General Conditions of Insurance (GCI) for UVG supplementary insurance

2017 version

www.hdi.global

Client information pursuant to the Swiss Federal Insurance Contracts Act (VVG), Article 3 The following information provides an overview of the insurer‘s identity and the general contents of the insurance contract. The individual rights and duties of the contractual parties are governed by the insurance quote and/or insurance contract, the contract terms and conditions and the applicable legislation, in particular the Swiss Federal Insurance Contracts Act (VVG). Upon acceptance of the quote, the policyholder will receive an insurance contract for signature.

Who is the insurer?HDI Global SESwiss branchDufourstrasse 468008 Zurich hereinafter referred to as HDI.

What risks are insured and what is the scope of the insurance cover?The insured risks and scope of the insurance cover can be found in the quote and/or, after concluding the policy, the insurance contract and conditions of insurance.

How much is the premium?The level of the premium depends on the insured risks and desired cover and is agreed individually in each specific case. There may be an additional fee for instalment payments if applicable. All other information about the premium and any fees is contained in the quote and/or the insurance contract.

When is there an entitlement to a premium refund?If the premium has been paid in advance for a specific term of insurance and the insurance contract is terminated prior to the end of this term, HDI will refund the premium applicable to the remaining insurance period.

The premium is owed to HDI in full if:• insurance benefits have been paid out due to the elimination of the risk;• insurance benefits for a partial loss have been paid out and the policy-

holder terminates the insurance contract during the year following conclusion of the contract.

What are the policyholder‘s duties?• Changes in risk:

If there is a change in a material fact during the term of the insurance which results in a significant increase in risk, the policyholder must notify HDI of this immediately in writing.

• Disclosure of information:The policyholder must cooperate with HDI in disclosing information per-taining to the insurance contract – e.g. with regard to breaches of noti-fication duties, increases in risk, claims assessments, etc. – and provide HDI with all information and documents requested by it, obtain these from third parties on behalf of HDI and authorise third parties in writing to provide HDI with the information and documents etc. requested. HDI is also entitled to carry out its own investigations.

• Insured event:An insured event must be reported to HDI immediately. The policyholder must respond immediately to all of HDI‘s questions about the insured event and provide the documents requested by it, obtain these from third parties on behalf of HDI and authorise third parties in writing to

provide HDI with the information and documents etc. requested. HDI is also entitled to carry out its own investigations.

This list includes only the most common duties. Other duties arise from the conditions of insurance and the Swiss Federal Insurance Contracts Act (VVG).

When does the insurance cover commence?The insurance cover commences on the date stipulated in the quote and/or insurance contract. If a provisional cover note has been issued, HDI will grant insurance cover until the client receives the insurance contract on the terms stated in writing in the provisional cover note or in accordance with the law.

When does the insurance contract end?The policyholder may end the insurance contract by termination:• no less than three months before the end of the insurance contract or,

if agreed, three months prior to the end of the insurance year. Notice of termination will have been duly given if it is received by HDI no later than the last day before commencement of the three-month notice period. If the insurance contract is not terminated, it will be automatically renewed for a further year. Fixed-term contracts without an extension clause end automatically on the date stipulated in the quote and/or insurance contract;

• following every insured event for which a benefit is owed, no later than 14 days from notice of payment by HDI;

• if HDI adjusts the premium. In this case, HDI must receive the termin-ation by the last day of the insurance year;

• if HDI has breached its statutory duty of notification pursuant to Article 3 of the VVG. The right of termination lapses four weeks after the policy-holder receives notification of the breach, but in all cases at the end of one year after the breach of duty.

HDI may end the insurance contract by termination:• no less than three months before the end of the insurance contract or,

if agreed, three months prior to the end of the insurance year. Notice of termination will have been duly given if it is received by the policyholder no later than the last day before commencement of the three-month notice period. If the insurance contract is not terminated, it will be automatically renewed for a further year. Fixed-term contracts without an extension clause end automatically on the date stipulated in the quote and/or insurance contract;

• following every insured event for which a benefit is owed, provided the contract is terminated no later than the payment or last partial payment, if the benefit is paid in multiple parts;

• if material facts relevant to the risk have been concealed or incorrectly stated (breach of the duty of notification).

