The words or expressions detailed below have the following meaning wherever they appear in this Policy and will appear in Bold.
Accident: Means a sudden and unforeseen bodily or psychological and emotional injury caused by external causes (resulting from events beyond the Insured’s and their Family’s will and control).
Accommodation for hospitalised Dependent Children: Means that if the Insured’s Dependent Children are hospitalised after an Accident in a public or private hospital which is situated further than 30 kms from the Insured’s main residence, the costs of the rooming in the Dependent Children’s hospital room or a hotel will be covered under this Insurance Policy. The details are explained below under Section E. for the Standard package, Section G. for the Comfort Package and Section I. for the Premium package titled What are You covered for?
Agent: Means PSA Insurance Solutions Ltd., a company authorised to act as an Insurance Agency for PSA Insurance Ltd. and carry on insurance intermediation in France under the freedom to provide services provisions by the Malta Financial Services Authority (MFSA) under Registration no C83206. Registered Office: MIB House, 53, Abate Rigord Street, XBX1122 Ta’ Xbiex, Malta.
Anniversary Date: Means the day after the current Period of Insurance will expire.
Beneficiary: Means the person receiving the benefits and compensation under this Insurance Policy. As described in Section L. How to make a Claim of this Insurance Policy.
Claim Limit: Means the maximum amount per Period of Insurance that the Insured, their Partner, their Dependent Adult and their Dependent Children can be compensated for under this Policy. These are explained in Section F. for the Standard package, Section H. for the Comfort package and Section J. for the Premium package titled What is Your indemnity and Your Claim Limit? and where applicable shown on Your Policy Schedule.
Consolidation: Means the moment when the invalidity is considered permanent since no further treatment can be provided, unless they are provided in order to limit the extent of said invalidity.
Cooling-off Period: Means the period of thirty (30) full calendar days (as explained below in Section O.1), during which You can cancel Your Policy without having to explain Your reasons.
Dependent Adult: Means any individual in Your care, who is :
- Between 18 years old and 25 years old if not engaged in Full-time study;
- Under 65 years old.
The Dependent Adult must be residing at the same address as You.
Dependent Children: Means any individual in Your care, who is under 18 years at the time of subscription or up to 25 years if engaged in Full-time study, who is not married or entered into a civil partnership.
Effective Date: Means the date from which this Insurance Policy has become legally binding for all parties.
Eligibility Criteria: Refers to the set of requirements that need to be in place for You and/or Your Family to subscribe to and benefit from this Insurance Policy.
Family: Refers to You and/or Your Partner and/or Your Dependent Adults and/or Your Dependent Children who live and are registered at the same address, (unless engaged in Full-time study in a different location) and if they are listed in the Policy Schedule.
Full-time study: Refers to any student who is required to carry a full course load, with a set number of hours as determined by the local school system, or the competent institution.
Funeral Expenses: Means the costs incurred for the organization of a funeral including costs of burial, cremation or any other chosen method of interment.
Geographical Limits: Means the area in which this Insurance Policy is providing You cover as described in Your Policy Schedule.
Home Assistance: Assistance in accomplishing the everyday tasks such as gardening, shopping for groceries, cleaning the house, Dependent Children sitting and cooking.
Hospitalisation: Refers to the period of time over and above 24 hours that You and/or Your Family need to be recovered in a private or public hospital as a result of an injury due to an Accident.
Exclusively referred to Pandemic Cover as in E.9., G.12. and I.18. : stay or permanence in:
- hospital structure of the national health service
- structure accredited or affiliated at national level
- duly supported facility authorised by government act;
Insurance Policy: Refers to Your Policy Schedule/s and these General Terms and Conditions.
Insurance Premium: This is the price You paid for the cover provided under this Policy including any taxes/fees due to the respective authorities in the country where this Policy is purchased. The Insurance Premium is shown on Your Policy Schedule. The Insurance Premium is constituted of the price of the package and any additional option that You selected.
Insured/You/Your: Means the main insured person named in the Policy Schedule.
Insurer/We/Us/Our: PSA Insurance Ltd., a company authorised by the Malta Financial Services Authority to carry on business of insurance under Registration no. C44567. Registered Office: MIB House, 53, Abate Rigord Street, XBX1122 Ta’ Xbiex, Malta. The Insurer operates under freedom of services in Germany.
Invalidity Percentage: Means the percentages as set in the invalidity percentage table in Section S. The percentage of indemnity varies depending on the condition which lead to the permanent invalidity.
