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GENERAL TERMS AND CONDITIONS

PERSONAL ACCIDENT INSURANCE

  
TABLE OF CONTENTS
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Introduction
 
Welcome to Personal Accident Insurance, within our InsuredMobility product range. Our Personal Accident Insurance covers You and Your Family for any Accident that may occur during everyday life as well as for hospitalisation or convalescence in the event of Pandemic Disease  Syndromes.Your level of cover will vary depending on the package and the options that You selected.
A. HOW TO UNDERSTAND YOUR POLICY DOCUMENTATION
 
This document contains the General Terms and Conditions for the Insurance Policy You have subscribed to. Any ‘Bold’ text that You come across in this document has been defined in Section D. Definitions.
 
Your Insurance Policy is made up of Your Policy Schedule and these General Terms and Conditions, both of which You have/will receive/d by email upon the purchase of this Personal Accident Insurance Policy. These can also be accessed at any point in time via the My Account area after Your purchase.
You have/will purchase/d this contract from PSA Insurance Solutions Ltd., an online sales platform. PSA Insurance Solutions Limited is an Agent acting for PSA Insurance Ltd.
 
Your Policy Schedule contains Your personal details, and those of Your Family, whom You have chosen to insure, under this Policy. It also contains the cover You have chosen and the period for which You are insured. Please make sure that at any point in time the details are correct.
 
Please read this Insurance Policy carefully and make sure You understand and fully comply with its terms and conditions as failure to do so may jeopardise the payment of any claim which might arise and may give the Insurer the right to terminate the Insurance Policy as further set out in Section M.
 
Our Personal Accident Insurance is an insurance covering the insured events described in Section E. for the Standard package, Section G. for the Comfort Package and Section I. for the Premium package which are titled What are you covered for?, provided there is no application of any exclusion set in Section K. Exclusions of this Insurance Policy.
 
The policy You have subscribed to is effective from the date You clicked on “Accept and Subscribe” and You are covered for the Period of Insurance stated in Your latest Policy Schedule.  
B. WHO ARE THE PARTIES TO THIS CONTRACT
 
PSA Insurance Limited: The Insurer, a company authorised by the Malta Financial Services Authority to carry on business of insurance under Registration no. C44567 and operates in France through the freedom of services regime. Registered Office: MIB House, 53, Abate Rigord Street, XBX1122 Ta’ Xbiex, Malta.
 
AND
 
You: The subscriber and Insured Person named in this Insurance Policy and who has satisfied all the following Eligibility Criteria required during the subscription process:
  • You are less than 65 years of age at the time of the subscription.
  • You are a resident in Germany.
C. SUM-UP OF THE COVERAGES 
 
The below table presents the coverages that are included in the Standard, Comfort and Premium packages. The extent of each coverage is further explained within this Insurance Policy. Specific conditions, limits and exclusions may apply to each coverage.

 

Coverages

  Insurance packages
Standard Comfort Premium

Death

  Yes   Yes
 Yes 
Medical Accident for the Insured, the Partner or the Dependent Adult  No  No Yes
Medical Accident for Dependent Children No No Yes
Permanent Total Invalidity Yes Yes Yes
Permanent Partial Invalidity (percentage)
 Yes Yes Yes
Medical Expenses
 Yes Yes Yes
Serious Injuries (under the Medical Expenses Limit)
No Yes Yes
Heart attack, stroke, Side Effects of Prescribed Medicines (under the Medical Expenses Limit)
No No Yes
Personal accident advisor (under the Medical Expenses Limit)
Yes Yes Yes
Hospitalisation
 Yes  Yes Yes
Accommodation for hospitalised Dependent Children
 Yes Yes Yes
Permanent Disfigurement
 No No Yes
Wheelchair and Prostheses
 No No  Yes
Home & Vehicle transformation
 No  No Yes
Private tuition Yes Yes Yes
Dependent Children’s activities fees No Yes Yes
Psychological assistance Yes Yes Yes
Home Assistance Yes Yes Yes
Pandemic CoverYesYesYes
 
In addition, the Insured may select the below options depending on the selected package during the subscription process. The extent of each optional coverage is further explained within this Insurance Policy. Specific conditions, limits and exclusions may apply to each coverage. The optional coverages that were selected by the Insured are listed in the Policy Schedule.

 

Optional Coverages

  Insurance packages
Standard Comfort Premium

Medical Accident for Dependent Children

 Option
 Option
Included
Permanent Disfigurement No Option Option 
Wheelchair and Protheses Option
 Option
  Included
Home & Vehicle transformation Option
 Option
  Included
Funeral Expenses
 Option Option
  Included
Psychological assistance Option Option
 Included
Travelling assistance No No Option 
Heart attack, stroke, Side Effects of Prescribed Medicines 
Option
(under the Medical Expenses limit)
Option
(under the Medical Expenses limit)
 Included
Diving Accident No No Option 
(under the Medical Expenses limit)
Drowning Accident, Suffocation & Frostbite No No Option 
(under the Medical Expenses limit) 
Pet caring
 Option Option
 Option
Pet insurance
 Option
 Option Option
 
D. DEFINITIONS
 
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.
 
My Account: 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 2.1.2.2. (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.
 
Renewal Notice: Means the renewal notification which We will send to the email address You provided Us during subscription.
 
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.

