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Magellan - PDF

VIEWS: 8 PAGES: 15

									                                                        [ La Mobilité ] Individuals




                            General conditions 2008
                            Magellan   [ Insurance solutions ] for short-term expatriates




                                                                                            APRIL Mobilité Ma 2008
                            Personal insurance for
                            short-term expatriates
                            up to age 75



Printed on recycled paper
                                                                                                                                        Magellan
                                                                                                                                        2008

General Conditions
Booklet - To be retained by the insured




                  1. Purpose of the insurance                                                                                          3

                  2. Eligibility requirements                                                                                          3

                  3. Start date, duration and cancellation of the policy                                                               3
                  3.1   Start date of membership and cover                                                                             3
                  3.2   Duration of cover                                                                                              4
                  3.3   Termination of cover                                                                                           4
                  3.4   Cancellation                                                                                                   4

                  4. Premiums                                                                                                          4

                  5. Cover and payment of benefits                                                                                     4
                  5.1   Medical expenses                                                                                               4
                  5.2   Repatriation assistance                                                                                        6
                  5.3   Counselling                                                                                                    9
                  5.4   Personal liability                                                                                             9
                  5.5   Legal cover                                                                                                   10
                  5.6   Personal accident                                                                                             10
                  5.7   Baggage                                                                                                       11

                  6. Exclusions common to all cover                                                                                   12

                  7. General conditions                                                                                               12
                  7.1   Limitation                                                                                                    12
                  7.2   Subrogation                                                                                                   12
                  7.3   Audit                                                                                                         13
                  7.4   Conciliation/Jurisdiction                                                                                     13
                  7.5   Data Protection and Freedom of Information                                                                    13
                  7.6   Glossary                                                                                                      13
                  7.7   Emergency contact numbers                                                                                     14




                 Remarque
                  The original version of this document is in French. In the event of a dispute, the French version shall prevail over any
                  translation into other languages.




2
                                                                                                                                  Magellan
                                                                                                                                  2008

General Conditions                                                                                                                           Booklet
                                                                                                                      To be retained by the insured


This policy is effected by the Association of APRIL Insured (regulated        1. Purpose of the insurance
by the Associations Act of 1901) located at 114, boulevard Marius Vivier
Merle, 69439 Lyon Cedex 03, FRANCE, whose purpose is to study, effect         Membership of these plans guarantees the Insured the following cover:
and promote, to the benefit of its Members, all types of group insurance
authorised under French law, the risk being insured by certified insurance    -   Medical expenses;
companies regulated either by the Insurance Code, the Mutuality Code          -   Counselling;
or the Social Security Code.                                                  -   Personal liability;
                                                                              -   Death or total or partial permanent Disability due to Accident;
For Medical expenses:                                                         -   Repatriation assistance;
an optional group insurance plan with Gan Eurocourtage Vie (number            -   Loss, theft or destruction of baggage.
219/936 265), a French endowment life insurance company regulated
by the French Insurance Code. A public limited company with fully paid
capital of 5 51,695,640 registered with Companies House in Paris under
number 340 427 525 (APE code: 660A), located at 8-10, rue d'Astorg,           2. Eligibility requirements
75383 Paris Cedex 8, FRANCE;
                                                                              To be eligible for insurance, each applicant must:
For Personal liability, Personal accident, Baggage insurance and              - be a member of the Association of APRIL Insured;
Legal cover:                                                                  - be under 75 years of age;
an optional group insurance plan with Gan Eurocourtage IARD (number            - be temporarily outside France or the French Overseas Territories, and
GCRV000004), a French property and casualty insurance and reinsurance            outside their country of origin for study, work experience, pleasure,
company regulated by the French Insurance Code.                                  business or private visits, for a minimum of 15 days and a maximum
A public limited company with fully paid capital of 5 8,055,564, registered      of 12 months. The insurance is renewable only once on agreement
with Companies House in Paris under number 410 332 738 (APE code:                with the insurer (if option 2 is selected, the maximum period of cover
660E) and located at 8-10, rue d’Astorg, 75383 Paris Cedex 8, FRANCE;            is 3 months and cannot be renewed);
                                                                              - have completed and signed the Application form;
For Repatriation assistance:                                                  - have completed and signed the health questionnaire no more
an assistance plan with Inter Partner Assistance, part of the AXA                than three months before the desired Start date;
Assistance Group (number 0800243*02). Headquarters: 166, avenue               - not be affected by any incapacity or Disability, nor be under treatment
Louise, 1050 Brussels, BELGIUM. A public limited company regulated               for any illness, nor be liable to suffer a recurrence or progression of
by Belgian law with capital of 5 8,396,373. RCB/HRB 394 025 Insurance            any illness;
company registered under the number 0487.                                     - not have undergone any recent medical treatment, nor be planning
French branch located at 6, rue André Gide, 92320 Châtillon, FRANCE.             any treatment in the country he or she is visiting.
Registered with Companies House in Nanterre under number
316 139 500.                                                                  Membership is subject to medical approval by APRIL Mobilité who
                                                                              reserves the right to request additional medical information based on
The administration of these plans has been delegated to APRIL Mobilité,       the responses given in the health questionnaire. If the applicant presents
an insurance broker and administration company registered with                an aggravated risk, APRIL Mobilité can either accept them under special
Companies House in Paris under number B 309 707 727, and with ORIAS           conditions or reject the application.
under number 07 008 000 (www.orias.fr) located at 110, avenue de
la République, 75011 Paris, FRANCE.                                           Membership is formalised by the issuing of a Membership certificate
                                                                              stating the value of the cover and the Start date.
The bodies responsible for regulating insurance activities are:
- For insurance plans: Regulatory body for Insurance Activities and           Due to heightened tension there, certain countries may be excluded
  Mutual Institutions (ACAM), located at 6, rue Taitbout, 75436 Paris         from cover. The list of excluded countries may vary. This list is
  Cedex 09, FRANCE.                                                           available online at www.aprilmobilite.com or may be requested
- For the assistance plan: Commission for Banking, Finance and Insurance      by calling: + 33 (0)1 73 02 93 93.
  (CBFA) located at 12-14, rue du Congrès, 1000 Brussels, BELGIUM.

These plans are regulated by the French Insurance Code, these General
conditions and the Membership certificates issued to Members.                 3. Start date, duration and cancellation of the
                                                                                 policy
APRIL Mobilité also provides insured persons with “Counselling”services
offered by PSYA, a company registered with Companies House in
Nanterre under number 414 510 024 located at 69, rue Lafayette, 75009         3.1 Start date of membership and cover
Paris, FRANCE.
                                                                              On the date shown on the Membership certificate and at the earliest
                                                                              on the day after APRIL Mobilité receives the Application form (including
                                                                              the Application form and the health questionnaire, both completed
                                                                              and signed), subject to the suspensory condition of payment of the
                                                                              whole Premium due and to acceptance by APRIL Mobilité in the
                                                                              form of an issued Membership certificate summarising the selected
                                                                              cover and the amounts insured for each risk covered.




