Terms & Conditions Assistance Plus
GLOSSARY OF TERMS DEFINITIONS: a) User: any person who has access to the Assistance Services described in these General Conditions. b) Assistance Services: The Assistance Services provided by Iké to the Users under the terms of these General Conditions, in the event of a Beneficiary's Assistance Situation. c) Coordinator: person who is part of the Call Center. d) Assistance Situation: Any accident or illness of a User and/or Beneficiary occurring under the terms and with the limitations set forth in these General Conditions, as well as the other situations described that give the right to receive the Assistance Services. e) Illness: Any alteration in the health of the User and/or Beneficiary that occurs, originates or manifests itself during the term of this contract. f) Serious illness: It is defined as the sudden and unexpected onset of manifestations with or without loss of consciousness whose severity gives the impression of imminent death. g) Urgency: Urgency is considered to be any situation that, in the opinion of the Patient, his/her family or whoever makes the decision, requires immediate medical attention. h) Emergency: Defined as an injury or illness that poses an immediate threat to a person's life and whose care cannot be delayed. i) Medical Referrals with discount: All information or data provided to the User and/or Beneficiary of the network of medical providers of Iké with discount or preferential cost. j) Specialist: a person who practices a particular branch of a science. k) Call Center Booth: physical space where the Coordinators attend to the Assistance Services. TERRITORIALITY Assistance services are provided in the territory of the United Mexican States. PERSONS PROVIDING ASSISTANCE SERVICES The persons who provide the Assistance service are, for the most part, independent contractors of Iké and therefore Iké although it is responsible for the provision of the services in accordance with the provisions of these General Conditions, shall in no case be liable for the opinions and conclusions given by such persons. VALIDITY The program is valid per day, per person.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
ASSISTANCE 1. Medical assistance. 1.1 Ground ambulance for medical emergency If the User suffers an accident or serious illness that causes injuries or trauma such that the Iké medical team, in contact with the attending physician, recommends hospitalization, Iké will organize and cover the cost of transferring the User to the nearest or most appropriate hospital center by land ambulance. Limitations: This service is limited to 1 event per emergency, free of charge for the duration of the program. Exclusions: a) When the User does not provide truthful and timely information, or incurs in false information regarding the type of injury, mechanism or kinship. b) Transfers in case of mental illness are excluded. c) Patients in a state of inebriation or drug abuse who are in an aggressive state or do not wish to be transferred. d) Scheduled ambulances. 1.2
Air ambulance in case of emergency
Whenever Iké medical team recommends hospitalization, air transportation to the nearest or most appropriate hospital will be arranged and covered. 1. Location of the patient. Air transfer will be carried out as long as the locality where the patient is situated does not have the minimum infrastructure for medical attention and the displacement to another locality that does have all the physical resources and medical personnel required, as the case may be, is required. 2. Patient's Health Condition and Flight Authorization. If the patient's condition permits air transportation, the attending physician must grant written flight authorization. In case of voluntary discharge, the user or his/her family member will allow the patient to be evaluated by the medical crew and if the general conditions for the transfer do not exist, he/she will accept the cancellation or rescheduling of the transfer. 3. Medical report. The responsible family member, attending physician or designated legal representative must provide the Iké medical team with a detailed medical report, specifying background, current conditions, diagnoses and treatments, as well as the prognosis, in order for the user to be transferred with the necessary infrastructure to ensure their integrity. 4. Signing a disclaimer. Once the family member, user or legal representative is informed about the conditions of the flight and its risks, he/she must sign the liability waiver form in order to make it known that the airline company or Iké is not responsible for any complication that may arise during the transfer.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
Limitations: This service is limited to 1 event per emergency, up to 100,000 USD for the duration of the program. Exclusions: a) Strikes, war, invasion, acts of foreign enemies, hostilities (whether war has been declared or not), rebellion, civil war, insurrection, terrorism, pronunciations, demonstrations, popular movements, radioactivity or any other force majeure. b) Self-harm or participation of the User in intentional criminal acts. c) Suicide or illnesses and injuries resulting from attempted suicide. Mental illness or alienation; any type of accident or illness caused by nuclear radiation; any pre-existing, chronic or recurrent illness and convalescence are considered as part of the illness. d) Pregnancies in the last three months prior to the probable date of delivery, as well as the latter and prenatal examinations; transplants or transfer of organs of any kind. e) Diseases or pathological states produced by the intentional ingestion or administration of intoxicants (drugs), narcotics or by the use of medications without medical prescription. 