliged to inform the Insurer thereof in writing at the latest within 15 working days from the date of the occurrence of the reason for the cancellation. Article 37 (1) The Insured is obliged, within 30 days of the date when the trip should have commenced according to the original plan at the latest, to submit to the Insurer a claim along with the following documents: a) the original insurance policy; b) a payment slip and travel contract whereby he/she confirms that the travel has been paid for; c) a written certificate of the travel cancellation by the travel agency or the provider of accommodation and/or transportation services, on which the date of travel cancellation must be shown clearly and explicitly, and in the case of the termination of a trip which has already commenced, the date and place of the termination of the trip must be specified; d) a written statement by the travel agency or the provider of the accommodation and/or transportation services showing the amount that has been charged to the Insured because of the cancellation or termination of the trip; e) if a trip is cancelled or terminated because of illness, bodily injury, pregnancy or intolerance of a vaccine, the Insured must submit to the Insurer the complete medical documentation relating to the illness, injury, pregnancy andvaccination, which is related to the Insured’s inability to travel, as well as a sick-leave report or the employer’s certificate on the use of a paid holiday in that period if the Insured is employed; f) if a trip is cancelled or terminated because of death, the Insured or the Beneficiary must submit to the Insurer the death certificate or an extract from the Register of deaths; g) if a trip is cancelled or terminated because of a loss of and/or damage to property or a military exercise, the Insured must submit to the Insurer a certificate of the competent authority. Final provisions Article 38 The contract concerning personal travel health insurance, personal travel accident insurance, liability insurance, luggage insurance and travel cancellation insurance shall also be subject to other mandatory provisions of the Civil Obligations Act, and to dispositional provisions where the issues to which they relate are not regulated otherwise hereunder. In case of discrepancies between hereby noted and agreed wordings of subject policy in Croatian language and the English translation, the Croatian policy wordings will prevail. Applicable since 3rd of December 2013 Clause concerning the use of personal information for marketing purposes By entering into this Contract I give my consent to Allianz Zagreb d.d. and its affiliates for the use of my personal information, which is otherwise considered legally private and protected, as well as other information that has come to the knowledge of Allianz d.d. due to our business relationship. Until this authorization is cancelled, Allianz may store the above information in its business records, process and use it for the purpose of customer relation improvement and marketing (e.g. sending promotional information on products offered, promotions, campaigns and ads via phone, e-mail and mail, etc.). I hereby certify that I am aware of my right to object to such processing and that I am aware of the existence of a right to access and correct the data that relate to me. The list of affiliates was published on the website of Allianz Zagreb. The clause shall be considered in effect providing consent has been given in regard to the Clause concerning the use of personal information for marketing purposes in the insurance quote. Travel Insurance Package: Special Terms and Conditions Only those clauses the application of which has been explicitly agreed upon and for which the insurance premium has been paid shall be applicable in terms of the insurance contract. PO 1/2013 clause: Amateur sports Contrary to the provisions of Article 11 paragraph (1), item t) of the Travel Insurance Package Terms and Conditions 243-1213, providing that the travel health insurance coverage has been contracted, as specified in Article 18 paragraph (1), item c) of the Travel Insurance Package Terms and Conditions 243-1213, and that the travel accident insurance coverage has been contracted, the insurance coverage shall also cover amateur engagement in sports. All other applicable exclusions and provisions of the Travel Insurance Package Terms and Conditions 243-1213 remain unchanged. PO 2/2013 clause: Professional sports Contrary to the provisions of Article 11 paragraph (1), item t) of the Travel Insurance Package Terms and Conditions 243-1213, providing that the travel health insurance coverage has been contracted, as specified in Article 18 paragraph (1), item c) of the Travel Insurance Package Terms and Conditions 243-1213, and that the travel accident insurance coverage has been contracted, the insurance coverage shall also cover professional engagement in sports. All other applicable exclusions and provisions of the Travel Insurance Package Terms and Conditions 243-1213 remain unchanged. PO 3/2013 clause: Business trips Contrary to the provisions of Article 11 paragraph (1), item t) of the Travel Insurance Package Terms and Conditions 243-1213, the insurance shall also cover the losses incurred as a consequence of performing any paid manual labour or physical activity. All other applicable exclusions and provisions of the Travel Insurance Package Terms and Conditions 243-1213 remain unchanged. PO 4/2013 clause: "ALL RISK" travel cancellation insurance In addition to the provisions of coverage as specified in Article 34 of the Travel Insurance Package Terms and Conditions 243-1213, if the Insured cancels the contracted trip due to unforeseen obstacles or obstacles which could not have been prevented or avoided by the Insured, and which may have arisen between the time of the conclusion of the contract concerning the trip and the commencement of the trip, or if for these reasons the Insured is forced to interrupt a trip which has already commenced, on the condition that he had not used more than 50% of the planned trip, the Insurer shall indemnify him/her 90% of the actual travel cancellation costs providing that the causes to the loss event in question and the incurred costs do not include: - mistakes while selecting travel destinations (locales, hotels etc.) or service providers; - gross negligence or wilful misconduct of the Policyholder or the Insured; - multiple bookings or reservations with overlapping travel times; - the Insured’s unwillingness to travel; - war, hostilities, war operations or similar actions and terrorism of any kind; - epidemics and pandemics; - natural events; - act of God; - prohibitions and government decisions; - nuclear events; - events that occurred prior to insurance contract conclusion, or could have been predicted; - insolvency, payment incapability or bankruptcy of the travel operator; - planned, anticipated or deferred surgical procedures, medical treatments or interventions. All other applicable provisions of the Travel Insurance Package Terms and Conditions 243-1213 remain unchanged. PO 5/2013 clause: Extended travel cancellation insurance Article 34 paragraph 1 of the Travel Insurance Package Terms and Conditions 243-1213 shall be extended in terms of the following item and the corresponding coverage: f) failing a final secondary school exam or a grade. All other applicable provisions of the Travel Insurance Package Terms and Conditions 243-1213 remain unchanged.