Standard package
E. What are Your covered for? F. What is Your indemnity and Your Claim Limit?
For the Standard package, We will cover You and/or Your Family for the following insured events resulting from an Accident. The compensation received by the Beneficiary under this Insurance Policy will be subject to the following limits for the Standard package.
E.1. Death  F.1. Lump sum of €15,000 
E.2. Permanent Total Invalidity  F.2. Lump sum of €15,000 
E.3. Permanent Partial Invalidity  F.3. The indemnity will be calculated by taking the Invalidity Percentage and multiply it by the sum insured. The sum insured is set at €15,000. 
E.4. Medical Expenses
 F.4. The real costs borne by the Insured and/or their Family are refunded up to a limit of €5,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
E.5.Personal Accident Advisor
 F.5. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €5,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
E.6. Hospitalisation
 F.6. If the Insured and/or their Family is hospitalised as an in-patient for 24hours or more as a direct result of an Accident, We will pay a sum of €50 for each 24 hour period they are hospitalized, except where such benefits are available from another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits. This cover has a total limit of €1,500.
E.7. Accommodation for hospitalised Dependent Children
 F.7. The real costs borne by the Insured and/or their Family are refunded up to a daily limit of €30 per day and a total limit of €900, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
E.8. Home Assistance
 F.8. The Insured and/or their Family may need Home Assistance following the Accident. The Insured and/or their Family are entitled to 30 hours with a total limit of €450. The assistance must occur within 1 month from the date of the Accident.
E.9. Pandemic Cover
F.9. Hospitalisation for treatment of Pandemic Disease Syndromes: 35€ for each day of hospitalization up to a maximum of 30 days
Post intensive care unit (ICU): lump sum on remittance   after recovery from Pandemic Disease Syndromes amounting to €1,500.
 
 
Standard package - Optional covers
E. What are Your covered for? F. What is Your indemnity and Your Claim Limit?
For the Standard package, We will cover You and/or Your Family for the following insured events resulting from an Accident provided that You selected them during the subscription process. The chosen options will be indicated in Your latest Policy Schedule. The compensation received by the Beneficiary under this Insurance Policy will be subject to the following limits for the Standard package, only applicable when the Insured selected the option(s) during the subscription process.
E.1. Medical Accident for Dependent Children F.1. The real costs borne by the Insured for the Dependent Children will be refunded up to a limit of €2,500 following the Medical Accident, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
E.2. Wheelchair and Prostheses  F.2. The real costs borne by the Insured and/or their Family will be refunded up to a limit of €4,000 provided they are necessary following the Accident, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
E.3. Home & Vehicle transformation
 F.3. The costs that are necessary to transform the Insured's residence and their vehicle or to purchase a new one in order to cater for the Permanent Total Invalidity or the Permanent Partial Invalidity. The home and vehicle discomfort must be medically proven and explained in a Medical Certificate. If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits. The applicable limit is set at €30,000.
E.4. Funeral Expenses  F.4. The costs of the funeral will be refunded up to a limit of €1,500 per person.
E.5. Psychological assistance F.5. The Insured and/or their Family may need psychological assistance following the Accident. The Insured and/or their Family are entitled to 5 sessions with a psychologist (over the phone or at a practice), with a limit of €60 per session. The sessions must occur within 6 months from the date of the accident in order to be able to claim under this cover.
E.6 Heart Attack, Stroke & Side Effects of Prescribed Medicines
 F.6. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €5,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
E.7. Pet caring
 F.6. The costs of a kennel or cattery will be refunded provided that the Insured and/or their Family cannot take care of the Pet due to the Accident The Pet may be put in a licensed kennel or cattery for a duration of 1 month.
Alternatively, the reasonable costs of transport for both the Pet and/or a relative or a friend whom You nominated to take care of the Pet while You are unable to following the Accident are covered. The transport costs apply only between Your place of residence to/from that of Your relative or friend. The applicable limit for this cover is set at €450.
E.8. Pet insurance
 F.7. In the event the pet is injured due to an Accident, the costs of surgery done by a vet and the costs of medication post-surgery will be refunded. In the event the pet had to be taken in an animal ambulance from the place of the Accident to the vet clinic, the costs will be refunded as well. The applicable limit is set at €1,000.

Comfort package
G. What are Your covered for? H. What is Your indemnity and Your Claim Limit?
For the Comfort package, We will cover You and/or Your Family for the following insured events resulting from an Accident. The compensation received by the Beneficiary under this Insurance Policy will be subject to the following limits for the Comfort package.
G.1. Death  H.1. Lump sum of  €35,000
G.2. Permanent Total Invalidity  H.2. Lump sum of  €35,000 
G.3. Permanent Partial Invalidity  H.3. The indemnity will be calculated by taking the Invalidity Percentage and multiply it by the sum insured. The sum insured is set at €35,000. 
G.4. Medical Expenses
 H.4. The real costs borne by the Insured and/or their Family are refunded up to a limit of €10,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.5. Serious Injuries
 H.5. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €2,500, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.6. Personal Accident Advisor
 H.6. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €10,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.7. Hospitalisation
 H.7. If the Insured and/or their Family is hospitalised as an in-patient for 24 hours or more as a direct result of an Accident, We will pay a sum of €50 for each 24 hour period they are hospitalized, except where such benefits are available from another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits. This cover has a total limit of €2,500.
G.8. Accommodation for hospitalised Dependent Children
 H.8. The real costs borne by the Insured and/or their Family are refunded up to a daily limit of €50 per day and a total limit of €2,500 except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.9. Private tuition
 H.9. Assistance for the Dependent Children might be necessary after the Accident. The Dependent Children may have several private tuitions up to a limit of indemnity that is set at €300.
G.10. Dependent Children’s activities fees H.10. The costs of the Dependent Children's extracurricular activities will be refunded pro-rata temporis up to a limit of €450.
G.11. Home Assistance
 H.11. The Insured and/or their Family may need Home Assistance following the Accident. The Insured and/or their Family are entitled to 90 hours with a total limit of €1350. The assistance must occur within 2 months from the date of the Accident.
G.12. Pandemic Cover
H.12. Hospitalisation for treatment of Pandemic Disease Syndromes: 35€ for each day of hospitalization up to a maximum of 30 days
Post intensive care unit (ICU): lump sum on remittance after recovery from Pandemic Disease Syndromes amounting to 1,500.00€.
 
