Travel Insurance Policy Wording
Issue date: 22 April, 2022


These Conditions are an integral part of the “Tripinsurance” Traveler's Insurance Contract (Certificate) and include Special Conditions that expand the Insurance Rules.

Special Conditions

1. According to Tripinsurance Traveler's Insurance Certificate (hereinafter, the Certificate) the Insured Persons are individuals leaving the place of their principal residence, having a residence permit and/or a dual citizenship in the country of their envisaged stay.

2. The Certificate covers, inter alia, events occurring when the Insured Person performs the following actions: pedal boating, water-based recreational activities involving inflatable towable devices or parachutes, recreational kayaking or canoeing, water park visits, water polo games in hotel pools, segway rides, guided recreational rafting tours, beach volleyball or soccer games, skiing (except alpine skiing), guided cave tours, cycling (except off-road or mountain biking), tennis, golf, badminton, bowling, pool games, skating or roller skating, jogging, fishing (non-competitive), skateboarding or guided recreational animal rides (horse, camel, elephant rides, etc.).

3. If the Certificate provides for “Outdoor activities” the coverage includes the events provided in the Certificate that may occur while the Insured Person undertakes any outdoor activities. Outdoor activities are the types of active recreational activities such as water skiing, surfing, windsurfing, jet-skiing, rafting, yachting, kiting, recreational diving to the depth under 12 meters and accompanied by instructor, (competitive) fishing, hunting, alpine skiing, snowboarding, snowmobile rides, ice hockey games, mountain biking, trips on horseback.

4. If the Certificate provides for “Amateur sports” the coverage includes the events provided in the Certificate that may occur while the Insured Person undertakes any amateur sporting activities. Amateur sports are sporting activities aimed mainly on physical education and physical development of persons for whom sports are not the primary activity, through organized and/or independent training, participation in physical education and sports events with the purpose other than earning material rewards or a salary.

5. If the Certificate provides for “Hazardous work” the coverage includes the events provided in the Certificate that may occur while the Insured Person undertakes any hazardous work operations. Hazardous work means any type of hazardous operations inherent to the Insured Person’s work in the following fields or professions/industries: hazardous or harmful industries, industries, professions and occupations involving radiation, height over 15 m, surface or subsurface water operations, oil and gas industry, underground operations, operations involving explosives, hazardous chemical substances and compounds, and/or other jobs involving elevated levels of risk (automotive mechanics, underground or railroad train drivers and assistant drivers), truck drivers, fishing boat crew members, guards, security service employees at enterprises and organizations, armed policemen, personal bodyguards, crime detectives, night guards, army servicemen and officers, crane or steamroller operators, inland water transport employees, airline pilots and crew members, including helicopter and small aircraft pilots, metalsmiths, welders, grinders, sharpeners, diamond cutters, glass makers.

6. The following costs are neither considered insured events under the benefit nor compensated by the Insurer:

6.1. general medical check-ups and preventive examinations not related to diagnostics of acute illness or injury caused by an Accident, vaccination (except for emergency vaccination), disinfection;

6.2. caused by the Insured Person engaging in the following sporting activities: car and bike racing, mountaineering, marital arts, deep cave spelunking (except for guided cave tours), competitive hiking, scuba diving, rafting (except for guided rafting tours) surfing, windsurfing, kiting, water skiing, mountain biking, winter sports (alpine skiing, snowboarding, sledding, skiing or skating), horse racing, springboard diving, bungee jumping, parkour and/or any Professional sports, Amateur sports, Outdoor activities, Hazardous work, if the Insurance Contract does not provide otherwise.

7. The Insurer’s expenses covering Emergency Medical Care in cases of chronic condition acute exacerbation shall not exceed the amount of three thousand (3,000) US Dollars.

8. A Certificate for the Insurance Limit of hundred thousand Euros or US Dollars (EUR or USD 100,000) covers expenses caused by an act or acts of terror, actions to control, prevent, pacify or in any other way counter act and/or acts of terror as well as acts of violence or acts posing risks for human life, performed in order to seize any tangible or intangible values, or in order or for the purpose of influencing any government or intimidating the population or any demographic group, that the person to whose benefit the Insurance Contract (Certificate) was signed was an innocent victim of.

In all other matters not provided in these Special Conditions, the Insurance Rules apply.

Comprehensive Insurance Rules for Individuals Traveling outside Their Principal Residence (Travel Insurance Rules)

Table of contents

  1. General Provisions and Key Definitions

  2. Parties to the insurance contract

  3. Objects Insured, Insured Benefits, Insured Events

  4. Insurance Limit, Insurance Tariff, Insurance Premium

  5. The procedure for insurance contract signing, performance, amendment and cancellation

  6. Rights and Obligations of the Parties

  7. Refusal of Insurance Claim Payment

  8. Force Majeure

  9. Other terms and conditions. Subrogation

  10. Insurance Benefits, Insured Events

  11. Insurance Exclusions. Expenses not Subject to Reimbursement by the Insurer

  12. Insurance reimbursement: limits and payment procedure

1. General Provisions and Key Definitions

1.1. In accordance with the applicable law and on the basis of these Comprehensive Insurance Rules for Individuals Traveling outside Their Principal Residence (hereinafter referred to as the Rules), Tripinsurance (Persefonia OU) (hereinafter referred to as the Insurer) shall enter into Insurance Contracts with legal entities and capable individuals (hereinafter referred to as the Policyholders) with respect to individuals traveling outside their principal residence and going on a tourist, business or other trip(s) during the Insurance Contract validity term. Individuals traveling abroad and holding a residence permit and (or) dual citizenship in the country of intended stay cannot be insured under the terms of these Rules, unless clearly stated otherwise in the Insurance Contract.

1.2. Upon execution of the Insurance Contract on the terms and conditions set out herein, these Rules shall become an integral part of the Insurance Contract and be binding on the Policyholder and the Insurer. The Insurance Contract shall be deemed executed on the terms and conditions set out herein if their application is expressly stated in the Contract and the Rules and (or) extracts from the Rules regarding the Insurance Benefits (Policy Wording) are attached to the Insurance Contract.

1.3. When entering into the Insurance Contract, the Policyholder and the Insurer may agree to amend or delete certain provisions hereof and to supplement the Insurance Contract with terms and conditions other than those set out herein, unless such amendments and addenda extend the insurance terms and conditions set out herein or contradict the applicable law.

Amendments to the provisions hereof agreed upon by the parties to the Insurance Contract upon its execution shall be incorporated into the Insurance Contract. In this case, these Rules shall apply to the Insurance Contract to the extent that they do not contradict the terms and conditions set out in the Insurance Contract. Should any disputes arise, the provisions of the Insurance Contract shall prevail over these Rules.

1.4. The following basic terms and definitions shall be used in these Rules:

Accident shall mean an actual, sudden, unforeseen, short-term (up to several hours), abrupt physical impact of one or more various external factors (mechanical, thermal, chemical, etc.) in relation to or on the Insured that occurred against the will of the Insured during the Insurance Contract term and resulted in bodily injuries or other impairment of internal and external bodily functions, or death of the Insured, not caused by a disease or medical manipulation. Any forms of acute, chronic, or hereditary diseases shall not be considered accidents.

Amateur Sports shall mean sports activities aimed at physical education and physical development of individuals for whom sport is not the principal activity, through organized and (or) independent activities, as well as participation in physical education and sports events, not aimed at receiving financial remuneration or wages.

Bodily Injury shall mean an injury sustained by the Insured as a result of an Accident.

Carrier shall mean any registered carrier transporting passengers by land, water or air, having the right (license) for and performing this type of transportation under a regular schedule.

Chronic Diseases shall mean diseases or injuries that meet at least two of the following conditions:
- has no known recognized ways of treatment;
- may exist for an indefinite period of time;
- there are or may be relapses;
- is permanent;
- requires palliative treatment;
- requires long-term monitoring, consultation, examination, tests or studies;
- the Insured needs to undergo rehabilitation or special training in order to cope with the disease.

Country (or Region) of Principal Residence shall mean the country (region) or countries that are the primary (or secondary) places of principal residence of the Insured whose primary place of residence corresponds to the principal citizenship of the Insured, and the secondary place of principal residence of the Insured corresponds to the country of the second citizenship, for Insureds with dual citizenship.

Country (or Region) of Stay shall mean the country (region) located in the Insurance Territory where the Insured temporarily resides or travels.

Deductible shall mean the part of the Insured’s losses stipulated by the Insurance Contract (in absolute amount or as a percentage) that is not subject to reimbursement by the Insurer.

Emergency Hospitalization shall mean hospitalization in case of an urgent need, carried out directly by the reception department of the hospital (without a physician’s referral) or upon referral of emergency and urgent medical care facilities.

Emergency Medical Care (Urgent Care) shall mean medical care, without which the life and health of the Insured are exposed to real threat.

Exacerbation of a Chronic Disease During a Trip shall mean an acute manifestation of the Insured’s chronic disease during the Insured Trip, with respect to which the Insured used to seek medical advice and/or receive treatment in the past, which a physician, however, found to be not an obstacle to travel, resulting in a real risk of long-term or permanent disability and (or) death of the Insured and requiring emergency medical care.

Hazardous Work shall mean a person’s activity related to their profession and occupation in a particular field or industry.

Immediate Family shall mean parents, children (including those adopted, being under custody or guardianship), legal spouse, siblings, grandparents, grandchildren, parents-in-law, sister-in-law, brother-in-law, daughter-in-law. One individual accompanying the Insured on a trip shall be considered immediate family.

Inpatient Facility shall mean a specialized medical facility that:
- is designed for round-the-clock stay, observation and Treatment of patients (ill persons);
- has diagnostic and surgical departments;
- is staffed with the necessary medical personnel (physicians, secondary medical personnel);
- has a special permit (license) for healthcare activities.

Insurance Contract (Insurance Policy, Policy) shall mean an agreement between the Insurer and the Policyholder binding one party (the Insurer) to reimburse the other party (the Policyholder) or other person for whose benefit the Insurance Contract has been entered into (the Insured/the Beneficiary), for a fee (Insurance Premium) under the Insurance Contract, upon the occurrence of an event (Insured Event) stipulated in the Contract, for losses caused by such event (to pay the reimbursement ) within the amount specified in the contract (the Insurance Limit).

Insurance Risk shall mean an assumed event that has features of probability and randomness of its occurrence, to be covered by the insurance.

Insurance Territory (Covered Territory) shall mean a country, set of countries, territory, or geographical area within which the Insurer shall be obliged to pay an insurance benefit in case of an Insured Event.

Insured Event shall mean an event provided for by the Insurance Contract, resulting in the Insurer’s obligation to reimburse to the Policyholder (the Insured, the Beneficiary or other third parties).

Insured Trip shall mean the departure of the Insured outside the principal residence for a tourist, business, education, private and other trip under the Insurance Contract, within the covered territory and during the Insurance Contract term.

Insurer’s Medical Expert shall mean a specialist with a diploma of higher medical education who is engaged by the Insurer under a civil law or employment contract to conduct medical expert review.

Insured’s Personal Liability shall mean the duty of the Insured to reimburse damage caused to life, health or property of third parties while the Insured is staying outside his/her principal residence, in the manner prescribed by the applicable law of the Insurance (Covered) Territory.

Leisure Activities shall mean various activities covered by the standard terms of the Insurance Contract: any type of physical education and sports in fitness clubs (centers) and gyms (except for martial arts), water biking, water entertainment using towed inflatables and parachutes, recreational kayaking or canoeing, visiting water parks, water polo in a hotel pool, segway riding, guided rafting, beach volleyball or football, winter skiing (except for alpine skiing), tour-guided speleology, cycling (except for off-road cycling, mountain cycling), tennis on the hotel grounds, ping-pong, golf, badminton, bowling, billiards, roller-skating or skating, jogging, fishing (except for sports), skateboarding, tracking, and guided animal rides (horses, camels, elephants, etc.).

Luggage shall mean personal belongings of the Insured carried by the latter during a trip outside the principal residence, that have been registered with the transport company for storage, and carry-on baggage that stays with the Insured in the vehicle cabin. Luggage also includes items purchased by the Insured during the stay outside the Insured’s principal residence.

Medical Expenses shall mean the costs of treatment performed or prescribed by a qualified physician.

Medical Facility shall mean an organization that has the right (license) to provide medical services under the law of the country where such services are provided.

Medical Transportation shall mean evacuation and (or) repatriation of the injured Insured as a result of an insured event.

Motor Vehicle shall mean a passenger car with a total weight of up to 3.5 tons, owned by the Policyholder/Insured (individual) used by the Policyholder/Insured to go on the Insured Trip.

Outdoor Activities shall mean a way of spending free time involving physical activities, including on-piste skiing or snowboarding, scuba diving to a depth of up to 12 meters with an instructor, rafting (non-guided), surfing, windsurfing, kiting, water skiing, sailing. The Insurance Contract (policy) may also provide for a different list of activities.

Outpatient Facility shall mean a licensed medical facility that provides outpatient, surgical treatment and care.

Personal Belongings shall mean the property belonging to the Policyholder under the right of ownership or on other legal grounds, in particular, received by the Policyholder under a lease, rental, pledge, bailment hire, gratuitous use (loan) agreement, etc., which is not luggage and is carried by him/her during the trip.

Physician shall mean a specialist with the completed and duly registered medical education who is not a relative of the Policyholder (Insured) and who acts under his/her license or other legal documents provided for by the law of the country of stay to treat the consequences of an Accident or Sudden Disease.