3
                                                                                                                                                                                                                       Magellan
                                                                                                                                                                                                                       2008

General Conditions                                                                                                                                                                                             Booklet
                                                                                                                                                                                        To be retained by the insured


Cover is acquired for the entire duration of the main stay abroad,             3.4 Cancellation
outside the country of origin, and outside France and the French Over-
seas Departments (cover is acquired in France and in the French Overseas       Signing the application form does not constitute a binding agreement
Departments for periods of less than 90 consecutive days between two           for the Member who can cancel the policy within 30 calendar days of
stays in the country of destination), in a private capacity only.              receipt of the Membership certificate.
                                                                               A letter, worded as follows, should be sent by recorded delivery with
Waiting period:                                                                proof of receipt to APRIL Mobilité, 110 avenue de la République,
- None in the event of an accident;                                            75011 Paris, FRANCE:
- Other cases: 8 days.
                                                                               « «I, the undersigned............................................................................(first name, surname, address)
Waiting period shall apply from the Start date shown on the                    wish to cancel my Magellan policy number.................................................................................
Membership certificate.                                                        which I signed on............................................................ at..................................................................................................... (place).
                                                                               Signed at ..........................................................at......................................................signature........................................................ »
The insurer shall be responsible only for expenses incurred as a
result of stipulated actions on or after the Start date of cover.              The cancellation is backdated so that the policy is considered never to
                                                                               have existed. The insurer will then make a full refund of the premium
                                                                               within 30 calendar days of receipt of the registered letter.
3.2 Duration of cover

Cover is acquired for a minimum period of 15 days and a maximum
period of twelve months. The contract is renewable only once at the            4. Premiums
Member’s request and on approval by APRIL Mobilité.
If option 2 is selected, the maximum period of cover is 3 months and           The premium may be increased from 1st January of each year, depending
cannot be renewed.                                                             on the claims history of the policy.The composition of the group takes
The maximum duration of cover is two years.                                    into account the age, the length of the stay and the degree and
Cover ends in all cases on the day of final return to the country of origin,   types of cover selected.
and at the latest, on the last day stated on the Membership certificate.       The Premium is payable either in advance in euros or by monthly
                                                                               instalments depending on the method of payment selected.
                                                                               If payment cannot be made in euros, the Member must make a bank
3.3 Termination of cover                                                       transfer to the account indicated by APRIL Mobilité. Bank charges for
                                                                               this transfer will be paid by the Member.
Cover under the policy ends:
                                                                               If the premium remains unpaid 10 days after its due date, APRIL Mobilité
a) if the Premium is not paid;
                                                                               will serve formal notice with suspension of cover 30 days later. The policy
b) if the agreement is cancelled by the Association or the insurer at
                                                                               will be terminated 10 days after the expiry of this 30-day period. Legal
   the annual renewal date (in which case, the Association will inform
                                                                               action may be taken to secure payment of any unpaid premiums. Once
   the Members);
                                                                               formal notice has been served, the premium due for the entire period
c) once the Insured ceases to meet the Membership conditions out-
                                                                               of cover is immediately payable under the French Insurance Code.
   lined in Article 2;
                                                                               If the amount stated on the letter of formal notice is paid after suspen-
d) on the day of final return to the country of origin, and at the
                                                                               sion of the policy but before termination, the policy will be revived at
   latest, on the last day stated on the Membership certificate.
                                                                               noon on the day after the premium is paid.
If the contract is terminated by the insurer or the Association under          If travel is cancelled, the Premium will be reimbursed, excluding mem-
the conditions listed in paragraph c) above, the insurer will, at the Insu-    bership fees, as long as APRIL Mobilité has received notice of this before
red’s request, continue to provide Medical expenses cover equivalent           the Start date of cover and the original Membership certificates have
to the cover in place on the cancellation date on payment of a Pre-            been returned and, if applicable, as long as the APRIL Mobilité card has
mium indicated by the insurer.                                                 been returned if option 1 is selected. In the event of a trip being cut
                                                                               short, there will be no reimbursement of the Premium.
Penalties for false declarations
Any inaccuracy, omission, concealment or false declaration,
intentional or not, on the part of the Insured having a bearing
on the nature or level of the risk at the time of application or during        5. Cover and payment of benefits
the period of membership will result in a reduction of the benefits
or cancellation of membership even if the risk that the Insured                5.1 Medical expenses
concealed or distorted has had no impact on the loss.
Any omission, concealment, false declaration, intentional or not,              5.1.1 Type and level of reimbursements
in making a Claim, failure to declare other concurrent insurance               Reimbursement is guaranteed for all medical expenses for treatments
cover, the submission of inaccurate supporting documentation                   listed in the benefits schedule prescribed by a qualified medical authority
or the use of any fraudulent means puts the Insured or the                     and covered by French Social security.
Beneficiary at risk of withdrawal of cover and the Cancellation of             For treatment dispensed in France, the conditions required for cover
membership.                                                                    to take effect are those defined in the general schedule of professional
                                                                               procedures of French Social security or the common classification of
                                                                               medical procedures or by any other similar body.




4
                                                                                                                                                    Magellan
                                                                                                                                                    2008

General Conditions                                                                                                                                             Booklet
                                                                                                                                        To be retained by the insured


The reimbursement of all medical expenses is guaranteed up to the                             In France and in the country of origin:
limit of actual costs, up to the overall limit indicated in the benefits                      During a temporary return to France or the country of origin (maximum
schedule, and up to contractual limits.                                                       90 days), between two periods abroad, the same procedures are cove-
The maximum reimbursement made by the insurer under Medical                                   red up to a limit of 100% of the basic reimbursement rate of French
expenses cover is 5 200,000 per Membership year per Insured.                                  Social security and with the upper limits mentioned on the pre-
During stays of up to 3 months the Insured can opt for reimburse-                             vious page.This cover complements any benefits that the Insured
ments as a top-up to French Social security. In this case he or she                           may receive from Social security and/or any private health insu-
must provide APRIL Mobilité with proof that he or she has recei-                              rance plans within the limits outlined in the chapter on double
ved reimbursements from the French state scheme.                                              insurance.



Medical expenses benefits schedule:

                                                                                                           Option 1:                             Option 2:
                                                                                                 reimbursement from the first          reimbursement as a top-up to
    Abroad:                                                                                       euro spent as a percentage         the French Social security scheme
                                                                                                        of actual réels                 (for stays of up to 3 months)

    Medical expenses                                                                                              up to 5 200,000 per Membership year

    Third party payment see definition during approved hospitalisation for 24 hours or more        provided on request 24 hours a day (unless you selected option 2)

    Hospitalisation                                                                                    100% of actual costs

    Daily hospital fee                                                                                 100% of actual costs

    Private room                                                                                        up to 5 50 per day

                                                                                                      95% of actual costs                Reimbursement as a top-up
    Consultations and visits to general practitioners or specialists                                                                     to the French Social security
                                                                                                    up to 5 80 per procedure
                                                                                                                                     scheme with the same percentages
    Radiography, diagnostic test, drugs, nursing and specialist procedures                             95% of actual costs             of reimbursement and the same
                                                                                                                                          upper limits as in Option 1.
    Physiotherapy                                                                                      100% of actual costs
    (following hospitalisation paid for directly by APRIL Mobilité)                                   up to 5 50 per session

    Optical and dental care, except for dental prostheses                                              100% of actual costs
    (following a Reported accident only)                                                         up to 5 350 per person per year

    Contraceptives (condoms)                                                                           up to 5 20 per year                   up to 5 20 per year




5.1.2 Payment of benefits                                                                       treatment was given as a direct consequence of a Reported accident,
                                                                                                as defined in the Glossary.
Option 1: reimbursement from the first euro spent as a percentage
of actual costs.                                                                              Pre-payment agreement:
In order to qualify, claims for the reimbursement of medical expenses                         To obtain the reimbursement of procedures and courses of treatment
(forms available online at www.aprilmobilite.com or by calling                                (physiotherapy following hospitalisation for surgery covered under the
+33 (0)1 73 02 93 93) must reach APRIL Mobilité within three months                           policy etc.) you must request a pre-payment agreement.This form is available
of the date of treatment, accompanied by the following:                                       online at www.aprilmobilite.com or by calling +33 (0)173 02 93 93.You must
                                                                                              also have received authorisation from the medical examiner.
- the original copies of medical bills, fees and prescriptions, paid
  and dated, and mentioning the name and surname of the patient,                              Option 2: reimbursement as a top-up to French Social security.
  the type of illness, and the nature and date of visits and treatments                       To qualify for reimbursement, all healthcare claims must be sent
  received. Prescriptions must clearly state the name and price of                            no more than 3 months after the date of treatment.
  the drug, and indicate the local currency;                                                  The claim must first be sent to the Social security agency. The Insu-
- if treatment was dispensed in France, the Member must attach the                            red should then send his or her Social security reimbursement advice
  original of the form he or she was given by the doctor (“Feuille de                         note to APRIL Mobilité - 110, avenue de la République - 75011 Paris -
  Soins”), prescriptions and pharmaceuticals labels, and any                                  FRANCE to claim his or her top-up payment. April Mobilité may at
  reimbursement advice notes received from other organisations,                               any time request proof of expenditure particularly in the case of hos-
  along with his or her Member reference number;                                              pitalisation or when the Insured or the Beneficiary has been accep-
- for reimbursement of procedures carried out by medical auxiliaries,                         ted under special conditions.
  dental care and optical costs, the Insured must attach proof that the                       Photocopies of the following supporting documentation should be