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Uvjeti paketa putnog osiguranja Uvodne odredbe Uvjeti paketa putnog osiguranja sastavni su dio Ugovora o putnom zdravstvenom osiguranju, osiguranju putnika od posljedica nesretnog slučaja (nezgode), osiguranju od odgovornosti, osiguranju prtljage i osiguranju otkaza putovanja koji je ugovaratelj osiguranja zaključio s Allianz Zagreb d.d. Pojedini izrazi u ovim Uvjetima imaju sljedeća značenja: 1) osiguratelj - Allianz Zagreb d.d. s kojim je sklopljen ugovor o osiguranju; 2) ugovaratelj osiguranja - pravna ili fizička osoba koja s osigurateljem sklopi ugovor o osiguranju; 3) osiguranik - osoba navedena u polici osiguranja na koju se sklopljeno osiguranje odnosi, može biti isključivo fizička osoba; 4) korisnik - osoba koja ima pravo na naknadu temeljem ugovora o osiguranju. Korisnici za slučaj osiguranikove smrti su osiguranikovi zakonski nasljednici. Korisnik za ostala ugovorena pokrića sukladno ugovoru o osiguranju je sam osiguranik; 5) treća osoba - osoba koja nije subjekt ugovora o osiguranju, odnosno osoba čija odgovornost nije pokrivena osiguranjem; 6) iznos osiguranja - najveći iznos osigurateljeve obveze po jednom osiguranom slučaju; 7) premija osiguranja - iznos koji je ugovaratelj osiguranja dužan platiti osiguratelju prema ugovoru o osiguranju; 8) polica osiguranja - isprava o sklopljenom ugovoru o osiguranju; 9) prtljaga - sve stvari za osobnu uporabu na putovanju, uključujući poklone i suvenire; 10) amaterski sportaši - osobe koje se sportom ne bave kao svojim glavnim zanimanjem. Ipak oni su registrirani članovi sportske organizacije u kojoj treniraju i za koju se natječu. Eventualne naknade koje primaju temeljem svoga članstva ne predstavljaju njihov redoviti prihod; 11) profesionalni sportaši su osobe koje se sportom bave kao primarnim zanimanjem (trening, sudjelovanje u natjecanjima). Naknada koju primaju predstavlja njihov redoviti prihod. Opće odredbe Sklapanje ugovora o osiguranju Članak 1. (1) Ugovor o osiguranju sklapa se na temelju pisane police osiguranja, isključivo prije početka putovanja. (2) Osiguranje otkaza putovanja moguće je sklopiti isključivo prilikom sklapanja ugovora o putovanju. Ukoliko osiguranje otkaza putovanja nije sklopljeno prilikom sklapanja ugovora o putovanju, ne postoji obveza osiguratelja za isplatu odštete. (3) Ugovor o osiguranju sklopljen je samim plaćanjem premije osiguranja. Početak i trajanje ugovora o osiguranju Članak 2. (1) Osigurateljeva obveza počinje u 00,00 sati onoga dana koji je u polici označen kao početak osiguranja, ako je do tada u cijelosti plaćena premija osiguranja, i prestaje u 24,00 sata onoga dana koji je u polici označen kao dan isteka osiguranja. (2) Osiguranje otkaza putovanja: Osigurateljeva obveza za osiguranje otkaza putovanja počinje u 24,00 sata onoga dana koji je u polici označen kao datum sklapanja ugovora o osiguranju, ako je do tada u cijelosti plaćena premija osiguranja, a prestaje u 24,00 sata dana u kojem ističe 50% predviđenog trajanja putovanja osiguranika. (3) Godišnje putno osiguranje: Ukoliko je ugovoren program godišnjeg putnog osiguranja, trajanje osiguranja je isključivo jedna godina, s tim da pojedino putovanje osiguranika ne smije trajati dulje od 28 dana. Osigurateljeva obveza počinje u 24,00 sata onoga dana koji je u polici označen kao datum početka ugovora o osiguranju, ako je do tada u cijelosti plaćena premija osiguranja, a prestaje u 24,00 sata dana koji je na polici označen kao datum isteka osiguranja. Iznos osiguranja Članak 3. (1) Iznosi osiguranja umanjeni za iznose ugovorenih franšiza predstavljaju gornju granicu obveze osiguratelja po jednom osiguranom slučaju. (2) Iznosi osiguranja ugovoreni su u EUR. (3) Osiguratelj isplaćuje osigurninu u kunskoj protuvrijednosti EUR po srednjem tečaju HNB na dan obračuna štete. Jurisdikcija Članak 4. Za sva pitanja glede tumačenja ovih uvjeta i police osiguranja mjerodavno je hrvatsko pravo. Izvansudsko rješavanje sporova i rješavanje pritužbi Članak 5. (1) Strane su suglasne sve sporove proizašle iz odnosa osiguranja nastojati rješavati mirnim putem. (2) Ugovaratelj osiguranja, osiguranik te korisnik osiguranja obvezni su o svim spornim pitanjima, pritužbama i nesporazumima proizašlim iz odnosa osiguranja bez odgađanja obavijestiti osiguratelja. (3) Obavijest iz prethodnog stavka ovog članka podnositelji dostavljaju u pisanom obliku iz kojeg se sa sigurnošću može utvrditi sadržaj obavijesti, potpis podnositelja obavijesti i vrijeme slanja obavijesti. (4) Osiguranik, ugovaratelj osiguranja ili korisnik iz Ugovora o osiguranju može pritužbu protiv odluke ili postupanja osiguratelja, osiguratelju izjaviti usmeno na zapisnik ili podnijeti putem pošte, telefaksa ili elektroničke pošte na sljedeće adrese: - besplatni broj 0800 5000 - e-mail: osiguranje@allianz.hr - osobno na prodajnom mjestu osiguratelja - pisanim putem na adresu: Allianz Zagreb d.d. Služba za kontakte s klijentima, Heinzelova 70, Zagreb Pritužba treba sadržavati: a) ime i prezime i adresu podnositelja pritužbe koji je fizička osoba ili njegovog zakonskog zastupnika, odnosno, tvrtku, sjedište i ime i prezime odgovorne osobe podnositelja pritužbe koji je pravna osoba, b) razloge pritužbe i zahtjeve podnositelja pritužbe, c) dokaze kojima se potvrđuju navodi iz pritužbe kada ih je moguće priložiti, a može sadržavati i isprave koje nisu bile razmatrane u postupku u kojem je donesena odluka zbog koje se pritužba podnosi kao i prijedloge za izvođenje dokaza, d) datum podnošenja pritužbe i potpis podnositelja pritužbe odnosno osobe koja ga zastupa, e) punomoć za zastupanje, kada je pritužba podnesena po punomoćniku. Rok za podnošenje pritužbe protiv odluke ili postupanja Osiguratelja iznosi 15 dana od dana kada je podnositelj pritužbe primio odluku na koju podnosi pritužbu, odnosno od dana kada je saznao za razlog pritužbe. Osiguratelj je dužan u pisanom obliku odgovoriti na pritužbu najkasnije u roku od 15 dana od dana primitka pritužbe. (5) Prigovor na odgovor na pritužbu Osiguratelj će uputiti Drugostupanjskoj komisiji osiguratelja koja se sastoji od 2 (dva) člana, od kojih je najmanje 1 (jedan) diplomirani pravnik. Odgovor drugostupanjske komisije dostavlja se podnositelju prigovora u pisanom obliku bez odgađanja, najkasnije u roku od 8 (osam) dana od dana zaprimanja prigovora. (6) Svi sporovi koji proizlaze iz odnosa osiguranja ili u vezi s njim, uključujući i sporove koji se odnose na pitanja njegovog valjanog nastanka, povrede ili prestanka, kao i na pravne učinke koji iz toga proistječu, mogu se uputiti na mirenje pri jednoj od organizacija za mirenje u Republici Hrvatskoj (Hrvatski ured za osiguranje, Hrvatska gospodarska komora ili Hrvatska udruga poslodavaca). Nadležnost u slučaju spora Članak 6. U slučaju da se unatoč nastojanju sporazumnog rješavanja spora ne uspije postići mirno rješenje spora, za sudske sporove ugovara se mjesna nadležnost stvarno nadležnog suda u Zagrebu. Opseg osiguranja Osigurane osobe i opasnosti Članak 7. Opseg pokrića vrijedi samo za one osobe i one osigurane opasnosti koje su navedene u polici osiguranja. Putno zdravstveno osiguranje Osiguranik Članak 8. (1) Osiguranik za vrijeme puta i boravka u inozemstvu, prema ovim posebnim odredbama za putno zdravstveno osiguranje, može biti osoba koja je državljanin Republike