Supplementaryinsurance

Guest CareComprehensivecoverforyourguests

ThreegoodreasonsforchoosingGuestCare

Professionalsupportinmedicalemergencies fromSanitasAssistance (24/7phoneservice)

Shareoftransport,rescueandsearchcostscovered

Fullcostsofoutpatientandinpatientemergencytreatmentcoveredintheeventofillnessor accident

sanitas.com

GuestCareisaflexiblehealthinsurancesolutionforpeoplevisitingfromabroad.WithnomonetarylimitsonthetreatmentcostscoveredinSwitzer- land,andthankstotheminimumcoverinSchengenstatessetbytheSwissFederalOfficeforMigration,yourguestshavecomprehensivecover againstthefinancialconsequencesofillnessandaccident.

Sanitas AssistanceEmergencyhelpbyphone (Tel.+41444464747) – Anetworkofspecialistsonhandtohelparoundtheclockinanemergency – Supportwithorganisingtransport,commit-mentstoprovidecover,andmorebesides – SanitasAssistancemustbenotifiedimmedi-atelyifastayinhospitalisnecessary

Choose the desired cover – Generalward:multi-bedroom,withtreat-mentbyahospital-baseddoctor – Semiprivate:two-bedroomandprivatedoctor(canonlybetakenoutforpeopleuptoage65) – Private:singleroomandprivatedoctor(canonlybetakenoutforpeopleuptoage65)

Pleasenotethatexistingconditions, conditionsresultingfromanaccidentandmaternity-relatedclaimsarenotcovered.

EasytotakeoutStraightforward,comprehensivecover: Takingoutinsuranceforyourguestscouldn’tbeeasier.Simplyusetheenclosedpaying-inslip.Oncestampedbythepostoffice,thestubofthepaying-inslipisvalidconfirmationofinsurance.Youcaninsureuptofourpeoplewitheachpaying-inslip.Covercommencesonthedatechosenbyyou,butattheearliestwhenyourguestsenterSwitzerlandortheSchengenArea,providedthefollowingcondi-tionsaremet: – Insuranceistakenoutbeforeyour guestsenterthecountry – Alldetailsarefilledoutcorrectlyandinfull – Therelevantpremiumhasbeen transferredtoSanitas

CostsataglanceMonthlypremiums:GuestCarecanbetakenoutforwholemonthsonly(foramaximumofsixmonths)–dependingonrequirements–foranyonewhoisnotpermanentlyresidentinSwitzerland.MonthlypremiumsarespecifiedinSwissfrancs(CHF),anddependontheageofthepersoninsuredandthedesiredcatego-ryofcover.

Age* General Semiprivate Private

0–18 CHF140 CHF240 CHF290

19–25 CHF190 CHF290 CHF370

26–30 CHF250 CHF350 CHF450

31–40 CHF270 CHF400 CHF520

41–50 CHF290 CHF450 CHF590

51–60 CHF320 CHF500 CHF670

61–65 CHF350 CHF550 CHF750

66+ CHF350 Notinsurable Notinsurable

*Theagereachedinthecalendaryearinwhichinsurancecommences

MakingaclaimIntheeventofaclaim,pleasesendoriginalinvoicesandreceipts,medicalcertificates andreportsto:Sanitas,GuestCare,Jägergasse3,Postfach,8021Zürich

Scopeofcoverage

1 Basisoftheinsurancecontract

1 Theinsurancecontractisbasedonthegeneraltermsofinsurance.2 Intheeventthatamatterisnotexplicitlycoveredinthesedocuments,the

provisionsoftheInsuranceContractAct(IPA)shallapply.3 Thistranslationisprovidedforthesakeofconvenience.Thewordingofthe

Germanoriginalshalltakeprecedence.4 Inthisdocumentthemasculineformreferstobothgenders.

2 Subjectofinsurance

1 SanitasPrivatversicherungenAG(hereinafter“Sanitas”)coversthefinancialconsequencesofacuteillnessoraccidentduringatemporarystayinSwitzerlandoraSchengenmemberstate.Theinsuredpersoncanchoosebetweenthefollowingcategoriesofcoverage:– General:outpatienttreatment,plusthecostsofinpatientcareina generalward

– Semiprivate:outpatienttreatment,plusthecostsofinpatientcare inasemiprivateroom

– Private:outpatienttreatment,plusthecostsofinpatientcare inaprivateroom

2 Semiprivateandprivatecoveragecanonlybetakenoutiftheinsuredpersonisaged65orunderatthetimewhencoveragecommences.

3 Thefinancialconsequencesofmaternityarecoveredthroughtheendofthe26thweekofpregnancyintheeventofunforeseencomplicationsduringpregnancy.