 
Comfort package - Optional covers
G. What are Your covered for? H. What is Your indemnity and Your Claim Limit?
For the Comfort package, We will cover You and/or Your Family for the following insured events resulting from an Accident provided that You selected them during the subscription process. The chosen options will be indicated in Your latest Policy Schedule. The compensation received by the Beneficiary under this Insurance Policy will be subject to the following limits for the Comfort package, only applicable when the Insured selected the option(s) during the subscription process.
G.1. Medical Accident for Dependent Children H.1. The real costs borne by the Insured for the Dependent Children will be refunded up to a limit of €7,500 following the Medical Accident, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.2. Permanent Disfigurement H.2. The real costs borne by the Insured and/or their Family will be refunded up to a limit of €10,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.3. Wheelchair and Prostheses  H.3. The real costs borne by the Insured and/or their Family will be refunded up to a limit of €8,000 in the event they are necessary following the Accident, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.4. Home & Vehicle transformation
 H.4. The costs that are necessary to transform the Insured's residence and their vehicle or to purchase a new one in order to cater for the Permanent Total Invalidity or the Permanent Partial Invalidity. The discomfort must be proven medically and explained in a Medical Certificate. We are not liable where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits. The applicable limit is set at €50,000.
G.5. Funeral Expenses H.5. The costs of the funeral will be refunded up to a limit of €3,500 per person.
G.6. Psychological assistance
 H.6. The Insured and/or their Family may need psychological assistance following the Accident. The Insured and/or their Family are entitled to 5 sessions with a psychologist (over the phone or at a practice), with a limit of €60 per session. The sessions must occur within 6 months from the date of the Accident in order to be able to claim under this cover.
G.7. Heart Attack, stroke & Side Effects of Prescribed Medicines
 H.7. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €10,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
G.8. Pet caring
 H.8. The costs of a kennel or cattery will be refunded provided that the Insured and/or their Family cannot take care of the Pet due to the Accident. The Pet may be put in a licensed kennel or cattery for a duration of 1 month. Alternatively, the reasonable costs of transport for both the Pet and/or a relative or a friend whom You nominated to take care of the Pet while You are unable to following the Accident are covered. The transport costs apply only between Your place of residence to/from that of Your relative or friend. The applicable limit for this cover is set at €450.
G.9. Pet insurance
 H.9. In the event the pet is injured due to an Accident, the costs of surgery done by a vet and the costs of medication post-surgery will be refunded. In the event the pet had to be taken in an animal ambulance from the place of the Accident to the vet clinic, the costs will be refunded as well. The applicable limit is set at  €1000.

Premium package
I. What are Your covered for? J. What is Your indemnity and Your Claim Limit?
For the Premium package, We will cover You and/or Your Family for the following insured events resulting from an Accident. The compensation received by the Beneficiary under this Insurance Policy will be subject to the following limits for the Premium package.
I.1. Death  J.1. Lump sum of €50,000 
I.2.  Medical Accident for the Insured, the Partner or the Dependent Adult J.2. The real costs borne by the Insured and/or the Dependent Adult and/or the Partner will be refunded up to a limit of €7,500, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
 I.3. Medical Accident for Dependent Children J.3. The real costs borne by the Insured for the Dependent Children will be refunded up to a limit of €7,500, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.4. Permanent Total Invalidity  J.4. Lump sum of  €50,000 
I.5. Permanent Partial Invalidity  J.5. The indemnity will be calculated by taking the Invalidity Percentage and multiply it by the sum insured. The sum insured is set at €50,000. 
I.6. Medical Expenses
 J.6. The real costs borne by the Insured and/or their Family are refunded up to a limit of €20,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.7.Serious Injuries
 J.7. Under this cover, the compensation is deducted from the Medical Expenses total claim limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €5,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.6.Heart Attack, stroke & Side Effects of Prescribed Medicines
 J.8. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €20,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.9.Personal Accident Advisor
 J.9. Under this cover, the compensation is deducted from the Medical Expenses total Claim Limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €20,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.10. Hospitalisation
 J.10. If the Insured and/or their Family is hospitalised as an in-patient for 24 hours or more as a direct result of an Accident, We will pay a sum of €50 for each 24 hour period they are hospitalized, except where such benefits are available from another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits. This cover has a total limit of €7,500.
I.11. Accommodation for hospitalised Dependent Children
 J.11. The real costs borne by the Insured and/or their Family are refunded up to a daily limit of €50 per day and a total limit of €7,500, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.12. Permanent Disfigurement
 J.12. The real costs borne by the Insured and/or their Family will be refunded up to a limit of €20,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.13. Wheelchair and Prostheses
 J.13 The real costs borne by the Insured and/or their Family will be refunded up to a limit of €10,000 in the event they are necessary following the Accident, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.14. Home & Vehicle transformation J.14. The costs that are necessary to transform the Insured's residence and their vehicle or to purchase a new one in order to cater for the Permanent Total Invalidity or the Permanent Partial Invalidity. The discomfort must be proven medically and explained in a Medical Certificate. We are not liable where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits. The applicable limit is set at €75,000.
I.15. Private tuition
 J.15. Assistance for the Dependent Children might be necessary after the Accident. The Dependent Children may have several private tuitions. The limit of indemnity that the Insured will receive is set at €500.
I.16. Dependent Children’s activities fees J.16 The costs of the Dependent Children's extracurricular activities will be refunded pro-rata temporis up to a limit of €600.
I.17. Psychological assistance
 J.17. The Insured and/or their Family may need Psychological assistance following the Accident. The Insured and/or their Family are entitled to 15 sessions with a psychologist (over the phone or at a practice), with a limit of €60 per session. The sessions must occur within 6 months from the date of the Accident in order to be able to claim under this cover.
I.18. Home Assistance
 J.17. The Insured and/or their Family may need Home Assistance following the Accident. The Insured and/or their Family are entitled to 120 hours with a total limit of €1800. The assistance must occur within 2 months from the date of the Accident.
I.19. Pandemic Cover
J.19. Hospitalisation for treatment of Pandemic Disease Syndromes: 35€ for each day of hospitalization up to a maximum of 30 days
Post intensive care unit (ICU): lump sum on remittance after recovery from Pandemic Disease Syndromes amounting to 1,500.00€
 