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HDI may terminate the insurance contract by withdrawal:• if the policyholder defaults on payment of the premium, does not re-

spond to reminders and HDI ceases demanding payment of the premium within two months of the end of the statutory reminder period or subse-quently refuses to accept the premium payment;

• if the policyholder does not comply with their duty to cooperate in the disclosure of information. HDI is entitled to withdraw from the insur-ance contract within two weeks of the end of a four-week grace period stipulated in writing;

• in the event of insurance fraud.

This list includes only the most common general grounds for termination. Other grounds aside from the general termination options are set out in the contractual conditions and the Swiss Federal Insurance Contracts Act (VVG).

How does HDI handle data?HDI processes data deriving from the contract documents or the contract arrangement process and uses this in particular for premium calculation, risk assessment, processing insured events, statistical analyses and mar-keting purposes. Data is stored physically and/or electronically.

HDI may, insofar as is necessary, forward data for processing and storage to third parties involved in arranging the contract within Switzerland and abroad, in particular to co-insurers and reinsurers as well as Swiss and foreign companies and branches of HDI Global SE.

If offences against property or document fraud are suspected, or in the event that HDI withdraws from the insurance contract due to a fraudulent insurance claim (Article 40 VVG), a report may be sent to the Swiss Insur-ance Association (Schweizerischer Versicherungsverband or SVV) for entry in the central information system (CIS).

If a broker or agent is acting on behalf of the policyholder, HDI is entitled to disclose client data – e.g. data relating to the arranging of the contract, premium payments and insured events – to this person.

Furthermore, HDI may obtain pertinent information, in particular about the client‘s claims history, from public authorities and other third parties. This applies irrespective of whether or not an insurance contract is agreed.

By signing the insurance contract, the policyholder agrees that their data will be processed in accordance with the principles above. The policyholder is entitled to request the information stipulated by law about the process-ing of data relevant to it. The consent to processing of data may be revoked at any time.

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General Conditions of Insurance (GCI) for UVG supplementary insurance 2017 version

Table of contents

Basis of the contract 51 General principles ......................................................................5

Scope of the insurance 52 Nature of insurance cover ..........................................................53 Insured accidents and occupational illnesses .............................54 Insured persons ..........................................................................55 Geographical scope ...................................................................56 Term of insurance cover for insured individuals .........................5 6.1 Beginning of insurance cover .....................................................5 6.2 End of insurance cover ..............................................................5 6.3 Insured events still open when the contract expires ..................57 Insurance during unpaid holiday ................................................58 Transfer to individual insurance .................................................5 8.1 Right to transfer .........................................................................5 8.2 Reinstatement ............................................................................5 8.3 Restrictions on the right of transfer ...........................................69 Gross negligence, extraordinary risks and hazards ....................610 Restrictions on insurance cover ..................................................6

Benefits 611 Treatment costs (care services and reimbursement of costs) ......6 11.1 Entitlement, amount and duration of benefits ...........................6 11.2 Third-party benefits ....................................................................712 Daily hospital allowance ............................................................7 12.1 Entitlement ................................................................................7 12.2 Benefit period ............................................................................713 Daily allowance ..........................................................................7 13.1 Entitlement ................................................................................7 13.2 Waiting period ...........................................................................7 13.3 Benefit period ............................................................................7 13.4 Partial incapacity for work .........................................................7 13.5 Third-party benefits ....................................................................714 Disability ....................................................................................7 14.1 Lump-sum disability benefit .......................................................7 14.1.1 Entitlement ................................................................................7 14.1.2 Benefit calculation .....................................................................7 14.1.3 Degree of disability ....................................................................7 14.1.4 Progression options ...................................................................8 14.1.5 Pension payment........................................................................8 14.1.6 Payment of benefits ...................................................................8 14.1.7 Impairment compensation ........................................................8 14.2 Disability pension .......................................................................8 14.2.1 Entitlement ................................................................................8 14.2.2 Adjustment of the pension for inflation .....................................8 14.2.3 Buyout of pensions ....................................................................8 14.2.4 Third-party benefits ....................................................................815 Death .........................................................................................9 15.1 Lump-sum death benefit ............................................................9 15.1.1 Entitlement ................................................................................9