Hrvatske te stranac koji prema hrvatskom Zakonu o kretanju i boravku stranaca, u Hrvatskoj ima sljedeći status: - produženi boravak, - boravak s poslovnom vizom ili - trajno nastanjenje. (2) Osiguranik za vrijeme boravka u Republici Hrvatskoj može biti svaki strani posjetitelj. Strani posjetitelj je osoba s prebivalištem izvan Hrvatske koja putuje iz turističkih razloga izvan svoje uobičajene sredine na rok kraći od 12 mjeseci, s bilo kojim ciljem osim obavljanja djelatnosti koja mu se plaća u posjećenom mjestu. Područje na kojem vrijedi osiguranje Članak 9. Osigurateljno pokriće, temeljem ovih Uvjeta, vrijedi za sve zemlje navedene na polici osiguranja, izuzev država u kojima osiguranik ima stalno prebivalište ili pravo na javnu zdravstvenu zaštitu te onih u kojima osiguranik ostvaruje svoje državljanstvo. Opseg osigurateljeve obveze Članak 10. (1) Usluge koje pruža osiguratelj i za koje plaća troškove: a) Ukoliko je osiguranik bolestan ili ozlijeđen: - upućuje i savjetuje osiguranika kako doći do liječnika, medicinske ustanove, rendgenskog ili skenerskog centra, medicinskog laboratorija ili neke druge medicinske institucije; - u slučaju hospitalizacije, odabire medicinsku ustanovu koja najbolje odgovara prirodi i procesu osiguranikove bolesti, rezervira bolničku sobu, brine se o prijevozu do bolnice, obavještava bolnicu o načinu plaćanja računa; - po potrebi se raspituje o osiguraniku u bolnici da bi se uvjerio da se liječenje provodi korektno; - a samoinicijativno izabere hospitalizaciju u ustanovi koja ne odgovara prirodi i procesu osiguranikove bolesti premješta osiguranika u ustanovu koja bolje odgovara prirodi i procesu osiguranikove bolesti; b) Ukoliko zdravstveno stanje zahtijeva repatrijaciju, organizira repatrijaciju osiguranika od mjesta boravka do prebivališta osiguranika ili do bolnice u domicilnoj zemlji koju odabere medicinsko osoblje osiguratelja i po potrebi uz pratnju medicinske ekipe. Dodatni troškovi prijevoza osobe u pratnji biti će pokriveni ako medicinsko osoblje smatra da je takva pratnja nužna. Isključivo liječnici osiguratelja mogu odlučiti o preporučljivosti i sredstvu repatrijacije. Ako liječnici smatraju osiguranikovu repatrijaciju mogućom, a osiguranik ju odbije, usluge osiguratelja će se trenutno obustaviti, osobito glede medicinskih ili bolničkih troškova budućeg povratka osiguranika u domicilnu zemlju. Ukupni navedeni troškovi pokriveni su do limita od 50% iznosa osiguranja za putno zdravstveno osiguranje upisanog na polici osiguranja; c) Ukoliko osiguranik mora biti hospitaliziran u inozemstvu nakon planiranog završetka putovanja duže od 7 dana te ako ga prati osigurani član njegove obitelji, osiguratelj će platiti troškove hotelske sobe osobe u pratnji do repatrijacije osiguranika. Osiguratelj plaća maksimalno 50 EUR po noći do maksimalno 7 noći. d) Troškove spašavanja do limita od 10.000 EUR Kod spašavanja osiguranika helikopterom ili zrakoplovom osiguratelj naknađuje samo nužne i dokazane troškove koji su nastali radi spašavanja života osiguranika na nepristupačnim mjestima ili radi pružanja nužne i hitne medicinske pomoći. e) Ukoliko osiguranik plaća troškove liječenja prema liječničkom receptu ili troškove hospitalizacije: - stacionarno liječenje (prva medicinska pomoć do bolnice); - medicinski posjet u mjestu gdje osiguranik oboli; - lijekovi i naknada medicinskih potrepština koje prepiše liječnik; - nužna medicinska pomagala i pomagala za hodanje koja čine sastavni dio liječenja slomljenih ekstremiteta i povreda, a koja prepišu liječnici; - rendgen, skener i laboratorijska dijagnostika; - kliničko liječenje uz korištenje znanstveno dokazanih metoda u bolnici u mjestu osiguranikovog boravka ili najbližoj pogodnoj bolnici; - troškovi prijevoza od strane službeno odobrene hitne službe radi osiguranikovog prihvata u najbližu bolnicu ili kod najbližegraspoloživog liječnika, iznimno i taxi prijevoz; - troškovi premještaja u specijalističku kliniku ako to bude medicinski indicirano i propisano od strane liječnika; - operacije uključujući sve troškove u vezi s operacijama; - stomatološku uslugu isključivo u svrhu oslobađanja akutne zubobolje do 2% iznosa osiguranja putnog zdravstvenog osiguranja upisanog na polici osiguranja; f) U slučaju smrti osiguranika: - osiguratelj organizira i preuzima troškove prijevoza tijela od mjesta gdje je nastupila smrt do kuće pokojnika ili preuzima troškove pogreba u mjestu smrti do limita od 50% iznosa osiguranja putnog zdravstvenog osiguranja upisanog na polici osiguranja; ovaj iznos uključuje troškove kovčega; - ako obitelj osiguranika organizira transport osiguranikovog tijela prije odobrenja osiguratelja, osiguratelj će naknaditi troškove do iznosa koji odgovara svoti koju bi zahtijevala osoba koja bi pružila uslugu osiguratelju da je isti organizirao uslugu prijevoza; - ako osiguranik nije državljanin zemlje iz koje dolazi i njegova obitelj želi repatrirati tijelo u domovinu pokojnika, osiguratelj će organizirati prijevoz tijela i prihvatiti financijsku odgovornost do limita od 50% iznosa osiguranja putnog zdravstvenog osiguranja upisanog na polici osiguranja. Isključenje osigurateljeve obveze Članak 11. (1) Osiguratelj nije u obvezi isplatiti naknadu za: a) štete nastale zbog kroničnih bolesti, njihovih posljedica i posljedica nezgoda koje su postojale ili su bile poznate ili su morale biti poznate u vrijeme zaključivanja osiguranja, čak i ako nisu bile liječene, kao ni za posljedice bolesti koje su liječene u posljednjih šest mjeseci prije početka osiguranja, osim u slučaju kada je liječnička pomoć pružena radi spašavanja osiguranikova života ili oslobađanja akutne boli; b) putovanja u terapeutske svrhe; f) troškove nastale zbog posljedica bolesti ili nesretnog slučaja u ratu ili ratnim događanjima (bilo da je rat objavljen ili ne), neredima, masovnim pokretima, terorističkim činovima i sabotažama, napadima, pobunama, građanskim nemirima ili sličnim događanjima, radioaktivne kontaminacije bilo kojeg opisa i bilo kako uzrokovane; g) sve štete ili troškove uzrokovane epidemijama, zagađenjem ili prirodnim katastrofama koje su bile poznate prije polaska na put; h) štete nastale zbog vlastitog izlaganja nepotrebnim opasnostima (osim u slučaju spašavanja nečijeg života, ali ne i sudjelovanja u potragama) ili upletenosti u kaznena i nezakonita djela ili kao posljedica pijanstva ili ovisnosti (alkohol, droga, lijekovi) osiguranika; i) štete nastale za vrijeme manualnog odnosno fizičkog rada koji se obavlja u svrhu privređivanja. Manualni odnosno fizički rad je rad koji zahtijeva povećanu fizičku aktivnost kao što su npr. građevinski i montažni radovi, rad na otvorenom, rad sa strojevima, rad u uslužnim djelatnostima (konobari, kuhari, sobarice i sl.); j) korištenje opojnih droga ili narkotika; k) troškove bilo koje medicinske usluge i pomoći u zemlji stalnog prebivališta; l) troškove svakog operativnog ili medicinskog zahvata koji se može bez rizika odgoditi do povratka u domovinu; m) bilo koju medicinsku uslugu ili lijek za koji se znalo da je potreban ili se nastavlja tijekom puta ili boravka u inozemstvu; n) troškove rehabilitacije i fizioterapije i troškove umjetnih nadomjestaka ili slično ( proteza, stomatoloških i ortopedskih pomagala, slušnih pomagala, leća, pomagala za vid isl.) o) nezgode koje je osiguranik namjerno izazvao te posljedice pokušaja ili izvršenja samoubojstva; p) troškove uslijed psihičkih ili depresivnih