Travel Insurance Conditions
The travel insurance conditions were developed in accordance with the legislative and normative acts of the Republic of Moldova. Insurance conditions, insurance application, insurance policy and insurance contract together with all documents signed by the Contractor, as well all the documents issued by the Insurer, are an integral part of the travel insurance contract and constitutes its legal basis.
II. DEFINITION OF BASIC TERMS
- 2.1. The Insurer is the insurance company CA “GRAWE CARAT Asigurări” SA.
- 2.2. The Contractor is the physical or legal person who signs the insurance contract with the Insurer.
- 2.3. The Insured is the physical person nominated in the insurance policy, who benefits from protection for the risks provided under the insurance conditions.
- 2.4. The Beneficiary is the Insured, and in case of death of the Insured is the natural or legal person who has directly supported the expenses or legal heirs of the Insured
- 2.5. The policy is the written document, issued by the Insurer to the Contractor, which confirms the conclusion of the insurance contract.
- 2.6. The insurance period is the period of time in which the Insurer is liable and for which the insurance premium was established and is mentioned in the insurance policy.
- 2.7. The insurance indemnity is the amount the Insurer pays according to the insurance contract after finding the insured case.
- 2.8. S. The insured sum is the maximum amount that the Insurer is obliged to pay, according to the conditions of the insurance contract.
- 2.9. The insurance premium is the amount to be paid by the insurance Contractor to the Insurer
- 2.10. The insured risk is the future event, possible, but uncertain, provided by the insurance contract, produced outside the borders of the Republic of Moldova during the insurance period of the contract.
- 2.11. The insured case consists of producing the insured risk that arises the obligation of the Insurer to pay the insurance indemnity.
- 2.12. Acute disease is a symptom that has appeared suddenly or rapidly developing which requires urgent medical intervention.
- 2.13. Body injury as a result of an accident - the damage caused to health by disturbing the anatomical integrity of the organs and tissues or their functions, caused by the action of the different external agents: mechanical, physical, chemical, biological.
- 2.14. The Insurer Assistance Office is the company indicated in the policy that insures and monitors the providing of medical assistance to the Insured, outside the borders of the Republic of Moldova.
- 2.15. The information obligation concerns the circumstances that the Contractor knows or should know and which are the subject of questions asked in writing by the Insurer
- 2.16. The aggravation of the risk constitutes the modification of the relevant circumstances that were the subject of the questions included in the insurance application.
III. CONCLUDING OF THE CONTRACT
- 3.1. The insurance contract is concluded in written form.
- 3.2. For the conclusion of the insurance contract, the insurance applicant submits to the Insurer a written application regarding his interest in insurance.
- 3.3. At the conclusion of the insurance contract, the applicant is obliged to inform the Insurer about the circumstances relevant to the risk assessment that he knows or should know and which are the subject of the questions included in the insurance application.
- 3.4. The Insurer may request additional information relevant to the risk assessment.
IV. SUBJECTS OF INSURANCE
- 4.1. Insurance Company „Grawe Carat Asigurări” SA, as an Insurer, signs health insurance contracts for travellers outside the borders of the Republic of Moldova.
- 4.2. In the insurance contract, legal persons and physical persons can act as Contractor, having the legal address or residency in the Republic of Moldova.
- 4.3. The Contractor has the right to conclude the insurance contract for the benefit of third parties (Insured). According to these Conditions, as an Insured can be only physical persons.
- 4.4. Within the family tariff, up to 2 adults and 5 minor children up to 16 years old can be insured (regardless of the degree of kinship), but at least 3 persons.
V. OBJECT OF INSURANCE
The object of the insurance represents the patrimonial interests related to the unforeseen and necessary expenses as a result of an acute illness or personal injury following an accident and the death following these events, on the conditions that the risks are produced and the expenses incurred outside the borders of the Republic of Moldova.
VI. INSURED RISKS
- 6.1. Under these conditions, the following risks are insured:
- 6.1.1. sudden acute illness
- 6.1.2. bodily injury following as a result of an accident
- 6.1.3. death as a result of an acute illness or accident
- 6.1.4. illness caused by coronavirus SARS-Cov-2 (COVID-19) (valid only when applying the coefficient established according to the tariff).
- 6.2. The auxiliary insured risk produced on the date of the trip, but not earlier than the beginning of the insurance period, is the cancellation of the trip for the following reasons:
- 6.2.1. bodily injury resulting from an accident or acute illness requiring hospitalization, as well as the death of the Insured or his family members (husband, wife, mother, father, son, daughter, brother, sister).