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15.1.2 Eligible beneficiaries ..................................................................9 15.2 Survivors‘ pension ......................................................................9 15.2.1 Entitlement ................................................................................9 15.2.2 Partner’s pension .......................................................................9 15.2.3 Third-party benefits ....................................................................9 15.2.4 Adjustment of the pension for inflation .....................................9 15.2.5 Buyout of pensions ....................................................................916 UVG difference coverage............................................................9

Additionalinsurancebenefits 917 Insurance of continued salary payments after death..................918 Insurance for the consequences of earlier accidents ................10 18.1 Entitlement ..............................................................................10 18.2 Benefits ....................................................................................10 18.2.1 Treatment costs ........................................................................10 18.2.2 Daily allowance ........................................................................10 18.3 Third-party benefits ..................................................................1019 Determination of insured benefits based on insured earnings ...................................................................................10 19.1 Calculation basis ......................................................................10 19.2 Allowable earnings ..................................................................1020 Set-off against liability claims ..................................................1021 Aircraft hijackings and similar events ......................................10

Premiums 1022 Premium calculation ................................................................1023 Advance premium and premium adjustment ...........................1124 Flat-rate premium ....................................................................1125 Payment in instalments ............................................................1126 Reimbursement ........................................................................1127 Change in the premium tariff ...................................................11

Surplus share 1128 Surplus share ...........................................................................11

Claims 1129 Obligations ..............................................................................1130 Consequences of a breach of contract .....................................11

Term of the contract and right of termination 1131 Term of the contract .................................................................1132 Increase or decrease in risk ......................................................1233 Right of termination in the event of a claim ............................12

Miscellaneous 1234 Non-negligent breach of contract ............................................1235 Assignment of claims ...............................................................1236 Notifying HDI ...........................................................................1237 Place of performance and jurisdiction ......................................12

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Basis of the contract

1 General principlesThe insurance contract shall be based on

a) these General Conditions of Insurance, any special terms together with the provisions of the policy with any addenda;

b) the Swiss Insurance Contracts Act (Bundesgesetz über den Versi-cherungsvertrag or VVG) dated 2 April 1908 for matters not gov-erned by the provisions in a) above;

c) all existing written contractual agreements between HDI and the policyholder or insured person.

Scope of the insurance

2 Nature of insurance coverHDI grants insurance cover against the financial consequences of ac-cidents and occupational illnesses on the basis of the benefits set out in the policy.

3 Insured accidents and occupational illnessesa) The insurance covers

• accidents, occupational illnesses and bodily injuries pursuant to Art. 6 para. 2 UVG that are recognised as insurable events by the UVG insurer of the insured company or for which the UVG insurer of the insured company refuses cover due to culpable causation or extraordinary risks or hazards;

• accidents occurring during Swiss military service or another activity covered by military insurance, provided the insured person − had they not performed the stated activities − would have been previ-ously insured by the UVG insurer pursuant to a), first bullet point, against non-occupational accidents.

The prerequisite for HDI’s benefit obligation is that

• the occurrence of accidents pursuant to Art. 6 para. 2 UVG

• the last hazard that occurred prior to the onset of an occupational illness

falls within the term of insurance cover of this insurance contract. In all cases, this is without prejudice to section 10.

b) Disability and death benefits will be reduced accordingly if the dam-age to health or death is only partially attributable to an insured accident.

4 Insured personsa) The insured persons shall be designated in the policy.

b) The insurance may cover persons who are eligible for insurance in the compulsory or voluntary insurance of the insured company or occupation pursuant to the Swiss Federal Law on Accident Insurance (Bundesgesetz über die Unfallversicherung or UVG) of 20 March 1981.

The insurance cover will also be granted to persons who work for the policyholder for at least eight hours per week if the accident occurs at another company or occupation subject to the UVG (multiple em-ployers). This also applies to non-occupational accidents for which the UVG insurer of the other company subject to UVG insurance is responsible. HDI will provide insurance benefits within the scope of and based on the salary insured and declared in this insurance con-tract. HDI’s insurance cover shall be subsidiary to the existing insur-ance cover of the other company subject to the UVG.