2. Travel assistance 2.1 Advice on procedures and document formalities Iké will assist and advise the User via telephone to notify the corresponding authorities and institutions of the loss or theft of essential documents for the continuation of his/her trip (such as: passport, visa, traveler's checks, credit cards, airline tickets, etc.) and will provide the User with the necessary instructions via telephone or e-mail to obtain the replacement or reissuance of such documents. Limitations: This service is unlimited and free of charge. 2.2 Medical evacuation If the User is ill or injured during the trip, physically unable to travel on his/her own and it is recommended by the treating physician and the medical team of Iké determines that it is necessary, commercial air transportation to his/her place of residence will be arranged. Limitations: This service is limited to 1 event per emergency, up to 100,000 USD for the duration of the program. Exclusions: a) When the user does not provide truthful and timely information or incurs in false information regarding the type of injury, mechanism or relationship. b) Transfers in case of mental illness are excluded. c) Intoxicated or drug-abused patients who are in an aggressive state or do not wish to be transferred.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
2.3 Bagagge recovery Iké will provide the user with the necessary information and telephone support for the location and recovery of luggage on any airline in the world, as well as coordination of the shipment to the place of origin. Limitations: The expenses derived from the shipment shall be charged to the user, with no limit on the number of events during the term of the program. Exclusions: a) Requests outside the legal or ethical framework. b) When the User and/or beneficiaries do not provide truthful and timely information that would allow us to duly provide the assistance or incur in false declarations. c) Baggage recovery is not guaranteed, although every effort is made to achieve this. 2.4 Transfer of a family member in case of convalescence In the event of hospitalization of the User and if the hospitalization is expected to last up to 3 (three) calendar days, a round trip economy class airline ticket will be made available to a person designated by the User, with origin in the User's city of permanent residence, in order to go to the User's side. Limitations: This service is limited to 1 event with round trip economy class ticket, during the term of the program. Up to 20,000 USD. Exclusions: a) It will be indispensable for the User to contact Iké at the time he/she requires the assistance service in order to receive the corresponding orientation. In the absence of such notifications, Iké will hold the User responsible for the costs and expenses incurred. b) No reimbursement applies c) Service subject to availability, terms and conditions of suppliers. d) When the owner and/or User does not provide truthful and timely information that would allow us to properly provide assistance. 2.5 Repatriation or funeral transfers. • International. If the User dies while traveling, all the necessary formalities will be carried out (including any legal formalities) and will be responsible for the coordination and expenses inherent to the repatriation of the mortal remains to the burial or cremation site indicated by the beneficiary, including the expenses inherent to the transfer from the airport to the User's place of residence. If the beneficiary decides to have the mortal remains of the user buried or cremated at the place where the death occurred, Iké will be in charge of the coordination and expenses resulting from such burial or cremation.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
The maximum limit of liability of Iké shall be: the amount of the transportation expenses of the mortal remains, as well as the legal expenses incurred for the corresponding procedure or management, considering as such: management fees and taxes according to the legislation of the city and/or country where the death occurs. In the event that the burial or cremation takes place at the place of death of the User, the maximum limit of liability shall be the equivalent of the cost of repatriation of the mortal remains as described in the preceding paragraphs. Important: Crypt and grave are not included and will correspond to a basic service. No reimbursement applies. It applies for Sickness or Accident. • National: If the user dies while traveling, Iké will carry out all the necessary formalities (including any legal formalities) and will be in charge of the coordination and expenses inherent to the transfer of the mortal remains to the burial or cremation site indicated by the beneficiary, including the expenses inherent to the transfer from the airport to the User's place of residence. If the beneficiary decides to have the mortal remains of the User buried or cremated at the place where the death occurred, Iké will pay for the expenses resulting from such burial or cremation. The maximum limit of liability of Iké assistance shall be the amount of the transportation expenses of the mortal remains, as well as the legal expenses incurred for the corresponding procedure or management, considering as such: fees for the management and taxes according to the legislation of the city where the death occurs. In case the burial or cremation takes place at the place of death of the User, the maximum limit of liability payable by Iké shall be as indicated in this item. Applies for natural death, illness or accident not marked in the exclusions. No reimbursement applies. Limitations: This Service is limited only to the User’s death and to the term of the Program and up to $10,000.00 (ten thousand U.S. dollars, legal tender in the United States of America). In case of excess, it shall be covered by the responsible party. Exclusions: a) In cases of repatriation, Iké will decide when is the most appropriate time for repatriation and will determine the most appropriate dates and means. b) It will be indispensable for the User's relatives to contact the Iké assistance once the death occurs in order to receive the corresponding orientation. In the absence of such notifications, Iké shall hold the beneficiary responsible for the costs and expenses incurred. c) No redemption or refund applies.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