5
                                                                                                                                 Magellan
                                                                                                                                 2008

General Conditions                                                                                                                          Booklet
                                                                                                                     To be retained by the insured


sent directly to APRILMobilité:                                              - all fertility-related treatments;
- any agreement to cover courses of treatment and dentures;                  - psychotherapy, psychoanalysis, treatments for mental illness,
- optician’s invoice;                                                          depression, nervous disorders, and acupuncture;
- hospital invoice.                                                          - vaccinations, dermatology, medical check-ups and the consequen-
                                                                               ces of tropical diseases;
When claiming for the reimbursement of physiotherapy the Insured             - costs that could have been incurred when the Insured returned
should enclose, with the pre-payment request, proof that the treatment         to his or her country of origin;
followed surgery which was covered by APRIL Mobilité.                        - related costs, such as telephone charges, in the event of Hospita-
                                                                               lisation, or costs deemed excessive, unreasonable or unusual in
The insurer reserves the right to require any other proof he may               the country where they were incurred;
deem necessary.                                                              - Hospitalisation or stay in an establishment not approved by the
                                                                               competent public authority in the country where such care was
In the event of a dispute over the amount of the settlement, the Member        provided;
must notify APRIL Mobilité to this effect within three months of the         - transportation costs other than an ambulance to the closest,
date on the reimbursement advice note. No claim will be accepted after         appropriate medical centre;
this date.                                                                   - supplies that are not indispensable to the diagnosis or treatment
                                                                               of the illness;
The Insured can be reimbursed:                                               - dental care, optical costs, and medical auxiliaries services that do
- by cheque in euros sent to the address of his or her choice. He or she       not follow a Reported accident;
  will have no bank charges to pay. In this case, please send us details     - medical treatment in hospital or a stay in a sanatorium or home
  of his or her bank account;                                                  if these establishments are not approved by the competent public
- by bank transfer to a bank account in France;                                authority;
- by cheque in US dollars only if he or she reside in the United States.     - claims for costs incurred in hospitals or clinics which are not
  He or she will pay bank charges on any payment over 5 75;                    covered by Social security will be limited to the equivalent Social
- by bank charges to a foreign account in any country and in any currency.     security rate.
  International bank details are required including the IBAN number,
  SWIFT code, his or her bank’s address, routing number or sort code and
  an ABA routing number for the US. Please specify his or her choice of      Double Insurance:
  currency. He or she will pay bank charges on any payment over 5 75.        Reimbursements received from any National Health Service scheme,
                                                                             from the insurer and from any other organisation cannot be higher
Reimbursements will only be made if the above procedures are                 than the amount of expenses actually incurred.
followed.                                                                    Double insurance operates within the limits of each type of
                                                                             cover regardless of the date of commencement of cover. Within
5.1.3 Direct payment of hospital fees                                        these limits the Insured can claim reimbursement from the provider
Expenses incurred for treatments covered under this policy, particularly     of his choice.
those related to Hospitalisation of more than 24 hours may be paid
directly by APRIL Mobilité (option 1 only) within the limits of cover        THE MEMBER RISKS THE CANCELLATION OF THE POLICY IF HE DOES
provided under this policy, any excess to be settled directly by the         NOT DECLARE ANY DOUBLE INSURANCE ARRANGEMENTS. THIS
Member. Hospital costs will be paid directly in accordance with the          OBLIGATION REMAINS IN FORCE DURING THE ENTIRE PERIOD OF
benefits schedule when carried out under the usual, customary and            THE MEMBERSHIP.
reasonable conditions in the country of travel unless the medical team
expresses a different view at the time of the request for cover.             The limits of reimbursement of actual costs incurred is determined
                                                                             by the insurer for each service or treatment covered.
Direct payment is only available if Option 1has been selected and subject
to the use of the personal “APRIL Mobilité” card issued to the Insured or
the use of the emergency contact numbers listed in Article 7.7 up to the     5.2 Repatriation assistance
limits of the agreements made locally by the insurer or APRIL Mobilité.
Before any intervention and on payment of the Premium, the hospital          5.2.1 Conditions for the implementation of cover
must obtain the agreement of the insurers (see the emergency contact         To benefit from repatriation assistance, it is obligatory to obtain prior
numbers in article 7.7 below).                                               approval from APRIL Mobilité Assistance in the event of illness or serious
                                                                             Accident either by telephoning +33 (0)1 55 92 23 09 (in France) or by
                                                                             faxing +33 (0)155 92 40 50.
5.1.4 Risks excluded from the Medical expenses cover
                                                                             APRIL Mobilité Assistance will intervene only after first aid has
In addition to the Exclusions listed in Article 6 below, the following
                                                                             been given on the orders of a competent medical authority.
are excluded from cover:
- costs that do not give rise to the right to health insurance cover         After the initial call, the medical team contacts the on-site doctor in
  under French Social security;                                              order to take the action best suited to the condition of the sick or
- all medical and surgical costs not prescribed by a qualified medi-         injured person.
  cal authority and not covered by French Social security;                   If the Beneficiary or persons accompanying him or her should take any
- cosmetic, anti-aging, weight loss, weight gain, thermal and tha-           of the actions listed below, this will only give rise to reimbursement if
  lassotherapy treatments;                                                   APRIL Mobilité Assistance has been notified and has given its express




6
                                                                                                                                        Magellan
                                                                                                                                        2008

General Conditions                                                                                                                                Booklet
                                                                                                                           To be retained by the insured