Poisoning shall mean a disorder of vital activity as a result of ingestion of a poison or toxin. Poisoning may result from food or ingestion of carbon monoxide, or coal gas, chemicals and acids.

Prescription shall mean a written prescription from a physician for the use of medicines.

Principal Residence shall mean the place where the Policyholder (Insured) permanently or predominantly resides.

Professional Sports shall mean a kind of sports aimed at organizing and conducting sports competitions, with athletes receiving remuneration and (or) wages from the competition organizers for participation in and preparation of the competitions, as their principal activity.

Regular Flight shall mean domestic and international air transportation of passengers, luggage, cargo under the flight schedule.

Service Company shall mean a specialized organization that, on behalf of the Insurer, ensures round-the-clock availability of services provided for by these Rules.

Sudden Disease (Illness) shall mean a health problem of the Insured not caused by an accident but resulting from an external factor, which is stochastic and random in nature, occurring beyond the will of the Insured and/or Beneficiary, diagnosed based on objective symptoms for the first time after the Insurance Contract has come into force and requiring urgent medical intervention.

Urgent Report shall mean first request of the Policyholder (Insured) to the Service Company by telephone, Fax or other available communication means, including text messages.

2. Parties to the insurance contract

2.1. The Insurer, Tripinsurance (Persefonia OU) is a legal person incorporated under the laws of the Estonian Republic in order to render insurance services and licensed appropriately as provided by the law.

2.2. The Policyholders are:

2.2.1.individual entrepreneurs or corporate entities of any form of ownership which signed Insurance Contracts with the Insurer. The beneficiaries of Insurance Contracts paid for by an entity may be corporate employees and/or other persons.

2.2.2.legally competent individuals - nationals of the respective country of their principal residence, or foreign nationals, or stateless persons. Individual Policyholders may sign Insurance Contracts with the Insurer to benefit other persons (Insured Persons or Beneficiaries).

2.3. Insured Persons (Insureds) are individuals - nationals of the respective country of their principal residence, or foreign nationals, or stateless persons whose property interests have been insured according to these Rules:

2.3.1.Insured Persons are stated in the Insurance Contract.

2.3.2.If an individual Policyholder signs a contract insuring his or her property interest, such Policyholder shall also be deemed the Insured Person.

2.3.3.The Insurer may set the requirements as to the Insureds’ age, health or other factors that influence the risk level for some of the Insured Persons.

2.3.4.The benefit “Trip Cancellation” shall not apply to the persons who are not nationals of the respective countries of their principal residence, due to rejection of their entry/exit visa application (see cl.10.1.7.5. hereof) if the Insurance Contract does not indicate otherwise.

2.3.5.The Policyholder may at any time up to the occurrence of an insured event replace a Beneficiary with another person subject to a respective written notice to the Insurer. In the context of personal insurance contracts the Policyholder may replace an Insured Person only with such Insured Person’s consent.

2.4. A Beneficiary under an Insurance Contract is:

2.4.1. in the context of medical assistance and other expenses: the Insured Person, if the Contract does not provide for another person as the Beneficiary (in case of the Insured Person’s death the beneficiaries are the lawful heirs of such Person). An insurance contract to the benefit of a person other than the Insured Person, including an Policyholder who is not the Insured Person may be signed only subject to the Insured Person’s written consent. In absence of such consent the Insured Person (in case of the Insured Person’s death - the lawful heirs of such a Person) may sue to declare the Insurance Contract invalid.

2.4.2. in the context of personal liability insurance: a person whose life, health and/or property may be at risk of damage (in case of such person’s death, his or her lawful heirs);

2.4.3. in the context of property insurance: a person having a legal, regulatory or contractual interest in preserving the property covered by insurance.

2.4.4.in the context of extra expenses coverage: the person bearing such expenses.

2.5. Signing an Insurance Contract for the benefit of a beneficiary does not release the Policyholder from fulfilling his or her obligations thereunder if the Contract in question does not provide otherwise or if the Policyholder’s obligations have not been fulfilled by the person for the benefit of which the Contract has been signed. If the Beneficiary files an insurance claim the Policyholder shall have the right to request that the Beneficiary fulfill his or her obligations under the relevant Insurance Contract, including the outstanding obligations of the Policyholder. The Beneficiary bears the consequences of non-fulfillment or late of outstanding obligations.

3. Objects Insured, Insured Benefits, Insured Events

3.1. Objects Insured are property interests of the Insured Persons which are in line with the applicable laws:

3.1.1. those related to the risk of extra expenses caused by:

3.1.1.1. the need for medical and medical transport services (“Medical and Medical Transport and Evacuation Expenses” benefit);

3.1.1.2. the need for transport services (“Transport Expenses” benefit);

3.1.1.3. delay or cancellation of a flight (“Expenses of Flight Delay” benefit);

3.1.1.4. transmission of urgent messages (“Urgent Messages Expenses” benefit);

3.1.1.5. need for legal assistance (“Legal Assistance Expenses” benefit);

3.1.1.6. loss or theft of documents (“Expenses of Loss or Theft of Documents” benefit);

3.1.1.7. emergency cancellation of the Insured Trip (“Trip Cancellation Expenses” benefit);

3.1.1.8. interruption of the Insured Trip (“Trip Interruption Expenses” benefit);

3.1.2. those related to the risk of luggage loss (destruction), partial loss or damage (“Lost Checked Luggage Expenses” benefit);

3.1.3. those related to the risk of extra expenses due to luggage delay in the Country of Stay in the course of a scheduled flight undertaken by the Insured Person (“Luggage Delay Expenses” benefit);

3.1.4. those related to the risk of liability for causing damage to life, health and/or property of third persons (“Personal Liability” benefit);

3.1.5. those related to harm caused to the Insured Person’s health, the Insured person’s disability or Injury as a result of an Accident, or death of the Insured Person as a result of an Accident occurring in the course of the Insured Person’s stay outside of his or her Principal residence (“Health and Accident” benefit).

3.2. An insured risk is an envisaged event covered by the insurance. An event which is considered an insured risk is both probable and random in nature.

3.3. An Insured Event is an event stated in the Insurance Contract that has already occurred and led to the Insurer’s obligation to pay the insurance claim.

3.4. An Insured Event means:

3.4.1. the Policyholder (the Insured Person) suffering extra expenses caused by:

3.4.1.1. the need for medical and medical transport services (“Medical and Medical Transport and Evacuation Expenses” benefit);

3.4.1.2. the need for transport services (“Transport Expenses” benefit);

3.4.1.3. delay or cancellation of a flight (“Expenses of Flight Delay” benefit);

3.4.1.4. transmission of urgent messages (“Urgent Messages Expenses” benefit);

3.4.1.5. need for legal assistance (“Legal Assistance Expenses” benefit);

3.4.1.6. loss or theft of documents (“Expenses of Loss or Theft of Documents” benefit);

3.4.1.7. emergency cancellation of the Insured Trip (“Trip Cancellation Expenses” benefit);

3.4.1.8. interruption of the Insured Trip (“Trip Interruption Expenses” benefit);

3.4.2. the Policyholder (Insured Person) suffering extra expenses due to luggage loss (destruction), partial loss or damage (“Lost Checked Luggage Expenses” benefit);

3.4.3. the Policyholder (Insured Person) suffering extra expenses due to luggage delay in the Country of Stay in the course of a scheduled flight undertaken by the Insured Person (“Luggage Delay Expenses” benefit);

3.4.4. the Policyholder(Insured Person) suffering extra expenses due to liability for causing damage to life, health and/or property of third persons (“Personal Liability” benefit);

3.4.5. the Policyholder (Insured Person) suffering extra expenses due to harm to the Insured Person’s health, the Insured Person’s disability or Injury as a result of an Accident, or death of the Insured Person as a result of an Accident occurring in the course of the Insured Person’s stay outside of his or her Principal residence (“Health and Accident” benefit).

3.5. An Insurance claim is paid after occurrence of an Insured Event to the Insured Person (Beneficiary) after he or she returns to the Region of his or her principal residence, or to the Service Company that has paid the Insured Person’s expenses in the Country (Region) of Stay.

3.6. The Insurance Territory does not include (i.e. no extra expenses suffered at the territories indicated in this clause are considered insured events):

3.6.1. countries where war action is currently ongoing;

3.6.2. countries where epidemic outbreaks have been declared and are currently active;

3.6.3. countries declared by UN or other government bodies as unsafe or unadvisable for travel;

3.6.4. countries under sanctions declared by the UN or international organizations.

4. Insurance Limit, Insurance Tariff, Insurance Premium

4.1. Insurance Limit is a monetary Amount stated in the Insurance Contract and serving as a basis for the insurance premium (insurance payment) and the amount of the insurance claim paid in case of an insured event occurrence.

4.2. The Parties establish the Insurance Limit by mutual consent. If the Insurance Contract is signed for several Insured Persons, the Insurance Limit is established for each of the Insured Persons.

4.3. The parties may agree to establish the Insurance Limit cumulatively for all benefits, or separately for each benefit or group of benefits, for each Insured Person or for all Insured Persons in total. In any case, an insurance claim payment for a single benefit may not exceed the amounts (limits of liability) provided for by the Insurance Contract for the relevant benefit, and the total of all insurance claim payments for all benefits under the Insurance Contract may not exceed the total Insurance Limit provided for by the Insurance Contract.

4.4. For Luggage insurance, the Insurance Limit may not exceed the actual value of the Luggage. Such value is the actual value of the Luggage at its actual location on the day of signing the Insurance Contract. The actual value is based on the amount required to replace the lost item, minus the normal wear.

4.5. If the expenses constituting an insured event exceed the Insurance Limit established for the relevant benefit in the Insurance Contract, the Insured Person shall pay a share of the expenses in excess of the Insurance Limit from his or her own funds.

4.6. The Parties may establish the minimum amount of the damages not covered by the Insurer (a deductible), in which case all the Insured Person’s expenses in excess of the deductible are compensated.

4.7. The Parties may establish a non-deductible (conditional) franchise in the Insurance Contract. The Insurer shall not be liable for the losses within the franchise amount and shall compensate the expenses suffered by the Insured person in full in case they exceed the conditional franchise amount.

4.8. The Insurance Premium is the amount the Policyholder pays to the Insurer under an Insurance Contract.

4.9. The Insurance Rate is the rate of the insurance premium per exposure unit, considering the object insured and the nature of the insured risk.

4.10. If an Insurance Contract signed for a single Insured Person does not provide otherwise, the insurance premium thereunder is to be paid as a lump sum. Insurance premium under an Insurance Contract signed for multiple Insured Persons may be paid as a lump sum or in installments. The procedure and the schedule for insurance payments are established in the Insurance Contract.

4.11. If the insurance premium or the first installment thereof (if payment is stipulated to be paid in installments) is paid in cash, the day of payment is the day when the insurance premium (installment) is entered into the Insurer or the Insurer’s representative’s cash register.

4.12. For cashless payments, the payment day is the day the required amount is recorded at the Insurer’s current account.

4.13. Insurance premium (installments thereof) may be denominated, if the parties so agree and if the law permits, in US dollars or in other currencies.

4.14. The Insurance Limit may be denominated, if the parties so agree, in US dollars or in other currencies.

4.15. When calculating the insurance premium, the Insurer may use factors, established by experts depending on the Insured Persons’ age, history of serious illnesses or disability, the duration of the Insured Persons’ stay abroad, the Insurance Territory, the number of Insured Persons, the purpose of the trip and other individual risk factors.

5. The procedure for insurance contract signing, amendment and cancellation

5.1. In order to sign an Insurance Contract the Policyholder submits a relevant oral request or a written application on the Insurer’s letterhead to the Insurer. The Insurer determines the application form individually on a case by case basis.

5.2. In cases established by the laws the Policyholder shall provide the Insurer with information and documents to identify the Policyholder, the Insured Persons, their representatives, ultimate owners and beneficiaries, in order to ensure legal compliance.

5.3. If an Insurance Contract is signed for multiple Insured Persons, the Policyholder attaches the Insured Persons list complied according to the Insurer’s requirements to the application (if the application is to be submitted in writing).

5.4. An Insurance Contract may be signed only when the Policyholder and the Insured Persons are present in the Country (Region) of their principal residence (except for special Insurance Contract conditions as indicated in clause 5.6 of these Rules). If the Policyholder signed and (or) paid for an Insurance Contract (certificate of insurance) after crossing the border of the Insurance Territory (while being outside of the Country (Region) of their principal residence), the contract in question shall be considered invalid, the Insurer shall bear no liability thereunder and the insurance premium paid thereunder shall be returned to the Policyholder in full based on a written request.

5.5. An Insurance Contract comes into force on a date indicated therein as the date of its entry into force, but not earlier than the day following the day of insurance premium payment, if such payment is to be paid before the person in question crosses the Insurance Territory border, and if the Insurance Contract, as provided in clause 5.6 hereof, does not indicate otherwise.

5.6. Special Insurance Contract Conditions: if an Insurance Contract indicates that as of the moment of its signing the Insured Person is already outside the Country (Region) of his or her principal residence (in which case the insurance contract (certificate) shall state the “already travelling” condition), clauses 5.4, 5.5 and 7.3 hereof are excluded and the Insurance Contract may be signed regardless of the Policyholder and the Insured Persons’ physical location and comes into force at the date indicated in the Insurance Contract as the date of its entry into force, but not earlier than the day following the day of insurance premium payment.