d) The following do not entitle the User to Assistance Services: emergency situations occurring during trips or vacations undertaken by the User against medical prescription or during trips abroad for more than 60 (sixty) calendar days. e) When an intentional action of the User results in the commission of a crime. f) The participation of the User in any kind of race, competition or exhibition (automobile, horse, bicycle). Also excluded are Assistance Situations that are a direct or indirect consequence of: a) Strikes, war, invasion, acts of foreign enemies, hostilities (whether war has been declared or not), rebellion, civil war, insurrection, terrorism, pronunciations, demonstrations, popular movements, earthquakes, pandemics, epidemics, radioactivity or any other cause of force majeure. b) Self-injury or participation of the User in intentional criminal acts will depend on Service availability, terms and conditions of the suppliers. g) When the beneficiary does not provide truthful and timely information that would allow us to properly provide the assistance. h) Service subject to local legislation. 3. Legal Assistance 3.1 Funeral legal assistance Iké will provide the User's family with advice for the coordination of the following procedures or document formalities: Death certificate from the Secretariat of Health. Death certificate before the Civil Registry. In this process, Iké will be in charge of paying the attorney's fees and the bereaved will cover the rights of the certificates that correspond to each State. Limitations: This Service is limited to 1 (one) event at no cost (only for death of the user), during the term of the Program. Exclusions: a) When the User does not provide truthful and timely information that allows us to properly provide the Service. 3.2 Telephone legal advice Legal advice will be provided 24 hours a day, 365 days a year, through the network of lawyers, in criminal and civil matters. Limitations: This Service has no event limit. Exclusions: a) When the User does not provide truthful and timely information that allows us to properly provide the service.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
b) It does not include the expenses and fees for the case that for legal advice and assistance it is necessary to follow any judicial or notarial procedure such as inheritance trials, rectification of deeds, granting of wills, etc., cases in which the User or his/her relatives may resort to the lawyer of their convenience. c) When the User is under the influence of alcoholic beverages, intoxication by substances related to drug dependency, and his call becomes aggressive and offensive. d) When the User makes use of rude words. 4. Specialized Assistance. 4.1 National and International Concierge At the user's request, specialized assistance will be provided, and information related to: Assistance in Life & Style: • Restaurants: Recommendation and reservation at the best restaurants in the world. • Nightlife: Recommendation and reservation at the best night clubs in the world. • Shows: Recommendation, reservation and purchase of the best shows in the world or special events. • Cinema: Location and recommendation of complexes and/or movies, as well as reservation/purchase in complexes with such faculty. • Museums and art galleries: Recommendation of temporary and permanent exhibitions and museums or galleries anywhere in the world. • Golf Courses: Recommendation and reservation at the best golf courses in the world. • Spa's and beauty salons: Recommendation and reservation at the best spa's and salons in the world, with the most appropriate treatment for each User. • Real Estate: Locating, listing and leasing real estate to meet temporary or permanent housing needs anywhere in the world. • Recommendations: Recommendation of gyms and sports facilities. • Special Services Referrals: Personal shopper, pet walking referrals, pet boarding, interior design, image consultation, event planning, photographers, security and car cleaning services. • Luxury Transportation: Private jet, helicopter or yachts in most of the cities of the world. Travel Services: • Airline Tickets: Information, reservation and purchase of airline tickets on any airline in the world. • Hotels: Information, recommendations and reservations. • Train Tickets: Information, reservation and purchase of tickets. • Cruises: Recommendation, reservation and purchase of any cruise in the world. • Travel: Recommendation, reservation and purchase, in any tourist destination at national and international level. • Car Leasing: Reservation of any type of vehicle. • Transportation: From cab service to luxury car rental. Including Pick-Up service at any airport in the world. • Limousines: Information and limousine reservations.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