Individuals sent abroad by the policyholder are covered by this insur-ance contract for the duration of their stay abroad, but no longer than a term of six years (subject to section 6.2).

Temporary staff hired by the policyholder from a third-party organi-sation are excluded from this UVG supplementary insurance policy.

c) Only if this is expressly mentioned in the policy are the insured per-sons voluntarily insured under UVG insurance.

5 Geographical scopeThe insurance shall apply all over the world.

6Term of insurance cover for insured individuals

6.1 Beginningofinsurancecover

• The insurance cover for insured individuals begins on the day the employment relationship commences or wage entitlement first exists, but in any event at the time when the employee begins their journey to work. However, the insurance cover shall begin no earlier than the commencement date designated in the policy.

• The insurance cover automatically applies to individuals who are not named but who belong to a group of insured persons listed in the policy; this is without prejudice to section 6.1, first bullet point.

• The insurance shall only apply to persons identified by name upon confirmation by HDI.

6.2 Endofinsurancecover

The insurance cover for an insured individual ends

• when the person leaves the insured company;The insurance cover remains in effect for as long as the insured person is covered by the compulsory UVG insurance of the insured company. If the insured person first begins a new job, the insur-ance cover ends when the insured person begins the new job.

• for interruptions of work during which the insured person does not receive a salary and, insofar as the premium is defined in tenths of a percent of the salary, pursuant to the provisions of the UVG;The insurance may be extended beyond the statutory period in individual cases by means of an extended cover policy.

• in case of unemployment according to the provisions of the UVG;

• upon cancellation of the contract.

6.3 Insuredeventsstillopenwhenthecontractexpires HDI will pay benefits after this date if applicable.

7 Insurance during unpaid holidayIf the insured person has taken out a UVG extended cover policy, cover is also provided in the UVG supplementary insurance. No daily benefits are paid during unpaid holidays. However, periods of unpaid holiday are included in the waiting period. Daily benefits will not be paid before the date on which the insured person would have had to return to work.

8 Transfer to individual insurance

8.1 Righttotransfer

If an insured person leaves the group of insured individuals or this contract is cancelled, an insured person resident in Switzerland has the right to transfer to individual insurance policy from HDI. The right of transfer must be exercised within 90 days.

8.2 Reinstatement

HDI will reinstate the previous insured benefits subject to the terms and conditions and tariffs for individual insurance applicable at the time of transfer. The state of health and age of the insured person at the date of joining the UVG supplementary insurance are the deter-mining factors for reinstatement of insurance.

8.3 Restrictionsontherightoftransfer

The right of transfer does not apply in the following circumstances:

• job changes and transfer into the UVG supplementary insurance of a new employer;

• cancellation of this UVG supplementary insurance policy and con-tinuation of the policy with another insurer for the same group of individuals;

• over the age of 70;

• if the insured person moves abroad.

9Grossnegligence,extraordinaryrisksandhazardsHDI will not reduce benefits for accidents insured under this contract that result from gross negligence, extraordinary risks or hazards as de-fined by the UVG. This is without prejudice to section 10.

10 RestrictionsoninsurancecoverInsurance cover shall not include the following:

a) consequences of warlike events• in Switzerland;• abroad. However, should war break out unexpectedly and surprise

the insured person in the country in which they are located, the insurance cover will remain in effect for 14 days following the out-break of war;

b) accidents resulting from a deliberate criminal act or offence;

c) benefits for accidents that occur while carrying out an offence will be reduced or denied pursuant to the customary reduction under UVG. This also includes accidents resulting from alcohol or drug consump-tion, unless there is evidently no causal connection between the insobriety/intoxication and the accident;

d) suicide, self-inflicted injury or an attempt to do so;

Exception: However, cover will be granted if the insured individual was completely incapable, through no fault of their own, of act-ing reasonably at the time of the incident, or if the suicide, suicide attempt or self-inflicted injury evidently resulted from an insured accident.

e) accidents caused by the operation of aircraft and parachute jumping, if the insured person wilfully fails to comply with official regulations or does not hold the required official identification documents and permits;

f) the effects of ionising radiation;

Exception: There shall be cover for damage to health resulting from radiation treatments ordered by a doctor due to an insured accident.

