1. Prior dispositions

1.1 Insured person

The individual residing in Spain, beneficiary of a health care insurance policy of HEALTH INSURANCE ISSUER.

1.2 Territorial scope of the insurance

The insurance is valid anywhere in the world, starting from the provincial limit of the insured person’s habitual residence. Only the guarantees 2.1.1.1, 2.1.2.1, 2.2.8 and the guarantee 2.2.2 referring to hotel expenses are not applicable in Spain, and cover the insured person’s trips abroad.

1.3 Duration Its duration is the same as that of the health care policy.

1.4 Validity to be able to benefit from the guaranteed services, the insured person must have his usual residence in Spain, habitually reside in it and the length of his stays away from this habitual residence, must not exceed 180 days consecutively per trip or journey.

2. Description of the coverage

2.1 Medical guarantees

2.1.1 Direct Medical Expenses

2.1.1.1 Medical, pharmaceutical, surgical, hospitalisation and ambulance expenses abroad HEALTH INSURANCE ISSUER will cover the medical surgical expenses, pharmaceuticals prescribed by a doctor, those of hospitalisation and ambulances that arise as a consequence of an illness or accident that takes place abroad during his trip, up to a limit of 20.000 EUR.

2.1.1.2 Emergency dental expenses

If acute dental problems such as infections, pains or traumas that require emergency treatment appear during the trip, HEALTH INSURANCE ISSUER will cover the inherent expenses for the mentioned treatment, up to a maximum of 150 EUR.

2.1.2 Indirect Costs

2.1.2.1 Extended stay in a hotel

When the previous guarantee of payment of medical expenses (2.1.1.1) is applicable HEALTH INSURANCE ISSUER will cover the expenses of the insured person’s extended stay in a hotel, after hospitalisation with written medical prescription, up to an amount of 30 EUR per day and with a maximum of 300 EUR.

2.1.2.2 Repatriation or health care transfer

In case the insured person suffers an illness or accident during his trip, HEALTH INSURANCE ISSUER will:

1. a) Cover the expenses of transport by ambulance to the nearest clinic or hospital.
2. b) Establish contact with the doctor that has attended the wounded or sick insured person, to determine the convenient measures, the best treatment to follow and the most suitable means for his eventual transfer, if necessary, to another more suitable hospital centre or to his home.
3. c) Cover the expenses of the transfer of the wounded or sick person by the most appropriate means of transport to another hospital centre or to his habitual home. If the insured person is admitted to a hospital centre that is not near his home, HEALTH INSURANCE ISSUER will cover the subsequent transfer to his home once has been discharged from hospital. The means of transport used in Europe and Mediterranean coastal countries, when the emergency and the seriousness of the case requires it, will be a special health care airplane. Otherwise, or in the rest of the world, the transfer will be made by regular airline or by the quickest and most appropriate means, according to the circumstances.

2.1.2.3 Repatriation of the deceased and his companions HEALTH INSURANCE ISSUER will deal with all the formalities required in the place of the insured person’s death and the repatriation of the body to the place of burial in Spain. If the insured deceased person travelled accompanied by other insured relatives and these could not return by the initially foreseen means or with the purchased return ticket, HEALTH INSURANCE ISSUER will pay for their transport to the place of the burial or their home in Spain.

If the relatives were the insured deceased person’s children under 15 years of age who didn’t have a relative or person of trust to accompany them on their return trip, HEALTH INSURANCE ISSUER will arrange for a person to travel with them to the place of the burial or their home in Spain. If the insured deceased person had travelled alone, HEALTH INSURANCE ISSUER will arrange the return trip for a relative to accompany the cadaver.

2.2 Other guarantees

2.2.1 Repatriation or transfer of other insured persons.

When one of the insured persons has been transferred or repatriated due to illness or accident and these circumstances also impede the return of the rest of the insured relatives to their home by the initially foreseen means, HEALTH INSURANCE ISSUER will cover the expenses corresponding to:

1. a) The transport of the remaining insured persons to the place of their habitual residence or to the place where the repatriated insured person has been hospitalised or transferred.
2. b) Arranging for a person to travel and accompany the remaining insured persons as described in point a) before, when these are the repatriated insured person’s children under 15 years of age and they do not have a relative or person of trust to accompany them on their return trip.

 2.2.2 Companion’s travel

When the insured person is hospitalised for more than five days, HEALTH INSURANCE ISSUER will arrange a return ticket for the insured person’s relative to be by his side. Also, if the hospitalisation takes place abroad, HEALTH INSURANCE ISSUER will cover the expenses of the relative’s stay in a hotel, on presenting proof of such, up to 30 EUR daily, with a maximum of 300 EUR

2.2.3 Premature return home If during a trip, when the insured person was away from his habitual home, a fire or serious catastrophe occurred, or the death of a first degree relative, HEALTH INSURANCE ISSUER will arrange for a return ticket for the insured person to return home, if this were not already covered by the insured person’s return ticket. Also, in the event that the insured person, having resolved the situation that forced him to return to his habitual home, wanted to return to where he was previously, HEALTH INSURANCE ISSUER will arrange for a ticket to such effect.