5.7. An Insurance Contract is signed by executing a single document, or by the Insurer (the Insurer’s representative) delivering an insurance certificate signed by the Insurer (the Insurer’s representative) to the Policyholder on the Policyholder’s oral or written request. An Insurance certificate is issued on the day the insurance premium/the first installment thereof enters the Insurer’s (the Insurer’s representative’s) cash register or the Insurer’s current account.

5.8. An Insurance Contract is signed for the term that the parties agree on which shall not in any case be longer than one year; furthermore, the Insurance term is established as the duration of the Insured Person’s Insured Trip, if the Insurance Contract does not provide otherwise.

5.9. If the Insurance Contract provides for multiple trips of the Insured person outside of the Country (Region) of his or her principal residence, the insurance coverage of each trip shall last for each Insured Trip of the Insured Person.

5.10. Insurance coverage, except for the trip cancellation coverage, starts at the moment the Insured person crosses the border of the Country (Region) of his or her principal residence stated in the Insurance Contract and ends when the Insured person crosses the border of the Country (Region) of their principal residence when coming back to the Country (Region) of their principal residence, but not later than on 24:00 of the day stated in the insurance certificate as the Insurance Contract expiry date.

5.11. When it comes to trip cancellation insurance, the coverage starts 48 hours after the insurance premium payment and ends after the Insured person crosses the border of the Country (Region) of his or her principal residence, but not later than on 24:00 of the day stated as the Insured Trip commencement day.

5.12. If medical services were (partly) rendered by foreign Healthcare Institution in consequence of an Accident that occurred when crossing the border in the course of travel (flight sea voyage) over the territory of the Insured Person’s Country of principal residence, the services in question shall be covered by the Insurer.

5.13. If by the moment of expiry of the Insurance Contract, the Insured Person’s return to the Country (Region) of his or her principal residence is delayed due to such person’s inability to leave the Country of his or her stay as medically indicated due to an Insured Event that has occurred earlier, the Insurer shall continue performing its obligations related to the relevant Insured Event as provided for in the Insurance Contract (Insurance Certificate). The Insured Person’s inability to leave the Country of his or her stay shall be certified by the Insured person’s attending physician and the medical expert of the Insurer.

5.14. If by the moment of the Insurance Contract expiry, the Insured Person’s return to the Country (Region) of his or her principal residence is delayed for reasons other than those stated in cl. 5.11, the Contract validity term may be extended with the Insurer’s consent, subject to additional premium payment.
5.15. An Insurance Contract terminates completely or for any Insured person (if the contract was signed for the benefit of multiple Insured Persons) for the following reasons:

5.15.1. expiry of the Insurance contract;

5.15.2. the Insurer fulfilling its obligations under the Insurance Contract in total, or in relation to any Insured person respectively;

5.15.3. death of the individual Policyholder (Insured Person);

5.15.4. liquidation of the corporate Policyholder, except for the cases of replacement of the Policyholder under an Insurance Contract due to the former’s reorganization (merger, consolidation, separation, split-up, transformation);

5.15.5. a court decision declaring the Insurance Contract invalid;

5.15.6. if occurrence of the insured event ceased to be possible and the insured risk has been eliminated for reasons other than an insured event.

5.15.7. in other cases provided by applicable laws.

5.16. If the Insurance Contract is cancelled early according to cl.5.15.6 hereof, the Insurer may retain a portion of the insurance premium commensurate to the time for which the coverage has been valid, and receive compensation for case administration expenses as per the established rate structure, if the Insurance Contract does not provide otherwise.

5.17. The Policyholder may withdraw from the Insurance Contract at any time, if by the moment of withdrawal the possibility of occurrence of the insured event has not been eliminated for reasons other than the insured event. If the Policyholder withdraws from the Insurance Contract early, the insurance premium paid to the Insurer shall not be returned if the Insurance Contract does not provide otherwise.

5.18. If the coverage amounts were denominated in foreign currencies and the Insurance Contract was cancelled (terminated) early fully or in part so a portion of the insurance premium paid for the remainder of the contract term is to be returned to the payer, such remainder is returned in U.S. dollars.

5.19. The insurance premium is returned before the deadline established in the Insurance Contract, but not later than ten (10) business days after signing the agreement on early termination of the Insurance Contract or receiving the relevant written request from the Policyholder.

5.20. If the Policyholder fails to pay one of the installments before the time provided in the Insurance Contract (if the insurance premium is paid in installments) the Insurance coverage stops on the day following the day provided in the Contract as the deadline for such installment, if the Insurance Contract does not provide otherwise.

5.21. If an insured event occurs before the late installment is paid, the Insurer may, when determining the claim amount, set it off against the amount of the late installment.

5.22. During the Insurance Contract validity term the Policyholder informs the Insurer immediately of any changes in information provided in the Insurance Contract and the application for insurance (if such application was submitted in writing) that the Policyholder becomes aware of.

5.23. If the Insurer becomes aware of any circumstances that may raise the insured risk level, the Insurer may request to amend the Insurance Contract provisions or to increase the insurance premium commensurate to the relevant risk increase. If the Policyholder objects against the changes made to the Insurance Contract provisions or against the extra premium payment, the Policyholder may request termination of the Insurance Contract.

5.24. The Policyholder may not request the Insurance Contract to be terminated if the circumstances that caused the risk increase have already ceased.

5.25. The Insurance Contract provisions may be changed upon the parties mutual consent.

5.26. An agreement to change or terminate the Insurance Contract shall be in writing and signed by the parties.

6. Rights and Obligations of the Parties

6.1. The Policyholder may:

6.1.1. study these Rules;

6.1.2. choose the Insurance Benefit which he or she desires to cover;

6.1.3. during the Insurance Contract validity term, replace the Beneficiary stated in the Insurance Contract with another person subject to a relevant written notice issued to the Insurer, except for the cases when the Beneficiary stated in the Insurance Contract have already performed one of his or her obligations under the Insurance Contract, or submitted an insurance claim to the Insurer;

6.1.4. receive a copy of the insurance certificate (certified by the Insurer) if the original certificate has been lost;

6.1.5. withdraw from the Insurance Contract at any time, if the possibility of occurrence of the insured event has not been eliminated for reasons other than the insured event.

6.1.6. receive information about the Insurer as provided by the laws of the Estonian Republic;

6.1.7. receive the insurance claim payment upon occurrence of an insured event, according to the provisions of the Insurance Contract and these Rules;

6.1.8. request an independent expert assessment in order to more precisely determine the causes of an insured event and the amount of losses caused thereby; An independent expert assessment shall be carried out by an expert (expert committee) appointed by the parties’ mutual consent. The party requesting the independent expert assessment shall bear the expenses thereof. If the expert assessment finds that the Insurer has wrongfully refused to provide insurance claim payment, the Insurer shall assume the portion of the expert assessment cost commensurate to the ratio between the claim amount that was initially refused for payment and the amount paid after the expert assessment. If the Policyholder requested an expert assessment, the Policyholder shall bear the expenses of such assessment for the events that the assessment found out not to be insured events.

6.2. The Insured Person may, if he or she is not able to get in contact with the Service and the Insurer on his or her own and if the Insurance Contract does not indicate otherwise, contact the nearest Healthcare Institution directly and provide the Insurance Contract to them.

6.3. The Insurer may:

6.3.1. verify the information provided by the Policyholder (Insured Person) and pertaining to the Insurance Contract;

6.3.2. in order to carry out insurance claim payment, receive from the Insured Person all the required documents verifying the occurrence of the insurance event and certifying the envisaged insurance claim amount, as well as proof that the medical assistance rendered was due to an emergency;

6.3.3. request provision of all documents and proofs and all information required for the Insurer to enforce the right of claim against third persons responsible for the losses covered by the Insurer, that was assigned to the Insurer.

6.3.4. request information related to the insured event from the law enforcement agencies, healthcare institutions, other establishments, enterprises and organizations that possess information about the circumstances of the insured event.

6.3.5. carry out independent investigation of the cause and the circumstances of an insured event, as well as of the damage amount;

6.3.6.verify the documents provided;

6.3.7.carry out medical examination of the Insured Person through the Insurer’s healthcare expert;

6.3.8. if any competent bodies have materials that give the Insurer grounds to refuse the insurance claim payment, postpone the payment until all the circumstances are fully clarified;

6.3.9. perform the insurance claim payment without documents certifying occurrence of an insured event if the damage amount does not exceed five per cent (5%) of the Insurance Limit (or the limit of liability) established for the relevant insurance benefit;

6.3.10. initiate subrogation lawsuits against persons responsible for the damages within the amount of the insurance claim paid;

6.3.11. delay claim report execution and insurance claim payment if:

6.3.11.1. there was an independent expert assessment of the cause and circumstances of the insured event and of the damage amount. The delay lasts till the expert assessment is finished and the relevant report is prepared;

6.3.11.2. a litigation was started in relation to the insured event. The delay lasts till the court decision becomes legally binding and not appealed against. In case of appellation the final non-appealable court decision is announced.

6.3.12. if the Beneficiary issues an insurance claim, request that the Beneficiary fulfill his or her obligations under the relevant Insurance Contract, including the outstanding obligations of the Policyholder. The Beneficiary bears the consequences of non-fulfillment or late of outstanding obligations.

6.3.13. set off the cost of unused travel documents that have not been provided to the Insurer upon occurrence of any events stated in cl. 10.1.1.3.3, 10.1.2.1, 10.1.2.2, 10.1.2.4 hereof against the amount of compensation paid to the Insured Person.

6.3.14. at the Insurer’s discretion take measures in order to minimize the damages; subject to the Policyholder’s (the Beneficiary’s) written request take over the defense of his or her rights and take all actions required to settle the damages;

6.3.15. demand that the Insurance Contract be declared invalid if it comes to light after the Contract signing that the Policyholder knowingly provided the Insurer with false information about the matters listed in cl.6.5.2. hereof;

6.3.16. request transfer of claims for medical expenses coverage in cases where the Policyholder (the Insured Person) submits claims for health damages against third persons and those claims are not related to the legal insurance aspects;

6.3.17. delay considering a claim until all the documents required to make decision on the insurance claim payment are provided to the Insurer;

6.3.18. the Insurer may request that all the foreign documents provided to the Insurer be translated to the Russian language and notarized if needed.

6.4. The Insurer shall:

6.4.1. make the Policyholder familiar with these Rules;

6.4.2. issue the insurance certificate accompanies by these Rules to the Policyholder; 6.4.3. upon occurrence of an insured event, make the insurance claim payment within the term established by these Rules;

6.4.4. not disclose any information about the Policyholder, his or her health or financial status, if it is not required by the laws of the Country of principal residence.

6.5. The Policyholder shall:

6.5.1. pay the insurance premium (installments) on time;

6.5.2. when signing an Insurance Contract, provide the following information to the Insurer:

6.5.2.1. full individual or legal name of the Policyholder;

6.5.2.2. full name and job title of the manager of corporate Policyholder;

6.5.2.3. address, types of activities, phone and fax numbers, e-mail address and banking details of corporate Policyholder;

6.5.2.4. residence address, passport details, date of birth, phone number and e-mail address of individual Policyholder;

6.5.2.5. first and last names of the Insured Person (Cyrillic and Latin);

6.5.2.6. date of birth of the Insured Person;

6.5.2.7. the Insured Trip commencement and end dates (duration of the trip);

6.5.2.8. Country or Countries of stay;

6.5.2.9. purpose of the Insured Trip;

6.5.2.10. locations of the Policyholder and the Insured Persons as of the time of signing the Insurance Contract;

6.5.2.11. details of the Insured Person’s health required to estimate the risks covered;

6.5.3. inform the Insurer immediately if any Insurance Contracts are signed with other insurers in relation to the Objects Insured under the Insurance Contract.

6.6. The Insured Person shall:

6.6.1. ensure safekeeping of the Insurance Contract and confirmation of payment;

6.6.2. upon occurrence of any event that may be considered an insured event hereunder:

6.6.2.1. if the Insurance Contract does not require otherwise, immediately when possible provide the Service Company or the Insurer at the phone numbers stated in the Insurance Contract, with the following information:

6.6.2.1.1. first and last names of the Insured Person;

6.6.2.1.2. the Insurance Contract number;

6.6.2.1.3. details of the event that has occurred;

6.6.2.1.4. location of the Insured Person;

6.6.2.1.5. phone number for contacts. The cost of contacting the Service Company and/or the Insurer is compensated to the Insured Person subject to provision of the supporting documents as per cl. 12.7, if the Insurance Contract provides for such compensation.

6.6.2.2. follow recommendations of the Service Company and/or the Insurer;

6.6.2.3. follow recommendations of the attending physician given in the course of treatment and the requirements of the Healthcare Institution;

6.6.2.4. take all necessary steps to minimize damages;

6.6.2.5. hand over to the Insurer all the required documents and proofs needed to enforce the claim of the Insured Person against the person liable for the damages covered by the Insurer;

6.6.2.6. continuously provide the Service Company with all the required information;

6.6.2.7. not assume any obligations or liability for any payments save for those approved by the Service Company;

6.6.2.8. Before signing the Insurance Contract, release the doctors at the Healthcare Institutions from their medical confidentiality obligation when it comes to providing the Insurer with information pertinent to the insured event, and agree to provide the Insurer and/or the Service Company with medical documents related to his or her health and treatment received;

6.6.2.9. not hinder the Insurer’s and/or the Service Company’s representatives’ access to the Insured Person in order to examine his or her health, otherwise the medical assistance coverage will be withheld from the Insured Person;

6.6.2.10. at the Insurer’s request provide all the required information about his or her health (medical history and other medical documents) or undergo a medical check-up.