 
Premium package - Optional covers
I. What are Your covered for? J. What is Your indemnity and Your Claim Limit?
For the Premium package, We will cover You and/or Your Family for the following insured events resulting from an Accident provided that You selected them during the subscription process. The chosen options will be indicated in Your latest Policy Schedule. The compensation received by the Beneficiary under this Insurance Policy will be subject to the following limits for the Premium package, only applicable when the Insured selected the option(s) during the subscription process.
I.1. Funeral Expenses
 J.1. The costs of the funeral will be refunded up to a limit of €5,000 per person..
I.2. Travelling Assistance
 J.2. The reasonable costs of travelling of a relative up to a limit of €200 will be refunded.
I.3. Diving Accident
 J.3 Under this cover, the compensation is deducted from the Medical Expenses total claim limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €20,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.4. Drowning Accident, suffocation & frostbite
 J.4. Under this cover, the compensation is deducted from the Medical Expenses total claim limit. Therefore, the real costs borne by the Insured and/or their Family are refunded up to a total limit of €20,000, except where these costs are borne by another insurer (for example under another private accident, health or third party liability cover). If there is also a claim to benefits from the statutory accident insurance or the statutory pension insurance, to statutory medical care or accident care, the Insurer is only liable for the expenses which remain necessary despite the statutory benefits.
I.5. Pet caring
J.5. The costs of a kennel or cattery will be refunded provided that the Insured and/or their Family cannot take care of the Pet due to the Accident The Pet may be put in a licensed kennel or cattery for a duration of 2 months.
Alternatively, the reasonable costs of transport for both the Pet and/or a relative or a friend whom You nominated to take care of the Pet while You are unable to following the Accident are covered. The transport costs apply only between Your place of residence to/from that of Your relative or friend. The applicable limit for this cover is set at 1000€.
I.6. Pet insurance
 J.6. In the event the Pet is injured due to an Accident, the costs of surgery done by a vet and the costs of medication post-surgery will be refunded. In the event the Pet had to be taken in an animal ambulance from the place of the Accident to the Vet clinic, the costs will be refunded as well. The applicable limit is set at €1,000. .
K. GENERAL EXCLUSIONS
 

For all the coverages, We will NOT cover You and/or Your Family:

K.1. For any event which is not directly or indirectly caused by an Accident: illnesses, diseases, surgeries, back pain, psychological disorders (without prejudice to psychological assistance required because of the Accident as stated out above) and any other medical conditions, irrespective of whether they are of a chronic nature or not.
Heart attacks, strokes or Side Effects of Prescribed Medicines are not covered unless:
-either the option was specifically selected under the Standard or Comfort package.
-Or You are insured under the Premium package.
 
If the consequences of an Accident coincide with any of the aforementioned illnesses or other circumstances, the following applies:
 
In accordance with the extent to which the illness or other circumstances have contributed to the damage to health or its consequences (participation share), the following reductions shall be made by applying the relevant percentage to:
- the percentage of the degree of Permanent Total Invalidity or Permanent Partial Invalidity.
- the amount of the benefit itself, in case of death and other types of benefit.
 
Example:
After a leg injury, there is a degree of Invalidity of 15%. A rheumatic disease contributed 50% to this. The degree of Permanent Partial Invalidity caused by an Accident is therefore 7.5%.
 
If the proportion of contributory factors is less than 25%, We do not make any reductions.
 
K.2. For any Accident resulting from You and/or Your Family being under the influence of alcohol, narcotics, plants or un-prescribed drugs as defined, and in excess of the thresholds set by the legislation within the Geographical Limits. Being under the influence shall mean that the relevant person's ability to perceive and to react are so impaired that the relevant person is no longer able to cope with the requirements of the specific dangers of the situation.
 
K.3. For any claim caused by:
  • medicines taken incorrectly;
  • medicines for treating drug addiction;
  • known risks associated with a medical or surgical procedure;
  • a gradual loss of use or function which is not a direct result of an Accident.
K.4. For any claim for hospitalisation in a psychiatric ward, nursing, convalescent or residential care home, rehabilitation centre, or any establishment used primarily for the treatment of alcohol or drug addiction; or any similar wards/units within a hospital which provide any of these services
 
K.5. For any Accident if the driver didn’t have a valid driving licence.
 
K.6. For any Accident resulting from the participation in or acting as an accessory to any crime or attempted crime.
 
K.7. For any deliberate Accident which is caused by any of the Beneficiaries.
 
K.8. If the Accident occurs outside the Geographical Limits or outside the Period of Insurance, stated in Your Schedule.
 
K.9. For any claim resulting from an insured person’s:
  • suicide or deliberate self inflicted injury;
  • reckless and deliberate exposure to known danger (except in an attempt to save human life);
K.10. If the Accident arises directly or indirectly, in whole or in part, due to any act or omission which is wilful, unlawful or negligent on Your and/or Your Family’s part.
 
K.11. If the Accident occurs during sport trials, speed racing and the following dangerous sports: scuba diving, sky diving, paragliding, climbing, abseiling, rafting, base jumping and horse riding. Scuba Diving is not covered unless the option was specifically covered.
 
K.12. For Accidents arising from riots, strikes and civil commotion, war, acts of war and terrorism provided the Insured and/or their Family took an active part in it.
 
K.13.If the costs are already paid by the National Social Security, or are to be refunded by other private health or accident insurance.
 
K.14. If the Hospitalisation lasts less than 24 hours.
 
K.15. Any further treatment after Consolidation.
 