• International Sports Events: Super Bowl, Formula One Grand Prix, US Open, Roland Garros, NASCAR, figure skating, sailing, regatta and any other requested by the User. • Weather Information: Weather information, seasonal information and weather forecasts. • Location References: Locations and hours of operation of any points of interest at the traveler's destination. • Pre-Trip Assistance: Information on embassy and consulate offices, pre-trip information such as vaccinations, measures to be taken by the User prior to travel, as well as formalities and requirements such as visas, passports, etc. • Schedule Information: Schedules of museums in the main cities of the world, sporting events and shows, airports and bus stations and offices for procedures before the competent authorities. • Consular Information: Addresses of embassies, consulates and/or representative offices of the Mexican government in the city or country where you are located, to report the loss, theft or misplacement of your official documents. If possible, coordinate an appointment with the corresponding Mexican authority to report the loss. Purchasing assistance: • Flowers and Gifts: Recommendation and coordination of delivery. • Hard to Find Items: From original gifts, collectibles, imports, wine, among many others. • Store Locator: Information about the location of the most prestigious brands worldwide. • Gift and Home Delivery: Product research and comparison, purchase and home delivery. • Assistance in National or International Purchases: search, purchase and delivery of any item. Personal Assistance: • Business Logistics: Coordination of any type of event for executive meetings. • Banquets, Catering and Private Events: Your personal concierge will recommend the perfect caterer for your needs. • Sending of Documents: Sending of documents to any part of the world, in case of forgetfulness, loss or theft with cost to the User. Executive Assistance: • References: References of interpreters, temporary secretarial services or protection, in the main cities of the world. Support in locating computer equipment and telephones. • Executive Transportation: At the client's request, an executive cab will be arranged for transfers. • Customs and Usages: Local customs and etiquette, protocol and etiquette for international business. All costs generated by the information, reservation, purchase or any other activity will be charged to the User. Limitations: This Service has no event limit during the term of the Program.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
Exclusions: Iké cannot guarantee to provide the user with the service required in any of the following situations: a) Rates or discounts other than those offered to the public are not guaranteed. b) Availability is not guaranteed (e.g. restaurant full, flights or events completely sold out). c) Access to private venues or events is not guaranteed. d) There is privileged or restricted information that the Concierge cannot access to (e.g. an artist's hosting itinerary). e) Access to establishments is not guaranteed outside working hours, nor when the product or service is not available (e.g., when a construction site is out of season). f) Purchase and delivery to non-permitted locations is not guaranteed. g) No services are provided in circumstances that are not legal or ethical. h) Iké is not responsible for any non-compliance or fault committed by the contacted supplier or referenced establishment, or for the services and/or products sold by them. i) Iké is not responsible for information provided that for some reason differs from reality (e.g. advertising or promotional errors). j) Iké is not obliged to know street information, main tourist destinations or very focused information about a place, but it will definitively research it. 4.2 Urgent messages: Upon request, the user will be able to send or receive urgent messages derived from emergency situations, anywhere in the world. Limitations: This service is unlimited and free of charge. Exclusions: a) Under any circumstance, Iké will lend itself to requests outside the law, excluding requests such as purchase, monitoring or any type of information about narcotics, erotic massages, weapons, or any type of fraudulent or illicit information that affects the integrity of the service. Requests outside the legal or ethical framework. b) When the User does not provide truthful and timely information that allows us to properly provide assistance or incurs in false declarations. 5. Insurance This service will be provided by an insurance company duly registered and authorized by the National Insurance and Bonding Commission, as well as by the Ministry of Finance and Public Credit. Preliminary The Company and the Insured Party have agreed as contracted the sections, coverages and sums insured or maximum limits of liability, deductibles and coinsurance that appear on the title page of the
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
Terms & Conditions Assistance Plus
policy, with the knowledge that one or more of the sections or additional coverages may be chosen by express agreement, which are not expressly indicated, shall not have any validity or legal effectiveness between the parties, even though they are mentioned and regulated in these general conditions. These general conditions govern the insurance contract entered into between the parties, and in all matters not provided for herein, the provisions of the Insurance Contract Law shall apply. Clause 1. Specification of sections and coverages. Section I. Medical assistance. This section, if contracted, must be expressly indicated on the title page of the policy and the Company covers without exceeding the sum insured contracted and stipulated on the title page of the policy, which operates as a single and combined limit (LUC). It is also stipulated that in the event of granting a sub-limit of the sum insured in any of the coverages of this section, this amount is part of the sum insured contracted and is not additional. These hedges operate as follows: I. Medical. I.I Assets covered. The assets we will cover are the expenses incurred for medical services including: a) Hospitalization b) Surgical interventions c) Medical fees d) Prescribed medications e) Dental expenses f) Medical transfer g) Transportation and repatriation h) Prolongation of the Insured's hospitalization i) Displacement and stay of a relative of the Insured j) Services due to death k) Early return home Which are generated in case of accident or illness of the Insured occurring during the trip insured under this policy, hereinafter. The relationship between the Insured covered under this coverage and the medical providers is at the Insured's own risk; therefore, the Company assumes no responsibility whatsoever for the service received or payment of damages. I.II Medical and hospitalization expenses Expenses for medical treatment required during the insured trip and paid by doctor's order are covered. Included is the cost of:
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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a) Treatment of patients, if required, including hospital admission and surgical interventions. b) Medications, dressings and bandages, up to 300 USD (United States Dollars). This amount is a sub- limit of the contracted sum insured and is therefore included in the sum insured. c) In case of premature birth, the treatment cost required by the newborn up to the contracted sum insured and stipulated on the title page of the policy. The foregoing applies in cases in which the insured trip is made without prior complications in the pregnancy. d) If during the insured trip the pregnancy develops complications, the required medical treatment is covered, up to the contracted sum insured and stipulated on the title page of the policy, to avoid immediate risks that threaten the life of the mother and/or the baby, but not for abortion, provided that the pregnant woman is under 38 years of age and is not less than 30 weeks pregnant at the time the problem arises. e) Assistive devices such as walking aids, wheelchair rental, oxygen if required for the first time due to an accident or illness occurring during the insured trip and prescribed by a physician, up to a total of 250 USD (U.S. Dollars). This amount is a sub-limit of the contracted sum insured and is therefore included in the sum insured. I.III Prolongation of the insured's hospitalization on the insured trip In the event that the treating physician indicates that it is not possible to move the Insured from the place where he/she is hospitalized due to an accident or illness occurring during the insured trip to another hospital for the continuation of his/her treatment, the Company shall pay the costs of medical treatment up to the day on which it is possible to move the Insured and up to the total limit of the sum insured contracted and stipulated on the title page of the policy. I.IV Dental costs Emergency dental treatment to alleviate pain, including simple or temporary fillings and cures to restore the functions of the dentition and dental replacement, up to a total of 150 USD (U.S. Dollars) is covered. This amount is a sub-limit of the contracted sum insured and is therefore included in the sum insured. I.V Stay of a family member If a child up to twelve years of age covered by this insurance policy should be hospitalized, the Company shall pay the lodging costs for one person accompanying the child in the hospital up to a maximum of $500 USD (U.S. Dollars). This amount is a sub-limit of the contracted sum insured and is therefore included in the policy. I.VI Medical transfer In the event that during the insured trip an illness, injury or traumatism should occur, requiring the hospitalization of the Insured Party, this coverage shall cover the transfer of the Insured Party from the place where he/she is during the trip to the nearest hospital center or to his/her usual domicile, using the most adequate means of transportation according to the circumstances, including air ambulance. The transfer shall be carried out under the conditions agreed upon by the Company's physician in coordination with the attending physician. The sum insured contracted is that stipulated on the title page of the policy for assistance benefits and operates as a single and combined limit (LUC).
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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I.VII Repatriation and/or death services In case of death of one of the Insured during the trip, the Company shall make the necessary arrangements for the transportation or repatriation of the corpse and shall cover the transportation expenses up to the time of burial. At the request of the bereaved, the Company shall cover burial at the place of death or the transfer of ashes to the city of permanent residence of the Insured Party. The Company shall bear the transportation expenses of the insured companions to their respective domicile or to the place of burial, provided that such transportation cannot be carried out by the means of transportation foreseen for the purpose of the trip. In the event that the deceased Insured had traveled without an adult companion, the Company shall cover the payment of a round trip economy class ticket for a family member, by the most convenient means of transportation, from his/her place of residence to his/her place of death. The contracted sum insured is that stipulated on the front side of the policy for assistance benefits and operates as a single and combined limit (LUC for Límite Único y Combinado). Section II. Additional health care benefits The Company shall provide 24-hour assistance services through its emergency call center, in case the Insured requires any of the following services. II.I Medical reference The Company provides at the Insured's request information on the medical care options available to the Insured at the place of travel, and whenever possible, a Spanish or English speaking physician will be available. Up-to-date information on doctors, clinics and hospitals in the place of travel is provided, and if required, initial psychological counseling via telephone is provided if required due to trauma suffered during the insured trip. The company shall not be responsible for the quality of the services rendered, the costs incurred, or the consequences arising therefrom. II.II Hospitalization-related care When the Insured receives inpatient treatment in a hospital as a result of an accident or illness