6.6.2.11. if contacting the Insurer and/or the Service Company before receiving a Doctor’s visit or being committed for a hospital stay is impossible, the Insured Person shall make such contact at the first opportunity if the Insurance Contract does not provide for a mandatory Service Company contact. In any case, when receiving a Doctor’s visit or being admitted for hospitalisation, the Insured person shall provide to the healthcare professionals the Insurance Contract in order to agree upon the further steps with the Insurer through the Service Company.

6.6.2.12. if the Insured Person paid the expenses related to an insured event from his own funds, then upon coming back from the Insured Trip, the Insured Person shall inform the Insurer about the event in writing, providing the following documents to the Insurer:

6.6.2.12.1. If the insured event was related to the “Medical and Medical Transport and Evacuation Expenses” benefit:
- a request for compensation of the expenses related to the insured event, executed according to the approved template; if medical assistance was obtained: with explanation as to why the Service Company has not been contacted;
- the Insurance Contract or its photocopy;
- copies of passports or other documents certifying the departure from the country of the principal residence and the date of such departure (on the Insurer’s request);
- originals of paid bills from Healthcare and/or other institutions (on official letterheads or certified by official stamps) stating the last name of the Insured Person, diagnosis, date of request of medical assistance, treatment duration, list of medical services rendered, broken down by date and cost and indicating the total amount paid;
- originals of the Doctor’s prescriptions issued in relation to the illness or condition in question with pharmacy stamps and indicating the cost of every medicine purchased;
- original of the Doctor’s referral for laboratory tests and the laboratory report stating dates, names and cost of the services rendered;
Documents certifying payment made for treatment, medicines and other services (payment stamp, money receipt, or banking confirmation of the money transfer).

6.6.2.12.2. If the insured event was related to the “Transport Expenses” benefit:
- a request for compensation of the expenses related to the insured event, executed according to the approved template;
- the Insurance Contract or its photocopy;
- originals of paid hotel bills or mass transport tickets;
- documents confirming return of unused tickets if the Insurance Contract so requires.

6.6.2.12.3. If the insured event was related to Damage to a Vehicle:
- a request for compensation of the expenses related to the insured event, executed according to the approved template;
- the Insurance Contract or its photocopy;
- originals of paid bills issues by transport or other companies.

6.6.2.12.4. If the insured event was related to the “Expenses of Flight Delay” benefit:
- a request for compensation of the expenses related to the insured event, executed according to the approved template;
- the Insurance Contract or its photocopy;
- originals of paid catering and hotel bills;
- supporting documents issued by authorized carrier in writing (as marks on an airline ticket or a letter of the flight delay to a later time) certified by signature and stamp of an authorized person.
If the insured event was related to the “Urgent MessagesExpenses” benefit: The Policyholder (the Insured Person) shall within 30 calendar days after coming back to the Country of principal residence inform the Insurer about occurrence of the insured event in relation to this benefit:
- a request for compensation of the expenses related to the insured event, executed according to the approved template;
- the Insurance Contract or its photocopy;
- extract or original bill for telecom services with payment confirmation.

6.6.2.12.5. If the insured event was related to the “Legal Assistance Expenses” benefit:
- a request for compensation of the expenses related to the insured event, executed according to the approved template;
- the Insurance Contract or its photocopy;
- originals of paid bills.

6.6.2.12.6. If the insured event was related to the “Expenses of Loss or Theft of Documents” benefit:
- a request for compensation of the expenses related to the insured event, executed according to the approved template;
- the Insurance Contract or its photocopy;
- originals of paid bills issued by consular and transport services.

6.6.2.12.7. If the insured event was related to the “Trip Cancellation Expenses” benefit:
- a request executed according to the approved template and stating the nature and the circumstances of the insured event, the intermediary organization that organized the tourist group and the date of departure. The Policyholder (the Insured Person) shall submit a request to the Insurer immediately (within three days) after the Policyholder (the Insured Person) becomes aware of the circumstances preventing him or her from making the scheduled trip.
- the Insurance Contract or its photocopy;
- original tourist services contract and the documents confirming payment made for the trip;
- documents certifying that the travel agency returned a certain part of the money paid to them under the tourist service contract, to the Policyholder (the Insured Person) (the return calculation and the cash order);
- documents issued by transport companies, consulates, hotels or other entities whose services the Insured Person utilized to organize their foreign trip, to confirm the losses caused by loss of travel documents, cancellation of hotel stays etc. (the documents above are provided on the Insurer’s special request).
- if the Insured Trip becomes impossible due to illness, injury or death of the Insured Person, his or her close relative and/or one adult person travelling together with the Insured Person and covered by the same insurance certificate: a certificate issued by a Healthcare Institution, a notarized copy of the death certificate and the documents certifying the relation between the Insured Person and the Close Relative.
- if the Insured Trip becomes impossible to make due to damage or loss of property owned by the Insured Person: the documents certifying the property title as well as reports issued by the police or other competent authorities to confirm the damage suffered.
- if the Insured Trip becomes impossible to make due to litigation: a court summon certified by the court;
- if the Insured Trip becomes impossible to make due to a military commissariat summon: a summon certified by the military commissariat;
- if an entry visa application was rejected: the original passport and the official rejection letter issued by the consulate (if any);
- if a visa was granted late (after the envisaged date on which the trip was supposed to commence): the original passport, the document certifying the date the visa documents were submitted and the document certifying that the visa was granted after the envisaged date on which the trip was supposed to start.

6.6.2.12.8. If the insured event was related to the “Trip Interruption Expenses” benefit:
- a request executed according to the approved template shall be provided to the Insurer within thirty (30) calendar days after the Insured Person returns from the Insured Trip;
- the Insurance Contract or its photocopy;
- original tourist services contract and the documents confirming payment made for the trip;
- travel documents and documents certifying their cost, or the documents certifying the travel documents reissue cost;
- calculation of the unused tourist services prepared by the travel agency or other entity signing the tourist services contract with the Insured;
- if the Insured Trip was interrupted due to the Insured Person’s illness: a certificate issued by a Healthcare Institution;
- if the Insured Trip was interrupted due to death of the Insured Person or any of his/her Close Relatives: a certificate issued by a Healthcare Institution; a notarized copy of the death certificate, documents certifying the relation between the Insured Person and the Close Relative.
- in case of interruption of the Insured Trip due to damage or loss of property owned by the Insured Person: documents certifying the property title as well as reports issued by the police or other competent authorities to confirm the damage suffered.

6.6.2.12.9. If the insured event was related to the “Lost Checked Luggage Expenses” or “Luggage Delay Expenses” benefits:
- a request executed according to the approved template shall be provided to the Insurer within thirty (30) calendar days after the Insured Person returns from the Insured Trip. The request shall specify the nature and the circumstances of the insured event, the entity that organized the tourist group, the trip commencement date and the list of items that have been lost or damaged;
- the Insurance Contract or its photocopy;
- receipts, pay slips, labels, etc. for the lost or damaged items;
- documents issued by the competent authorities (hotel administration, transport company, local law enforcement bodies) certifying loss or damage of the Luggage (i.e. a damage act issued by the representatives of the airline). If the authorities mentioned above refuse to issue proper certifying documents, the refusal shall also be in writing.

6.6.2.12.10. If the insured event was related to the “Personal Liability” benefit:
- a request executed according to the approved template;
- the Insurance Contract or its photocopy;
- a court decision stating that actions of the Policyholder (the Insured person) caused bodily or property damage to the third person, if the Insurance Contract does not provide otherwise.

6.6.2.12.11. If the insured event was related to the “Health and Accident” benefit: In order to receive insurance claim payment the Insured Person (or his or her lawful heirs in case of Insured Person’s death) shall no later than thirty (30) days after the accident (or its consequences, i.e. disability registration) provide the Insurer with the following documents:
- an insurance claim;
- the original Insurance Contract (insurance certificate);
- a personal ID of the Insured Person, the Beneficiary or of their respective lawful heir;
- in case of illness, injury or other harm to health provided for in the Insurance Payment Table: documents confirming occurrence of the insured event (evaluation, certificates issued by foreign or Russian Healthcare Institutions (originals), including x-ray examination reports);
- on registered disability: certificate of disability tier issued according to the established procedure;
- in case of death: a notarized official death certificate issued by the civil registry and a medical death certificate as well as the document certifying the inheritance rights;
- if a preliminary investigation into the Insured Person’s death took place, order on commencement of criminal proceedings or refusal to commence criminal proceedings (originals or duly certified copies) are provided as well;
- if the event took place outside the Country of principal residence, medical and other documents enabling the Insurer to identify the insured event and the nature of the damage suffered shall be provided to the Insurer.

6.6.2.12.12. Any documents in foreign languages are provided with notarized (apostilled) translations. The Policyholder (the Insured Person) bears the expenses of collecting and translating the documents.

7.Refusal of Insurance Claim Payment

7.1. The Insurer may refuse to pay an insurance claim (if the Insurance Contract does not provide otherwise) if the insured event was caused by:

7.1.1. willful action/inaction of the Policyholder, the Insured Person or the Beneficiary taken in order to make the insured event occur;

7.1.2. the Policyholder or the beneficiary of the Insurance Contract willfully committing a crime or a misdemeanor in a direct relation to the insured event;

7.1.3. impact of a nuclear explosion, radiation, radioactive or other damage caused by weapons of mass destruction or their consequences;

7.1.4. war, civil war, strikes, riots, uprising, sabotage, civil unrest, violent demonstrations and other similar events whether or not the Insured Person participated in any of them;

7.1.5. capture, confiscation, nationalization, requisition, impounding or destruction of the insured property on orders issued by state bodies, or other political steps taken on orders issued by military or civil authorities and political organizations;

7.1.6. act or acts of terror, actions to control, prevent, pacify or in any other way counter act or acts of terror;

7.2. The Insurer may refuse to pay an insurance claim if the Policyholder (the Insured Person) or his or her representative:

7.2.1. fails to timely inform the Insurer or the Insurer’s representative (the Service Company) about occurrence of the insured event, if it cannot be proven that the Insurer became aware of the insured event occurrence in good time or that the Insurer being unaware of the insured event could not influence the Insurer’s ability to pay the insurance claim in any way;

7.2.2. fails to provide the documents required to make a decision on the insurance claim payment;

7.2.3. if the Insured Person went on the Insured Trip as a part of his or her employment contract and the insured event occurred through the fault of his or her employer;

7.2.4. if the insured event occurred while the Policyholder (the Insured Person) was performing any kind of work not provided for in his or her employment contract;

7.2.5. if the Policyholder (the Insured Person) knowingly provided to the Insurer some false information about his or her health (or health of the Insured Person) and/or the scope and the cost of the medical services rendered upon occurrence of the insured event;

7.2.6. if the Insured Person refuses to undergo medical check-up in order to determine his or her actual health and/or did not give consent to provide the Insurer with his or her health information;

7.2.7. knowingly provided to the Insurer documents containing false information about the Insured Person’s health or medical and related services provided to the Insured Person.

7.3. The Insurer may refuse to pay an insurance claim if the Insurance Contract was signed and/or paid for after the Policyholder or the Insured Persons crossed the border of the Insurance Territory.

7.4. The Insurer compensates the expenses provided in the Insurance Contract only.

7.5. Pain and suffering are not compensated under any Insurance Contracts signed according to these Rules.

7.6. Insurance Contracts do not cover the damages suffered by the Policyholder during the term of the Insurance contract, but caused by some factors that occurred before the Insurance Contract came into force (such damages shall not be considered as insured events).

7.7. A decision to refuse an insurance claim payment specifying the reasons for such refusal is communicated to the Policyholder in writing within ten (10) business days after receiving all the documents required under clause 10 hereof.

7.8. The Policyholder (the Insured Person or the Beneficiary) may appeal a decision to refuse an insurance claim payment as provided in the applicable laws.

8. Force Majeure

8.1. The parties shall not be liable for full or partial non-performance or improper performance of their obligations under the Insurance Contract if such non-performance or improper performance was caused by extraordinary circumstances that occurred after signing the Contract and could not be foreseen or prevented by the parties.

8.2. Such circumstances include: flood, fire, earthquake, explosion, storm, soil subsidence, epidemic and other natural phenomena, war, war-like action, industrial or regional strike.

8.3. A possible non-performance of contractual obligations must be caused directly by the factors listed in this clause.

8.4. The party that finds it impossible to perform its obligations shall inform the other party about the occurrence and the envisaged duration of any such factors as soon as practicable in writing.

8.5. Failure to inform the other party thereof at all or on time shall deprive the informing party of the rights to plead any of the above circumstances as the grounds to be relieved from liability for non-performance or improper performance of their obligations.