bolesti; q) posljedice trudnoće ili komplikacija u trudnoći, osobito: namjerni prekid trudnoće, porod, spontani pobačaj. Ipak, u slučaju akutnih komplikacija tijekom trudnoće osiguratelj će u okviru police naknaditi trošak prve medicinske intervencije koja je potrebna da bi se otklonila opasnost po život majke i/ili djeteta; r) medicinski potpomognutu oplodnju ili neko drugo liječenje od neplodnosti te troškove kontracepcije; s) posljedice spolno prenosivih bolesti, AIDS-a; t) nezgode koje proizlaze iz bavljenja sportovima na amaterskoj i profesionalnoj osnovi bilo da se radi o natjecanjima ili treninzima; u) nezgode koje proizlaze iz bavljenja ekstremnim sportovima, skokova padobranom ili slično, ekstremnih planinarskih tura bez ovlaštenog planinarskog vodiča i onih iznad 6.000 m nadmorske visine, ekspedicija i sportskih aktivnosti u divljim vodama; v) nezgode koje proizlaze zbog upravljanja motornim vozilima, plovilima te zračnim uređajima kada osiguranik ne posjeduje propisanu službenu ispravu; w) nezgode koje su posljedica ronjenja ukoliko osoba ne posjeduje valjanu potvrdu za ronjenje; x) nezgode koje proizlaze iz sudjelovanja u okladama ili koje nastanu za vrijeme ili kao posljedica kaznenog djela ili tučnjave (osim slučajeva samoobrane); y) troškove uslijed termalnog liječenja, radioterapije, fototerapije, helioterapije, estetskih zahvata; z) troškove cijepljenja i stomatološke troškove (osim troškova hitne stomatološke intervencije); aa) liječenje ili njegu koju pruža liječnik koji je član obitelji; bb) troškove za koje već postoji pravo na naknadu temeljem nekog drugog ugovora ili prava. (2) Ipak, osiguratelj uvijek garantira pomoć osiguranoj osobi u bilo kojoj situaciji neposredne smrtne opasnosti. Situacijom smrtne opasnosti smatra se situacija u kojoj se može utvrditi da bi osiguranik izgubio život da nije bilo medicinske intervencije. Ostvarivanje prava iz osiguranja Članak 12. (1) U slučaju nastupa osiguranog slučaja osiguranik je dužan pridržavati se uputa osiguratelja, koje su sastavni dio police osiguranja. Ako se osiguranik pridržavao uputa iz stavka (1) ovog članka, tada ne mora u inozemstvu podmiriti troškove iz članka 10. ovih Uvjeta. (3) Ako se osiguranik nije pridržavao uputa iz stavka (1) ovog članka, dužan je izvijestiti osiguratelja o razlozima za to. Nakon utvrđivanja obveze, osiguratelj će osiguraniku naknaditi troškove iz članka 10. ovih Uvjeta, uključujući troškove kućnih posjeta i nabavke lijekova. (4) Osiguranik je dužan kontaktirati osiguratelja najkasnije 5 dana nakon osiguranog slučaja, osim u nepredviđenim slučajevima i slučajevima više sile. (5) U svojim intervencijama osiguratelj uvijek poštuje državne i međudržavne zakone i odredbe. (6) Osiguratelj ne može biti odgovoran za kašnjenja ili neočekivane događaje tijekom izvršenja ugovorenih usluga u slučaju štrajka, eksplozije, demonstracija, masovnih pokreta, prometnih ograničenja, sabotaža, terorizma, građanskog ili međudržavnog rata, posljedica radioaktivnosti ili u bilo kojemm drugom slučaju više sile, nepredviđenih okolnosti ili ograničenja djelovanja osiguratelja. (7) Osiguratelj je u obvezi isplatiti štetu samo ako je uz dokaz o osigurateljnom pokriću (original police) predočena sljedeća dokumentacija: a) originalni računi koji moraju sadržavati ime liječene osobe, vrstu bolesti, podatke o pojedinačnim stavkama pruženog liječničkog tretmana kao i njihovim datumima; u slučaju da se radi o troškovima nabave lijekova pod računom se podrazumijeva recept izdan od strane liječnika na kojem moraju biti jasno vidljivi propisani lijekovi, njihova cijena i potvrda ljekarne (pečat) da je lijek plaćen; u slučaju stomatološke usluge na računu moraju biti navedeni podaci o liječenom zubu i izvršenoj usluzi; b) u slučaju naknade troškova za prijevoz posmrtnih ostataka osiguranika ili njegovog pogreba u mjestu smrti, računi moraju biti potkrijepljeni službenom potvrdom o smrti i izvješćem mrtvozornika iz kojeg će biti vidljiv uzrok smrti; c) u slučaju prijevoza u mjesto prebivališta, računi moraju biti potkrijepljeni medicinskim izvješćem koje potvrđuje nužnost prijevoza. Osiguranik je dužan sve račune koje primi na kućnu adresu odmah dostaviti osiguratelju radi plaćanja. Ukoliko postupi suprotno ovoj odredbi osiguratelj će naknaditi samo troškove koji se odnose na pružene zdravstvene usluge, dok će troškove opomene i zateznih kamata snositi sam osiguranik. (8) Osiguratelj može zatražiti prijevod računa i prateće medicinske dokumentacije, a troškove prijevoda tada snosi ugovaratelj osiguranja. Ako troškove prijevoda snosi osiguratelj, oni će se odbiti od iznosa štete. Odštetni zahtjev Članak 13. (1) U svrhu ostvarivanja prava iz osiguranja odštetni zahtjevi podnose se osiguratelju najkasnije jedan mjesec nakon završetka liječenja (u mjestu putovanja) ili prijevoza u mjesto prebivališta, ili u slučaju smrti nakon prijevoza posmrtnih ostataka, odnosno nakon pokopa u mjestu smrti. (2) Ugovaratelj osiguranja, osiguranik odnosno korisnik osiguranja će na zahtjev osiguratelja dostaviti sve potrebne podatke za utvrđivanje nastanka osiguranog slučaja ili opsega odgovornosti osiguratelja za isplatu naknade, uključujući i dokaz o stvarnom početku putovanja. (3) Na zahtjev osiguratelja osiguranik se obvezuje podvrgnuti liječničkom pregledu od strane liječnika po izboru osiguratelja. (4) Ugovaratelj osiguranja i osiguranik ovlašćuju osiguratelja za pribavljanje svih podataka od trećih osoba pružatelja medicinske i ostalih usluga u smislu ovih Uvjeta, potrebnih za utvrđivanje obveze osiguratelja. Osiguranje putnika od posljedica nesretnog slučaja (nezgode) Sposobnost za osiguranje Članak 14. Osobe koje su osigurane po ovim Uvjetima uključuju se u potpunu obvezu osiguratelja bez obzira na njihovo zdravstveno stanje, opću radnu sposobnost, osim duševno bolesnih osoba i osoba potpuno lišenih poslovne sposobnosti, koje su u svakom slučaju isključene iz osiguranja. Pojam nesretnog slučaja Članak 15. (1) Nesretnim slučajem u smislu ovih uvjeta smatra se svaki iznenadni i o osiguranikovoj volji neovisan događaj koji, djelujući uglavnom izvana i naglo na osiguranikovo tijelo ima za posljedicu njegovu smrt ili prijelom kostiju. (2) U smislu prethodnog stavka, nesretnim se slučajem smatraju sljedeći događaji: gaženje, sudar, udar kakvim predmetom ili o kakav predmet, udar električne struje ili groma, pad, okliznuće, survavanje, ranjavanje oružjem, ubod ili ujed životinje i ubod insekta, osim ako je takvim ubodom prouzročena kakva infektivna bolest ili anafilaktička reakcija na otrov insekta. (3) Pod nesretnim slučajem smatra se i sljedeće: - trovanje kemijskim sredstvima iz osiguranikova neznanja, osim profesionalnih bolesti; - infekcija ozljede uzrokovane nesretnim slučajem; - trovanje zbog udisanja plinova ili otrovnih para, osim profesionalnih bolesti; - opekline vatrom ili elektricitetom, vrućim predmetom, tekućinama ili parom, kiselinama, lužinama i sl.; - davljenje i utapanje; - gušenje ili ugušenje zbog zatrpavanja (zemljom, pijeskom i sl.); - istegnuće mišića, iščašenje, uganuće, prijelom kostiju koji nastane zbog naglih tjelesnih pokreta ili iznenadnih naprezanja izazvanih nepredviđenim vanjskim događajima, ako je to nakon ozljede utvrđeno od odgovarajućeg liječnika specijalista; - djelovanje svjetlosti, sunčanih zraka, temperature ili lošeg vremena, ako im je osiguranik bio izložen neposredno zbog jednog nesretnog slučaja nastalog prije