- 6.2.2. causing damage to property of the Insured as a result of fire, explosion, natural calamities (floods, landslides, earthquakes), as well as the premeditated cause of damage of property of the Insured by third parties, after which his presence is necessary to investigate the circumstances of the case.
- 6.2.3. unforeseen procedural judicial action, in which the Insured must participate according to the summons of the competent body.
- 6.2.4. illness caused by coronavirus infection SARS-Cov-2 (COVID-19) or quarantine of the Insured (according to the instructions of the authorities, presenting the official document issued by the authorities) or illness caused by coronavirus infection SARS-Cov-2 (COVID-19) of the family member of the Insured (husband, wife, mother, father, son, daughter, brother, sister) who has a life-threatening condition and need intensive care in a medical institution (valid only when applying the coefficient established according to the tariff).
VII. EXPENSES COVERED BY THE INSURER
- 7.1.In case of acute illness or bodily injury as a result of an accident, the following healthcare services and additional services are organized and paid:
- - transporting the Insured to the nearest doctor or hospital;
- - the medical examination necessary to establish or confirm the diagnosis;
- - outpatient treatment;
- - medicines and medical supplies prescribed by the doctor, with the exception of prostheses;
- - hospitalization in authorized medical institutions until the health status of the Insured allows his return for the continuation of treatment in the Republic of Moldova;
- - emergency surgery;
- - transporting of the Insured to the nearest hospital at the airport in the Republic of Moldova if the attending physician decides in agreement with the Insurer's Assistance Office that the health status of the Insured allows him to return even as a regular passenger or if special means and accompanying are required;
- - the costs for the person accompanying the Insured to the Republic of Moldova, which include the cost of the return ticket in economy class and the accommodation expenses abroad of up to 200 EUR per day, for a maximum of 5 days;
- - emergency dental treatment up to 500 EUR (for examination expenses, emergency treatment and the cost of medicines, in case of acute inflammation of the tooth and surrounding tissues, as well as in the case of tooth trauma following an accident), once for the entire duration of the insurance contract;
- 7.2. In case of death due to acute illness or accident, are organized and paid the following expenses and services:
- - necessary medical care, if it was provided;
- - the services for the morgue and the coffin that correspond to the requirements of international transport;
- - repatriation of the body in the Republic of Moldova is covered within the limit of 3.000 EUR from CIS countries, 5.000 EUR from Europe and 10.000 EUR from other countries;
- - transportation of the body and the burial of the insured outside the borders of the Republic of Moldova (within the limit of the expenses of repatriation of the body in the Republic of Moldova).
- In the case of the death of the Insured, the expenses mentioned in this subpoint are reimbursed to the physical or legal persons who directly incurred this expenses, or to the legal heirs of the Insured, based on the supporting documents.
- 7.3. In case of the insured risk of trip cancellation, the expenses incurred within the limit of 1.000 EUR are covered.
VIII. UNINSURED RISKS8.1. Are not insured the following risks related to or caused directly or indirectly by:
- - Military actions, establishing the state of war or the exceptional situation, mass disorder, terrorist acts;
- - Explosion or action of atomic or nuclear energy, chemical, biological, radioactive, toxic or explosive contamination or other dangerous components;
- - Natural disasters, epidemics and pandemics, except for the disease caused by coronavirus SARS-Cov-2 (COVID-19), declared a pandemic by the World Health Organization on 11 March 2020 (valid only when applying the coefficient established according to the tariff).
- - Risks due to SARS Cov-2 (COVID-19) are not insured:
- If the trip takes place in the countries / areas for which the authorities have issued travel alerts (according to the official communiqués of the authorities);
- Results of the Insured's fear of traveling;
- Results of the Insured's non-compliance with the norms and regulations imposed in the destination area;
- Results of negligence or deliberate infection of the Insured.