agreement by providing a reference number. In this case, costs will              If it is available, it will be sent as quickly as possible, subject to the
be reimbursed based on valid receipts, up to the amount that APRIL               constraints of local law and the available means of transport.
Mobilité Assistance would have spent if they had organised the service           This cover is based on specific demands and under no circumstances
themselves.                                                                      shall it be granted in the context of long-term treatments that neces-
APRIL Mobilité Assistance will not be held liable for any professional           sitate regular shipments or a request for a vaccine.
or commercial damage suffered by the Beneficiary following an incident           The Insured is responsible for the cost of the medicines and agrees
requiring the intervention of assistance services. APRIL Mobilité                to reimburse any excess costs of customs clearance within a maximum
Assistance does not replace local or national emergency or search and            of 30 days of the date of shipment.
rescue agencies and shall not cover the costs of intervention by the
same, unless contractual stipulations state otherwise.                           5.2.5 Early return due to death of a family member or hospitalisation
APRIL Mobilité Assistance agrees to take all actions at its disposal to          for more than 5 days
fulfil the cover stated herein. However, it is understood that the obligation    APRIL Mobilité Assistance will provide the Insured with a return eco-
of APRIL Mobilité Assistance is dependent on the provision of means,             nomy class airline ticket or first class railway ticket in the event of the
not results, considering the context in which the cover is implemented.          death or hospitalisation for more than 5 days of a family member (father,
                                                                                 mother,sister,brother or legal guardian) in the Insured’s country of usual
5.2.2 Repatriation for health reasons                                            residence.
In the event of Accident or illness, APRIL Mobilité Assistance doctors           Outbound travel must be made within eight days of the date of death.
will contact on-site doctors and take the decisions best suited to the           This benefit is acquired when the date of death is later than the date of
condition of the Insured, based on the information gathered and medical          the Insured’s departure abroad.
requirements.                                                                    APRIL Mobilité Assistance reserves the right to verify the reality of the
If the APRIL Mobilité Assistance medical team recommends the Insured             covered event (hospital report, death certificate, etc.) prior to any pro-
be repatriated, this team will organise and carry this out, based on             vision of services.
the medical requirements they deem appropriate.
Repatriation may be to:                                                          5.2.6 Search and rescue costs
- the hospital best suited to the situation,                                     The purpose of this cover is to reimburse the Insured for the costs of
- or the hospital nearest the Insured’s home in his or her usual country         search and rescue, in either the private or public domain, by specialised
   of residence or in the main country of residence,                             teams equipped with all resources, including a helicopter, needed to
- or his or her home in the country of usual residence or in the main            locate the Insured and evacuate him or her to the nearest equipped
   country of residence.                                                         reception centre, up to a limit of 5 5,000 per Insured and 5 15,000 per
If the Beneficiary is hospitalised in a health centre outside the hospital       event.
district of his or her usual place of residence, APRIL Mobilité Assistance       In all cases, this cover is limited to the total amount that the Insured must
will organise his or her return after it has been established that his or        pay, based on invoices to be paid in full or in part, to official entities
her medical condition is stable, and will have the Beneficiary transferred       that have taken part in search or rescue efforts. This cover takes effect
to his or her home in the country of usual or current residence.                 to complement, or after exhaustion of, any other similar cover that the
Repatriation may be carried out by light sanitary vehicle, ambulance,            Insured may have.
train, scheduled airline, or air ambulance.                                      The Insured, or anyone acting on behalf of the same, must provide APRIL
The medical team is solely responsible for the final choice of place and         Mobilité Assistance with immediate verbal notice no more than 48 hours
date of Hospitalisation, the need for the Insured to be accompanied,             after the intervention, also indicating the reasons for the same. In the
and any means or resources to be used.                                           five days following the date of invoice, the Insured or his or her
Any refusal of the solution proposed by the medical team will result             beneficiaries must send the following documents directly to IPA - APRIL
in the cancellation of personal assistance cover.                                Mobilité Assistance, Service Gestion des Sinistres, 6 rue André Gide,
APRIL Mobilité Assistance may require the Insured to use his or her              92320 Châtillon FRANCE:
own transport ticket, if this can be changed.                                    - the original paid invoice(s), indicating the date, motives and nature
                                                                                   of the intervention;
5.2.3 Presence of a relative for Hospitalisation of more than 6 days             - an initial medical certificate stating the nature of the unforeseeable
If the condition of the Insured does not permit or does not necessitate            illness or bodily Accident, sent confidentially to the medical examiner
his or her repatriation, and if the Insured stays in a local hospital for 6        of Inter Partner Assistance, if applicable;
or more consecutive days, APRIL Mobilité Assistance will provide a               - a death certificate or police report, as applicable.
return economy class airline ticket or first class railway ticket for a family
                                                                                 Costs are reimbursed either to the Insured or to the beneficiaries
member or a companion to be with the Insured.
                                                                                 of the same. Any reimbursement that does not comply with
This cover is acquired only if a (legally adult) family member of the
                                                                                 these regulations will result in forfeiture of all right to
Insured is not on site.
                                                                                 reimbursement.
APRIL Mobilité Assistance will organise and cover accommodation costs
(bed and breakfast only) for up to 10 nights at a rate of 5 80 per night.
No other temporary accommodation will give rise to compensation of               Cover also excludes search and rescue costs:
any kind.                                                                        - resulting from failure to observe the precautions stated by the
                                                                                   operators of the site and/or the regulations governing the
5.2.4 Search for and shipment of medicine not available on site                    activity engaged in by the Insured;
If it is impossible to find indispensable medicine or its equivalent on          - resulting from the practice of a professional sport, or partici-
site, when such medicine has been prescribed before departure by the               pation in an expedition or competition, unless expressly stipulated
Insured's doctor in the usual country of residence, APRIL Mobilité Assis-          otherwise.
tance will search for it in France.




7
                                                                                                                                      Magellan
                                                                                                                                      2008

General Conditions                                                                                                                              Booklet
                                                                                                                         To be retained by the insured


5.2.7 Repatriation of body in case of death and Provision of coffin            This advance is made through an on-site lawyer up to a limit of 5 15,000
In the event of the death of the Beneficiary, APRIL Mobilité Assistance        per event.
will organise and undertake repatriation of the body or ashes of the           The Beneficiary must reimburse this payment to APRIL Mobilité Assistance:
deceased until burial in the usual country of residence.                       - after restitution of the bond in the case of nonsuit or acquittal;
APRIL Mobilité Assistance will cover the costs of post-mortem treat-           - within 15 days of judicial sentencing being carried into effect in
ment, placement in coffin and necessary transport arrangements. APRIL            the event of conviction;
Mobilité Assistance will organise and cover the cost of coffin trans-          - in all cases, within three months of the date of payment.
port up to a limit of 5 1,000.
The family of the Insured is responsible for the costs of the funeral, cere-   5.2.13 Legal assistance abroad
mony, procession, and burial or incineration.                                  APRIL Mobilité Assistance will pay the costs of an on-site lawyer up
The choice of companies taking part in the repatriation process rests          to a maximum of 5 3,000 per event.
solely with APRIL Mobilité Assistance.
                                                                               5.2.14 Transmission of urgent messages
5.2.8 Accompanying the deceased                                                If it is physically impossible for the Beneficiary to transmit an urgent mes-
In the event of the death of the Insured, if it is essential for a family      sage and if the Beneficiary so requests,APRIL Mobilité Assistance will,at
member or a friend to be on site to identify the body and complete             no charge and by the fastest possible means,transmit messages or news
the formalities involved in repatriation or incineration of the deceased,      from the Insured to members of his or her family, relations or employer.
APRIL Mobilité Assistance will provide a return economy class airline          APRIL Mobilité Assistance may also act as intermediary in the opposite
ticket or first class railway ticket.                                          direction.
This cover is applicable only if the Insured was alone on site at the          Messages remain the sole responsibility of their authors, who must be
time of his or her death.                                                      identifiable, APRIL Mobilité Assistance acts solely as an intermediary
                                                                               in the transmission of the messages.
5.2.9 Return after stabilisation
When, after repatriation for medical reasons, the collaborator is ready        5.2.15 Travel assistance in the event of loss or theft of personal items
to continue with his or her professional activity, APRIL Mobilité              On trips abroad, in the event of loss or theft of the Beneficiary’s personal
Assistance, with the agreement of the medical team, will organise              items (identity documents, means of payment, baggage) or transport
the return to his or her country of employment, in order to continue           tickets, and after an official statement has been made to the competent
the interrupted mission.                                                       local authorities, APRIL Mobilité Assistance will do everything possible
APRIL Mobilité Assistance will pay the cost of a single one-way economy        to assist the Beneficiary with proceedings.
class airline ticket or a first class railway ticket.                          APRIL Mobilité Assistance is not authorised to stop payments on
This cover cannot be applied concurrently with the benefit: "Sending           behalf of third parties.
a substitute collaborator”     .                                               If replacement documents are made available in the country of
                                                                               residence, APRIL Mobilité Assistance will forward them by the fastest
5.2.10 Sending a substitute collaborator                                       means available.
In the event of the death of the Beneficiary, or if the Beneficiary must       APRIL Mobilité Assistance may make a maximum advance payment of
be hospitalised for 10 days or more, APRIL Mobilité Assistance will            5 750 per event to enable the Insured to make immediately essential
organise and pay for a single one-way economy class airline ticket or          purchases.
a first class railway ticket to send a substitute collaborator from the        If a transport ticket is lost or stolen,APRIL Mobilité Assistance may provide
Insured’s usual country of residence to the country of employment.             the Insured with a new, non-negotiable ticket paid in advance.
This request must be made by the Member no more than 8 days                    These advance payments may be made against a security provided either
after the death or the medical decision to repatriate made by the              by the Insured or by a third party.Reimbursement of all advances must be
assistance service.                                                            made within 30 days of the date on which the funds are made available.
This cover cannot be applied concurrently with the benefit: "Return
after stabilisation” .                                                         5.2.16 Limitations on cover
                                                                               When APRIL Mobilité Assistance organises and pays for repatriation
5.2.11 Early return in the event of loss at home                               or transport, the Beneficiary may be asked to first use his or her own
If the Beneficiary is away from home and if his or her presence is indis-      travel ticket.
pensable there to carry out necessary formalities, APRIL Mobilité              When APRIL Mobilité Assistance has, at its own cost, assured the return
Assistance will organise the transport of a Beneficiary and any minor          of the Beneficiary,the latter must return the unused travel ticket to APRIL
children who cannot be cared for where they are, to the said home.             Mobilité Assistance.
APRIL Mobilité Assistance will pay for a single one-way economy
class airline ticket, a first class railway ticket or a category A or B ren-
tal car for up to 24 hours, as long as the transport tickets for the planned   5.2.17 Exclusions to Repatriation Assistance cover
return cannot be used or changed.
                                                                               Medical exclusions:
This cover is granted within 72 hours of the date of the event or
knowledge of the loss, and the Beneficiary must be more than                   In addition to the Exclusions stated in Article 6 below, Assistance
50 km from his or her home.                                                    cover does not cover costs resulting from the following situations
                                                                               or events (which shall not give rise to compensation of any kind
5.2.12 Advance of bail abroad                                                  nor to any action on the part of APRIL Mobilité Assistance):
Abroad, APRIL Mobilité Assistance will provide the bail required by            - any action and/or reimbursement relating to medical check-ups
foreign authorities to free the Beneficiary or to enable him or her to avoid     or preventative screenings;
incarceration.                                                                 - benign ailments or injuries that may be treated on site and which