K.16. For protheses and glasses under the Medical Expenses cover.
 
K.17. Pandemic Disease Syndromes ascertained pre-existing before the start date of the policy and related investigations and treatments. 
L. HOW TO MAKE A CLAIM AND YOUR CLAIM CONDITIONS


You must comply with the following instructions to have the full protection of Your Policy. 

We are not obliged to pay if You intentionally fail to comply with any of the obligations contained in this section L.
 
In the case of Your grossly negligent non-compliance, We can deny or reduce coverage according to the severity of the fault. This does not apply if You can prove to Us that You did not fail to comply with the obligation as a result of gross negligence.
 
Your insurance cover will remain in effect if You prove that the failure to comply with the obligation was not the cause for the occurrence or the determination of the insured event, nor for the determination or scope of the benefit. However, as far as You fail to comply with any obligation fraudulently, We are under no obligation to pay).
 
L.1. In the event of an Accident, please contact Us to report Your claim via this link: psa-insurance-solutions.de/my-account.
 
L.2. You must report Your claim within ten (10) days from when the Accident has occurred or, in case of Pandemic Cover as in E.12., G.12. and I.19., from the date of the hospitalisation or release from the Intensive Care Unit (ICU).
 
L.3. You must provide the Insurer with the following documents:
 
For all packages General documentation Specific documentation
Death Completed Claim Declaration Form; Identification for each of the claimants; Proof of residence of the claimants; Proof of Accident – including any existing police reports; Claim form (as can be accessible from Our website) completed by the treating physician/general practitioner/consulting specialist. In case of assault or terrorism, the Insured and/or their Family must provide a police report.
Death certificate
Notarial deed or certificate of inheritance
Medical Accident for the Insured, the Partner or the Dependent Adult
 Payment schedule of national/private health insurance
Medical Accident for Dependent Children
 Birth certificate and family affiliation;
Permanent Total Invalidity
 Certificate by the National Competent Authority or Medical Certificate issued by a Medical Expert as proof of invalidity level/percentage
Permanent Partial Invalidity
 Certificate by the National Competent Authority or Medical Certificate issued by a Medical Expert as proof of invalidity level/percentage
Medical Expenses
Payment schedule of national/private health insurance
Medical invoices
Serious Injuries
Payment schedule of national/private health insurance
Medical invoices
Heart attack, Stroke, Side Effects of Prescribed Medicines
Payment schedule of national/private health insurance
Medical invoices
Personal Accident Advisor
Payment schedule of national/private health insurance
Medical invoices
Hospitalisation
 Hospital records highlighting the date of admission and date of discharge
Accommodation for hospitalised Dependent Children
Accommodation invoices
Hospital records highlighting the date of admission and date of discharge
Payment schedule of National/Private health Insurance
Permanent Disfigurement
 Medical invoices
Wheelchair / Prostheses
Invoices
Proof of payment of the indemnity paid by other insurers
Home & Vehicle transformation
Invoices
Private tuition
 Tuition invoice
Dependent Children’s activities fees
Invoice
Proof of payment
Psychological assistance
Therapy invoice
Home Assistance
Services invoice
Pandemic Cover
Hospital Report
Medical Certificate 
Optional coverages
Medical Accident for Dependent Children
 Completed claim form; Identification for each of the claimants; Proof of Residence of the claimants; Proof of Accident – including any existing police reports; Claim form (as can be accessible from Our website) completed by the treating physician/general practitioner/consulting specialist. In case of assault or terrorism, the Insured and/or their Family must file a police report.
Birth certificate and family affiliation;
Permanent Disfigurement
Payment schedule of national/private health insurance
Medical invoices
Birth certificate and family affiliation;
Wheelchair and Protheses Invoices
Funeral Expenses
 Funeral Invoices
Home & Vehicle Transformation
 Invoices
Psychological assistance
 Therapy invoice
Travelling assistance
 Invoices
Heart attack, Stroke, Side Effects of Prescribed Medicines
Payment schedule of national/private health insurance.
Medical invoices
Diving Accident
Payment schedule of national/private health insurance.
Medical invoices
Drowning Accident, Suffocation & Frostbite
Payment schedule of national/private health insurance
Medical invoices
Pet caring
Kennel or cattery invoices
Transport receipts for the Pet and the accompanying nominated carer
Pet insurance
Vet invoices
 
Additionally, We reserve the right to request any additional document deemed necessary to verify Your claim.
 
In order to verify Our obligation to perform, We may require information from
  • physicians, general practitioners or consulting specialists who treated or examined the Insured before or after the Accident;
  • other insurers, institutions and authorities.
 
You or Your Family must enable us to obtain the necessary information.
For this purpose, the Insured may authorise the physicians, general practitioners or consulting specialists and the aforementioned authorities to provide Us with the information directly. Otherwise, the Insured may obtain the information themselves and make it available to us.
 
Where required, We have the right to select and authorize one or more Medical Experts to assess any claim under this Insurance Policy. Any Insured has the obligation to permit the required medical examination by any of these Medical Experts. We shall bear the costs of any earnings lost as a consequence of the examination.
 
We hereby undertake to pay to the Beneficiary the compensation to which he/she is entitled within thirty (30) days of the date of receipt of the notification, provided that all the supporting documentation required in list L.3 above have been provided, and that the claim is covered.
 
Attention: if the Insured and/or their Family act in bad faith and willingly increase the extent of the loss or hide the receipt of indemnities by other private or public entities, We will not cover the claim.
 
L.4. Determination of the Beneficiary of the Compensation
 
The indemnities under all the coverages are paid to the Insured (except for death and Funeral Expenses as indicated below).
 