9. Other terms and conditions.

9.1. The Policyholder, by entering into an insurance Contract based on these Rules, agrees to the Insurer to process the personal data of the Policyholder, the insured persons, and the beneficiary, being for these purposes a representative of these persons authorized to give such consent, for the conclusion and execution of the Insurance Contract during the Insurance Contract validity term, as well as during the period of archival storage of the Contract by the Insurer. Within the framework of these Rules and Insurance Contracts concluded on their basis, personal data specified in the Insurance Contract, as well as received by the Insurer in the course of execution of the Insurance Contract, may be processed by the Insurer and/or third parties engaged by it with or without the use of automation tools by means of: collection, recording, systematization, accumulation, storage, clarification (updating, modification), extraction, use, transfer (distribution, provision, access), including cross-border transfer, depersonalization, blocking, delete and destroy. The Consent is given to the processing of personal data for the purpose of the Insurance Contract execution, support, including informing about the Insurer's services, participating in marketing, advertising campaigns and research using SMS messages, e-mail and other available communication methods. The Consent may be withdrawn by sending a written notice to the Insurer by email: support@tripinsurance.us.

Section II. Insurance of Medical, Medical Transportation, and other Expenses.

10. Insurance Benefits, Insured Events

10.1. The Insured Events under the Insurance Contract concluded based on these Rules shall include:

10.1.1. Under the benefit “Medical and Medical Transport and Evacuation expenses”, the unexpected expenses associated with receiving Emergency Medical Care (in the event of threat to life of the Insured) and urgent (no obvious signs of a threat to the Insured’s life) forms in connection with a Sudden Disease, Poisoning, Accident, death of the Insured occurring in the course of the Insured Trip during the Insurance Contract validity period in the Insurance Territory (Covered Territory) stipulated in the Insurance Contract. The following Insured’s unexpected expenses shall be subject to reimbursement:

10.1.1.1. Medical expenses:

10.1.1.1.1. Expenses for the treatment in an Outpatient and/or Inpatient Facility (including the expenses for medical appointments and consultations, medical manipulations and procedures, tests and studies required for diagnosis and determination of treatment methods, hospital stay, medical consumables);

10.1.1.1.2. Expenses for payment of medications, dressings, simple fixation devices prescribed by the attending Physician as well as delivery of the same to the Insured, if there are no similar medications or their analogs at the Insured’s location;

10.1.1.1.3. Expenses for paying for a Physician’s visit to the Insured for medical reasons if such a service is provided in the Country of Stay;

10.1.1.1.4. Expenses for monitoring the Insured’s condition and monitoring the course of Treatment;

10.1.1.1.5. Expenses for surgeries and diagnostic tests and studies.

10.1.1.1.6. Expenses for payment of Emergency Medical Care and urgent forms rendered to the Insured shall be reimbursed regardless of the Insurance Contract expiration date, only if the insured event occurs during the Insurance Contract validity period.

10.1.1.2. Expenses for emergency dental treatment (emergency dental treatment benefit) shall be reimbursed by the Insurer within the amount stipulated in the Insurance Contract, namely:

10.1.1.2.1. Expenses associated with the soothing treatment of a natural tooth in case of tooth injury as a result of an Accident;

10.1.1.2.2. Expenses associated with the soothing treatment of a natural tooth and an associated sealing, in acute inflammation of a tooth and the tissue surrounding the tooth;

10.1.1.3. Medical transportation and evacuation expenses (excluding travel to and from the cruise and/or other vessels), which include:

10.1.1.3.1. Expenses for medical evacuation (including Emergency Transportation and Evacuation) and moving (transporting by ambulance or another vehicle) from the scene to the nearest Medical Facility or a nearby Physician in the Country of Stay, or from one Medical Facility to another — if medically required to rescue the Insured and/or to provide the required medical care, as well as the expenses for travel from the Medical Facility to the location in the Country (or Region) of Stay (total expenses may not exceed the amount of fifty (50) U.S. dollars.

10.1.1.3.2. Expenses for medical repatriation by a vehicle, including the expenses for an accompanying person (if such accompanying is prescribed by a Physician) from the Country (or Region) of Stay of the Insured to the Country (or Region) of Principal Residence or to the nearest Medical Facility in the Country (Region) of Stay in the absence of the possibility to provide the required medical care in the Country (Region) of Stay as well as in cases when the expenses for staying in an Inpatient Facility may exceed the Insurance Limit under the Insurance Contract or in cases where the treatment abroad the Country (or Region) of Principal Residence exceeds significantly the expenses for medical repatriation. Medical repatriation shall be carried out exclusively in cases when its necessity is confirmed by the opinion of the Insurer’s Medical Expert, based on the documents provided by the local attending Physician and subject to the absence of medical contraindications. Medical repatriation expenses shall be covered only with the Insurer’s prior consent and within the amount stipulated in the Insurance Contract;

10.1.1.3.3. Expenses for repatriation of the Insured to the Country (Region) of Principal Residence within the scope of the Insurance Contract limit, one-way, economy-class, including transfer to the airport if the Insured’s departure did not take place on time, i.e., on the day specified in the travel documents held by the Insured, due to the occurrence of a Sudden Disease or Accident that necessitated the Insured’s stay in an Inpatient Facility for treatment. The Insured shall return (return for a refund) unused travel documents or reimburse their expenses to the Insurer. In case of a failure to fulfill this condition, the Insurer may deduct the cost of unused travel documents from the indemnity amount compensating for the Insured’s expenses. Unless otherwise provided for in the Insurance Contract, such expenses may not exceed one thousand (1,000) U.S. dollars.

10.1.1.4. Repatriation of Remains - authorized by the Service Company in connection with the death of the Insured shall be made with the prior consent of the Insurer. The following expenses shall be reimbursed if the Insured’s death occurred as a result of an Accident, Sudden Disease, or Poisoning, or an exacerbation of chronic disease:

10.1.1.4.1. Transportation of the remains to the nearest airport in the Country of Principal Residence of the Insured, including the expenses required to prepare the Insured’s body for repatriation;

10.1.1.4.2. Cremation of the body and subsequent transportation of the remains to the nearest airport in the Country of Principal Residence of the Insured;

10.1.1.4.3. Local burial of the Insured in the Country of Stay – within the amount specified in the Insurance Contract. Unless the Insurance Contract specifies this amount explicitly, it shall not exceed f two thousand five hundred (2,500) U.S. dollars;

10.1.1.4.4. Expenses for remains repatriation shall be covered within the amount stipulated in the Insurance Contract. The Insurer shall not pay for funeral services rendered in the Country of Principal Residence of the Insured unless otherwise provided for in the Insurance Contract.

10.1.2. Under the benefit “Transport Expenses” the occurrence of unexpected expenses due to Sudden Disease, Poisoning, Accident, death of the Insured, as well as sudden or unforeseen death or hospitalization in the Country of Principal Residence of an Immediate Family member of the Insured, or loss or damage to the property of the Insured in the Country of Principal Residence. In this case, the following Insured’s unexpected expenses shall be subject to compensation in the amount not exceeding the amount specified in the Insurance Contract:

10.1.2.1. Return of Minor Children benefit, i.e., expenses for a one-way economy-class trip of minor children who are staying with the Insured on the Insured Trip to the Country of Principal Residence if the children are left unattended as a result of an Accident, Sudden Disease, or death of the Insured, as well as payment of travel expenses of one adult accompanying the child or children. If the Insured cannot name such a person, the Insurer shall arrange and pay for the appropriate accompanying;

10.1.2.2. Third-party accommodation and travel expenses, i.e., expenses for accommodation in the Country of Stay and a subsequent economy-class trip to the Country of Principal Residence of one Immediate Family member or adult third party staying with the Insured in the Country of Stay, if the Insured’s departure did not occur on time, i.e., on the day specified in the travel documents issued in the name of the Insured, due to the occurrence of a Sudden Disease or Accident that necessitated the Insured’s stay in an Inpatient Facility or quarantine for treatment. The Insured, as well as his/her Immediate Family member or an adult third party who is staying with the Insured in the Country of Stay, shall make the reasonable effort to return (return for a refund) unused travel documents. In this case, the expenses for stay of an Immediate Family member or an adult third party in the Country of Stay shall be covered by the Insurer for the period specified in the Insurance Contract but not exceeding ten (10) nights, and the amount of expenses may not exceed one hundred (100) U.S. dollars per night;

10.1.2.3. Emergency Reunion benefit, i.e., expenses for an economy-class round trip (from the Country of Principal Residence and back) of one Immediate Family member, if the period of hospitalization of the Insured traveling alone has exceeded ten (10) days of treatment in an Inpatient Facility due to the occurrence of a Sudden Disease or Accident. The Insurer shall pay a daily accommodation of an Immediate Family Member or an adult third party, for the time of the Insured’s stay in the Inpatient Facility within the period specified in the Insurance Contract but not exceeding ten (10) nights, and the amount of expenses shall not exceed the amount equivalent to one hundred (100) U.S. dollars per night;

10.1.2.4. Early return benefit, i.e., expenses for a one-way economy-class trip of the Insured, unless otherwise stipulated in the Insurance Contract, in connection with the early return to the Country (Region) of Principal Residence in the event of:

10.1.2.4.1. A sudden or unforeseen death of an Immediate Family Member or sudden and unforeseen hospitalization of an Immediate Family Member of the Insured due to an Accident or Sudden Disease, provided that the Insured returns the unused return ticket to the Insurer;

10.1.2.4.2. If law enforcement authorities require the presence of the Insured in the Country of Principal Residence in connection with the theft, flooding, fire, or damage to the Insured’s property in the amount exceeding two thousand five hundred (2,500) U.S. dollars, provided that the Insured returns the unused return ticket to the Insurer.

10.1.2.5. Temporary return benefit (such expenses shall be reimbursed only under the Insurance Contracts for which the insurance period is not less than 180 days), i.e., expenses for arranging and paying for the Insured’s economy-class trip, unless otherwise provided for in the Insurance Contract, to the Country (Region) of Principal Residence and his/her return back (temporary return) in the event of:

10.1.2.5.1. A sudden or unforeseen death of an Immediate Family Member or sudden and unforeseen hospitalization of an Immediate Family Member of the Insured due to an Accident or Sudden Disease;

10.1.2.5.2. If law enforcement authorities require the presence of the Insured in the Country of Principal Residence in connection with the theft, flooding, fire, or damage to the Insured’s property in the amount exceeding two thousand five hundred (2,500) U.S. dollars.

10.1.2.6. Expenses related to the damage to a personal Vehicle as a result of an accident or a breakdown as well as the loss (theft) of a Vehicle (Damage to a Vehicle).

10.1.2.6.1. Transportation expenses for the delivery of all passengers, including the driver, to the place of residence in the Country of Temporary Residence. In this case, the Insurer shall pay for the provision of such transport but within the amount specified in the Insurance Contract;

10.1.2.6.2. Expenses for calling a maintenance team to the place of a breakdown of the Vehicle and repair or towing (evacuation) of the Vehicle but not exceeding the amount specified in the Insurance Contract. If this amount is not specified in the Insurance Contract, such amount shall not exceed the amount of three hundred (300) U.S. dollars.

10.1.2.6.3. Expenses for the evacuation of the Insured’s Vehicle to the Region of Principal Residence of the Insured in the amount not exceeding the amount specified in the Insurance Contract in the following cases: - After the repair of the Vehicle due to its damage (breakdown or accident) if, according to experts, more than 10-day repair is required and the time of stay of the Policyholder (Insured) in the Country of Stay is less than ten (10) days; - If the Insured’s Vehicle was lost and then found — after the Insured left the Country of Temporary Residence.

10.1.2.6.4. Expenses for the return of all Insureds to the Country or Region of Principal Residence (by plane, economy-class, if the distance to the Region of Principal Residence exceeds 700 km, by train in a compartment, or by bus) if, by the end of the Insured Trip, the Insured’s Vehicle remains defective or lost (stolen). Such expenses shall be reimbursed by the Insurer within the amount stipulated by the Insurance Contract.

10.1.3. Under the benefit “Expenses of Flight Delay”, i.e., the Insured’s unexpected expenses, namely, the expenses for food and accommodation but not exceeding the amount stipulated in the Insurance Contract, incurred in connection with the following events:

10.1.3.1. Delayed departure and/or cancellation of a scheduled flight. A delay and/or cancellation of a scheduled flight shall mean a flight delay of more than four (4) hours relative to the scheduled departure time or a flight cancellation for which the Insured was not offered an alternative means of transportation within four (4) hours of the scheduled departure time.

10.1.3.2. Unintentional denial to board a scheduled flight. Unintentional denial to board a scheduled flight shall mean that the Insured has checked in or attempted to check in during the announced check-in time but was unintentionally denied boarding as a result of an overcrowded flight.

10.1.3.3. Missed transfer from one scheduled flight to another. A missed transfer (or connection) of a regular flight shall mean that the Insured was late for the next confirmed regular flight at the transfer point due to the late arrival of the previous (delayed) regular flight, and within four (4) hours after the actual arrival time of the previous flight, the Insured was not provided with an alternative means of further transportation.

10.1.4. Urgent Messages benefit, i.e., the Insured’s expenses related to the payment of Urgent Messages but not exceeding the amount stipulated in the Insurance Contract. The expenses shall be paid on the grounds of documents confirming such expenses, the amount thereof, and the telephone numbers to which calls were made. The following unexpected expenses shall be subject to reimbursement:

10.1.4.1. The Insured’s expenses for transmitting one Urgent Message to an Immediate Family Member of the injured Insured in connection with medical evacuation, medical repatriation, or remains repatriation;

10.1.4.2. The Insured’s expenses for telephone conversations with the Service Company and/or the Insurer.

10.1.5. Legal Assistance benefit, i.e., unexpected expenses the Insured incurred in connection with obtaining initial legal advice, if he/she is being persecuted in court in accordance with the civil legislation of the Country of Stay as a result of unintentional infliction of damage to a third party, unintentional violation of regulations of the Country of Stay, or violation of the road traffic rules. The Insured’s expenses associated with charges related to his/her professional activities shall not be paid.