- - Actions of the Insured caused intentionally or negligently;
- - Illegal actions of the Insured;
- - Claims for compensation made on the basis of statements not in conformity with reality;
- - Consumption of alcohol, drugs and / or substances that caused the drunkenness (alcohol concentration from 0.8 g/l in blood and / or 0.4 mg/l in exhaled air), except when drunkenness or the actions of the Insured did not influence the production of the insured risk;
- - Attempted suicide and suicide;
- - Driving the vehicle or aircraft without a driver’s license / pilot license;
- - Involvement of the Insured in aviation other than as an air passenger operated by a company authorized to carry persons;
- - Operation of flying equipment and accessories (parachuting, gliding, hang gliding, paragliding, etc.);
- - Participation in trainings and competitions with the use of motor vehicles;
- - Practicing extreme sports, such as: mountaineering, extreme mountain excursions without a patented alpine guide, sports activities in the wild waters, aquatic diving without having a certificate of aptitude (qualification for the appropriate depth);
- - Travel to countries where they are not recommended by the competent authorities;
- - Non-compliance with precautionary measures in order to avoid the occurrence of the insured risk;
- - Insured’s trip contrary to the recommendations of doctors;
- - Activities that do not correspond to the purpose of the trip declared to the Insurer
IX. EXPENSES NOT COVERED BY THE INSURER
9.1 Expenditure are not covered for:
- - treatment which is the purpose of the trip;
- - the existing illnesses of the Insured before the travel date (the restriction is not valid, if the medical assistance was necessary to save the life, to prevent a long-term inability to work or to eliminate acute pain);
- - mental, neurological, oncological diseases and their aggravations, congenital and hereditary pathologies;
- - the treatment of infectious diseases in the countries, at the border crossing where vaccinations are required;
- - birth after 26 weeks of pregnancy, abortion, pregnancy monitoring and treatment of its complications, except for extra uterine pregnancy or in cases where termination of pregnancy or treatment is necessary to save the life of the Insured;
- - treatment that goes beyond the necessary medical care and / or is not confirmed by the documents;
- - cosmetic and plastic prosthetic surgeries;
- - medical examinations, treatments, medicines and other medical services that are not related to acute illness or bodily injury;
- - medical examinations, treatments, medicines and other medical services not prescribed by the physician;
- - physiotherapy, rehabilitation and non-traditional medicine services, vaccinations, prophylactic medical examinations, disinfections, medical expertise;
- - spa treatment, psychoanalytic and psychotherapeutic treatment;
- - medical examinations, treatments, diagnoses that are not scientifically recognized and / or performed by persons who do not have a medical practice authorization;
- - cosmetic dental treatments, dental implants, dental appliances, prostheses, etc.;
- - prescribing glasses and contact lenses;
- - diagnosis and treatment of immunodeficiency syndrome (HIV), AIDS, AIDS-related diseases, venereal diseases, alcoholism, drug addiction;
- - the transport of the Insured, when acute illness or bodily injury as a result of an accident could be treated locally and would not prevent the Insured journey from continuing;
- - the cases in which the Insured refuses to return to the country of permanent residence, although, in the opinion of the physician, it is possible to repatriate and the health of the Insured has improved, then the expenses for the subsequent treatment and the subsequent return are not compensated;
- - the test for SARS-Cov-2 (COVID-19) performed as a mandatory requirement to enter a specific country
- - related to risks that are not provided for in the Insurance Contract
X. INSURANCE TERRITORIALITY
The insurance is valid outside the borders of the Republic of Moldova, according to the destination mentioned in the insurance policy. The insurance is not valid in the country in which the Insured is resident, except when Insured have dual citizenship – of the Republic of Moldova and Romania. In this case, are covered including the insured risks produced on the territory of Romania.
XI. INSURANCE PERIOD
- 11.1. The insurance contract is concluded for the period of the Insured’s stay over the borders of the Republic of Moldova, for a minimum of 2 days and at most one year.
- 11.2. If the insurance contract provides for several trips abroad of the Insured, during the insurance period, then the Insurer is liable only within a certain number of days specified in the insurance policy. On each trip with the destination stipulated in the insurance contract, the number of days mentioned in the policy decreases with the number of days of actual stay over the borders of the Republic of Moldova.
- 11.3. The contract takes effect from the date and time indicated in the insurance policy, but not before the passing of the borders of the Republic of Moldova and the payment by the Contractor of the insurance premium for the entire insurance period, except for the waiting period of 3 working days. In case of payment by the Contractor of the insurance premium during the waiting period, the insurance period will start to run only from the moment the insurance premium has been paid.
- 11.4. If at the time of expiration of the Insurance Contract, the return of the Insured from abroad is not possible due to the occurrence of an insured risk, a fact confirmed by an appropriate medical document, then the Insurer’s obligations are kept maximum 60 days after the expiry date of the Contract within the limit of the insured sum.
XII. INSURANCE PREMIUM
- 12.1. The insurance premium is established by the Insurer in accordance with the approved insurance tariffs, the size of the premium being stipulated in the insurance policy.
