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Types of Insurance > Travel and Health Insurance > Insurance Conditions

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Except from Conditions for Travel Health Insurance

1. The Insurer provides the insurance cover for immediate medical help as a consequence of illness or accident of insured person while being abroad.

2. With regard to exclusions listed in Article 7. Insurer will indemnify costs made for medically necessary treatment during temporary stay abroad. Within these Conditions, it will be considered that treatment includes only the following:

out-of-hospital treatment;

prescribed medications and bandages;

part of the treatment for broken body parts or injuries and accessory means for walking prescribed by physician;

radium-therapy, warmth-therapy or phototherapy and other such treatments prescribed by physician;

x-ray diagnosis;

Hospital treatment carried out at the institution which is generally considered as a hospital in a foreign country, under constant medical instructions by physicians, with sufficient number of diagnostic and therapy apparatus available and which provide methods considered scientific and medically tested in that country. Local hospital in the place where the insured stays or the nearest appropriate hospital will be used.

transportation costs considered as first aid to the nearest hospital or the nearest available physician;

Surgery (including surgery and associated costs);

dental treatment for easing the acute toothache only;
Together with previously listed, the Insurer will indemnify the following:

in case of death extra costs of transportation home of the remains of the deceased or extra costs of burial in the place of death abroad, but with maximum of 10.000 KM.
Extra costs within these Conditions are:

in the case of transportation home, additional costs arising from transportation home as a consequence of the insured event,

in the case of death, costs that exceeds those that would normally appeared if the insured has died in the place of his permanent residence in his country. Total maximum limit of liability of the insured for each travel is stated in the insurance policy.

3. The insurer is not liable to pay indemnification in following cases:

For chronic diseases and consequences of such diseases that exist or are known in the time of requisition and/or in the beginning of the insurance even if they have not been treated or for diseases treated six months before inception of insurance, including its consequences, unless the medical help asked for abroad does not include unforeseen urgent life-saving for the insured, or measures exclusively taken for easing the acute pains. Same limitations in respect of indemnification are applied to consequences of the accidents.

For costs beyond reasonable and usual costs. As reasonable and usual costs will be considered those costs for medical care considered as reasonable and usual to the extent of not going beyond general level of costs made for other similar stays in the location where costs made for same or comparable treatment, services or means to individual persons of the same gender and comparable age, for alike illnesses and injuries.

For diseases or accidents as a result of wars or similar events or active participation in commotion.

For any incapability caused by intentional self-injury, suicide, attempt to commit suicide (no matter be it criminal or not).

For sports risks which include training or participation in competitions of professional or amateur sportsmen and sportswomen, unless sport risks are agreed separately and increased premium of 100% paid.

For diseases and accidents which the insured has caused on purpose, or by committing the crime or as a result of being drunk or addiction to alcohol, drugs etc. for removal of physical defects or anomalies (cosmetics treatment).

For any costs made in connection with vacation trips or recovery in spas or sanatoriums, convalescent homes or similar institution.

For psychoanalytical or psychotherapeutic treatment.

For pregnancy, child birth and their consequences. In case of acute complication during pregnancy the Insurer will indemnify, within the scope of the policy, medical measures for preventing danger to the mother and childe’s life under the condition that mother has not reached age of 38 years and that 30th week of pregnancy is not finished yet.

For medical treatment of typical difficulties during pregnancy and its consequences including changes in permanent living conditions as a result of pregnancy.

For check-ups during pregnancy or abortion.

For treatment by spouse, parents or children.

For rehabilitation and physiotherapy and costs of prosthesis (artificial parts etc.).

For any costs not mentioned as indemnifiable in Article 6.

4. Hospitalization, out of hospital treatment, first aid transport, transport home, transport of deceased’s remains and burial are costs to be indemnified by means of claim. Those costs do not have to be paid by the insuree himself, but will be settled directly by assistance company «MONDIAL» WIEN. The insuree will release physicians contacted by authorised agents of the Insuree of their liability not to reveal information in his case. All costs of transports need to have documents from hospital, physicians etc.

5. Claims for indemnification have to be submitted to the Insurer no later then one month after finishing the treatment or transportation home or, in case of death, after transportation of remains/burial. 6. Insurer provides to the insure person options for additional risks like:
Accident Insurance:Insurer will provide services of insurance for accidents that happen during the travelling that leads to death or permanent invalidity of insured person, if that person survive unwanted interruption of its health as a result of event where there is a sudden external hit to his or her body or dislocated ankle due to overexertionor muscules, or ligaments or capsules get strained or broken. Above services of Insurer are limited up to highest amount per insured travelmentioned in the insurance policy.
Luggage insurance: This insurance is covering damage on your luggage during the travelling, or staying at the place of travel and returnee as well. For luggage under supervision, Insurer will indemnify cost if the luggage under supervision get lost or get damaged as a result of: criminal acts (robbery or stealing), accident of transportation vehicles or other kinds ( etc. Car accident), or fire and natural disasters (etc storm, flood). For luggage which is not under supervision insurer will indemnify cost that is determined if luggage which is not under supervision get lost or be damaged while is under supervision of Travelling company. Company that provides place for staying and place for luggage. Insurer will indemnify cost that is determined up to 100,00 EUR for buying new replacement luggage which is not under supervision delivered with more then 12 hours of delay since time of arrival written in travelling schedule. Under luggage we consider personal things, presents and souvenirs. Insured person participate in damage for each insured event in amount of 50,00 EUR by one damage request.
Luggage for period more than 90 days can not be subject of insurance.
Cancelled trip insurance: If insured person cancelled the trip before even start, Insurer will pay cost by agreement specified costs if cancelling happens because of following reasons: death, serious injury, unexpected illness, pregnancy, lost or damage on property of insured person caused by fire, or some other natural events or criminal acts, military drill and problems with pregnancy. Above services of Insurer are limited up to highest amount by insurance travel amounts that are mentioned in insurance policy. Insured person participate in damage for each insured event with 50,00 EUR.
Travel insurance of personal liability: Insurer gives the insurance for risks of personal liability that happens in a daily life. Insurance covers cases where in the case of death or injury the third side has authorization which is determined by law about personal liability to seek for insurance assets for damage. If Insurer would like to cover the request for personal liability by accepting responsibility or out of court agreement and cant be done because third person not agree, Insurer will not be in obligation to pay extra costs since date of rejection of base amount, interests and costs.
Above services of Insurer are limited up to highest amount by insured travel, amounts that are mentioned in insurance policy. Insured person will participate for each damage event in amount of 100,00 EUR by damage request.

In case of dispute, the Court in Tuzla is in competence.

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