3 Insuredpersons

1 CoverageisavailabletopersonswhoarenotresidentinSwitzerlandandarenotobligatedtotakeoutmandatoryhealthinsuranceundertheHealthInsuranceAct(HIA).

2 Theinsurancecoversthepersonsspecifiedontheremittanceslip(insuredpersons).

4 Scopeofbenefits

1 Theinsurancepayscostsinexcessofthebenefitspaidunderanysocialsecurityschemeintheinsured’scountryofresidence.InSchengenmemberstates,entitlementtominimumcoverageislimitedinaccordancewiththeSwissFederalOfficeforMigration’sdirectiveonthegrantingofvisas.

2 Ifinflatedchargesarebilled,Sanitasmaydefinebenefitsinlinewithcustomarylocalrates.

3 Ifcostsarenotitemized,Sanitaswillbreakthemdownatitsowndiscretion.

5 Definitions

1 Illnessisdefinedastheimpairmentofone’sphysical,mental,orpsychologi-calhealththatisnottheconsequenceofanaccidentandwhichrequiresmedicalattentionorpreventstheinsuredpersonfromworking.

2 Anaccidentisdefinedasthesudden,unintentional,harmfulinfluenceofanexceptionalexternalforceonthehumanbody,resultingintheimpairmentofone’sphysical,mental,orpsychologicalhealth,ordeath.Occupationalillnessesandaccident-likephysicalinjuriesaredeemedtobeequivalenttoanaccident.TheprovisionsoftheAccidentInsuranceAct(UVG/LAA)apply.

3 Acutehospitalsaredefinedastreatmentfacilitiesandclinicsthataremanagedandmonitoredbyphysiciansandonlyadmitpersonssufferingfromacuteillnessesoraccidents.Forthepurposeshereof,acutehospitalsalsoincludematernity,psychiatricandrehabilitationfacilities.

4 Thecountryofresidenceisdefinedastheinsuredperson’susualplaceofresidence.

6 Geographicalscopeofcoverage

CoverageisvalidinSwitzerlandandinSchengenmemberstates(apartfromtheinsured’scountryofresidence).

Insuredbenefits

7 Outpatientcare

Theinsurancecoversthecostsofoutpatienttreatmentbydoctorsandmedicallyprescribedoutpatienttreatment.

8 Hospitalcare

Theinsurancecoversthecostsofaccommodation,nursingcareandtreatmentintheinsuredwardofanacutehospitalfacilityasdefinedinSection5(3)aboveprovidedthatacutehospitalisationisnecessaryfromamedicalpointofviewandrepatriationisnotpossibleorappropriateformedicalreasons.

9 Costsoftransport,searchandrescue

1 TheinsurancewillpayuptoatotalofCHF50,000foremergencytransporttothenearestdoctorortothenearestacutehospitalfacilitysuitablefortherequisitetreatment,andformedicallynecessarytransfers.

2 TheinsurancewillpayuptoatotalofCHF20,000forsearchandrescueoperationsintheeventofanacuteillnessoraccident.

10 Sanitas Assistance

1 SanitasAssistanceisaserviceofferedbytheglobalemergencyassistanceorganisationEuropAssistanceonbehalfofSanitas.Theserviceincludescare,adviceandtheorganisationoftransportandtreatment,andtheassumptionofcostsasspecifiedinSection10 (2)below.

2 Intheeventofacuteillnessoraccidentsufferedbytheinsuredperson,SanitasAssistancewillprovidethefollowingbenefits:– Advancemoneytocoverthecostsofinpatienttreatment.–Organiseandpayfortherepatriationoftheinsuredpersonandanaccompanyingpersontotheircountryofresidence,providedthatrepatriationismedicallypossibleandappropriate.

–Organiseandpayforsomeonetoaccompanythechildren(underage16)oftheinsuredpersonincaseswhereaninsuredeventpreventstheinsuredpersonoranotheraccompanyingpersonfromlookingafterthem.

–Organiseandpayfortravelandhotelaccommodation(10nights’accommodationatamaximumofCHF200pernight)foravisitordesignatedbytheinsuredpersonorhisorherfamilyifitisnotpossible,formedicalreasons,torepatriatetheinsuredpersontohisorhercountryofresidencewithin10daysofthecommencementofinpatienttreatment.