2.2.4 Delivery of medications HEALTH INSURANCE ISSUER will cover the cost of delivery of the necessary medication for the insured person’s cure if it cannot be found in the place where he is situated.

2.2.5 Telephone medical consultation

If the insured person requires medical information during his trip, he can request it by telephoning the Call Centre. Given the impossible nature of establishing a diagnosis by telephone, the information should be considered as merely indicative, without HEALTH INSURANCE ISSUER accepting any responsibility whatsoever.

2.2.6 Help in the search for lost luggage

In the event of loss of luggage, HEALTH INSURANCE ISSUER will provide support in order to request and administer the search for locating the lost luggage and, once located, will cover any delivery costs to the insured person’s home.

2.2.7 Delivery of documents If the insured person requires some documents that have been forgotten, HEALTH INSURANCE ISSUER will arrange for their delivery to the destination.

2.2.8 Legal defence expenses and advance on bail abroad When, as a consequence of a traffic accident that occurred abroad during a trip, the insured person needs to arrange his legal defence, HEALTH INSURANCE ISSUER will assume the expenses for such up to a limit of 1.500 EUR. If the insured person is not able to designate a lawyer, HEALTH INSURANCE ISSUER will do so, without accepting any responsibility whatsoever regarding the lawyer’s subsequent performance. If the competent authorities of the country in which the accident occurs required bail from the insured person, HEALTH INSURANCE ISSUER will advance this, up to a limit of 6.000 EUR.

The insured person must refund the amount of the bail advanced within the maximum term of three months starting from the date on which HEALTH INSURANCE ISSUER provided the loan. If before that term the amount had been reimbursed by the competent authorities of the country, the insured person is obliged to reimburse HEALTH INSURANCE ISSUER immediately.

2.2.9 Travel assistance When the insured person requires information about the countries that he will visit such as, for example, entrance formalities, concession of visas, currency, economic and political conditions, population, language, level of health care, etc; HEALTH INSURANCE ISSUER will provide him with this general information if requested by means of a phone call or electronic mail.

2.2.10 Transmission of messages

HEALTH INSURANCE ISSUER will take care of sending urgent messages to the insured person’s relatives due to events covered by the guarantees of the present policy.

3. Limitations of the contract

3.1 Exclusions

3.1.1 The guarantees and services that have not been requested from HEALTH INSURANCE ISSUER and which have not been made with their agreement or by them, except in cases of acts of god or those whose nature makes it impossible to demonstrate.

3.1.2 Illnesses or injuries that take place as a consequence of chronic suffering or prior to the beginning of the trip, as well as their complications or relapses.

3.1.3 Death as a result of suicide or the illnesses and injuries resulting from attempted suicide or those caused deliberately by the Insured person to himself, as well as those arising from his criminal actions, either directly or indirectly.

3.1.4 The treatment of illnesses or pathological states caused by the intentional ingestion or administration of toxins (drugs), narcotics, or by the use of medications without medical prescription.

3.1.5 The costs of prostheses, spectacles and contact lenses, births and pregnancies except for unforeseen complications during the first six months, and any type of mental illness.

3.1.6 Events due to the practice of sports in competition and the rescue of people at sea, in mountains or in deserts.

3.1.7 Any medical or pharmaceutical expenses under 10 EUR.

3.1.8 Expenses corresponding to the burial and funeral ceremony.

4. Additional dispositions

In the telephone communications requesting the services of the indicated guarantees, the following must be clearly indicated: the insured person’s name, the policy number of the health care policy or the card number, the place where he/she is situated, a contact telephone number and the type of assistance that he/she requires. Delays or non fulfilment due to acts of god or the special administrative or political characteristics of a certain country will not be dealt with. In any event, if a direct intervention were not possible, the insured person would be reimbursed the expenses he had incurred and that are guaranteed, having presented the corresponding documents justifying these, on his return to Spain or, if required, as soon as he enters a country where the previous circumstances are not occurring.

Medical services and those of health care repatriation should be made by agreement with the doctor of the hospital centre that is attending to the insured person and HEALTH INSURANCE ISSUER medical team. If the insured person were entitled to a refund for part of the unused ticket, when making use of the repatriation guarantee, this refund must revert to HEALTH INSURANCE ISSUER.

The compensations fixed in the guarantees will be in any event additional to the contracts that the insured person may have covering the same risks, the benefits from social security or of any other body. HEALTH INSURANCE ISSUER is subrogated in the rights and actions that can correspond to the insured person for facts that have motivated their intervention up to the total of the amount of the services provided.