10.1.6. Under the benefit “Expenses associated with the document loss or theft” (Expenses of Loss or Theft of Documents), i.e., the occurrence of the Insured’s unexpected expenses in connection with the search for and issuance of lost documents required for movement and/or departure from the Country of Stay (passport with a visa, travel transport documents) within the amount specified in the Insurance Contract.

10.1.7. Trip Cancellation benefit, i.e., the unexpected expenses of the Insured and Immediate Family Member and/or individual traveling with him/her and entered into the Insurance Contract, resulting from the cancellation of the Insured Trip by the Insured, for the following reasons and associated with the annulment of travel documents, cancellation of a booking, and also due to the Insured’s unilateral repudiation of the agreement signed with a travel agency for the Insured Trip and associated with the cancellation of travel documents, cancellation of the booked hotel rooms, and other expenses paid under the tourist services agreement that are not subject to compensation or are subject to partial compensation under the agreement with the travel agency, and confirmed by the relevant documents of the transport company, hotels, and other organizations in the following cases:

10.1.7.1. Death of the Insured or an Immediate Family member that occurred before the commencement of the Insured Trip due to an Accident or Sudden Disease;

10.1.7.2. Sudden Disease of the Insured or his/her Immediate Family member that occurred before the commencement of the Insured Trip and hindered the intended trip due to the emergency hospitalization of the Insured or his/her Immediate Family member;

10.1.7.3. The Insured’s injuries of any severity that occurred as a result of an accident not earlier than twenty-one (21) day before the commencement of the Insured Trip but only in that case if there are medical contraindications for the Insured Trip, confirmed by the Insurer’s Medical Expert;

10.1.7.4. An infectious disease, other than the upper respiratory tract infection and/or influenza, that prevents the Insured from making a trip, which occurred not earlier than fifteen (15) days before the commencement of the Insured Trip, which shall be confirmed by the Insurer’s Medical Expert;

10.1.7.5. The Insured’s failure to obtain a visa (a refusal to issue a visa) upon timely submission of all the documents required for issuance in accordance with the requirements of the destination country’ Consulate;

10.1.7.6. Late receipt of a visa (after the date assumed as the commencement date of the Insured Trip) with the timely submission of all the documents required for issuance in accordance with the requirements of the destination country’s Consulate in cases of failure (excluding strikes) in the operation of the Consular services;

10.1.7.7. Damage to or loss of the Insured’s property (except the vehicle) which occurred not earlier than fifteen (15) days before the commencement of the Insured Trip as a result of:
– fire (fire shall mean the ignition which is capable to independently spread out of the places which are specially designated for its fire making and maintenance);
– natural disasters (earthquake, landslide, storm, hurricane, flooding, inundation, hail, or downpour);
– flooding from water, sewer, heating systems;
– misconduct of third parties.
The Insured’s expenses shall be reimbursed, provided that the damage is significant (destruction of over 50% of the property or the amount of damages is not less than the amount determined in the Insurance Contract), and in cases when the establishment of the fact of damage requires the presence of the Insured.

10.1.7.8. Receipt by the Insured — after the conclusion of the Insurance Contract, not earlier than fifteen (15) days before the commencement of the Insured Trip, — of a summons to appear before investigative authorities or to a court session in the framework of criminal proceedings or a court trial in which the Insured participates as a witness or is obliged to participate in a court hearing as a juror during the Insurance Contract validity period.

10.1.7.9. Conscription of the Insured for military service or military training after the conclusion of the Insurance Contract but not earlier than fifteen (15) days before the commencement of the Insured Trip.

10.1.8. Trip Interruption benefit, i.e., unexpected expenses of the Insured and/or one adult accompanying the Insured in the Insured Trip specified in the Insurance Contract, incurred as a result of the early return from the Insured Trip, within the amount stipulated in the Insurance Contract. In this case, the expenses for purchasing/reissuing of travel tickets (economy-class) shall be reimbursed as well as the expenses for hotel accommodation, confirmed by the trip organizer and/or the travel agency for the unused part of the Insured Trip period under the tourist services agreement. In the case of reissue of travel documents, the Insurer shall reimburse the documented expenses related to the reissue of travel documents. Expenses for the purchase of travel documents shall be reimbursed only if the initial ticket is not to be replaced. All of the above expenses shall be reimbursed only if incurred for the following reasons:

10.1.8.1. The Insured repatriation for medical reasons, arranged by the Service Company and agreed with the Insurer in connection with the occurrence of a Sudden Disease, Accident, or Death of the Insured;

10.1.8.2. Early return of the Insured from the Insured Trip due to the death of another Insured or one of the Immediate Family members of the Insured as a result of an Accident or Sudden Disease;

10.1.8.3. Significant material damage (more than 50%) that requires the mandatory presence of the Insured, caused by burglary, fire, flood, or other natural disasters, and inflicted on:
a) the place of residence of the Insured;
b) cottage and country-side buildings;
d) garage.
In any case, the amount of damage under Clause 10.1.8.3. cannot be less than the amount specified in the Insurance Contract;

10.1.8.4. Legal proceedings occurring during the period of the Insured Trip, in which the Insured participates as a witness or juror, and the official notification whereof has been received after the Insured left for the Insured Trip.

10.1.9. Lost Checked Luggage benefit, i.e., the destruction or loss of Luggage that occurred as a result of:
a) natural disasters: storms, hail, floods, inundation, hurricanes, landslides, etc.;
b) fire, lightning strike, explosion, measures taken to extinguish the fire;
c) theft, burglary, robbery;
d) traffic accident or Accident with the Insured;
e) deliberate damage of Luggage by third parties;
f) actions of transport or loading and unloading service providers.

10.1.9.1. When an insured event occurs under this benefit, the reimbursement shall be paid:

10.1.9.1.1. In the amount of the actual value of Luggage less its residual value in case of the destruction, total or partial loss of Luggage but not exceeding the amount specified in the Insurance Contract;

10.1.9.1.2. In the amount of the expenses for repairing the Luggage in case of its partial damage;

10.1.9.1.3. In the amount of expenses for the search, examination, storage, and forwarding of found items as well as for the rescue and fixing of Luggage. Indirect expenses (hotel accommodation, transport expenses, etc.) are not subject to reimbursement.

10.1.9.2. Full destruction of Luggage shall be deemed to occur if the repair cost, including depreciation, together with the residual value, exceed the actual value of the Luggage. The Luggage shall be deemed damaged if the amount of repair cost and residual value do not exceed the actual value of the Luggage intact.

10.1.9.3. In case of theft of Luggage from a car, the reimbursement shall be paid if there are documents from law enforcement agencies, confirming that the theft occurred during the daytime (from 6.00 a.m. to 10.00 p.m.) in a parking lot with a checkpoint during the car stop for not more than three (3) hours, and the stolen items were in the locked luggage compartment of the car. In this case, the insurance shall not cover portable audio, photo, film, video equipment, mobile phones, computer and software systems, typewriters, and any accessories thereto.

10.1.9.4. If the Insured’s Luggage is lost during the regular flight taken by the Insured, the Insurer shall reimburse equal to that which the airline is obliged to pay in accordance with the Rules for the carriage of passengers and Luggage but not exceeding the amount specified in the Insurance Contract. In this case, the Insured shall waive the right to receive Luggage or the corresponding compensation from the carrier in favor of the Insurer. If the lost Baggage is found after the Insured receives the reimbursement , the Insured may receive his/her Luggage only upon the return to the Insurer of the reimbursement paid earlier.

10.1.10. Under the benefit “Luggage delay expenses” (Luggage delay), i.e., the delay in Luggage collection in the Country of Stay when the Insured takes a regular flight.

10.1.10.1. If an insured event occurs under this benefit, the expenses incurred by the Insured for the purchase of necessary clothing and hygiene accessories shall be reimbursed but not exceed the amount specified in the Insurance Contract in case of the Luggage delay of more than six (6) hours, unless a different duration of Luggage delay is specified in the Insurance Contract.

10.1.11. Personal Liability benefit, i.e., establishing the fact that the Insured is obliged to compensate third parties in accordance with the legislation of the Country of Stay in case of unintentional damage inflicted by the Insured on third parties in the coverage territory and during the Insured Trip:

10.1.11.1. Direct real property damage inflicted by the Insured on a third party as a result of damage (destruction), loss of property owned by a third party (or belonging to him/her on the grounds of a legitimate documented legal relationship), within the actual value of the property or the cost of its restoration (repair);

10.1.11.2. Damage inflicted by the Insured to the life and health of a third person (affected person), within the limits of:
(a) the amount of expenses required for medical treatment and/or subsequent rehabilitation;
(b) the amount of part of earnings, which his/her dependent persons lose in case of death of the affected person;
(c) amount of the incurred funeral expenses — in case of the death of the affected person.

10.1.11.3. Necessary and reasonable expenses attributed to property salvage and rescue of the persons who incurred damage through the Insured Event, or to minimize the damage arising through the Insured Event;

10.1.11.4. If provided for in the Insurance Contract:
(a) reasonable expenses for preliminary investigation of the insured event circumstances and degree of fault of the Insured;
(b) expenses for handling cases in courts.
The event shall be deemed an Insured Event if the fact of damage and/or harm is confirmed by an enforced decision of judicial bodies or recognition by the Insured with the Insurer’s written approval of the proved property claim for compensation of harm inflicted to lives and health or property of third parties.

10.2. The Insurance Contract may specify all or several insured events in any combination of those mentioned in these Rules.

10.3. The Insurer may develop special insurance programs based on the coverage territory, a set of insurance benefits (or insured events), the amount of the Insurance Limit, the validity period of the Insurance Contract, and other criteria to be specified in the Insurance Contract.

11. Insurance Exclusions. Expenses not Subject to Reimbursement by the Insurer

11.1. Under the benefit “Medical and medical transportation expenses”, the following expenses shall not be deemed insured events and shall not be subject to reimbursement by the Insurer:

11.1.1. Related to the aggravation or complication of diseases the Insured was aware of at the time of conclusion of the Insurance Contract, as well as to the Accidents that occurred to the Insured before the commencement of the Insured Trip. In case of exacerbation of Chronic Diseases, the Insurer shall only reimburse the expenses for providing emergency medical care necessary to relieve the acute condition as well as the expenses for the Insured’s remains repatriation in the event of his/her death. In any case, the Insurer’s expenses for emergency medical care in case of exacerbation of a Chronic disease shall not exceed the amount of one thousand (1,000) U.S. dollars otherwise provided for in the Insurance Contract;

11.1.2. Arising in connection with the exacerbation or complication of such diseases as tuberculosis, sarcoidosis, cystic fibrosis, chronic kidney and liver failure, chronic hepatitis, liver cirrhosis, diabetes, and other endocrine diseases, systemic connective tissue diseases, Bechterew’s disease, blood diseases, herpes, skin diseases (psoriasis, neurodermatitis, eczema), mycosis, parasitic diseases from the moment of making the relevant diagnosis;

11.1.3. Incurred due to the deterioration of the Insured’s health or death during the Insured Trip if made despite the presence of direct medical contraindications;

11.1.4. Incurred to pay for the course of treatment commencement before the commencement of the Insurance Term and continuing during the Insured Trip as well as the expenses for treatment that can be medically performed after the Insured returns to the Country of Principal Residence;

11.1.5. In the event of the occurrence, exacerbation, or complication of mental diseases, convulsive states, neuroses (panic attacks, depression, hysterical syndromes, stress), demyelinating diseases of the nervous system as well as expenses for the relief and treatment of complications and any other consequences (injuries, illness, or death) caused by these conditions;

11.1.6. Related to the provision of medical and medical transportation assistance for epilepsy as well as expenses for the treatment of complications and any other consequences (injury, illness, or death) caused by this condition, except for the relief of an epileptic seizure;

11.1.7. Related to diseases of the nervous system (multiple sclerosis, speech disorders, etc.), musculoskeletal system, vision and sensory organs of nontraumatic origin, requiring complex and/or reconstructive surgical treatment;

11.1.8. Related to oncological diseases, including malignant and benign neoplasms, including hemoblastoses, and their complications and consequences, from the moment of diagnosis. The expenses for any evacuation and/or repatriation related to the consequences of oncological diseases shall not be reimbursed;

11.1.9. Incurred due to exacerbation or complication of circulatory system diseases that require cardiosurgical or neurosurgical treatment (coronary angiography, angiography, balloon angioplasty of the coronary arteries, coronary artery bypass grafting, installation of a coronary stent, implantation of an artificial cardiac pacemaker, etc.);

11.1.10. Related to the provision of medical and medical transportation assistance in connection with any manifestations, complications, or exacerbations of systemic diseases (according to the list established by ICD-10) diagnosed in the Insured;

11.1.11. Arising as a result of exacerbation or complication of hereditary and/or congenital diseases, abnormalities, and malformations of organs and complications thereof;

11.1.12. Incurred in case of occurrence, exacerbation, or complication of diseases of organs and tissues, requiring their transplantation and/or prosthetics;

11.1.13. Caused by the Insured’s intentional infliction of bodily injuries, suicide or attempted suicide, and related health complications;

11.1.14. Related to contraception, sterilization (or reverse procedure), infertility treatment, fertilization, or other forms of artificial reproduction, vasectomy, sex transformation, or other sexual conditions;