–Organiseandpayfortherepatriationofthebodyofadeceasedinsuredperson(includingCHF800foracoffin)andrepatriationofaccompanyingfamilymembers,providedthesefamilymembersarealsocoveredbySanitasAssistance.

3 InsuredcostsasperSection10 (2)abovewillnotbepaidunlessthecorrespondingmeasureswereinitiatedorapprovedinadvancebySanitasAssistance.

4 NeitherSanitasnorEuropAssistancemaybeheldliableforanyconsequenti-aldamagesifitisnotpossibletoprovideinsuredbenefits,oriftherearedelaysinprovidinginsuredbenefits,astheresultofeventsoverwhichSanitasandEuropAssistancehavenocontrol(e.g.warorwarlikeactivities,politicalunrest,strikes,naturaldisastersorrestrictionsimposedbygovernmentauthorities).

11 CoverageinSchengenmemberstates

1 InSchengenmemberstates,thecoveragelaiddownin7to10ofthepresentprovisionsislimitedtotheminimumcoveragespecifiedintheSwissFederalOfficeforMigration’sdirectivesonthegrantingofvisas.

2 Ifconfirmationofinsuranceisrequiredtoapplyforavisa,itcanberequestedbyphoning+41844150150orsendinganemailto info@sanitas.com,specifyingtheinsured’slastandfirstnameanddateofbirth,andthepolicynumberprintedonthereceipt.

Generaltermsofinsurance

SupplementaryinsuranceplansaspertheInsuranceContractAct(IPA)

July2009edition(amended2012),insurancecarrier:SanitasPrivatversicherungenAG

9049

 08.19 en

Restrictions to insurance coverage

12 Benefitexclusions

Nobenefitswillbepaidforthefollowing:– Contributionstocostsandbenefitreductionsunderotherinsurancepolicies

–Medicalconditionsandconsequencesofanaccidentexistingpriortotheeffectivedateofthecontract

– Treatmentsandmeasuresthatarenoteffective,expedientoreconomicalunderthetermsoftheHealthInsuranceAct(HIA),wherebyeffectivenessmustbescientificallyproven

–Dentaltreatment–Measuresimposedbyajudicialoradministrativeauthority– Theconsequencesoftheabuseofnarcoticsoraddictivesubstances(e.g.alcohol,drugsandmedications)

– Theconsequencesofracingandtrainingrunswithmotorvehiclesandmotorboatsonracingandtrainingcourses,andparticipationinralliesandsimilarracesinvolvingmotorvehicles

– Theconsequencesofconductwheretheinsuredpersonseriouslyprovokedothers

– Theconsequencesofunrest,terroristacts,crimesoroffensesofalltypes,whethercommittedorattempted,andthemeasurestakenagainstthem,unlesstheinsuredpersoncanprovethatheorshedidnotactivelyparticipateonthesideoftheperpetratorsorincitethem

13 Curtailmentorrefusalofbenefits

1 Benefitswillbecurtailed,andinparticularlyseriouscasesnotdisbursedatall,inthecaseofclaimsresultingfromriskyactivities.Riskyactivitiesaredefinedasactsthroughwhichtheinsuredpersonexposeshim-orherselftoexceptionaldangerwithouttakingorbeingabletotakeprecautionstoreducetherisktoareasonablelevel.However,actiontakentorescuepersonsisinsuredevenifthisactioncanbeviewedasariskyactivityinitself.

2 Sanitaswaivesitsrighttocurtailinsurancebenefitsintheeventofgrossnegligence.However,insuredpersonsarenotentitledtocompensationforthecurtailmentofbenefitsfromotherinsurancecompanies.

14 Multipleinsurancecoverage

Iftheinsuredpersonisinsuredwithmorethanoneinsurancecompany,thetotalinsuredcostsareonlycompensatedonce.InsuchcasesSanitaspaysbenefitsonlyinproportiontoitsinsuredbenefit’sshareofthetotalcoverage.

15 Third-partybenefits

1 TheinsuredpersonmustinformSanitaswithoutdelayofanybenefitsprovidedbythirdpartiesaswellasofanyagreementsregardinglump-sumsettlementsifSanitasisliabletopaybenefitsforthesameinsuranceclaim.

2 IfSanitaspaysbenefitsonbehalfofathirdparty,theinsuredpersonmustassignhisorherclaimstoSanitasintheamountofthebenefitsSanitasisobligatedtopay.