8
                                                                                                                               Magellan
                                                                                                                               2008

General Conditions                                                                                                                        Booklet
                                                                                                                   To be retained by the insured


  do not prevent the Insured from travelling;                              Proximate cause: personal accident, illness, death or legal difficulties
- convalescences, ailments currently under treatment and not yet           encountered by the Beneficiary.
  stabilised and/or needing further scheduled care;                        Usual country of residence: the Beneficiary’s main country of residence.
- illnesses already existing before departure and involving a risk
  of deterioration or relapse;
- ailments that have led to Hospitalisation in the six months prior        5.3 Counselling
  to departure;
- possible consequences (follow-up, additional treatments, relap-          This cover allows the Insured to benefit from a 24 hours a day, 7 days
  ses) of an ailment that has led to repatriation;                         a week counselling service, either by telephone (+33 (0)1 53 04 62
- fertility treatments;                                                    75) or by e-mail (consultant.am@psya.fr). This benefit is limited to five
- pregnancy, childbirth and their consequences involving new-              sessions per Membership year. The Beneficiary is responsible for the
  borns, voluntary termination of pregnancy;                               cost of communications. This counselling service is organised in
- cosmetic surgery, dermatological treatments, travel for the pur-         collaboration with PSYA, a company specialised in providing psy-
  pose of diagnosis and/or treatment;                                      chological assistance to persons temporarily abroad. The Insured
- the results of a failure or inability to receive a vaccination, or the   accessing this service will be put in contact with the PSYA counselling
  consequences of a vaccination or other treatment needed or               team made up of Clinical psychologists, psychologists specialised in
  mandatory for travel;                                                    victimology, and qualified and trained Expert consultants.
- tropical diseases, congenital diseases or deformities;
- AIDS and STDs;                                                           How the service operates:
- the result of a voluntary disregard for regulations in the visi-         By dialling the telephone number, the Insured will be put immediately
  ted country, or the practice of activities not authorised by local       in contact with a counsellor. Calls handled by the counsellors are
  authorities;                                                             kept totally anonymous and confidential, in accordance with the
- the results of participation in a wager, challenge, duel or crime;       psychologists’ rules of professional conduct.
- the results of failing to respect recognised safety rules related        At the first call, the Insured will be given a reference number. This
  to the practice of sports activities;                                    number will be required at the time of any further calls so that a quick
- the costs of a stay, except those agreed to in advance with the          link can be made to his or her file.
  assistance service;                                                      If, despite the systems in place, PSYA is not able to respond immediately
- the cost of fuel, tolls, or ferries;                                     to the Insured’s calls, the latter will be called within no more than
- costs not supported by original documents;                               one hour.
- all other costs not stipulated in the agreed cover.
                                                                           Scope of psychological counselling:
The following are not covered and will not give rise to reimbursement:     Within the strict bounds of the rules of professional conduct applicable
- medical costs, treatments, stays in rest homes, rehabilitation           to the profession of psychology, the counsellors conduct professional
  costs, contraception and fertility treatment costs, the cost of glas-    counselling that is non-leading, non-compassionate and non-
  ses, contact lenses, or cosmetic, dental or acoustic prostheses;         interventionist, while keeping a sympathetic distance and neutrality.
- repeated transport required by the Insured’s state of health.            This telephone service is not, however, simply a listening service. The
                                                                           counsellor listens to what the other person is saying. He or she unders-
Medical exclusions from Repatriation assistance cover may be               tands the unconscious bases and sense of what is said and, based on
included in Medical expenses cover under the policy.                       the words or silences noted, enables the Insured to understand the
                                                                           sense of what he or she is saying. The “sense” means a person’s invol-
                                                                           vement in a given situation, the benefits he or she can paradoxically
                                                                           draw from it, and the impediments that the person is putting in the
5.2.18 Glossary of terms: Repatriation Assistance                          way of resolving the situation.
                                                                           The goal of telephone counselling is to enable the Insured to release
Abroad: any country covered under the policy outside the beneficiary’s     built-up tension by putting experiences into words, thereby helping
usual country of residence.                                                the person achieve greater balance.
Beneficiary: person under the age of 75.                                   Telephone counselling must not be confused with face-to-face
Country of residence: the beneficiary’s main country of residence          psychotherapeutic work. Under no circumstances is PSYA authorised
during his or her stay abroad.                                             to undertake psychotherapy by telephone.

Family member: parents, sister, brother or legal guardian of the bene-
ficiary who reside in the same country as the beneficiary.                 5.4 Personal liability
Illness: any sudden and unexpected alteration in the state of health,
certified by a competent medical authority.                                5.4.1 Purpose of the cover
Medical authority: person holding a medical or surgical diploma which      We cover the pecuniary results of any Personal liability that the Insured
is valid in the beneficiary’s country of residence.                        may incur by virtue of the laws and regulations in force in the country
                                                                           where he or she is staying, in a private capacity only.
Medical team: structure adapted to each individual case and defined        Cover applies in the event of Bodily injury or Material damage to other
by our liaison doctor.                                                     persons, particularly as a result of:
Personal accident: any sudden, unexpected and violent event from an        - his or her own actions or those of persons for whom he or she is
external source not intended by the victim and resulting in grievous         responsible;
bodily harm.                                                               - things or animals owned or kept by the Insured;




9
                                                                                                                                            Magellan
                                                                                                                                            2008

General Conditions                                                                                                                                    Booklet
                                                                                                                               To be retained by the insured