11.1.15. Arising as a result of:

11.1.15.1. Consultations, examination related to pregnancy or treatment of complications regardless of the duration of pregnancy as well as prenatal monitoring, childbirth (including premature or cesarean section);

11.1.15.2. Performing abortions, except in cases when the surgery was performed to save the Insured’s life as a result of sudden complications of pregnancy, including termination of pregnancy due to ectopic pregnancy or fetal death, performed for medical reasons or as a result of a documented Accident. In any case, under Clause 11.1.15, the Insurer shall not be liable in any way for the newborn child and all expenses related to its treatment, medical supervision, and movement (including evacuation and/or repatriation) shall be borne by the Insured, except in cases where it is explicitly provided for in the Insurance Contract;

11.1.16. In case of venereal diseases and sexually transmitted or predominantly sexually transmitted diseases as well as illnesses resulting from the same;

11.1.17. For the diagnosis and treatment of HIV infection and diseases that are its consequence or complication as well as any forms of hepatitis;

11.1.18. Resulting from occupational diseases caused by harmful effects of chemical, physical production factors, laser radiation, Sudden Diseases, and Accidents that occurred during the professional activities or Hazardous Work unless otherwise provided for by the Contract, in particular, subject to payment of the additional insurance premium;

11.1.19. Related to the treatment of injuries and diseases caused by direct or indirect exposure to radiation of any kind, including solar exposure (exposure to ultraviolet radiation that led to burns, photodermatitis, and other similar skin damage, etc.), except in cases of threat to the Insured’s life;

11.1.20. For any evacuation and/or repatriation not arranged by the Insurer or the Service Company as well as expenses incurred as a result of the Insured’s voluntary refusal to be evacuated to the Country or Region of Principal Residence;

11.1.21. Incurred if the trip was undertaken by the Insured to receive treatment or related to applying to a Medical Institution with the intent of illness treatment, including the expenses for evacuation or repatriation;

11.1.22. Related to the treatment of diseases accompanied by chronic renal or hepatic insufficiency and requiring hemodialysis, plasmapheresis, ultraviolet irradiation of blood, except for the expenses for hemodialysis in the case of acute poisoning accompanied by acute renal or hepatic insufficiency;

11.1.23. For computed tomography scans, magnetic resonance imaging not agreed with the Service Company and/or the Insurer, except in cases when these studies are necessary for emergency medical reasons and are conducted to diagnose the severity of injuries and diseases or in connection with surgical intervention;

11.1.24. For the elimination of cosmetic defects of the face (including dental), body, regardless of the time of their occurrence;

11.1.25. For cosmetic, plastic, and reconstructive surgery and all types of prosthetics, including dental and eye prosthetics;

11.1.26. For immunity correction, extended immunological test;

11.1.27. For dental services (except for the expenses for examination, treatment, and medication for acute dental pain, as well as for dental trauma as a result of an Accident), treatment of periodontal diseases, replacement of old fillings, dental prosthetics, including preparation, restoration (reconstruction) of the crown part of the tooth, dental implants, orthodontics;

11.1.28. Arising as a result of the Insured’s refusal to observe the prescriptions of the attending Physician or the Insurer’s Medical Expert, received in connection with an application for an insured event as well as for alternative methods of treatment;

11.1.29. For the treatment and care of the Insured by their relatives, regardless of whether they are professional medical specialists or not;

11.1.30. Related to the provision of services by a Medical Institution not entitled to provide the relevant services (license) or by a person who is not entitled to carry out medical activities;

11.1.31. For health and rehabilitation treatment in Inpatient Institutions, dispensaries, sanatoriums, boarding houses, rest homes, rehabilitation centers, and other specialized Medical Institutions;

11.1.32. For physiotherapy, massage, manual therapy, exercise equipment, exercise therapy, swimming pool, hydrotherapy, heliotherapy, solarium, laser therapy, reflexology (acupuncture and stylostixis), hirudotherapy, chiropractic, homeopathy, phyto- and naturotherapy, etc.;

11.1.33. For general medical examinations, examinations for preventive purposes that are not related to the need to diagnose an acute illness or injury as a result of an Accident, for vaccination (except for emergency vaccination in connection with an insect or animal bite or Bodily Injury), disinfection;

11.1.34. For medical services and laboratory tests not related to an Accident or Sudden Disease;

11.1.35. Incurred by the Insured for the purchase of medical equipment, glasses, contact lenses, hearing aids as well as other corrective medical devices and appliances, and the expenses for fitting them unless otherwise provided for in the Insurance Contract;

11.1.36. For the purchase of preparations that are not medicines as well as noncertified medicines, medicines with the unknown composition as well as food, tonic, weight loss products, and laxatives, prescription drugs, cosmetics, mineral water, etc.;

11.1.37. For services related to the provision of additional comfort, namely, single rooms and suites, TV, telephone, air conditioning, humidifier, services of a hairdresser, masseur, cosmetologist, interpreter, etc. unless otherwise provided for in the Insurance Contract;

11.1.38. For funeral services (burial) in the territory of the Country of Principal Residence of the Insured unless otherwise provided for in the Insurance Contract;

11.1.39. Arising after the expiration of the Insurance Contract, except for the cases specified in Clause 5.10 hereof;

11.1.40. For treatment in an Inpatient Facility (for which no consent has been obtained from the Service Company before it commenced, in addition to providing medical care aimed at saving the Insured’s life, with the subsequent approval of these expenses by the Insurer and/or the Service Company) as well as surgery or treatment which can be postponed until the Insured returns to the Country of Principal Residence;

11.1.41. Having occurred after the Insured returned to the Country of Principal Residence unless otherwise provided for in the Insurance Contract;

11.1.42. For treatment of alcoholism, drug addiction, and other abuse/addictions or other addictive conditions caused by the use of narcotic, toxic substances, alcoholic beverages as well as for the treatment of injuries and diseases directly related to the use of the above substances (except for the treatment of injuries received at a time when the amount of alcohol in the blood did not exceed zero point seven (0.7) ppm), including the expenses for evacuation or repatriation of remains, except for illegal actions of third parties against the Insured, which shall be confirmed by the competent state authorities;

11.1.43. In case of a vehicle accident if the Insured operated the vehicle without a driver’s license or in a state of alcoholic (in accordance with the legislation of the Country (Region) of Stay), drug or other intoxication, or entrusted operation to the person without a driver’s license and a power of attorney to operate a vehicle or being in a state of alcoholic (in accordance with the legislation of the Country (Region) of Stay), drug or other intoxication and if the Insured has neglected and has not used the safety (protection) means, either in combination or separately, such as a seat belt, helmet, life jacket, and other safety devices stipulated by the rules of vehicle operation, when the above-mentioned safety means are available and may be used in a vehicle;

11.1.44. Incurred in connection with harm to the Insured’s health as a result of taking medicines without a Physician’s prescription;

11.1.45. Incurred in connection with the harm to the Insured’s health resulting from criminal acts as well as during his/her participation in political demonstrations, strikes or as a result of his service in any armed forces or paramilitaries;

11.1.46. Resulting from the Insured’s participation in the following sports activities: auto- or motorsports, mountaineering, rock climbing, combat sports, speleology (except for a tour-guided descent into caves), sports tourism, mountain biking, scuba diving to a depth of more than 12 meters, skiing or snowboarding outside of marked trails with or without an instructor, sledding, hockey, horse racing, diving and trampoline jumping, rope jumping, parkour, and/or any Professional Sports, Amateur Sports, and/or Outdoor Activities unless otherwise provided for in the Insurance Contract;

11.1.47. Arising as a result of:

11.1.47.1. Operation of an aircraft by the Insured, except for the cases of flight as a passenger who paid for travel on a regular flight or a licensed chartered flight along a specified route, on a civil aviation aircraft operated by a professional pilot;

11.1.47.2. Flight of the Insured on a nonmotorized aircraft, motor gliders, super-light aircraft,

11.1.47.3. Skydiving of the Insured, except in cases where it is explicitly provided for in the Insurance Contract;

11.1.48. Related to the violation by the Insured of the rules for the prevention of diseases endemic for the Country of Stay, which are included in the conditions for issuing a permit to enter this country, as well as medical and medical transportation expenses in connection with particularly dangerous infections (natural smallpox, plague, anthrax, cholera, smallpox, yellow fever, hemorrhagic fever, typhoid fever, tuberculosis, other diseases classified as particularly dangerous infectious diseases, according to the International Health Regulations of the World Health Organization) in violation of the requirements of the introduced quarantine measures, as well as related to epidemics, environmental pollution, and natural disasters in the Insurance Territory, known before the commencement of the Insured Trip.

11.2. Under the benefit “Transportation expenses”, the following expenses shall not be deemed insured events and shall not be reimbursed by the Insurer:

11.2.1. For early return (Clause 10.1.2.4 of the Insurance Rules) and expenses for temporary return (Clause 10.1.2.5 of the Insurance Rules) if an Immediate Family Member was hospitalized before the commencement of the Insured Trip;

11.2.2. If occurred in connection with the events specified in Clause 11.1 of the Rules;

11.2.3. Related to vehicle damage (Clause 10.1.2.6 of the Rules), namely:

11.2.3.1. Expenses associated with a breakdown or loss of a Vehicle older than five (5) years and in case of damage as a result of an accident of a Vehicle older than seven (7) years;

11.2.3.2. Expenses associated with the damage to a Vehicle with a maximum permissible weight exceeding 3.5 tons as well as 2- and 3-wheeled vehicles;

11.2.3.3. Associated with the occurrence of the civil liability of the Insured as the owner of Vehicles;

11.2.3.4. Associated with the breakdown and/or accident of a Vehicle carrying passengers for a fee, with or without a permit;

11.2.4. Not agreed upon with the Insurer.

11.3. Under the benefit “Expenses of Flight delay” the following expenses shall not be deemed insured events and shall not be reimbursed by the Insurer:

11.3.1. The Insured’s expenses for Urgent Reports (Clause 10.1.4 of the Insurance Rules) unless otherwise provided for in the Insurance Contract;

11.3.2. The Insured expenses for alternative means of transport.

11.4. Under the benefit “Urgent Report” expenses related to the payment of Urgent Reports shall not be deemed insured events or covered by the insurance if they occurred in connection with the events that were subsequently recognized by the Insurer as noninsured in accordance with these Rules.

11.5. Under the benefit “Trip Cancellation” the losses shall not be deemed insured events or covered by the insurance if occurred less than forty-eight (48) hours after the date of payment of the insurance premium as well as if occurred in connection with:

11.5.1. Alcoholic, narcotic, or another intoxication of the Insured;

11.5.2. Intentional actions of the Insured or the Beneficiary, aimed at causing the occurrence of an insured event;

11.5.3. Suicide (attempted suicide) of the Insured or his/her Immediate Family member;

11.5.4. Natural disasters and consequences thereof, except for the cases specified in Clause 10.1.7.7, epidemics, quarantine, weather conditions.

11.5.5. Acts of any public or government authorities except for the cases listed in Clause 10.1.7.8 and 10.1.7.9;

11.5.6. Committing illegal acts by the Insured, that are in direct causation with an insured event;

11.5.7. Flight of the Insured, before the commencement of an Insured Trip, on an aircraft of any sort, including engineless, except for cases of flight as the passenger on a civil aviation plane operated by a professional pilot, as well as parachute jumping before the commencement of the Insured Trip;

11.5.8. Exacerbation or complication of diseases, including Chronic Diseases, the Insured was aware of at the time of conclusion of the Insurance Contract (in him/her or his/her Immediate Family Members), as well as cases related to pregnancy or treatment of its complications at the term of over eight (8) weeks, as well as prenatal monitoring, hospitalization for pregnancy maintenance, and delivery (including premature or cesarean section);

11.5.9. Consequences of the Insured’s failure to comply with generally recognized safety rules effective in the Country of Stay or when engaging in any sports;

11.5.10. Entry visa denial, unless otherwise stipulated in the Insurance Contract, for the following reasons:

11.5.10.1. The Insured’s travel passport submitted to the embassy of a foreign country for obtaining a visa does not contain any marks of the border services on prior abroad trips;

11.5.10.2. The Insured’s travel passport submitted to the embassy of a foreign country for obtaining a visa has a mark on the earlier visa denial (or a mark on the acceptance of documents for consideration for a visa, but the visa was not issued) by the embassies of any country;

11.5.10.3. The Insured’s travel passport submitted to the embassy of a foreign country for obtaining a visa contains a mark of border service about visa rule violations when visiting any foreign state or a mark on the deportation of an Insured from any foreign state;

11.5.10.4. The Insured’s travel passport submitted to the embassy of a foreign country for obtaining a visa is in a poor state or has damage and blots;

11.5.10.5. Travel documents (travel passport, air ticket, hotel booking) and employment certificates provided by the Insured or his/her representative to the embassy of a foreign country are fake, false, or forged;

11.5.10.6. Absence or provision of false information about the availability of funds on the Insured’s account required to ensure the minimum subsistence level during the period of intended stay in the Country of Stay;

11.5.10.7. The Insured’s travel passport shows that he/she has already stayed in the country of temporary stay for ninety (90) days or more during the last six (6) months, which is the violation of rules of the Country of Stay.