3 AgreementsbetweentheinsuredpersonandthirdpartiesarenotbindinguponSanitas.

Obligationsandestablishmentofclaims

16 Generalobligations

Theinsuredpersonisobligatedtocomplywiththeinstructionsofdoctorsorotherserviceproviders.

17 Notificationofinpatienttreatment

SanitasAssistancemustbenotifiedofadmissiontoacutehospitalimmediately.Ifacommitmenttoprovidecoverageisrequired,Sanitasmustbenotifiedtwoweeksbeforeadmission.

18 Establishmentofclaims

1 Whenclaimsarefiledforbenefits,detailedoriginalinvoicesanddocuments,andanyotherrequesteddocumentation,mustbesubmittedtoSanitas.

2 Theentitlementtoclaimbenefitsexpirestwoyearsupontheoccurrenceoftheeventgivingrisetotheclaim.

3 Ifbenefitsaredisbursedbyanotherinsurer,copiesoftheinvoicesanddetailedstatementsfromtheseinsurersmustbesubmittedtoSanitas.

4 TheaccidentreportformmustbesubmittedtoSanitaswhenaccidentbenefitsareclaimed.

19 Violationofobligations

IftheinsuredpersonviolateshisobligationstowardSanitasintheeventofaclaim,benefitsmaybecurtailedorrefusedaltogether.

Commencementandendofinsurancecoverage

20 Taking out coverage

1 Insurancecoverageistakenoutthroughpaymentoftherelevantpremium.Ifthepremiumispaidatapostoffice,thedateofthepostofficestampshallapply.Ifthepremiumpaymentistransferredfromabankorpostalaccount,thedateonwhichtheamountisdebitedfromtheaccountofthepersonpayingthepremiumshallapply.

2 Premiumsarecalculatedonaslidingscaleaccordingtotheinsuredperson’sageinthecalendaryearinwhichcoveragecommences.

3 Ifthepremiumpaiddoesnotcorrespondtotheactualageoftheinsuredpersonorthetermofinsuranceappliedfor,theinsuredbenefitsmaybereducedinproportiontothedifferencebetweenthepremiumpaidandthepremiumowed.

21 Commencementofcoverage

CoveragecommencesatthemomenttheinsuredpersonentersSwitzerlandortheSchengenarea,butnoearlierthanthedateontheremittanceslip(commencementofinsurance),providedthat– InsurancewastakenoutbeforetheinsuredenteredSwitzerlandortheSchengenarea

– Alltheinformationgivenontheremittanceslipwascompleteandaccurate.

22 Termofcoverage

Coveragecanbetakenoutonamonthlybasis,foramaximumofsixmonths.Thismaximumtermcannotbeextended.

23 Endofcoverage

1 CoverageendsthemomenttheinsuredleavesSwitzerlandortheSchengenarea,butnolaterthanonthelastdayoftheagreedtermofcoverage.

2 If,owingtotheoccurrenceofaninsuredevent(illnessoraccident)duringthetermofcoverage,itisnotpossiblefortheinsuredpersontoreturntotheircountryofresidenceformedicalreasons,coveragewillbeextendedbyamaximumof30daysbeyondtheagreedterm.Thisalsoappliestoaccompanyingpersons,providedtheyarealsocoveredbySanitasAssistance.

Miscellaneousprovisions

24 Datacollection—obtaininginformation

InsuredpersonsauthoriseSanitastocapturealldataelectronicallyand,intheeventofaclaim,toobtainalltheinformationnecessarytosettletheclaim.

25 Paymentofbenefits

1 Sanitaswilltransferbenefitpaymentstotheinsuredperson’sbankorpostalaccount.Ifotherformsofpaymentarerequested,Sanitasmaychargeafeetocovertheaddedexpenseinvolved.Inordertoenablebenefitpaymentstobetransferred,thenecessarypaymentdetailsmustbesuppliedtoSanitaswhentheinsuredpersonfirstfilestheclaim.

2 Sanitasmaydeductmoniesowedbytheinsuredpersonfromthebenefitsdisbursed.

26 Placeofperformanceandvenue

1 TheplaceofperformanceforobligationsunderthiscontractisSwitzerland,performancetoberenderedinSwisscurrency.

2 ThiscontractualrelationshipshallbegovernedandinterpretedexclusivelyinaccordancewiththelawsofSwitzerland.ThecourtsofZurich,Switzerland,shallhaveexclusivejurisdictionwithregardtoanyandallactionsbroughtagainstSanitas.

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