In the event of death and for the Funeral Expenses:
 
In case of death of the Insured, the compensation is paid :
 In case of death of the Partner, the compensation is paid:
 In case of death of a Dependent Child, the compensation is paid:
 In case of death of a Dependent Adult, the compensation is paid:
- to the surviving spouse not legally or factually separated,
- failing that, to the Partner
- failing that, to their children,
- failing that, to their concubine not legally or factually separated,
- failing this, to the heirs of the Insured in accordance with the applicable regulations.
- to the surviving spouse not legally or factually separated,
- failing that, to the Partner
- failing that, to their children,
- failing that, to their concubine not legally or factually separated,
- failing this, to the heirs of the Insured in accordance with the applicable regulations.
 - to the legal representative
 - to the heirs of the Dependent Adult in accordance with the applicable regulations.
 
 
M. GENERAL CONDITIONS
 
Any failure by You to comply with the requirements set out in section M.1 to M.4 may entitle Us to deny or reduce coverage as set out at the beginning of section L above:
 
M.1. Duty of Care
 
You and Your Family must take reasonable precautions to avoid further injury in the event of an Accident.
 
M.2. Fraud
 
You and Your Family must not act in a fraudulent manner. If You, Your Family or anyone acting for You:
  • Make a claim under the Insurance Policy knowing the claim to be false, or fraudulently exaggerated in any respect; or
  • Make a statement in support of a claim, knowing the statement to be false in any respect; or
  • Submit a document in support of a claim, knowing the document to be forged or false in any respect; or
  • Make a claim in respect of any Accident caused by Your wilful act, or with Your connivance.

Then:

  • We shall not pay the claim;
  • We shall not pay any other claim which has been made or will be made under the Insurance Policy;
  • We may at Our option declare the Insurance Policy void;
  • We shall be entitled to recover from You the amount of any claim already paid under the Insurance Policy;
  • We shall not make any return of Insurance Premium;
  • We may inform the police of the circumstances.
M.3. Duty of Disclosure
 
The Insurance Policy has been issued based upon information, which You have given Us about Yourself, and Your Family. You have a duty to tell Us of any change to this information, as failure to do so may jeopardize Your cove this Insurance Policy as set out above at the beginning of Section L. We will then advise You of any change in terms. You must notify Us of any change in the information You provided to Us as soon as You become aware of the change request by completing the Queries Form on Our website www.psa-insurance-solutions.de/queries.
 
We need to be told whenever any of the following occur:
  • Any information on your current Policy Schedule changes.
  • You want to add or remove a Partner, a Dependent Adult or a Dependent Child to/from your insurance. - 
  • Your main private residence is no longer in Germany.
  • Your Partner stops residing at the same postal address as You.
  • Your Dependent Children:
    • get married or enter into a civil partnership;
    • reach age 18 or if engaged in Full-time study between 18 and 25, at the age of termination of the Full-time study;
    • stop residing at the same postal address as You, except for the Full-time study.
  • Your Dependent Adult:
    • Stops residing at the same postal address as You.
  • You or one member of Your Family pass away.
M.4. The Law Applicable to this Insurance Policy
 
This Policy is governed by German law. German courts shall have exclusive jurisdiction if You move Your residence to a place outside of Germany after the date of purchase of the cover under the Policy, or if Your residence is unknown. If there is a dispute, it will only be dealt with in the courts of Germany.
 
M.5. Statute of Limitations
 
Your claims arising from the Insurance Policy are subject to a limitation period of three (3) years. The limitation period commences at the end of the year in which the claim originated and in which You became or ought to have become aware. The calculation of the deadline shall be subject to the general regulations of the German Civil Code (BGB). The limitation period is interrupted by any of the ordinary causes of interruption of the limitation period and by the appointment of Medical Experts following an Accident.
 
N. YOUR INSURANCE PREMIUM, PAYMENT & RENEWAL
 

N.1. The Insurance Premium

The total price You will need to pay for the Period of Insurance stated in Your Schedule is based on the following monthly Insurance Premiums:

Premium (all taxes included) Standard  Comfort  Premium
 €4.00  € 5.00  €8.00
 
Depending on the options that You selected, additional Insurance Premiums might be charged and You can find the total in Your Policy Schedule. The above table presents the Insurance Premiums payable by each adult or Dependent Adult. Together with each adult, its Dependent children can be insured free of charge.
 
For each package, optional covers are available. You will find below the Insurance Premiums for each optional cover. The Insurance Premiums for each optional cover are per Insurance Policy. The Insurance Premiums vary depending on the limit of coverage that each option grants. 
 
 
You can find below two examples :
  1. A family of 2 adults and 2 Dependent Children who selected the Premium pack and the “Pet caring” and “Pet insurance” options will pay 17.25 euros per month (8 + 8 + 0.75 + 0.5).
  2. A Single parent insuring 1 Dependent Child and 1 student Dependent Child (under 25 years old and engaged in Full-time Study) who selected the Standard pack, “Home & vehicle transformation” and “Wheelchair and Protheses” will pay 5.50 euros per month (4 + 0.50 + 1).
The above Insurance Premiums include any applicable tax.
 
N.2. Payment
 
Your Insurance Premium will be paid on a monthly basis according to the payment method chosen upon subscription.
 
N.3. Renewal
 
Your Policy will be renewed automatically on the Anniversary Date of this Insurance Policy and You will be charged the Insurance Premium according to the cover and the payment method You selected during the subscription process.
 
We will inform You that Your Policy is due for renewal by sending You a Renewal Notice seventy (70) days prior to the Anniversary Date of the current Period of Insurance. 
O. TERMINATION AND CANCELLATION OF YOUR POLICY
 

You/ We may terminate or Cancel Your Policy in the following cases:

How and what will We be refunding You and other details:

O.1. You may cancel Your Policy during the Cooling-off period.