11.6. Under the benefit “Trip interruption expenses,” the losses shall not be deemed insured events and shall not be covered by this insurance if the same have been incurred in connection with:

11.6.1. The deliberate actions of the Policyholder (Insured) and consequences thereof;

11.6.2. Failure to comply with generally recognized safety rules in force in the Country of Stay or when engaging in any sports;

11.6.3. The events specified in Clause 11.1 hereof.

11.7. Under the benefit “Lost Checked Luggage expenses,”

11.7.1. The destruction or loss of Luggage shall not be covered by this insurance if the same has occurred in connection with:

11.7.1.1. Actions/omissions of the Insured who is in a state of alcoholic, narcotic, or other intoxication;

11.7.1.2. Suicide (attempted suicide) of the Insured;

11.7.1.3. Wear, rust, mold, discoloration, and other natural changes in the properties of the Luggage;

11.7.1.4. Damage to the Luggage by insects or rodents;

11.7.1.5. Scratches, peeling paint, other changes in the appearance of the Luggage that did not cause deterioration of its functions;

11.7.1.6. The Insured’s failure to take timely measures to rescue the Luggage;

11.7.1.7. Damage to the Luggage the shipment of which is not related to the Insured’s participation in the Insured Trip or postal delivery;

11.7.2. Death or loss of the following items shall not be an insured event:

11.7.2.1. Cash, precious objects, securities, discount and bank cards, jewelry of any kind;

11.7.2.2. Items made of precious metals, precious and semiprecious stones as well as precious metals in ingots, precious and semiprecious stones without frames;

11.7.2.3. Antique and unique items, works of art, and collection items;

11.7.2.4. Travel documents, passports and any type of documents, slides, photographs, film copies, information stored on magnetic media;

11.7.2.5. Manuscripts, plans, diagrams, drawings, samples, models, business and accounting papers;

11.7.2.6. All types of prostheses, glasses, contact lenses;

11.7.2.7. Animals, plants, seeds;

11.7.2.8. Means of auto, motor-, bicycle transport, air, and water transport as well as spare parts for the same;

11.7.2.9. Religious items;

11.7.2.10. Items that are prohibited to be imported or exported to or from the Insurance Territory or the Country of Principal Residence;

11.7.2.11. Fur products (made of natural and artificial fur);

11.7.2.12. Portable audio, photo, film, video equipment, mobile phones, computer and software systems, typewriter, etc., and any accessories thereto.

11.8. Under the benefit “Luggage delay expenses,” the expenses of the Insured shall not be insured events if the Luggage delay occurred due to the following reasons:

11.8.1. As a result of confiscation or requisition of Luggage by customs or other state authorities;

11.8.2. If the Luggage delay occurred when returning to the Country of Principal Residence;

11.8.3. If the Insured has failed to notify the relevant bodies of the transport company of the Luggage delay at the temporary stay point, and has not received the appropriate confirmation document concerning the delayed Luggage, and/or has not taken reasonable measures to return the Luggage.

11.9. Under the benefit “Personal Liability” the third-party damage inflicted by the Insured shall not be an insured event and shall not be covered by this insurance if the damage:

11.9.1. Has been inflicted as a result of the Insured’s professional (employment) activities under the contract;

11.9.2. Is associated with the infliction of moral harm;

11.9.3. Has been inflicted as a result of indirect losses including lost profits;

11.9.4. Has arisen from the Insured Person’s use or operation of auto, moto, air, and water vehicles;

11.9.5. Has been inflicted directly or indirectly or partially as a result of pollution of the atmosphere, water, or soil;

11.9.6. Has been inflicted through the actions or omissions of the Insured in a state of alcoholic, toxic, or narcotic intoxication or consequences thereof;

11.9.7. Has been inflicted as a result of committing by the Policyholder, the Insured, the Beneficiary of any deliberate action or crime which is in a direct causal relationship with an insured event;

11.9.8. Has been inflicted by the Insured to his/her family members;

11.9.9. Has been caused to the property that does not belong to the Insured under a title (for example, rented, leased, or stored property).

11.9.10. Has been inflicted as a result of a terrorist act and/or terrorism, actions to control, prevent, suppress, or any other action relating to a terrorist act and/or terrorism as well as acts of violence or acts threatening human life, to seize tangible and intangible property, or for the purpose and/or desire to influence any government or to intimidate the public or any segment of the public where the person in whose favor the Insurance Contract has been concluded is the innocent victim unless otherwise provided for in the Insurance Contract.

12. Insurance reimbursement: limits and payment procedure

12.1. Amount of loss inflicted on the insurance reimbursement amount shall be determined by the Insurer on the grounds of the Statement and additional documents received from law enforcement and control authorities (fire, emergency, and other services), based on economic and accounting materials and calculations, registration documents, invoices and receipts, opinions and calculations of legal, advisory, and other specialized firms (if they have a state license), and regarding the insurance of risk of civil liability under obligations resulting from damage to life, health, and/or property of the third parties — on the grounds of an enforced court ruling.

12.2. The amount of reimbursement shall be determined with the type and amount of the deductible stipulated by the Insurance Contract taken into account.

12.3. The expenses shall be reimbursed through the payment of the services provided and/or expenses incurred in connection with the occurrence of the insured event directly to the Insured (Policyholder) or the Service Company acting as a claims adjuster and having paid on the spot for these expenses, provided there is no dispute regarding whether there was an insurance event, and in the absence of a dispute regarding the Insured (the Policyholder) having the right to receive a reimbursement and obligations of the Insurer to pay the same, a causal connection between the insured event and the resulting damage. In this case, the reimbursement shall be paid to the Insured (Policyholder) only if he/she has agreed upon the expenses with the Insurer or its representative (Service Company), however, in cases that threaten the Insured’s life, the expenses incurred by the Insured (Policyholder) for treatment in an Outpatient or Inpatient Facility without agreement with the Insurer or its representative (Service Company) shall be paid in an amount not exceeding the amount specified in the Insurance Contract, provided that all the required documents related to the occurrence of an insured event are submitted upon the Insured’s (Policyholder’s) return from the Insured Trip.

12.4. In the case of an incident occurrence under the benefit “Medical and Medical Transport and Evacuation Expenses,” which may be recognized as an insured event in accordance with these Rules:

12.4.1. The Insurer or Service Company shall arrange for the provision of necessary medical, medical transportation, and other services to the Insured as stipulated in the Insurance Contract and ensure that these expenses are paid at the Insured’s place of stay;

12.4.2. If the Insured has incurred expenses related to the insured event independently, then:

12.4.2.1. The reimbursement shall be paid upon the return of the Insured from the Insured Trip on the grounds of a written application and documents submitted in accordance with Clause 6.6.2.12.1;

12.4.2.2. The Insurer shall accept only paid invoices for treatment in an Outpatient Facility. In this case, unpaid invoices received by the Insured via mail shall be provided to the Insurer within fifteen (15) calendar days from the date of receipt thereof;

12.4.2.3. The reimbursement in the form of compensation for the expenses incurred by the Insured shall be paid by the Insurer after receiving all the requested documents and, if necessary, their translations (including notarized ones) within the period stipulated by the Insurance Contract but not later than in fifteen (15) business days. Expenses incurred by the Policyholder that, in accordance with these Rules, require mandatory agreement with the Insurer or Service Company, or another representative of the Insurer but have not been agreed upon, are not subject to compensation.

12.5. If an insured event occurs under the benefit “Transportation expenses” reimbursement shall be paid in the relevant transportation services cost.

12.6. If an insured event occurs under the benefit “Expenses of Flight delay” reimbursement shall be paid in the amount of the expenses incurred by the Insured for food, soft drinks, and hotel accommodation but not exceeding the amount specified in the Insurance Contract for this benefit. In any case, the amount of expenses for one hour of flight delay may not exceed the amount in U.S. dollars equivalent to one-eighth (1/8) of the Insurance Limit, stipulated in the Insurance Contract (Insurance Policy) for the benefit of the insurance of flight delay expenses unless otherwise provided for in the Insurance Contract. The reimbursement shall be paid only on the grounds of documents confirming the fact of flight delay received from the official carrier. The Reimbursement shall not be paid if the Insured received compensation from the carrier in exchange for boarding denial.

12.7. If an insured event occurs under the benefit “Urgent MessagesExpenses” the reimbursement shall be paid in the amount of the cost of telecommunications services on the grounds of supporting documents received from mobile and/or Internet providers as well as on the grounds of an invoice received at the hotel with a breakdown of the expenses incurred.

12.8. If an insured event occurs under the benefit “Legal Assistance Expenses,” the reimbursement shall be paid in the amount of cost of the legal services (but not exceeding the amount stipulated in the Insurance Contract) on the grounds of original invoices and supporting documents received from law firms and/or Service Company that has arranged for such services.

12.9. If an insured event occurs under the benefit “Expenses of Loss or Theft of Documents” the reimbursement shall be paid in the amount of travel document restoration (but not exceeding the amount stipulated in the Insurance Contract) on the grounds of original invoices and supporting documents received from the consular services and/or Service Company that has arranged for such services.

12.10. If an insured event occurs under the benefit “Trip cancellation expenses” the reimbursement in the amount of the expenses incurred by the Insured shall be paid by the Insurer after receiving all the requested documents and, if necessary, notarized translations thereof — within the period stipulated by the Insurance Contract but not later than in fifteen (15) business days.

12.11. If an insurance event occurs under the benefit “Trip interruption expenses,” the reimbursement in the amount of the expenses incurred by the Insured shall be paid by the Insurer after receiving all the requested documents and, if necessary, notarized translations thereof — within the period stipulated by the Insurance Contract but not later than in fifteen (15) business days.

12.12. If an insured event occurs under the benefit “Lost Checked Luggage expenses”:

12.12.1. The reimbursement shall be paid:

12.12.1.1. In case of destruction, total or partial loss of the Luggage, in the amount of the actual value of Luggage less the residual value of the damaged Luggage but not exceeding the Insurance Limit;

12.12.1.2. In case of partial damage to the Luggage, in the amount of repair cost.

12.12.2. The Luggage shall be deemed fully destroyed if the amount of repair cost and residual value do not exceed the actual value of the Luggage intact.

12.12.3. The amount of damage shall be determined for each item individually. The total amount of payments may not exceed the Insurance Limit specified in the Insurance Contract.

12.12.4. If the stolen (missing) item was returned to the Policyholder, the Policyholder shall return to the Insurer the reimbursement received earlier, net of the expenses related to the insured event for repairing or fixing the returned item, not later than fifteen (15) calendar days after the return of the stolen (missing) item.

12.12.5. If the Policyholder has received compensation from third parties for lost or damaged Luggage or part thereof, the Insurer shall pay only the difference between the amount payable under the Insurance Contract and the amount received from third parties. The Policyholder shall notify the Insurer immediately of the receipt of such amounts.

12.12.6. In the case of loss (theft) of individual items that are part of a set, pack, etc., the amount of damage shall be determined as the difference between the value of such set, pack, etc. and the value of the intact items.

12.12.7. The insurance reimbursement shall be paid in a bulk sum within the period specified in the Insurance Contract but not later than within fifteen (15) business days after the end of the investigation by the Insurer of all the circumstances of the insured event and making the decision to reimburse.

12.13. If an insured event occurs under the benefit “Luggage delay expenses,” the insurance reimbursement shall be paid in the amount of the expenses based on the original invoices received from public catering companies, hotels, or on the grounds of the invoices of the Service Company that has arranged for such services.

12.14. If an insured event occurs under the benefit “Personal Liability”:

12.14.1. The insurance reimbursement shall be paid to a third party that has suffered property and/or physical damage as a result of the Insured’s actions, on the grounds of a court decision or acknowledgment by the Insured, with the Insurer’s written consent, of a justified property claim for the damage to the life, health, or property of third parties.

12.14.2. The amount of insurance reimbursement for this benefit shall include:

12.14.2.1. In case of inflicting damage on an individual or a legal entity, the direct real damage inflicted by destruction or damage of property, which is defined in the case of the total loss of the property — in the amount of its real value net of deterioration; in the case of partial damage — in the amount of the expenses required for bringing it in its state before the insured event;

12.14.2.2. In case of damage to the health of an individual or his/her death:

12.14.2.2.1. Expenses required for the restoration of health (medical care, recreational treatment, external care, prosthetics, transportation expenses, etc.), provided that such expenses are directly related to the event;

12.14.2.2.2. Expenses to reimburse the part of earnings, which his/her dependent persons lose in case of death of the affected person;

12.14.2.2.3. Burial expenses. 1

2.14.3. The amount of the reimbursement for this benefit shall also include:

12.14.3.1. Necessary and reasonable expenses attributed to property salvage and rescue of the persons who incurred damage due to the insured event or to minimize the damage inflicted through the insured event;

12.14.3.2. Reasonable expenses for preliminary investigation of the circumstances and degree of the Insured’s fault;

12.14.3.3. Expenses for handling cases in courts on the alleged insured events.

12.15. The Insurer shall be entitled to delay the payment of the insurance reimbursement if:

12.15.1. Any disputes related to the Insured’s right to receive the insurance reimbursement arise — until the required evidence is submitted;

12.15.2. If based on facts connected with the occurrence of an insured event, the relevant law enforcement authorities have initiated a criminal case, proceeding, litigation, or administrative investigation against the Policyholder or his/her/its authorized persons or in case of investigation of circumstances that caused loss — until the completion of the investigation (process) or proceedings and finding the Policyholder innocent;

12.15.3. If the Policyholder (Insured) has requested an expert examination in accordance with Clause 6.1.8 hereof —before obtaining the expert (expert committee) opinion

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