toga, ili se našao u takvim nepredviđenim okolnostima koje nije mogao spriječiti ili im je bio izložen radi spašavanja ljudskog života; - djelovanje rendgenskih ili radioaktivnih zraka, ako nastupe naglo ili iznenada, osim profesionalnih bolesti. (4) Ne smatraju se nesretnim slučajem u smislu ovih uvjeta: - zarazne, profesionalne i ostale bolesti urođene ili stečene bolesti i /ili deformacije, kao ni posljedice psihičkih utjecaja; - trbušne kile, kile na pupku, vodene ili ostale kile; - infekcije i bolesti koje nastanu zbog raznih alergija, rezanja ili kidanja žuljeva ili drugih izraslina tvrde kože; - anafilaktički šok, osim ako nastupi pri liječenju zbog nastalog nesretnog slučaja; - hernija disci intervertebralis, sve vrste lumbalgija, diskopatija, sakralgija, k okciodinija, ishialgija i miofascitis, fibrozitis, fascitis i sve patoanatomske promjene slabinsko križne regije označene analognim terminima; - odljepljenje mrežnice (ablatio retinae) prethodno bolesnog ili degenerativno promijenjenog oka, a iznimno se priznaje odljepljenje mrežnice prethodno zdravog oka, ako postoje znakovi izravne vanjske ozljede očne jabučice utvrđene u zdravstvenoj ustanovi; - posljedice koje nastanu zbog delirium tremensa i djelovanja droga; - posljedice medicinskih, posebice operativnih zahvata, koji se poduzimaju radi liječenja ili preventive radi sprječavanja bolesti, osim ako su te posljedice nastupile zbog dokazane pogreške medicinskog osoblja (vitium artis); - patološke promjene kostiju i patološki prijelomi kao ni stres frakture; - sustavne neuromuskularne bolesti i endokrine bolesti; - nesretni slučajevi koje uzrokuje srčana kljenut (infarkt). Srčana se kljenut (infarkt) ni u kojem slučaju ne smatra posljedicom nesretnog slučaja; - nesretni slučajevi zbog udara moždane kapi, poremećaja uma ili svijesti osim ako su i ti utjecaji neposredno uzrokovani nesretnim slučajem koji se može svesti u okvire nesretnog slučaja koji osiguratelj prihvaća. Opseg osigurateljeve obveze Članak 16. (1) Kad nastane nesretni slučaj u smislu ovih uvjeta, za slučaj smrti osiguratelj isplaćuje iznos osiguranja naznačen na polici osiguranja. (2) Ako nastupi smrt osiguranika mlađeg od 14 godina, osiguratelj je u obvezi isplatiti samo stvarne pogrebne troškove koji su dokumentirani računima, a najviše do iznosa osiguranja naznačenog na polici osiguranja. (3) Kada nastane nesretni slučaj loma kosti (prijelom kosti) osiguranika , osiguratelj isplaćuje iznos osiguranja naznačen na polici osiguranja, neovisno o broju slomljenih kostiju. Isključenje osigurateljeve obveze Članak 17. (1) Isključene su u cijelosti sve osigurateljeve obveze ako je nesretni slučaj nastao: a) zbog potresa; b) zbog rata ili ratnih događanja (bilo da je rat objavljen ili ne), nereda, masovnih pokreta, terorističkih činova i sabotaža, napada, pobuna, građanskih nemira ili sličnih događaja, radioaktivne kontaminacije bilo kojeg opisa i bilo kako uzrokovane; c) zbog bavljenja sportovima na amaterskoj i profesionalnoj osnovi bilo da se radi o natjecanjima ili treninzima; d) zbog bavljenja ekstremnim sportovima, skokova padobranom ili slično, ekstremnih planinarskih tura bez ovlaštenog planinarskog vodiča i onih iznad 6.000 m nadmorske visine, ekspedicija i sportskih aktivnosti u divljim vodama; e) zbog upravljanja motornim vozilima, plovilima te zračnim uređajima kada osiguranik ne posjeduje propisanu službenu ispravu; f) nezgode koje su posljedica ronjenja ukoliko osoba ne posjeduje valjanu potvrdu za ronjenje; g) kao posljedica sudjelovanja u okladama ili za vrijeme ili kao posljedica kaznenog djela ili tučnjave (osim slučajeva samoobrane); h) zbog pokušaja ili izvršenja samoubojstva; i) zato što je ugovaratelj osiguranja, osiguranik ili korisnik namjerno uzrokovao nesretni slučaj; j) zbog djelovanja alkohola i/ili narkotičkih sredstava na osiguranika, bez obzira na bilo kakvu odgovornost treće osobe za nastanak nesretnog slučaja. Smatra se da je nesretni slučaj nastao zbog djelovanja alkohola ako je u vrijeme nastanka nesretnog slučaja utvrđena koncentracija alkohola u krvi bila viša od zakonom dopuštene pri upravljanju prometnim sredstvom, a u ostalim slučajevima više od 0,80 g/kg. Smatra se da je osiguranik pod utjecajem alkohola ako se nakon prometne nesreće odbije podvrgnuti ispitivanju alkoholiziranosti, kao i ako se udalji s mjesta prometne nesreće prije dolaska policije, odnosno ukoliko nije pozvao policiju niti obavijestio najbližu policijsku postaju o prometnoj nesreći ili ako na drugi način izbjegne alko-testiranje; k) zbog aktivnog sudjelovanja u fizičkom obračunavanju (tučnjavi), osim u dokazanom slučaju samoobrane. (2) Ugovor o osiguranju ništetan je ako je u trenutku njegova sklapanja već nastao osigurani slučaj ili je bio u nastajanju, ili je bilo sigurno da će nastupiti, a uplaćena premija vraća se ugovaratelju umanjena za osigurateljeve troškove. Prijava nesretnog slučaja Članak 18. (1) Osiguranik koji je zbog nesretnog slučaja ozlijeđen, dužan je: a) odmah se prijaviti liječniku, odnosno pozvati liječnika radi pregleda i pružanja potrebne pomoći i odmah poduzeti sve potrebne mjere radi liječenja i držati se liječničkih savjeta i uputa u pogledu načina liječenja; b) nesretni slučaj prijaviti osiguratelju; c) u prijavi o nesretnom slučaju pružiti osiguratelju sva potrebna izvješća i podatke, posebice o mjestu i vremenu kad je slučaj nastao, potpuni opis događaja, ime liječnika koji ga je pregledao i uputio na liječenje ili koji ga liječi, liječnički nalaz o vrsti i težini tjelesne ozljede, o nastalim eventualnim posljedicama te podatke o manama, nedostacima i bolestima koje je eventualno osiguranik imao prije nastanka nesretnog slučaja, kao i RTG snimke. (2) Ako je nesretni slučaj imao za posljedicu osiguranikovu smrt, korisnik osiguranja dužan je o tome pisano izvijestiti osiguratelja i pribaviti potrebnu medicinsku i ostalu dokumentaciju te dokaz o svojem pravu na primanje osiguranog iznosa. (3) Troškovi za liječnički pregled i izvješća (početno i zaključno liječničko izvješće, ponovni liječnički pregled i nalaz specijalista), te ostali troškovi koji se odnose na dokazivanje okolnosti nastanka nesretnog slučaja i prava iz ugovora o osiguranju, padaju na teret podnositelja zahtjeva. (4) Osiguratelj je ovlašten i ima pravo od osiguranika, ugovaratelja, korisnika, zdravstvene ustanove ili bilo koje druge pravne ili fizičke osobe tražiti naknadna objašnjenja i dokaze, te na svoj trošak poduzimati radnje u svrhu liječničkog pregleda osiguranika od svojih liječnika ili liječničkih komisija, da bi se utvrdile važne okolnosti o prijavljenom nesretnom slučaju. Osiguranje od odgovornosti Opseg osigurateljeve obveze Članak 19. (1) Policom putnog osiguranja moguće je ugovoriti sljedeće vrste osiguranja od odgovornosti: a) Osiguranje privatne odgovornosti: osiguranjem je pokrivena građanskopravna izvanugovorna odgovornost osiguranika, za štetu zbog smrti, ozljede tijela ili zdravlja te oštećenja ili uništenja stvari treće osobe; b) Osiguranje privatne odgovornosti za stvari: Osiguranjem je pokrivena građanskopravna izvanugovorna odgovornost osiguranika za štetu uslijed oštećenja ili uništenja stvari treće osobe. (2) Osiguranjem su pokrivene štete: a) počinjenje u svojstvu privatne osobe u svakodnevnom životu, osim pri obavljanju zanatske djelatnosti, ili bilo koje djelatnosti kojim se privređuje; b) iz posjedovanja i uporabe bicikla bez motora; c) iz amaterskog