- any sport or outdoor activity practised by the Insured (except Exclusions        undertaken in the course of a single Membership year, with a minimum
  mentioned below);                                                                Intervention level of 5 228. This amount will not be reimbursed,
- liability incurred through participation in internships, with regard to          regardless of the duration of the legal action.
  those holding the internship, for damages caused to materials                    Any claims under the policy must be made by the Insured by registered
  used during the internship.                                                      letter to APRIL Mobilité no more than 15 days after he becomes aware
                                                                                   of it. The claim should include details of the events surrounding the
5.4.2 Limitations on cover                                                         claim and their consequences.
- Bodily injury: 5 4,500,000 per Claim.
- Material and consequential damage to a third party: 5 460,000 per                5.5.3 Specific provisions
  Membership year; Consequential damage is included for up to 20%
  of the Insured amount, that is 5 92,000. Excess of 7 76 per Claim.               Disputes:
- Damage caused to the materials of those holding the internship,                  In the event of disputes regarding the measures to be taken to settle a
  used during the internship: 512,000 per Membership year. Excess of               difference, this matter may be submitted to a third party designated
  7 76 per Claim.                                                                  by mutual agreement or else to the president of a departmental court
Any claims under the policy must be made by the Insured by registered              to act as arbiter.The insurer will cover the costs of establishing this faculty.
letter to APRIL Mobilité no more than 15 days after he becomes aware               However, the president of the departmental court may decide other-
of it. The claim should include details of the events surrounding the              wise if the Insured has established this faculty under abusive conditions.
claim and their consequences.                                                      If the Insured undertakes litigation at his or her own cost and obtains
                                                                                   a resolution that is more favourable than that proposed by the
                                                                                   insurer or by the third person mentioned above, the insurer will
5.4.3 Exclusions from Personal liability cover                                     reimburse the Insured the costs incurred up to the cover limit.
                                                                                   When the procedure described above is put in motion, the time limit on
Apart from the Exclusions stated in Article 6 below, the following are
                                                                                   appeals is suspended for all legal proceedings covered by the insurance
excluded from this cover:
                                                                                   and which the Insured may undertake, until the third person entrusted to
- damage resulting from any professional activity (except for                      propose a solution has been made aware of its contents.
  damage to materials used during internships);
- the pecuniary results of contractual liability incurred by the                   Choice of lawyer:
  Insured beyond any liability incurred with regard to those holding               In the event of legal or administrative action requiring the participation
  an internship for damages caused to materials used during the                    of a lawyer or any other person qualified by law or current regulations to
  said internship;                                                                 represent the interests of the Insured, the latter has free choice and the
- the traffic risks set forth in French law number 58208 (February                 insurer will pay the fees directly.
  27, 1958) on compulsory motor vehicle insurance;                                 If the Insured does not know a lawyer, the insurer may make one availa-
- Accidents suffered by the Insured, his or her employees or servants              ble to the former.The aforementioned free choice is also applicable if there
  in the course of their duties, as well as by his or her ascendants               is a conflict of interest between the Insured and the insurer.
  or descendants;
- damage caused to objects or animals owned or kept by the
  Insured;                                                                         5.5.4 Exclusions from Legal cover
- related fines and costs for which the Insured may be liable;
                                                                                   Apart from the Exclusions stated in Article 6 below, the following are
- damage resulting from the Insured’s use of any air navigation
                                                                                   excluded from cover:
  devices;
- damage resulting from pollution;                                                 - cost of legal action when the author of the damage is the Insured
- any spills, scratches or abrasions to sanitary fixtures, and any                   under the contract;
  breakage of crockery or damage to bed frames or bedding.                         - legal action in the case of Bodily injury or Material damage
                                                                                     suffered by the Insured when he or she is using any kind of
                                                                                     motorised land vehicle;
                                                                                   - legal action when less than 7 228 in Compensation is to be
5.5 Legal cover                                                                      obtained;
                                                                                   - claims relating to material damage grounded in the failure to
For legal recourse under Law number 891014 (December 31st, 1989)                     perform or poor performance of a contractual obligation on the
and the decree of August 1st, 1990, the insurer shall pay, up to the cover           part of the party responsible.
ceiling stated below, the costs of trials, proceedings, inquiries, expert
consultants, enforcement of judicial orders and lawyers’ fees.

5.5.1 Purpose of the cover                                                         5.6 Personal accident
The insurer shall claim monetary redress of the responsible party, either
by mutual agreement or by judicial order:                                          5.6.1 Accidental death
- for Bodily injury suffered by the Insured in the course of covered activities;   The insurer shall pay the Beneficiary or Beneficiaries a maximum sum
- for Material damage that would have been covered under Article 5.4               of 5 8,000.
  if they had involved Personal liability.                                         If the Insured is less than 16 years of age at the time of his or her death,
                                                                                   payment is in all cases limited to funeral costs.
5.5.2 Maximum amount and minimum Intervention level                                Cover applies to the death of the Insured occurring no more than
The maximum amount for any action taken is 5 3,100 for all litigation              one year after an Accident that has caused fatal injuries.




10
                                                                                                                                    Magellan
                                                                                                                                    2008

General Conditions                                                                                                                             Booklet
                                                                                                                        To be retained by the insured


However, if the Insured dies after having received compensation for           The degree of Disability is determined by the medical examiner and
permanent disability from the insurer for the same accident, the              the insurer after stabilisation of the injuries:
heirs will receive the sum stipulated in the event of death, minus the        - if the degree of partial permanent Disability is less than or equal to
amount of the said compensation.                                                20%, no Compensation is due.
                                                                              - if the degree of partial permanent Disability is greater than or
Beneficiary in the event of death:                                              equal to 20%, Compensation shall be equal to 5 35,000 multiplied
The Beneficiaries are named on the application form.The Member can              by the recognised degree of Disability.
change the named beneficiaries at any time. The naming of the
beneficiary can be done privately (e.g. by letter) or officially (e.g. in a   If the Insured is affected by a Disability prior to the occurrence of the
will lodged with a solicitor).The Member must send a dated and signed         covered Accident, injuries resulting from the former will not be taken
letter to APRIL Mobilité informing them of any change of beneficiary.         into account.
If there is no named Beneficiary, or if the designation proves to be null
and void, the amounts due will be paid first to the surviving spouse on       However, if the limb or organ already affected is affected by other
condition that they were neither divorced nor legally separated, second       injuries, compensation will be based on the difference between the
to the children living, to be born or represented as such for the purposes    state of the limb before and after the Accident.
of inheritance, equally, and third, to the other heirs, equally.              If the Insured has not undergone the treatment that he or she was
Where the Beneficiary is named, the Member can include his or her             prescribed, compensation will be based on the estimated consequences
contact details in the policy document to be used by the insurer in the       of the same Accident if the required treatment had been followed.
event of the Insured’s death.
                                                                              Necessary documents:
Consequences of the Beneficiary’s acceptance of the designation:              The Insured must make the Accident claim as quickly as possible to
The person named as Beneficiary in the event of the Member’s death            APRIL Mobilité. The claim must include all details on the seriousness,
can, at any time, accept the designation by contacting the insurer or         causes and circumstances of the Accident.
APRIL Mobilité. He or she is not required to inform the Member of this.
                                                                              The Insured must also:
If the designation is accepted by the Beneficiary he or she must agree
                                                                              - forward all documents proving his or her identity and/or marital
to any subsequent cashing in of the policy or change of beneficiary.
                                                                                status;
If his or her agreement is not obtained, the insurer will be unable to
                                                                              - forward a certificate from the doctor called to give first aid, describing
carry out the wishes of the Member.
                                                                                the exact nature and current state of the injuries, as well as their
In the event of death of an Insured person between 16 and 18 years
                                                                                consequences;
of age, payment reverts to the Insured’s parents in equal parts, or failing
                                                                              - forward all documents needed to establish the fact and significance
this, to the Insured’s other heirs.
                                                                                of the Accident;
The right of Beneficiaries to payment depends on their existence two
                                                                              - submit to a medical exam by the Insurer.
days after the date of the Insured’s death.