Medical Accident: Means an unforeseen event which had damaging consequences for the health or physical integrity of the Insured and/or their Family and which has altered the normal course of the initial pathology. In particular, Iatrogenic conditions and nosocomial infections are covered under this Insurance Policy. The Medical Accident must result from surgical procedures, prevention, diagnosis, exploration, treatment by certified medical professionals.
Medical Expert: Refers to a medical professional licensed to practice in Germany that has been engaged by the claimant or by a medical institution to certify the state of health or the cause of death of the Insured and/or their Family.
Medical Certificate: Refers to the document stating the result of a medical examination conducted by a professional doctor to give evidence of the Insured’s or their Family’s state of health or cause of death.
Medical Expenses: Means the medical, paramedical, pharmaceutical and/or surgical costs prescribed by certified medical professionals. In addition, transportation costs are covered under this Insurance Policy (i.e from the Accident site to the hospital or from the Insured’s residence to and from the place where the treatment takes place). Any infections caused by tick bites are included under this cover. Depending on the insurance package and options that You selected during the subscription process, heart attacks, strokes and Side Effects of Prescribed Medicines are included under the Medical Expenses cover. Accidents due to frostbites, drowning, diving and suffocating are included provided the option was selected during the subscription process. Finally, the establishment of the REHA report by a Personal Accident Advisor is included under this Medical Expenses cover for all packages.
Means the secure area on the website www.psa-insurance-solutions.de/my-account
, which You
may access by entering a user name and password. It contains Your Insurance Policy
, together with any other documents for the administration of Your Insurance Policy
National Competent Authority: Means any German authority which has the competence to assess invalidity for the purposes of granting social security benefits (such as Versorgungsamt), or any Medical Expert qualified to issue a Medical Certificate.
Pandemic Disease Syndromes: flu syndrome, caused by a new pathogen to which there is no immunization, the spread of which is rapid and affects entire communities in many geographical areas of the world, with a high number of serious cases and a high mortality and which affects an infectious pathogen that causes respiratory diseases of varying severity. Examples are reported: SARS-Cov, Sars-Cov2, Mers-Cov, CoViD-19.
Partner: Means the second insured person who may be the spouse, co-habiting Partner or Partner in civil union, residing at the same postal address of the Insured and provided they are not legally or factually separated.
Period of Insurance: Means the dates between which this Insurance Policy is in force as highlighted in Your Policy Schedule.
Permanent Disfigurement: Means a permanent alteration of the appearance of the Insured or their Family following an Accident. In particular, a scar, a distortion, a broken tooth are considered as a Permanent Disfigurement.
Permanent Total Invalidity: Refers to a permanent and incurable impairment due to an Accident, that renders You and/or Your Family permanently unable to exercise any work or professional activity, including professional activities which are different from the professional activity exercised so far. The Permanent Total Invalidity may be physical, mental and/or intellectual. A Permanent Total Invalidity must be confirmed by a certificate issued by a National Competent Authority or the Medical Certificate issued by a Medical Expert on the basis of the criteria set out in AUB2014 para 188.8.131.52. (see https://beck-online.beck.de/?bcid=Y-100-G-AUB2014).
Permanent Partial Invalidity: Refers to a permanent and incurable impairment due to an Accident which is partial. The Permanent Partial Invalidity may be physical, mental and/or intellectual. The Permanent Partial Invalidity must be confirmed by a certificate issued by a National Competent Authority, or the Medical Certificate of a Medical Expert. The Permanent Partial Invalidity indemnity will be assessed according to the table under Section S.
Pet: Refers to any cat or dog that You keep in Your place of residence for companionship. Your Pet must:
- comply with the regulations of Your country of residence
- be identifiable via a microchip or an identification tattoo
- be up to date with its vaccinations.
Policy Schedule: Means the document containing the details related to this Policy based on the information You provided.
Means the renewal notification which We
will send to the email address You
Serious injuries: Means an injury that is sustained in an Accident and which requires Hospitalisation for 24 hours or more, or results in a fracture, or results in damage to any internal organ or results in severe burns.
Side Effects of Prescribed Medicines: Any prejudicial and unforeseen effect of a medicine prescribed by a Medical Expert which can be covered by a guarantee under this Insurance Policy.
Unutilised Share of Premium: Is equal to Your Insurance Premium including any taxes, fees and parafiscal charges, which You have already paid multiplied by the number of remaining days covered by Your latest payment and then divided by the total number of days covered by Your latest payment.