bavljenja sportom, osim lova; d) iz držanja pitomih životinja kada se životinje ne drže u svrhu privređivanja. Isključenja iz osiguranja Članak 20. (1) Osiguranje ne vrijedi za: a) štete koje su nanesene samom ugovaratelju osiguranja, osiguraniku, njegovom bračnom ili izvanbračnom drugu, osiguranikovoj obitelji, ili drugim osobama koje žive s osiguranikom u zajedničkom kućanstvu; b) štete prouzročene namjerno; c) štete iz posjedovanja i uporabe: - letjelica i plovila, - motornih vozila i drugih vozila koja moraju biti registrirana prema pozitivnim zakonskim propisima; d) štete prouzročene hladnim oružjem i oružjem općenito; e) štete na stvarima ili izvršenim radovima koje je osiguranik ili koja druga osoba po njegovom nalogu ili za njegov račun izradio ili isporučio, ako je uzrok štete u izradi ili isporuci; f) štete od proizvoda s nedostatkom; g) štete na tuđim stvarima prouzročene pri obavljanju djelatnosti iz zanimanja od strane osiguranika na ovim ili s ovim stvarima (kao, primjerice, obrada, popravak, prijevoz, ispitivanje i sl.); h) štete koje su nastale kao posljedica postupanja protivno pravnim propisima; i) štete koje su posljedica bilo kakva utjecaja na okoliš, a posebno štete zbog onečišćenja (tla, vode i zraka), nanošenje šteta biljnim i životinjskim vrstama i/ili zaštićenim prirodnim staništima; j) imovinske štete u širem smislu, to jest za štete koje nisu nastale ni ozljedom tijela ili zdravlja neke osobe ni oštećenjem odnosno uništenjem stvari; k) štete zbog povrede prava osobnosti (neimovinska šteta) koja nije direktna posljedica povrede tijela ili zdravlja pri čemu su iz osiguranja navlastito isključeni svi odštetni zahtjevi koji proizlaze iz povrede prava na ugled, dobar glas, čast, dostojanstvo, poslovnu tajnu, slobodu privređivanja i sl.; l) štete nastale postupno. (2) Osiguranje nadalje ne vrijedi za: a) štete zbog rata ili ratnih događanja (bilo da je rat objavljen ili ne), nereda, masovnih pokreta, terorističkih činova i sabotaža, napada, pobuna, građanskih nemira ili sličnih događaja; b) odgovornost za štete koje su neposrednoj vezi s uporabom nukle arne energije, štete koje su izravno ili neizravno povezane s visokoenergetskim ionizirajućim zračenjima (npr. alpha, beta i gama zrakama koje se emitiraju radioaktivnim supstancama i neutronima ili zrakama koje se proizvode u čestičnim akceleratorima te laserskim i drugim sličnim zrakama); c) odgovornost za štete koje su posredno ili neposredno uzrokovane azbestom, proizvodima ili materijalima od azbesta bilo koje vrste, ili u bilo kojoj vezi s njime; d) odgovornost za štete koje su posredno ili neposredno posljedica djelovanja magnetskih, elektromagnetskih polja ili nuklearnog zračenja bez obzira na njihov izvor ili nastanak; e) osiguranikovu odgovornost na temelju ugovornog proširenja njegove odgovornosti i na slučajeve za koje inače prema zakonu ne odgovara; f) štete za koje osiguranik odgovara u svojstvu investitora, odnosno ulagača, ali su pokrivene štete za koje osiguranik odgovara u svojstvu naručitelja i/ili izvođača radova na vlastitim nekretninama. Osigurani slučaj Članak 21. (1) Osigurani je slučaj budući, neizvjestan i neovisan o isključivoj osiguranikovoj volji štetni događaj na temelju kojega bi treća osoba mogla zahtijevati naknadu štete. Smatra se da je osigurani slučaj nastao u onom trenutku kada se takav događaj počeo ostvarivati. (2) Jednim osiguranim slučajem smatra se i više vremenski povezanih šteta ako su one posljedica istog uzroka. Vrijeme valjanosti osiguranja Članak 22. (1) Osiguratelj je u obvezi samo onda ako osigurani slučaj nastane za vrijeme trajanja osiguranja. (2) Kod šteta zbog ozljede zdravlja koje nastaju postupno, smatra se da je štetni događaj nastao onda kada je prvi put liječničkim nalazom utvrđena ozljeda zdravlja. Iznos osiguranja i sudjelovanje osiguranika u šteti (franšiza) Članak 23. U svakoj šteti osiguranik sudjeluje s iznosom franšize od 100 EUR. Iznos osiguranja naveden na polici osiguranja i umanjen za franšizu, predstavljaju gornju granicu obveze osiguratelja po jednom osiguranom slučaju. Osiguranikove obveze nakon nastanka osiguranog slučaja Članak 24. (1) Osiguranik je dužan obavijestiti osiguratelja o nastanku osiguranog slučaja i o podnesenom zahtjevu za naknadu štete najkasnije u roku tri dana od saznanja. (2) Osiguranik je dužan obavijestiti osiguratelja i onda kada zahtjev za naknadu štete protiv njega bude pokrenut putem suda, kada bude stavljen u pritvor i onda kada bude poveden postupak za osiguranje dokaza. (3) Ako je proveden očevid, podignuta optužnica ili donesena odluka o kaznenom postupku, osiguranik je dužan o tomu odmah obavijestiti osiguratelja, pa i onda kada je već prijavio nastanak štetnog događaja. Također je dužan dostaviti nalaz mjerodavnog tijela u vezi s nastalim štetnim događajem. (4) Osiguranik nije ovlašten da se bez prethodne osigurateljeve suglasnosti izjašnjava o zahtjevu za naknadu štete, a posebno da ga prizna potpuno ili djelomično, da se o zahtjevu o naknadi štete nagodi ni da obavi isplatu, osim ako se prema činjeničnom stanju nije moglo odbiti priznanje, nagodba ili isplata a da se time ne učini očita nepravda. Ako je osiguranik u zabludi smatrao da postoji njegova odgovornost ili da su ispravno utvrđene činjenice, to ga neće opravdati. (5) Ako oštećeni podnese tužbu za naknadu štete protiv osiguranika, osiguranik je dužan dostaviti osiguratelju sudski poziv ili tužbu i sve spise u svezi sa štetnim događajem i zahtjevom za naknadu štete te vođenje spora prepustiti osiguratelju. (6) Ako se osiguranik protivi osigurateljevu prijedlogu da se zahtjev za naknadu štete riješi nagodbom, osiguratelj nije dužan platiti višak naknade, kamata i troškova koji su zbog toga nastali. (7) Ako se oštećenik sa zahtjevom za naknadu štete neposredno obrati osiguratelju, osiguranik je dužan osiguratelju pružiti sve dokaze i podatke kojima raspolaže, a koji su nužni za utvrđivanje odgovornosti za učinjenu štetu i za ocjenu osnovanosti zahtjeva, opsega i visine štete. (8) Ako zbog promijenjenih okolnosti osiguranik stekne pravo da se ukine ili smanji renta oštećenoj osobi, dužan je o tomu izvijestiti osiguratelja. Ako se osiguranik ne drži obveza iz ovog članka, snosit će štetne posljedice koje zbog toga nastanu, osim ako bi one nastale i da se držao obveza. Osigurateljeve obveze nakon zahtjeva oštećene osobe Članak 25. (1) U vezi sa zahtjevom za naknadu štete podnesenim od oštećene osobe osiguratelj je u obvezi: a) zajedno s osiguranikom poduzeti obranu od neosnovanih ili pretjeranih zahtjeva za naknadu štete (pravna zaštita- članak 26.); b) udovoljiti osnovanim zahtjevima za naknadu štete (naknada štete - članak 27.); c) naknaditi troškove sudskog postupka (naknada troškova postupka - članak 28.) Pravna zaštita Članak 26. (1) Osigurateljeva obveza u pružanju pravne zaštite obuhvaća: a) ispitivanje osiguranikove odgovornosti za nastalu štetu; b) vođenje spora ako oštećeni ostvaruje pravo na naknadu štete u parničnom postupku protiv osiguratelja neposredno; c) davanje u osiguranikovo ime svih izjava koje smatra korisnim za zadovoljenje ili obranu od neosnovanog ili pretjeranog zahtjeva za naknadu štete. (2) Osiguratelj može u parnici sudjelovati u svojstvu umješača. (3) Osiguratelj je ovlašten odbiti vođenje spora ili prepustiti vođenje spora osiguraniku, ako ocjeni da nema više mjesta za pružanje pravne zaštite s obzirom na odnos visine zahtjeva za naknadu štete