Necessary documents:                                                          In addition to the Exclusions stated in Article 6 below, the following
The policyholder must declare the death of an Insured as quickly as           are excluded from cover:
possible, forwarding the supporting documents necessary for settlement,
                                                                              - continuations and consequences of illnesses, heatstroke or other
namely:
                                                                                temperature-related effects (unless these are the result of a
- an extract of the death certificate;
                                                                                covered accident), drowning is always covered;
- an extract of the birth certificate;
- a medical certificate stating the date of death and whether the death       - rupture of aneurysm, attacks of paralysis or apoplexy, angina
  was natural, accidental, or the result of an excluded incident;               pectoris and its consquences, all results of vascular illnesses,
- any document proving the identity and/or marital status;                      hernias of all kinds, lumbago, rheumatism, varicose veins,
- any document stating the cause and circumstances of the Accident              dermatosis and, regardless of the circumstances in which they
  that led to the death;                                                        appear, Accidents that result from a pathological condition of
- an admission certificate (issued by the hospital);                            the victim.
- any document that proves the existence of the Accident and the
  direct cause-and-effect link between the accident and the death.
Settlement is made with the nominated Beneficiary within 20 days of
                                                                              5.7 Baggage
receipt of these documents.
If there are several Beneficiaries, the lump sum will not be divided up
                                                                              5.7.1 Cover
by the Insurer who will release the sum in return for a receipt signed
jointly by the interested parties.
                                                                              This provides cover up to 5 1,200 for all baggage, objects and personal
                                                                              effects carried by the Insured during outbound or inbound travel,
5.6.2 In the event of total or partial permanent Disability following an      against the risks of loss, theft or destruction (explosion, fire, or water
Accident                                                                      damage).
In the event of total permanent Disability, that is a degree of Disability    Registered or accompanied baggage is covered, as well as clothing and
of 100%, the insurer will pay the Insured the fixed sum of 5 30,000.          personal effects, cameras, photographic equipment, binoculars, hi-fi
                                                                              and computer equipment of all kinds owned by, or leased, rented or
In the event of partial permanent Disability, payment will be reduced         lent to the Insured during his or her stay.
based on the recognised degree of Disability.                                 However, if the baggage is registered with a carrier, we will take action




11
                                                                                                                              Magellan
                                                                                                                              2008

General Conditions                                                                                                                       Booklet
                                                                                                                  To be retained by the insured


only after due claim has been made to the carrier and after deducting    6. Exclusions common to all cover
any Compensation that may be provided by the latter as a result of
its own liability.
In the event of the disappearance of baggage or the contents of          Apart from the Exclusions from each individual area of cover,
baggage entrusted to a hotel operator, we will take action after         all cover excludes the results and consequences of :
deducting any Compensation that may be provided by the depositary
or its Insurer as a result of its own Personal liability.                - intentional or fraudulent acts on the part of the Insured or the
The insured must make the claim in writing to APRIL Mobilité within        Beneficiary and/or violations of the law of the country in which
five working days following the incident. Beyond this period APRIL         the Insured is staying;
Mobilité may reject your claim.                                          - voluntary participation in fights, popular movements wherever
Works of art and collector's items, silverware, jewellery, precious        they may take place and whoever those involved may be, except
stones and pearls, valuable paintings, furs, video recorders, cameras,     in legitimate self-defence;
binoculars, any type of hi-fi or IT equipment and hunting rifles are     - civil or foreign war,riots,strikes,acts of terrorism,piracy or sabotage;
covered up to 50% of the insured sum.For all Claims, the Insured         - suicide or attempted suicide by the Insured, use of drugs or nar-
will pay a 7 30 Excess.                                                    cotics without a medical prescription, alcoholism or drunkenness
                                                                           on the part of the Insured (blood alcohol concentration above
                                                                           that stipulated by vehicle traffic laws in force on the day of the
Exclusions from baggage insurance cover                                    loss);
                                                                         - the direct or indirect effects of changes in atomic structure,
Apart from the Exclusions stated in Article 6 below, the following are
                                                                           climatic events such as storms or hurricanes, earthquakes,
not covered under this article:
                                                                           flooding, tsunami or other cataclysms, unless in the context of
- cash, banknotes, securities of all kinds, documents, travel tickets;     compensation for natural disasters;
- smoking-related Accidents, damage to objects that fall or are          - Accidents or illnesses,ailments,deformations prior to the Start date
  thrown into a fireplace, or scorched by excess heat;                     of membership that are liable to recur or progress, and congenital
- damage to electrical devices due solely to their own functioning         illnesses or deformations not declared at the time of membership;
  or malfunctioning;                                                     - sailing or pleasure boating on the high seas;
- damage to covered goods resulting from their confiscation or           - dangerous sports such as microlighting, hang-gliding, paragliding,
  detention by customs officials or other public authorities;              driving cars, motorcycles or gocarts, parachuting, mountain
- breakage or damage to delicate or fragile objects such as watches,       climbing, rock climbing, underwater diving except for free-diving
  cameras, eyeglasses and computer equipment;                              up to 50 meters, caving, the skeleton, ski jumps, bobsleighing,
- normal wear and tear;                                                    bungee jumping, rafting, canyoning, airballooning, jet-skiing and
- theft committed by members of the Insured’s family, pursuant             sports practised off piste: skiing, cross-country skiing, sledging,
  to Article 380 of the Criminal code, or with their complicity, or        snowboarding;
  by domestic workers or servants of the Insured in the course of        - participation in any competitive sports or trainings, the practice
  their work;                                                              of sports within a club or federation, either as a professional or
- theft committed under the following circumstances:                       an amateur, and any sport requiring the use of any kind of
  a) in the case of registered baggage, if the theft was facilita-         land, sea or air motor or engine;
     ted by poor or defective packaging;                                 - air navigation Accidents unless the Insured is simply a passenger
  b) when objects were left unattended in a public place or in a           aboard an aircraft for which the owner and the pilot have all
     place open to use by several occupants;                               required permits and licenses.
  c) when objects were left:
     - in a convertible vehicle;
     - in a vehicle with windows that were not closed;
     - in a vehicle with doors or boot that were not locked;
     - between 10 p.m. and 7 a.m. in an automobile not parked in
        a public or private garage, except for objects in the hold or    7. General conditions
        boot of a bus or coach.

                                                                         7.1 Limitation

                                                                         All action deriving from this agreement is limited to a period of two
                                                                         years from the date of the event giving rise to the same, pursuant to
                                                                         articles L.114-1 and following of the Insurance Code. This period shall
                                                                         be extended to 10 years if the Beneficiaries are heirs of the Insured.


                                                                         7.2 Subrogation

                                                                         It is stipulated that the insurer shall not renounce the rights and actions
                                                                         pertaining to it by virtue of Article L.121-12 of the Insurance Code,
                                                                         relating to the summary remedy it may seek for third party liability.




12
                                                                                                                                          Magellan
                                                                                                                                          2008

General Conditions                                                                                                                                   Booklet
                                                                                                                              To be retained by the insured


7.3 Audit                                                                           Excess: sum for which the Insured is responsible in the settlement of
                                                                                    a Claim.
The insurer reserves the right to challenge the grounds of certain decisions
                                                                                    Exclusions: that which is not covered by the insurance policy. All
and to demand that the Insured provide any proof necessary to determine
                                                                                    policies include exclusions from cover.
exact cover, particularly by forwarding medical certificates, surgery reports
and/or a second opinion by the insurance company’s doctor.                          Expert consultant: psychologist, psychotherapist or doctor trained in
                                                                                    behavioural and cognitive therapies.
                                                                                    Hospitalisation: period of stay in a public or private hospital imme-
7.4 Conciliation / Jurisdiction                                                     diately subsequent to an accident or illness.