Right of cancellation: You can cancel Your contractual declaration in text form (e.g. letter, e-mail) within thirty (30) days without giving reasons. The period begins after You have received, in writing, the Policy Schedule, the contractual provisions, including the General Terms and Conditions, the additional information pursuant to § 7 par. 1 and 2 of the Insurance Contract Act (VVG) in conjunction with §§ 1 to 4 of the Decree on Information Duties (VVG-InfoV) and this cancellation notice respectively; with contracts in electronic business transactions, however, not before the fulfilment of Our obligations in accordance with § 312i par. 1 sentence 1 of the Civil Code (BGB) in conjunction with article 246c of the Introductory Act to the Civil Code (EGBGB).:

To comply with the cancellation deadline, it is sufficient that You send the cancellation within the specified period. Send the cancellation to:

Email: www.psa-insurance-solutions.de/queries

Consequences of cancellation: in the case of an effective cancellation, the insurance cover ends and We reimburse You the portion of the premium outstanding after receipt of the cancellation if You have consented to insurance cover beginning prior to the end of the cancellation period. We reserve the right to withhold the portion of the premium that is allocated to the period until receipt of the cancellation; this refers to the amount calculated pro rata per day. Amounts to be repaid will be reimbursed immediately, at the latest 30 days after receipt of the cancellation. If insurance cover does not begin before the end of the period of cancellation, the effective cancellation means that payments received must be refunded and uses made thereof (e.g. interest) must be returned.

If You have exercised Your right of cancellation effectively in accordance with § 8 of the Insurance Contract Act (VVG), You are also no longer bound to any contract linked to the insurance contract. A linked contract exists if it has reference to the cancelled contract and pertains a service provided by the Insurer or a third party on the basis of an agreement between the third party and the Insurer. A contractual penalty may be neither agreed nor claimed.
 
Special notes: Your right of cancellation expires if the contract has been fully performed upon Your explicit request both by You and by Us before You exercised Your right of cancellation.

O.2. We may terminate Your Policy on the Anniversary Date.

We must send a notice of termination by means of a registered letter or by email notification at least two (2) months prior to the Anniversary Date.

O.3. You may Terminate Your Policy at any time in the future and for any reason during the Period of Insurance.

Complete the cancellation form in the queries section of the website: www.psa-insurance-solutions.de/queries 

Provided that You have not reported any claims We will refund You, within thirty (30) days, the Proportionate Unutilised Share of Your Insurance Premium.

O.4. We may cancel or Terminate Your Policy in the event that You have intentionally or unintentionally undisclosed or misrepresented information about the risk to Us.
Your Policy will be declared null and void in case of intentional non-disclosure or misrepresentation on Your part, whenever such non-disclosure or misrepresentation changes the subject of the risk or causes Us to view the same more favourably, even if the risk which You failed to disclose or misrepresented had no influence on the Loss.
 
In case of any unintentional incomplete or inaccurate declaration on Your part noticed prior to any Loss. We reserve the right to either retain Your Policy in return for an increase in the Insurance Premium or to terminate Your Policy one (1) month after notice in text form has been given, refunding the portion of Insurance Premium paid for the period of time in which Your Policy is no longer in force.

O.5. We may Terminate Your Policy in the event that You do not pay part or all of Your Insurance Premium.

We reserve the option of sending You a registered letter giving formal notice, and if the Insurance Premium due is still not paid:

1. If the unpaid premium is the first one accrued under the agreement, or the single premium We may at Our sole discretion
- Terminate the agreement, or
- Continue claiming the premium
 
You will not be covered by the Insurance Policy unless You provide evidence that You are nor responsible for the failure to pay.
 
2. If the premium is accrued during the term of the Insurance Policy and You fail to regularize the payment within one (1) month as from the date when You have received a reminder specifically setting out the outstanding Insurance Premium, interest and expenses (if any), We may at Our sole discretion: .
- Terminate the Insurance Policy with immediate effect,  or
- Claim the amount due; in such case, You will not be covered by the Insurance Policy until the payment has been effected, unless You provide evidence that You are nor responsible for the failure to make the payments set out in the reminder. 
 

O.6. We may terminate Your Policy in the event that there is a direct or indirect disclosed change in risk which is not compliant with the Eligibility Criteria of this Policy.

We will send You a written notification by means of a registered letter or by email within one month from receipt of Your disclosed change request.
 
We will refund You within thirty (30) days the proportionate Unutilised Share of Your Insurance Premium.
P. HOW TO MAKE A COMPLAINT

 

This Policy is subject to German law.
 

For any request related to this Insurance Policy, You may contact Us by using the form in the complaints section of the website: www.psa-insurance-solutions.de/complaints. We hereby undertake to acknowledge receipt within ten (10) working days and to deal with Your complaint within fifteen (15) days of receipt of all the documents necessary in order to examine the same.

If You are not satisfied with the response given by Us to Your complaint, You may:

At any point in time, You retain the right to refer any dispute related to this Insurance Policy to the German courts.

 
During the online subscription, You consent and agree freely to the personal data process done by Us. If You provide third parties’ personal data during the process of online subscription, You will be implicitly declaring to have the third party’s authorization to supply the data in question and undertake to inform the third party in question about the data protection terms herein.
 
We inform You that Your data is collected by PSA Insurance Limited, identified as the Data Controller, and processed by the Agent, PSA Insurance Solutions Limited, the Data Processor. The data collected is processed for the following purposes: (i) the conclusion, management and execution of Your insurance contracts, (ii) the fight against money laundering (iii) combating insurance fraud, and (iv) analysing Your data and cross-referencing it with those of Our partners to improve our products and services. The recipient is PSA Insurance Manager.
 
Your data is kept for the duration necessary for this processing which will not exceed ten (10) years starting from the end of the cover or the last communication with the client depending on which event occurred last.
 
We inform You that, when taking out an Insurance Policy, the answer to certain questions is mandatory. In the event of false declarations or omissions, the consequences for You may be the nullity of Your contract or the reduction of the indemnities paid.
 