during the insured trip, and if the Insured has a family doctor or a doctor he/she trusts, at the Insured's request, the Company shall try to communicate the Insured with the doctors attending him/her at the place of the trip, so that all of them share the information of the medical procedures being carried out. If requested, the Company shall also keep the Insured's relatives informed. II.III Travel and stay of an accompanying person In case of hospitalization for more than five days, the Company shall cover the following expenses up to the maximum limit of liability contracted and stipulated on the title page of the policy. The cost of a round trip of a family member to the place of hospitalization in economy class as well as hotel stay expenses, which are stipulated at 150 USD (US Dollars) per day for the companion. This amount is a sub-limit of the contracted sum insured and is therefore included in the sum insured.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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II.IV Delivery of medicines When the Insured requires medicines that have been lost during the trip, the Company will assist the Insured in the procurement or replacement of medicines and will pay for the delivery services. The Insured shall pay for the cost of replacement medicines. Clause 2. General exclusions applicable to all sections. In no event shall the Company be liable for any loss or damage resulting from: a) Fraud, deceit or bad faith on the part of the Insured Party, his family members, or whoever represents his interests. b) Medical treatment that is the reason for the insured trip, c) Periodic medical check-ups, preventive, pediatric, endodontic, periodontal, orthodontic dentistry, fillings, dental prostheses, apicoectomies, implantologies and the diagnostic means necessary to carry out these treatments. d) If the insured makes the trip in spite of requiring treatment for medical reasons (e.g. dialysis) in a hospital facility close to his/her usual place of residence and requires this policy to cover the treatment at the place of travel. e) For illnesses or injuries derived from chronic conditions or those diagnosed prior to the trip. f) Purchase or repair of pacemakers, any type of prosthesis, visual aid devices. g) Expenses for treatments and/or medications that are not scientifically recognized. h) For treatments in health spas or clinics or other rehabilitation methods. i) Bodily injuries occurring in a state of mental derangement, paralysis, apoplexy, epilepsy, diabetes, alcoholism, drug addiction, spinal cord disease, syphilis, AIDS, encephalitis and, in general, any injury or illness that diminishes the physical or mental capacity of the Insured Party. j) Bodily injuries resulting from participation in criminal actions, provocations, quarrels -except in case of legitimate defense- and duels, imprudence, bets or any risky or reckless undertaking and accidents suffered as a consequence of pandemics, earthquakes, floods and volcanic eruptions. k) Illnesses, hernias, lumbago, heart attacks, intestinal strangulation, complications of varicose veins, poisoning or infections not directly and exclusively caused by an injury resulting from a travel accident. l) The consequences of surgical operations or unnecessary treatment for the cure of accidents suffered and those pertaining to the care of the person himself. m) Injuries resulting from accidents derived from the use of two-wheeled vehicles with a cylinder capacity greater than 75 cc. n) Injuries occurring in the exercise of a professional activity, except for those of a commercial, artistic or intellectual nature. o) Not covered if the loss is intentionally caused by the Insured. p) Situations of aggravation of an accident occurring prior to the formalization of the policy are not included. q) Cosmetic surgery. r) The Insured does not follow the restrictions, recommendations or suggestions of the airline, the crew, the government or any other official authority during his/her trip.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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s) Mental illnesses and depressions without hospitalization or that justify a hospitalization of less than seven days. t) Illnesses being treated or under medical care within 30 days prior to the travel booking date. u) That the Insured is under the influence of drugs, solvents or alcohol, with the exception of drugs prescribed by a certified physician, but not those used for the treatment of drug addiction. v) Losses or damages suffered by the Insured Party as a consequence of war operations, whether arising from foreign war or civil war, insurrection, subversion, rebellion, expropriation, requisition, confiscation, seizure or detention by the legally recognized authorities in the course of their duties, when intervening in such acts. w) As a result of events related to radioactive energy. x) Due to suicide and/or injuries or sequels caused by the attempt thereof. y) Training or action supervised by a military authority. z) Any sport that is practiced professionally or under a paid contract, sports competitions or in their respective preparatory training as an amateur, and at any level, in motor sports (cars, motorcycles or any motorized vehicle), flying sports, scuba diving, using oxygen tanks or breathing apparatus, and free diving. Dangerous sports such as rappelling, soccer, baseball, big game hunting, bungee jumping, boxing, canoeing, whitewater rafting, soccer and cricket, dangerous expeditions, endurance tests, go karts, motor rally, field hockey, ice hockey, marathons, motorcycle stunts, martial arts, mountain biking, polo, rock climbing, gun safaris, parachuting, gliding, war games, water ski jumping, weight lifting, river rafting and wrestling, mountaineering, climbing, caving, skiing, surfing, motocross, speed or endurance races, aeronautical ascents or