- 12.2. The insurance premium is paid in full by the Contractor on the date of conclusion of the contract for the entire insurance period. Payment can be made by transfer or in cash.
XIII. INSURANCE SUM
- 13.1. The insured sum is calculated according to the destination and the type of chosen tariff.
- 13.2. The insured sum in the case of the individual tariff is established for one insured.
- 13.3. The insured sum in the case of the family tariff is unique and established for all Insured mentioned in the insurance policy.
Deductible is not applicable to travel health insurance contracts.
XV. ACTIONS OF THE PARTIES IN CASE OF INSURED RISK
- 15.1.When producing the insured risk, the Insured must promptly contact the Insurer's Assistance Office, to the telephone number mentioned in the insurance policy and inform the operator what happened, indicating the data in his insurance policy
- 15.2. After addressing, the Insurer's Assistance Office organizes the Insured to provide medical services, transport services and other necessary services stipulated in the insurance contract.
- 15.3. If until the consulting a doctor or transported to the clinic, calling the Insurer's Assistance Office is not possible, the Insured must call the Office at the first opportunity.
- 15.4. In case of hospitalization or addressing to the doctor, the Insured must present the insurance policy to the medical personnel.
- 15.5 . If contacting the Insurer's Assistance Office is not possible, the Insured can contact the nearest medical institution, presenting the insurance policy.
- 15.6. If the Insured has borne the expenses related to the insured risk on his own account, then, upon his return from abroad, he must declare to the Insurer in writing about what happened.
- 15.7. In case of any insured risk, the following documents will be presented:
- 15.7.1. The request to compensate the expenses related to the insured risk, arguing the reasons for not addressing to the Insurer's Assistance Office to organize the necessary medical assistance, where appropriate;
- 15.7.2. The insurance policy and the proof of payment of the insurance premium;
- 15.7.3. Identity documents and confirmatory documents regarding the proof of the border crossing;
- 15.7.4 . The original of all the documents issued by the medical institutions (on the header form or with the corresponding stamp), indicating the patient's name, diagnosis, date of address for medical assistance, duration of treatment; references for carrying out laboratory analyzes and treatment indications; recipes where appropriate;
- 15.7.5. Invoices and receipts for medical expenses, including those for pharmaceuticals and the fiscal receipt for the purchase of medicines; in the case of dental treatment, the invoices must contain information about the diagnosis, the treatment applied and the treated teeth;
- 15.7.6. Other documents relevant to the settlement of the claim regarding the circumstances of the production of the insured risk.
- 15.8. In case of repatriation of the Insured body of the Insured in the Republic of Moldova or the transport of the body and the burial outside the Republic of Moldova, will be presented the death certificate of the Insured and documents proving the cause, the place of death and proof of the expenses for which the application for compensation has been filed.
- 15.9. In case of cancellation of the trip, the documents proving the cancellation of the trip will be presented for the reasons mentioned in points 6.2.1, 6.2.2, 6.2.3.
- 15.10. The documents must be presented to the Insurer within 30 (thirty) calendar days from the date of the insurance risk occurring or from the date of the Insured ’ s return to the Republic of Moldova.
- 15.11. The Insurer completes the investigations regarding the production of the insured risk and determines the amount of the insurance indemnity within 1 month from the date of receipt of the claim or informs in writing about the reasons for rejecting the claim.
- 15.12. In the event of the impossibility of ascertaining the circumstances of producing the insured risk and the extent of the Insurer's obligation, including due to the necessity of presenting documents or conducting an investigation, the Insurer postpones the examination of the application and sends a written notification of the reasons for the postponement.
- 15.13 . Payment of the insurance indemnity for the expenses incurred shall be made within one week of finding the insured case and issuing the decision to pay the insurance indemnity
XVI. REFUSAL TO PAY THE INSURANCE COMPENSATION
16.1. The Insurer has the right to refuse totally or partially the payment of the insurance indemnity for the uninsured risks and the expenses not covered, stipulated in points 8 and 9 of these Conditions, as well as in the cases in which:
- 16.1.1. The information obligation was breached at the conclusion of the contract, and the Insurer proves that he would not have concluded the insurance contract if he knew that information.
- 16.1.2. When producing the insured risk, the Insurer was intentionally provided with false information and statements and or concealed documents relevant to the insured risk.