This contract has been made and signed in good faith and the parties                Insured: the Member, an individual who has been granted the insu-
agree, in the event of a dispute, not to take legal action until they have          rance and whose life, actions and goods are covered under this contract.
attempted to reach a conciliatory agreement.To this effect, each party              Intervention level: minimum amount above which the Insurer will
will name an arbiter. If the two arbiters cannot agree on a decision,               consider direct intervention or reimbursement.
they will choose, by mutual agreement, a third arbiter to break the
                                                                                    Material damage: damage affecting the structure or substance of a
deadlock and all three will act on a majority decision. Each party will
                                                                                    thing and resulting in a covered event.
pay the costs and fees of its arbiter, as well as half the fees of the
third arbiter, if applicable.                                                       Member: a person who is member of the Association and who has
The Insured agree to submit to the jurisdiction of the courts of Paris              adhered to the group agreement.
and waive the right to any proceedings in any other country.                        Membership certificate: document issued to the Member by APRIL
                                                                                    Mobilité confirming his or her membership of the Magellan plan and
                                                                                    specifying the Start date of membership, levels of cover and options
7.5 Data Protection of Freedom of Information                                       selected.
The Insured has the right to receive and correct any information on                 Membership year: one-year period that separates two anniversaries
him or her contained in any file used by APRIL Mobilité, its represen-              of the Start date of cover.
tatives or insurers. The right to access and correct information may                Personal accident: cover for the payment of money in the case of death
be exercised at APRIL Mobilité headquarters (Law 78.17 of January 6,                or Disability on the part of the Insured as a result of an accidental event.
1978, amended).
                                                                                    Personal liability: the legal obligation of all persons to repair damage
                                                                                    caused to others.
7.6 Glossary                                                                        Precedents: events prior to the membership that suggest the existence
                                                                                    of a risk.This is a determining factor in risk evaluation and therefore in
Each term defined below, when spelled with a capital letter, has the                determining the insurer’s liability and the amount of the Premium.
following meaning:
                                                                                    Premium: sum paid by the Insured in exchange for the cover
Accident: any physical injury not intended by the victim, which is the              granted by the insurer.
result of a sudden action with an external cause. Pursuant to Article
                                                                                    Reimbursement basis of the French Social security rate: reimburse-
L.1315 of the Civil Code, the Member is responsible for providing proof
                                                                                    ment basis used by the French Social security scheme for procedures
of the Accident and of the direct cause-and-effect relationship
                                                                                    or prescriptions performed or issued by health professionals. Where
between the accident and the costs incurred.
                                                                                    generic medicines exist, the reimbursement basis shall be the flat
Actual costs: set of medical expenses billed to the Insured.                        rate corresponding to the price of a generic medicine.
Beneficiary: person who receives Compensation or money from the                     Request for pre-payment agreement: form completed by a qualified
insurer.                                                                            medical authority enabling the Insured to obtain an agreement from
Bodily injury: injury affecting a person’s physical integrity.                      APRIL Mobilité for certain medical procedures or treatments. Reported
                                                                                    accident: an accident recorded by a competent authority (police force,
Certificate of insurance: document issued by the insurer, presuming                 fire fighters, medical authority, etc.) and for which a certificate has been
the existence of the contract. Article R 211-17 stipulates that this docu-          issued.
ment acts as proof of insurance during the valid period of the insurance.
                                                                                    Start date: date on which cover under a contract takes effect. This is
Claim: event, illness or Accident which gives rise to cover when the                the date on which the policy starts.
contract is in effect.
                                                                                    Termination: final and early cancellation of the contract.
Compensation: sum paid to repair damage or injury suffered by the
Insured or a victim.                                                                Third party payment: with the insurer’s prior agreement and if the
                                                                                    Insured is hospitalised for more than 24 hours, direct cover of hospital
Consequential damage: all damage other than physical or material                    fees is available to holders of the APRIL Mobilité card.
ones resulting directly and immediately from physical or material dama-
ges covered by the insurance.                                                       (total or partial) Disability: Disability immediately subsequent to an
                                                                                    illness or accident making it totally or partially physically impossible
Daily charge: share of the fixed daily charge of a hospital stay not cove-
                                                                                    (as medically verified and recognised by the insurer) for the Member
red by the French Social security system.
                                                                                    to carry out the normal exercise of his or her profession or another pro-
Equivalent Social security rate: rate applicable to medical treatment dis-          fession with conditions equivalent to the one he or she had before
pensed by private sector practitioners or clinics not covered by Social security.   stopping work after the illness or Accident.




13
                                                                                      Magellan
                                                                                      2008

General Conditions                                                                                 Booklet
                                                                            To be retained by the insured


Valuables: pearls, jewellery, wrist watches, furs, devices and accesso-
ries for the reproduction of images, hunting arms and portable
computers.
Victim support counsellor: a psychologist who holds a diploma in Vic-
timology or has been trained in victim support counselling to individuals
or groups.
Waiting period: period starting from the date of commencement of
cover during which certain types of treatment will not be reimbursed.


7.7 Emergency contact numbers

Claims for reimbursement must be addressed in all cases to:


                            APRIL Mobilité
                          Service Prestations
                    110, avenue de la République
                         75011 Paris, FRANCE

                  Telephone: + 33 (0)1 73 02 93 93

                      Fax: + 33 (0)1 73 02 93 90



For assistance benefits, you must have received prior agreement from
APRIL Mobilité Assistance either by calling +33 (0)1 55 92 23 09 (reverse
charge call) within France or sending a fax to +33 (0)155 92 40 50.
Remember to include the Insured’s reference number shown on the
APRIL Mobilité card.

To obtain direct payment of Hospitalisation benefits, if you selec-
ted Medical expenses Option 1:
- if you are in the United States, Canada or certain parts of Mexico,
  dial (+1) 866 299 2900 (freephone);
- if you are in a South American country, dial (+1) 305 3816977 (reverse
  charge call);
- if you are in a European or African country, dial +33 (0)1 73 02 93 99,
  fax: +33 (0)1 73 02 93 70;
- if you are in the rest of the world, dial +33 (0)1 55 92 23 09.



To benefit from the Counselling service:
- Tel: +33 (0)1 53 04 62 75
- E-mail: consultant.am@psya.fr




14
APRIL Mobilité by your side
Specialising in insurance for people living outside their home country, APRIL Mobilité provides simple and innovative healthcare
and life insurance products for individuals, businesses and the self-employed. Our products meet the needs of travellers,
expatriates, impatriates, employees on assignment abroad and students. For more than 30 years, APRIL Mobilité (formerly AIPS)
has been wholly committed to total client satisfaction by means of our clear and easy to understand products supported by
a range of services and top quality management of your insurance choices.




        Personal and Group Insurance for expatriates, impatriates and travellers                                                    www.aprilmobilite.com




APRIL, tailor-made insurance solutions
April provides a wide range of insurance solutions meeting the needs of individuals, professionals and businesses across
all areas of insurance.




                                                                                                                                                            Any reproduction of any kind, either partial or total, of the said elements and text is prohibited and will result in prosecution. Non-contractual document. July 2008.
To find out more about our insurance solutions                                      www.aprilgroup.com




APRIL GROUP, changing the face of insurance
From our beginnings in 1988, the APRIL GROUP has been committed to changing the face of the insurance industry by
ensuring that the client is always at the heart of our business.
Today, more than 2.5 million people know they can count on our 2460 employees and 61 companies to protect their
goods and families day after day.




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For more information, contact your insurance consultant:




APRIL MOBILITÉ MEMBER OF APRIL GROUP

Headquarters
110, avenue de la République - 75011 Paris - FRANCE
Tel: +33 (0)1 73 02 93 93 - Fax: +33 (0)1 73 02 93 90
E-mail : info @ aprilmobilite.com - Internet : www.aprilmobilite.com
Public limited company with capital of 5 200 000 - Registered with Companies House in Paris under number 309 707 727
Insurance broker - Registered with ORIAS (Organisation for the registration of insurance brokers) under number 07 008 000 (www.orias.fr)
Regulatory body for Insurance Activities - 61, rue Taitbout 75436 Paris cedex 09

								
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