trips, gliding, hang gliding, paragliding, polo, boxing, rugby, underwater fishing, parachuting or others of a similar degree of risk. aa) Epidemics or pandemics officially declared by health authorities. bb) Consequential damages resulting from strikes, riots, civil commotion, vandalism and damages due to acts of malicious persons. Clause 3. Beginning and termination of validity This insurance takes effect from the moment the insured trip begins, continues during the course of the insured trip until the end of the insured trip, except for section I which takes effect from the date of reservation of the insured trip and ends on the date of commencement of the insured trip. Clause 4. Sums insured The amount to be paid in each coverage for indemnifiable loss is for each risk covered under this contract and specified on the title page of the policy. Clause 5. Obligations of the insured I. In the event of loss, the Insured undertakes to: a) Precautions. Execute all acts tending to avoid or diminish the damage. If there is no danger in the delay, he shall request instructions from the Company, and shall abide by the instructions given by the Company. The expenses incurred by the Insured Party, which are not manifestly improper, shall be covered by the Company, and if the Company gives instructions, it shall advance such expenses.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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If the Insured Party does not comply with the obligations imposed by the preceding paragraph, the Company shall have the right to limit or reduce the indemnity up to the amount that it would have amounted to if the Insured Party had complied with such obligations. b) Notice of loss. To give notice to the Company as soon as he has knowledge of the loss occurrence and of the right constituted in his favor by the insurance contract, within a term not exceeding five days, except in cases of force majeure or fortuitous events, which notice shall be given as soon as one or the other ceases. When the Insured Party does not comply with such obligation, the Company shall reduce the benefit due up to the amount that would have been payable if the notice had been given in due time. The Company shall be released from all obligations under the contract if the Insured fails to give notice within the aforementioned term, with the intention of preventing timely verification of the circumstances of the loss. II.
In addition to the above, the Insured undertakes to: a) Notice of claim: The Insured Party undertakes to notify the Company, as soon as he/she becomes aware of the claims or demands received by him/her or by his/her representatives, for which purpose he/she shall send the Company the documents or copies thereof, which for such purpose have been delivered to him/her. Failure on the part of the Insured Party to comply with this obligation shall release the Company from covering the indemnity corresponding to the coverage affected by the loss. The Company shall not be bound by acknowledgement of debts, transactions or any other legal acts of similar nature, made or entered into without its consent. The confession of the materiality of a fact shall not be assimilated to the acknowledgement of liability. b) Notice of Trip Cancellation. In case of the occurrence of an appropriate event as specified in Clause 1. Specification of Coverages. Coverage I. Trip Cancellation, which is the cause of cancelling a trip, the Insured is obliged to make arrangements for the trip cancellation immediately in order to keep the cancellation charges to a minimum.
III.
At the Company's express request, the Insured shall be obliged to carry out the following: a) Present a medical certificate or report that proves the inability to travel. b) To allow the Company to make an investigation in relation to the inability to undertake the trip due to accidental injury or illness, in order to have such inability confirmed by a medical specialist appointed by the Company and to submit to such medical examinations as the Company may require.
IV. Communicate the existence of other insurances: When insurance is contracted with several companies against the same risk and for the same interest, the Insured Party shall be obliged to inform each of the insurers of the existence of the other insurances. The notice shall be given in writing and shall indicate the name of the insurers, as well as the sums insured.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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If the Insured Party intentionally omits the aforementioned notice, or if he/she contracts the various insurances in order to obtain an illicit benefit, the Company shall be released from its obligations. Clause 6. Basis of valuation and indemnification for damages. 1. Documents, data and reports that the Insured must submit to the Company: a) The Insured Party is obliged to verify the basis of his or her claim and of all matters stated therein. The Company shall have the right to demand from the Insured Party all kinds of reports on the facts related to the loss and by which the circumstances of its occurrence and the consequences there of may be determined, and the Insured Party shall deliver to the Company the documents and data specified in the following paragraphs. 2. In no case may it be required that the loss be proven in court, in accordance with the provisions of Art. 71 of the Insurance Contract Law. 3. All documents such as invoices or sales notes must comply with current tax requirements. 