i visine iznosa osiguranja. (4) U slučaju da osiguratelj na ime naknade štete isplati iznos osiguranja prije pokretanja spora, prestaje i njegova obveza na pravnu zaštitu. Naknada štete Članak 27. (1) Osiguratelj isplaćuje naknadu iz osiguranja na temelju: a) priznanja koje je dao ili odobrio; b) nagodbe koje je zaključio ili odobrio; c) sudske odluke, ali najviše do iznosa obveze iz ugovora o osiguranju. (2) Osiguratelj je ovlašten na ime naknade osiguraniku položiti iznos osiguranja umanjen za iznos ugovorene franšize, te se u tom slučaju oslobađa svih obveza i postupaka u vezi s osiguranim slučajem. (3) Kada je osiguranik u obvezi položiti depozit radi osiguranja naknade štete temeljem zakonskih propisa ili sudske odluke, osiguratelj sudjeluje u deponiranju najviše do visine njegove obveze na naknadu štete. (4) Ako je osiguranik obvezan platiti na ime naknade štete rentu, a kapitalizirana vrijednost rente premašuje iznos osiguranja umanjen za iznos ugovorene franšize, ili ostatak iznosa nakon odbitka drugih davanja u svezi s tim osiguranim slučajem, dugovana renta naknadit će se samo u omjeru između iznosa osiguranja, odnosno ostatka iznosa osiguranja i kapitalizirane vrijednosti rente. Kapitalizirana vrijednost rente za izračunavanje omjera računa se na temelju tablica smrtnosti za osiguranje života u Republici Hrvatskoj. (5) Ako se osiguratelj protivi osiguranikovu prijedlogu da se o zahtjevu za naknadu štete nagodi, dužan je platiti naknadu, kamate i troškove koji zbog toga nastanu, i onda kada premašuju svotu osiguranja. Naknada troškova postupka Članak 28. (1) Osiguratelj naknađuje sve troškove parničnog postupka, neovisno o tome da li osiguratelj vodi spor ili oštećeni ostvaruje svoje pravo na naknadu štete u sudskom postupku neposredno protiv osiguranika, ako troškovi zajedno s naknadom štete (i pripadajućim kamatama) ne premašuju iznos osiguranja. (2) Osiguratelj plaća troškove branitelju u kaznenom postupku pokrenutom protiv osiguranika zbog događaja koji bi mogao imati za posljedicu postavljanje zahtjeva za naknadu štete na temelju odgovornosti pokrivene osiguranjem, i to samo iznimno: ako je obaviješten o izboru branitelja i prihvatio platiti troškove. Troškove kaznenog postupka i troškove zastupanja oštećenika osiguratelj ne naknađuje. (3) Isplatom ugovorenog iznosa osiguranja, osiguratelj se oslobađa daljnjih davanja na ime naknade i troškova po jednom osiguranom slučaju. Osiguranje prtljage Opseg osigurateljeve obveze Članak 29. (1) Osiguranje pokriva gubitak, oštećenje ili uništenje prtljage koju osiguranik nosi na sebi i sa sobom tijekom trajanja putovanja, u odlasku i dolasku, te za vrijeme boravka, uslijed: - prometne nesreće, - elementarnih nepogoda (potresa, poplave, oluje i sl.), - požara i eksplozije, - kaznenog djela treće osobe (krađe, razbojstva), te - prilikom predaje prtljage prijevozniku. (2) U smislu ovih Uvjeta, mjestom boravka u odredištu putovanja smatra se mjesto u kojem osiguranik boravi za vrijeme trajanja putovanja, bez namjere da se u tom mjestu naseli. (3) Osiguratelj će pokriti troškove nabavke zamjenske prtljage (nužna zamjenska odjeća, osnovne higijenske i ostale potrepštine i sl.) do najviše 250 EUR u slučaju da osobna prtljaga koja je predana na prijevoz ne stigne na odredište putovanja izvan mjesta prebivališta ili boravišta isti dan kada i osiguranik zbog zakašnjenja u prijevozu. (4) Isključuje se odšteta za nabavku zamjenske prtljage pri povratku u mjesto boravišta. Isključenja i ograničenja osigurateljeve obveze Članak 30. (1) Nakit, satovi, krzno, aparati i uređaji svake vrste s pripadajućom opremom (npr. foto-aparat, video-kamera, mobitel, tablet, laptop) i muzički instrumenti, osigurani su samo do 1/3 ugovorenog iznosa osiguranja prtljage upisanog na polici osiguranja i to samo ako se nose sa sobom. Ukoliko se nalaze u predanoj prtljazi i za vrijeme uporabe navedeni predmeti nisu ni u kojem slučaju pokriveni osiguranjem. (2) Bicikli, kajaci, sportski čamci na sklapanje i gumeni čamci, kao i drugi sportski rekviziti s pripadajućom opremom osigurani su samo za vrijeme prijevoza do i od odredišta putovanja te u turističkom smještaju u zaključanoj prostoriji, ali ne i za vrijeme uporabe. (3) Prtljaga u parkiranom vozilu, kamp kućici ili plovilu osigurana je od provalne krađe samo ako se ista nalazi unutar zaključanog vozila, kamp kućice odnosno plovila, ili u zaključanom tvorničkom nosaču opreme, isključivo u vremenu od 6.00 do 22.00 sata. Iznimno, ako prekid putovanja ne traje dulje od 2 sata, osigurateljna zaštita postoji neprekidno. (4) Iz osiguranja su isključeni: novac i vrijednosni papiri, nakit, putne karte, kreditne kartice, te svi osobni i identifikacijski dokumenti (putovnica, vozačka dozvola, i sl.), umjetnine i životinje. Iz osiguranja su isključene i naočale, kontaktne leće te proteze, osim u slučaju prometne nesreće. (5) Osiguratelj nije u obvezi za: a) štete koje nastanu zbog svojstva ili stanja same prtljage, odnosno unutrašnje mane i prirodnih osobina stvari koje čine prtljagu; b) štete uslijed uništenja odjeće, obuće i osobne prtljage tijekom isprobavanja i nošenja; c) štete nastale uništenjem lomljivih predmeta (od keramike, stakla i sl.); d) oštećenja uslijed kojih su nastale ogrebotine na prtljazi, a posebice ogrebotine na putnim torbama, koferima i sl.; e) krađu prtljage s mjesta bez nadzora i nadgledavanja; f) gubitak prtljage zbog zaboravljanja prtljage uslijed putovanja, odnosno na mjestu odredišta i mjestu polaska na putovanje; g) štete uslijed gubitka, uništenja i oštećenja osobne kozmetike; h) bilo kakav gubitak kojeg je uzrokovala upotreba, kvarenje i uništenje prouzrokovano gamadi ili drugim insektima, klimatski i atmosferski uvjeti, mehanički ili električni kvarovi, mrljanje ili bilo koji proces bojanja ili čišćenja ili štete koju je uzrokovala voda na bilo koji način; i) štete kada je osiguranik namjerno ili iz grubog nemara prouzročio osigurani slučaj ili kada prilikom nastanka osiguranog slučaja, osobito u prijavi štete, namjerno navede neistinite podatke; j) štete zbog rata ili ratnih događanja (bilo da je rat objavljen ili ne), nereda, masovnih pokreta, terorističkih činova i sabotaža, napada, pobuna, građanskih nemira ili sličnih događaja, kao i zbog aktivnog sudjelovanja u njima, radioaktivne kontaminacije bilo kojeg opisa i bilo kako uzrokovane. Prijava osiguranog slučaja Članak 31. (1) Osiguranik je obvezan odmah po nastanku štetnog događaja bez odgađanja prijaviti štete nastale zbog kaznenih djela treće osobe nadležnoj ili najbližoj policijskoj postaji. Policijski zapisnik s popisom svih izgubljenih ili oštećenih stvari treba dostaviti osiguratelju zajedno s pisanom prijavom štete najkasnije u roku 30 (trideset) dana od dana nastanka osiguranog slučaja. (2) Štete na predanoj prtljazi moraju se odmah bez odgađanja prijaviti prijevozniku ili organizaciji koja pruža usluge smještaja. Potvrda o šteti izdana od nadležnog poduzeća mora se dostaviti osiguratelju zajedno s pisanom prijavom štete najkasnije u roku 30 (trideset) dana od dana nastanka osiguranog slučaja. (3) Ukoliko je štete u cijelosti naplaćena od nadležnog poduzeća, istu nije moguće naknaditi od osiguranja. Naknada iz osiguranja Članak 32. (1) Naknada iz osiguranja isplaćuje se prema novonabavnoj cijeni izgubljene stvari umanjene za procijenjeni iznos izgubljene vrijednosti zbog starosti ili istrošenosti (sadašnja vrijednost), ali najviše do ugovorenog