SPECIAL CONDITIONS OF THE „MOUNTAIN CARE” INSURANCE
І. GENERAL TERMS
1. LEV INS AD, hereinafter referred to as the Insurer on the grounds of the General Terms and conditions of the “Travel assistance” insurance and on the grounds of the present Special conditions may enter into “Mountain care” insurance contracts with Bulgarian and foreign physical persons and legal entities, hereinafter referred to as Insuring person.
2. The Insurer insures physical persons (hereinafter referred to as Insured persons) for the duration of the time of their active recreation, hiking and sports activities in mountain areas.
2.1. The insurance covers events, occurred with tourists in the mountain and related to the following activities:
2.1.1. hiking along marked, non-marked and well-established tourist routes, visits to well-developed caves;
2.1.2. amateur and professional winter sports (skiing, snowboarding, etc.) within the limits of processed ski slopes as well as outside marked and non-marked ski slopes;
2.1.3. children’s camps, excursions, hikes, nature schools (green schools, traveling schools), ski holidays and winter sports training and other trips for educational, cultural, recreational and familiarization purposes.
ІІ. COVERED RISKS
3. Pursuant to the present terms and conditions, the Insurer covers the following risks:
3.1. Rescue action by helicopter as a result of an accident or acute illness;
3.2. Rescue expenses due to accident or acute illness.
ІІІ. EXCLUDED RISKS
4. In addition to the risks excluded under the Travel Assistance General Terms and Conditions, the Insurer shall not pay an insurance compensation or an insurance amount and shall not reimburse any costs, borne by the Insured costs for any events occurring as a result of any of the following:
4.1. events with persons holding an insurance certificate if the certificate is not activated;
4.2. events occurred before the commencement of the insurance period, even if the assistance is used within that term.
ІV. CONCLUSION, FORM, TERM OF DURATION AND EFFECT OT THE INSURANCE AGREEMENT
5. The insurance agreement shall be concluded in writing in the form of an Insurance policy and shall cover only the risks, explicitly stated therein.
6. The insurance policy may be concluded by the Insured or on behalf of a third person (Insuring person) and may be one of the following types:
6.1. Individual – the insurance is concluded on a name basis with the issuance of an insurance policy.
6.2. Opened – with insurance certificates, issued by the Insurer. The Insurer and the Insuring person enter into a framework insurance agreement. On the basis of the agreement the Insurer provides to each Insured person a certificate with a unique number in the form of a scratch card.
7. The insurance agreement shall be concluded for a period of one year from the date of its entry into force indicated in the policy as the beginning of its term. The term of the insurance contract shall expire at 24.00 h on the first anniversary from its entry into force. The expiration date is stated in the insurance policy as date of the contractual term expiration. Where, due to a delay in the payment of the insurance premium or the first installment thereof (upon agreed deferred payment), the insurance contract shall into force on a date later than the date indicated therein as the beginning of the term. In this case, its term shall also expire at 24.00 h on the date specified in the insurance policy as end date of the insurance.
7.1. The insurance certificate, part of an open type insurance policy shall enter into force after its activation. In order to activate the certificate, the Insured person shall call 0800 10 200, and shall provide his/her three names, Personal Identifying Number, the certificate number and the number from the scratch card. The Insured person shall keep the scratch card until expiration of its validity.
V. GEOGRAPHICAL COVERAGE
8. The insurance coverage is valid on the territory of Republic of Bulgaria.
VІ. INSURANCE AMOUNT
9. The sum insured is in BGN and in the amount of 10 000 for the “rescue action by helicopter as a result of an accident or acute illness” risk and in amount of BGN 1000 for the “Rescue costs following an accident or acute illness” risk.
VІІ. INSURANCE PREMIUM
10. The insurance premium is calculated in BGN on the basis of the Insurer’s Tariff.
11. The insurance premium shall be paid as a lump sum upon conclusion of the insurance policy, unless the parties agree otherwise. In case of payment of the premium in installments, the Insurer shall terminate the insurance policy upon failure of the payee to pay the due installment.
12. Upon conclusion of an open type insurance contract with an insurance certificate, the insurance premium for each certificate shall be paid at once.
VІІІ. PROCEDURE IN CASE OF OCCURRENCE OF AN INSURANCE EVENT
13. Upon occurrence of an insurance event, the Insured person himself or acting through his / her representative, shall immediately notify the Insurer through a phone call to a toll-free 24-hour hotline 0800 10 200 in order urgent measures for organizing and conducting search and / or rescue activities to be undertaken.
14. Provided that the Insured person fails to fulfill his/her obligation to notify the Insurer, the latter shall be entitled to refuse to pay or to recognize partially for payment any expenses in related to the event and the assistance provided with respect thereto.
15. Under exceptional circumstances, where the Insured person failed to contact the Insurer and has organized his own transportation from the place of occurrence of the insurance event, the Insurer shall reimburse the actual transport expenses, borne by the Insured person. The injured party or his/her authorized representative shall file his / her application by submitting a written notice to the Insurer’s office within 7 days of the occurrence of the event together with the relevant medical documentation and originals of payment documents (invoice, cash receipt and others.).
16. In the cases under the preceding article 15, the Insurer shall pay or respectively shall refuse to pay the insurance indemnity within fifteen working days from the submission of all necessary and required documentation, related to the reimbursement of the transport expenses.
IX. INSURANCE INDEMNITY
17. Under the “rescue action by helicopter as a result of an accident or acute illness” risk, the Insurer shall cover the costs for using a helicopter in a rescue action of an injured person in the mountain and his/her transportation to a location where the necessary medical care can be provided. The insurer covers the actual costs of using a helicopter for a rescue action, but not more than BGN 10,000.
18.1. A decision to use a helicopter for a rescue operation shall be taken after consultation with and at the discretion of a medical professional appointed by the Insurer following an internal procedure of the Insurer and subject to the presence of all of the following conditions:
18.1.1. the weather conditions allow the use of a helicopter;
18.1.2. there is no other way of rescuing the Insured person and / or if his/her life is immediately threatened and urgent evacuation is required.
19. With respect to the “Rescue costs following an accident or acute illness” risk, the Insurer shall cover the actual expenses for the search and rescue activities, emergency medical assistance and transportation to a medical facility by the Mountain Rescue Service at the BRC or other entities engaged in activities for search and / or rescue of the Insured person. Within the term of the insurance, up to three such events are subject to coverage, with a total limit of up to BGN 1 000.
20. MOUNTAIN TOURISM – recreation or travel undertaken by the Insured person in the mountain.
21. MOUNTAIN – convex terrestrial forms, located 500 m above sea level, with distinct footpaths, slopes and peaks.
22. SPORT – all forms of physical activity that, through self-directed or organized participation, aim at realizing or improving physical fitness and emotional state, forming social relationships or achieving results in competitions at all levels.
The present Special Conditions were adopted by the Board of Directors of LEV INS AD by virtue of the Minutes Protocol for the meeting of January 12, 2018 and are effective as of January 15, 2018.