4. For the effective fulfillment of Article 71 of the Insurance Contract Law, it shall be understood that the Insured Party has complied with his obligation, by delivering to the Company the documentation specified in the instructions that shall be delivered together with the policy, and which is part of the same. 5. No reimbursement shall be paid for services contracted by the insured without the prior consent of the Company, except in the case of proven force majeure preventing the insured from communicating with the Company or with the third parties in charge of rendering such services. At the moment at which the Company makes payment of any of the indemnities foreseen in these coverages, the Insured Party shall assign to the Company all the rights he/she may have against third parties and shall be obliged to issue the documents required for such purpose. 6. The Company shall make the payments and indemnities referred to in this policy, provided that this does not generate profit for the insured parties. Clause 7. Fraud, malice or bad faith. Extinction of the Insurer's obligations, whereby the right to be indemnified is lost for the following causes: a) It is the obligation of the contracting party and/or his representative to declare in writing all the facts important for the appreciation of the risk that he knows or should know at the time of the conclusion of the contract. b) In case of omissions and/or false declarations by the contracting party and/or representative, when declaring in writing in the Company's applications or in any other document, the Company may terminate the contract as of right in terms of the provisions of Article 47 of the Insurance Contract Law, in connection with Articles 8, 9 and 10 of the same Law. c) If the Insured Party, the beneficiary or their representatives, with the purpose of causing it to incur in error, conceal or inaccurately declare facts that would exclude or could restrict such obligations.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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d) If, for the same purpose, they do not deliver in time to the Company the documentation specified of general conditions. e) If there is fraud or bad faith in the loss or in the claim on the part of the Insured Party, the beneficiary, the successors in title or the attorneys-in-fact of any of them. Clause 8. Impediment of payment The Company shall not be liable to pay any claim or any benefit derived from this policy, when it implies any sanction, prohibition or restriction of an economic or legal nature, established in resolutions issued by the United Nations, laws or regulations of the European Union, United Kingdom or United States of America, or due to being on restrictive lists or resolutions issued by international organizations. CLAUSE 9. Insurance Contract Law which at the bottom reads as follows Article 69.- The insurance company shall have the right to demand from the insured or beneficiary all kinds of information on the facts related to the loss and by which the circumstances of its occurrence and the consequences thereof may be determined. Article 70.- The obligations of the company shall be extinguished if it proves that the insured, the beneficiary or the representatives of both, with the purpose of making it incur in error, dissimulate or declare inaccurately facts that would exclude or could restrict such obligations. The same shall be observed in the event that, for the same purpose, the documentation referred to in the preceding article is not submitted in due time. Data from the specialized unit of attention to users and data from CONDUSEF. Atlas insurance data Specialized Unit Paseo de los Tamarindos No. 60 P.B. Colonia Bosques de las Lomas, Cuajimalpa de Morelos, Mexico. C.P. 05120, Mexico City. Telephone: 5591-7752-20 or 800 849 39 16 Website: www.segurosatlas.com.mx The Branch Office is at the Insured Party's disposal for different types of operations located at Paseo de los Tamarindos No.60, P.B., Col. Bosques de las Lomas C.P 05120 Alcaldía Cuajimalpa, in Mexico City, with telephone numbers in Mexico City and Metropolitan Area 5591 77-5220 or 800- 849-3916 with opening hours from Monday to Friday from 8:00 am to 15:30 pm hours. For attention in the interior of the Republic, the nearest branch can be located according to the Insured's location on the website of Seguros Atlas, S.A. www.segurosatlas.com.mx. CONDUSEF data National Commission for the Protection and Defense of Users of Financial Services Av. Insurgentes Sur No. 762 Colonia Del Valle Benito Juárez Delegation
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón
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C.P. 03100, Mexico City. Telephone numbers 5553-4009-99 and 800-999-80-80 Website: www.condusef.gob.mx Special conditions Section I. Hotel expenses for convalescence Lodging services for convalescence of the Insured shall apply when, due to accident or illness, the Insured has been admitted to a hospital and requires an extended stay as prescribed by the attending physician; and such stay has been accepted and authorized by the Company. This service shall be subject to a maximum amount determined by the plan and package contracted in the policy. This service shall not exceed the maximum contracted limit and the calendar days indicated in the description of the contracted plan and established in the policy and per Insured Party. This amount is a sub-limit of the contracted sum insured and is therefore included in the sum insured. Important: Hotel expenses are understood to mean only simple lodging, without restaurant expenses, laundry, telephone calls, transportation, internet access, personal expenses, among others. (The enumeration is exhaustive and non-enunciative). Section 2. Medical care for amateur sports The Company will cover medical and hospitalization expenses for medical emergency in case they are originated by the amateur practice of the following sports: recreational motorized vehicles (all terrain-vehicle (ATV), motorcycle, scooter, jet-ski, amphibious vehicles, boats), zip line, swimming with dolphins, scuba diving, snorkeling, fly board, rappel, parachuting and bungee jumping.
Torre Anseli, Av. Revolución 1267, Col. Los Alpes, Álvaro Obregón