iznosa osiguranja. (2) Ako su osigurane stvari potpuno uništene ili ukradene, a osiguranik ne može dokazati njihovu sadašnju vrijednost u smislu prethodnog stavka, osigurateljeva je obveza najviše do 50% od nabavne vrijednosti nove stvari. (3) Za oštećene stvari Osiguratelj je u obvezi naknaditi nužne troškove popravka, ali najviše do iznosa sadašnje vrijednosti osiguranih stvari. (4) Za filmove, nosače slike, zvuka i podataka (kraće mediji), Osiguratelj naknađuje sadašnju vrijednost izgubljenog medija. Snimljeni materijali koji su pohranjeni na izgubljenim medijima nisu predmet naknade i u svakom slučaju su isključeni iz osiguranja. (5) U slučaju štete na prtljazi koju osiguranik nosi sa sobom, osiguranik sudjeluje u šteti s iznosom 50 EUR po štetnom događaju. Osiguranje otkaza putovanja Iznos osiguranja Članak 33. Iznos osiguranja jednak je cijeni putovanja koje je osiguranik ugovorio i uplatio i za koje je s osigurateljem zaključio ugovor o osiguranju. Opseg osigurateljeve obveze Članak 34. (1) Ako osiguranik otkaže ugovoreno putovanje zbog nepredviđenih zapreka, odnosno zapreka koje osiguranik nije mogao spriječiti, izbjeći ili otkloniti, a koje su nastale od trenutka sklapanja ugovora o putovanju do trenutka početka putovanja ili ako zbog istih razloga bude prisiljen prekinuti već započeto putovanje ali pod uvjetom da nije iskoristio više od 50% predviđenog putovanja, osiguratelj će naknaditi osiguraniku troškove otkaza putovanja ako je do njega došlo zbog: a) iznenadne akutne bolesti (osim psihičkih bolesti) koja zahtjeva liječničku skrb, poremećaja u trudnoći, smrtnog slučaja ili teške tjelesne ozljede osiguranika, bračnog, odnosno izvanbračnog druga s kojim osiguranik živi u bračnoj, odnosno izvanbračnoj zajednici, djeteta osiguranika, roditelja, brata, sestre osiguranika ili osoba o kojima osiguranik skrbi; b) osjetljivosti osiguranika na cjepiva, ukoliko su ista neophodna, odnosno koja je osiguranik bio obvezan primiti slijedom propisa države u koju osiguranik putuje; c) šteta većeg razmjera na imovini osiguranika uslijed nastanka elementarne nepogode, požara ili namjernog kaznenog djela treće osobe; d) poziva na vojnu vježbu; e) krađe ili totalne štete na vozilu osiguranika, ako se putuje vozilom. Naknada iz osiguranja Članak 35. (1) Osiguratelj je u slučaju nastanka osiguranog slučaja dužan isplatiti osigurninu u iznosu od 90% iznosa cijene putovanja koje je osiguranik ugovorio i uplatio. (2) Ukoliko je putovanje opravdano otkazano prije planiranog početka putovanja osiguratelj će naknaditi i ukupno uplaćenu premiju za ostala neiskorištena pokrića sklopljena na ugovoru o putnom osiguranju po kojem se isplaćuje naknada za otkaz putovanja. Prijava osiguranog slučaja Članak 36. (1) Osiguranik je obvezan u roku od 3 (tri) radna dana po nastanku nekog od razloga za otkaz putovanja navedenih u članku 34. ovih Uvjeta otkazati putovanje kod putničko-turističke tvrtke s kojom je zaključio ugovor o putovanju ili kod pružatelja usluga smještaja ili prijevoza za vrijeme putovanja. (2) Ako je osiguranik iz bilo kojeg od razloga navedenih u članku 34. ovih Uvjeta morao otkazati ugovoreno ili započeto putovanje, dužan je o tomu izvijestiti osiguratelja u pisanu obliku i to najkasnije u roku 15 radnih dana računajući od dana nastanka razloga za otkaz. Članak 37. (1) Osiguranik je dužan, najkasnije u roku 30 dana od dana kada je putovanje prema planu trebalo započeti, podnijeti osiguratelju odštetni zahtjev zajedno sa sljedećim dokumentima: a) izvornik police osiguranja; b) uplatnicu i ugovor o putovanju kojima potvrđuje da je putovanje uplaćeno; c) pisanu potvrdu putničko-turističke tvrtke o otkazivanju putovanja, pružatelja usluge smještaja i/ili prijevoza; pri tome datum otkaza putovanja mora biti jasno i izričito naveden, a u slučaju prekida već započetog putovanja mora biti naveden datum i mjesto prekida putovanja; d) potvrdu putničko-turističke tvrtke, pružatelja usluge smještaja i/ili prijevoza o iznosu koji je ustegnut od osiguranika zbog otkaza odnosno prekida putovanja; e) ako je putovanje otkazano ili prekinuto zbog bolesti, tjelesne ozljede, trudnoće ili nepodnošenja cjepiva, osiguranik mora dostaviti osiguratelju cjelovitu medicinsku dokumentaciju koja se odnosi na bolest, ozljedu, trudnoću i cijepljenje, a koja je povezana s osiguranikovom nemogućnosti korištenja putovanja, te izvješće o bolovanju ili potvrdu poslodavca o korištenju godišnjeg odmora u tom periodu, ukoliko je osiguranik zaposlen; f) ako je putovanje otkazano ili prekinuto zbog smrtnog slučaja, osiguranik ili korisnik osiguranja mora dostaviti osiguratelju smrtovnicu / izvod iz matične knjige umrlih; g) ako je putovanje otkazano ili prekinuto zbog štete na imovini, vojne vježbe, osiguranik mora dostaviti osiguratelju potvrdu nadležnog tijela. Završne odredbe Članak 38. Na ugovor o putnom zdravstvenom osiguranju osoba na putovanju, osiguranju putnika od posljedica nesretnog slučaja (nezgode), osiguranju od odgovornosti, osiguranju prtljage i osiguranju otkaza putovanja primjenjuju se i ostale obvezne odredbe Zakona o obveznim odnosima, a dispozitivne odredbe, ako pitanja na koja se odnose nisu u ovim uvjetima drukčije uređena. U primjeni od 3.12.2013. Klauzula za korištenje osobnih podataka u marketinške svrhe Sklapanjem ovog Ugovora dajem izričitu privolu Allianz Zagreb d.d. I poslovno povezanim osobama s Allianz Zagreb da navedene moje osobne podatke, kao i druge podatke koje je Allianz Zagreb d.d. saznao temeljem poslovnog odnosa, a koji podaci su zakonom zaštićeni kao tajni, može trajno odnosno do opoziva koristiti i obrađivati u svojim poslovnim evidencijama u svrhu unaprjeđenja kvalitete poslovnog odnosa s klijentom i marketinga (npr. slanje ponuda o proizvodima, promotivnim ponudama, kampanjama i oglasima putem telefona, e-maila i pošte i dr.). Potvrđujem kako sam upoznat s pravom da se takvoj obradi usprotivim te da sam upoznat s postojanjem prava na pristup i ispravak podataka koji se na mene odnose. Popis poslovno povezanih osoba objavljen je na Internet stranici Allianz Zagreb. Klauzula se primjenjuje uz prethodnu suglasnost s Klauzulom za korištenje osobnih podataka u marketinške svrhe na ponudi osiguranja. Posebni uvjeti paketa putnog osiguranja Na ugovor osiguranju primjenjuju se samo one Klauzule čija je primjena izričito ugovorena i za koje je plaćena premija osiguranja. Klauzula PO 1/2013: Amatersko bavljenje sportom Za razliku od članka 11. stavka (1), točke t) Uvjeta paketa putnog osiguranja 243-1213, ukoliko je ugovoreno pokriće putnog zdravstvenog osiguranja, odnosno članka 18. stavka (1), točke c) Uvjeta paketa putnog osiguranja 243-1213, ukoliko je ugovoreno pokriće osiguranje od posljedica nesretnog slučaja (nezgode), osigurateljnim pokrićem obuhvaćeno je amatersko bavljenje sportom. Sva ostala isključenja i odredbe Uvjeta paketa putnog osiguranja 243-1213 ostaju nepromijenjena. Klauzula PO 2/2013: Profesionalno bavljenje sportom Za razliku od članka 11. stavka (1), točke t) Uvjeta paketa putnog osiguranja 243-1213, ukoliko je ugovoreno pokriće putnog zdravstvenog osiguranja, odnosno članka 18. stavka (1), točke c) Uvjeta paketa putnog osiguranja 243-1213, ukoliko je ugovoreno pokriće osiguranje od posljedica nesretnog slučaja (nezgode), osigurateljnim pokrićem obuhvaćeno je profesionalno bavljenje sportom. Sva ostala isključenja i odredbe Uvjeta paketa putnog osiguranja 243-1213 ostaju nepromijenjena.