You have the right to access, rectify, delete Your data, a right of portability of Your data, as well as a right of limitation and opposition to processing. You may exercise Your rights by sending an email to psainsurance-privacy@mpsa.com or by mail to Data Protection Officer, PSA Insurance, MIB House, 53, Abate Rigord Street, Ta’ Xbiex, XBX1122, Malta.
 
We have policies, standards and procedures in place which support the GDPR principles in relation to the protection of customer data.
 
You also have the right to lodge a complaint with the competent national supervisory authority.
R. REMOTE PURCHASING AND ELECTRONIC RELATIONSHIP
 

The conclusion of the Insurance Policy on the website https://www.psa-insurance-solutions.de represents the supply of a service consisting of a remote insurance transaction.

A service consisting of a remote insurance transaction is said to have been supplied whenever insurance transactions are supplied to an Insured, who is a natural person not acting in any commercial or professional capacity, as part of a system for remote selling or provision of services organised by the Insurer or insurance intermediary who, for this particular Insurance Policy, uses remote communication technology only, and this up until, and inclusive of, the conclusion of the Insurance Policy.
 
This Insurance Policy was purchased on PSA Insurance Solutions Ltd. website following Your review and acknowledgement of all the necessary pre-contractual information. By choosing to purchase the Insurance Policy online, You agree to use electronic means for the conclusion and maintenance of Your Insurance Policy.
 
To connect to Your My Account area, You must use the user name that You selected and Your password. It is up to You to ensure that this information remains confidential and to safeguard the security of Your account. To do so, You must keep this information confidential, log off after every session and change Your password regularly.
 
Furthermore, by agreeing to an electronic relationship, You have expressly agreed to the receiving correspondence from Us by email. The email address that You gave may be used for the dispatch of such letters. Thus, You undertake: (i) in case You change Your email address, to inform Us as soon as possible by changing Your personal contact details in Your My Account area; (ii) to regularly check the messages sent to this email address.
 
We shall moreover maintain the electronic documents for the entire statutory document maintenance period. You may therefore, during this period, ask Us to forward these documents in electronic format to You by contacting Our services www.psa-insurance-solutions.de/queries.

 

Documentary evidence agreement
 
Pursuant to the regulations in force, We would like to inform the Insured that clicking on “VALIDATE” and on "Pay now" is the equivalent of an electronic signature. 

You hereby acknowledge:

  • That the receipt of Your Insurance Policy in an electronic email sent to the email address that You have provided, indicating the fact that Your Insurance Policy was signed electronically, and have been made available in Your My Account Area is the equivalent of the submission of the said documents.
  • That the fact that the documents are sent by e-mail as pdf-attachment or downloadable in PDF format from the My Account area and printable means that the character of the medium thus communicated meets the criteria of integrity and durability as required by law.
  • That in case of any dispute, the data transmitted by You and the electronic certificates and signatures or exploitation of the log used in the context of the digital services are admissible to the courts and will provide evidence of the data and facts that they contain and of the signatures and authentication procedures expressed by them.
  • That in case of any dispute, the time stamps or exploitation of the log are admissible to the courts and provide evidence of the data and facts that they contain. Evidence of the connections made by You and of other elements of identification or actions taken by You will be established as and when necessary with the aid of the connection logs kept by the Agent and of the computer records retained for such purposes.
You hereby expressly acknowledge the fact that by having clicked on the buttons "VALIDATE" and "Pay now":
  • You provide Your consent to the contents of Your Insurance Policy,
  • You confer the same legal value to Your Insurance Policy, as a document written and signed by hand.
S. INVALIDITY PERCENTAGES
 
The Permanent Partial Invalidity indemnity will be calculated by taking the invalidity percentage as set in the below table and multiply it by the sum insured. The percentages are as follows : 
 
 Physical Impairment  Standard Comfort   Premium
 One eye 50% of Sum Insured 50% of sum Insured  50% of Sum Insured 
 One ear 30% of Sum Insured 30% of Sum Insured  40% of Sum Insured 
 Sense of smell 10% of Sum Insured 10% of Sum Insured  20% of Sum Insured 
 Taste 5% of Sum Insured  5% of Sum Insured  10% of Sum Insured 
 Arm 70% of Sum Insured  70% of Sum Insured 75% of Sum Insured 
 Hand 55% of Sum Insured 55% of Sum Insured 70% of Sum Insured 
 Thumb 20% of Sum Insured 20% of Sum Insured   25% of Sum Insured
 Index finger 10% of Sum Insured  10% of Sum Insured  20% of Sum Insured 
Another finger 5% of Sum Insured 5% of Sum Insured  10% of Sum Insured 
Leg  70% of Sum Insured 70% of Sum Insured  80% of Sum Insured 
Foot  40% of Sum Insured 40% of Sum Insured  50% of Sum Insured 
Big Toe  5% of Sum Insured 5 % of Sum Insured  10% of Sum Insured 
Other Toes  2% of Sum Insured  2% of Sum Insured 5% of Sum Insured 
 
 
PSA Insurance Limited, Reg; C44567 is a limited liability company under Maltese law, having its registered address at: MIB House, 53 Abate Rigord Street, Ta’ Xbiex, XBX1122 Malta. The company is authorised to carry on business in terms of the Insurance Business Act, and authorised to carry on Insurance business under the freedom to provide services provisions, by the Malta Financial Services Authority (MFSA), Notabile Road, Attard BKR 3000, Malta.
 
DE2WCOMP01
© PSA Insurance Solutions
PSA Insurance Solutions Ltd Reg No: C83206 is a limited liability company under Maltese Law, having its registered address at: MIB building 53 Abate Rigord Street Ta’ Xbiex Malta, Tel + 356 22 58 34 92. The company is enrolled to act as an insurance agent in terms of the Insurance Intermediaries Act, 2006 by the Malta Financial Services Authority (MFSA), Notabile Road, Attard BKR 3000, Malta.
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