- 16.1.3. The Insurer is not presented with the documents referred to in point 15.7 of these Conditions, which is why it is impossible to determine the causes and circumstances of producing the insured risk and the extent of the obligations.
XVII. RIGHTS AND OBLIGATIONS OF THE PARTIES
- 17.1. The Contractor is entitled:
- 17.1.1. to receive information on travel health insurance at the conclusion of the contract and during it;
- 17.1.2. to request the modification or termination of the contract according to these insurance conditions.
- 17.2. The Insured is entitled:
- 17.2.1. to be compensated for the expenses incurred as a result of the production of the insured case.
- 17.3. The Insurer is entitled:
- 17.3.1. to verify the information presented by the Contractor at the conclusion of the contract;
- 17.3.2. to request all the information necessary to establish the circumstances of the production of the insured risk, of the expenses incurred in order to evaluate the amount of the insurance indemnity;
- 17.3.3. to request from the authorities documents and information on the facts, circumstances and causes of the occurrence of the insured risk;
- 17.3.4. to propose the modification of the contract in case of breach of the information obligation at the conclusion of the insurance contract or in case of aggravation of the risk;
- 17.3.5. to declare the resolution of the insurance contract within one month if it finds that at the conclusion of the contract the information obligation was breached, and the Insurer would not have concluded the insurance contract if he knew that information, with one-month notice;
- 17.3.6. to compensate from the account of the insurance indemnity due insurance premiums and the other amounts due under the insurance contract;
- 17.3.7. in the case of multiple insurances, to submit a request for recourse for the proportional recovery of the paid insurance indemnity.
- 17.4. The Contractor is obliged:
- 17.4.1. to give correct and complete answers in the documents drawn up at the conclusion of the contract or subsequently requested by the Insurer;
- 17.4.2. to pay the insurance premium in the amount and term provided in the insurance contract.
- 17.5. The Insured is obliged:
- 17.5.1. to comply with the procedure and the deadline for announcing the insured risk and the instructions of the Insurer Assistance Office;
- 17.5.2. to observe and take all precautionary measures in order to avoid the occurrence of the insured risk;
- 17.5.3. to limit the consequences of the risk and avoid unnecessary expenses;
- 17.5.4. to request and accept medical treatment as soon as possible and to follow the doctor’s prescriptions;
- 17.5.5. to inform the Insurer about the existence of other insurance contracts concluded with other insurers for the same risks;
- 17.5.6. to provide all the information and documents requested by the Insurer in the state language and to facilitate investigations regarding the circumstances of producing the insured risk and the expenses incurred
- 17.6. The Insurer is obliged:
- 17.6.1. To inform the insurance Contractor about the conditions and clauses of the travel health insurance contract;
- 17.6.2. To ensure the fulfillment of the obligations assumed under the insurance contract;
- 17.6.3. To ensure the confidentiality of the data obtained in connection with the conclusion and execution of the insurance contract.
XVII. MODIFICATION AND TERMINATION OF THE INSURANCE CONTRACT
- 18.1. The modification of the insurance contract is made by the written agreement of the parties.
- 18.2. The resolution of the insurance contract can be declared at the initiative of either party, by submitting a written notification.
- 18.3. In the case of insurance resolution, the Insurer returns the insurance premium for the remaining period until the contract expires, with the retention of management expenses amounting to 25% of the amount to be refunded. The reimbursement of the insurance premiums provided above is made only in cases where no insurance payments have been paid or due.
- 18.4. In case the Contractor, for objective reasons (illness, accident, inability to obtain the travel visa or force majeure), requests the termination of the contract until the beginning of the insurance period, the Insurer returns the insurance premium to the Contractor, being entitled to deduct the administration tax according to the insurance tariff.
- 18.5. The insurance contract ends in the following cases:
- 18.5.1. Upon the fulfillment by the Insurer, of its obligations under the Contract – the payment of the insurance indemnities in the amount of the insured sum;
- 18.5.2. At 24:00 on the last day of the insurance period;
- 18.5.3. Other cases accepted by the parties or provided by law
- 18.6. The insurance contract ends by termination.
XIX. SETTLEMENT OF DISPUTES
- 19.1. Misunderstandings between the parties during the validity of the insurance contract concluded in accordance with these conditions, or that derive from this contract, will be resolved amicably.
- 19.2 Any amicably unresolved disputes will be resolved by the competent courts of the Republic of Moldova.
- 19.3. These conditions are approved and notified to the supervisory authority in the state language. In case of discrepancies between the versions translated into other languages, the version in the state language prevails.