Damage to health resulting from radiation exposure while perform-ing a professional activity for the insured company or occupation shall also be covered under the UVG, provided this has been expressly agreed with HDI.

g) damage to health resulting from interventions, therapeutic measures and examinations that are not caused by an insured accident;

h) accidents occurring during foreign military service;

i) participation in war and warlike operations;

j) participation in acts of terror and gang crimes;

k) participation in scuffles and brawls, unless the insured person is injured by the fighting parties as a bystander or while assisting a defenceless individual;

l) participation in riots and civil commotion.

Benefits

11 Treatment costs (care services and reimbursement of costs)

11.1Entitlement,amountanddurationofbenefits

If treatment costs are insured, HDI shall assume the portion of the necessary expenses not covered by the UVG insurer and/or military insurance for an unlimited amount and period − subject to b), d), f), g) and h) below − for the following measures:

a) medically prescribed or administered

• therapies (including medications);HDI shall also assume the deduction from daily benefits that the UVG insurer and/or military insurance makes for running costs.

• hospital and convalescent stays as defined by section 12.1 b);

• hiring of medical equipment;

• first-time acquisition of aids that compensate for bodily injuries or functional deficiencies: prostheses, glasses, hearing aids and orthopaedic devices;

• repair or replacement (replacement value) of objects that replace a body part or body function. Insured persons are only entitled to the repair or replacement of glasses, hearing aids and dental prostheses if these have been damaged or destroyed in an insured accident that results in bodily injury requiring treatment;

b) complementary medicine treatments such as acupuncture, anthro-posophical medicine, traditional Chinese medicine (TCM) therapies, traditional medical homeopathy and phytotherapy prescribed by a doctor and administered by doctors with the corresponding training. The total costs shall be limited to CHF 1,000 per person per case;

c) HDI will provide home care (i.e. care of the accident victim at home) and take care of household errands for the duration of the medical treatment if the insured person is not able to do so themselves for accident-related reasons;

d) all travel and transport of the insured person to the treatment loca-tion resulting from the accident, however only by aircraft if this is un-avoidable for medical or technical reasons. However, the insurance shall not cover travel expenses for individuals who can reasonably be expected to walk. Should the insured person have an accident abroad that requires a hospital stay of more than 14 days, they may request to be transferred to a Swiss hospital. The transport must be adapted to the specifics of the injury and the medical interventions taken. HDI shall credit any savings resulting from refunds of unused train, plane and boat tickets against its benefit obligations;

e) rescue operations for the benefit of the insured person that are not caused by illness;

f) rescue operations and repatriation (transport to the place of burial) of the body if an insured accident results in death. If the transport of the body is accompanied by a family member, HDI will assume the travel costs for one person (first-class train travel or economy-class flight);

g) search operations conducted to rescue or recover the insured person, up to a maximum of CHF 20,000 per insured individual;

h) property damage up to CHF 5,000 per case; the policy covers ex-penses for cleaning, repairing or replacing clothing or other personal items (vehicles with registration plates are excluded) of the insured person damaged in an insured accident at replacement value as well as the cleaning of vehicles or other items of private individuals who were involved in rescuing and transporting the injured person.

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11.2Third-partybenefits

If the insured person or beneficiaries are entitled to benefits from social insurance (e.g. the Swiss old age and survivors’, dis-ability, health, accident, unemployment or military insurance), under a (compulsory and non-compulsory) occupational pension, other indemnity insurers or a liable third party, HDI will supple-ment these third-party benefits up to the amount of the treat-ment costs incurred. HDI will pay no more than the costs set out in section 11.1. The above provision is also applicable to corresponding insurance institutions based in the Principality of Liechtenstein or other foreign countries.

Should multiple insurances from licensed companies cover the treat-ment costs, they will only be paid once in total. HDI’s payment ob-ligations in such cases will be governed by the statutory provisions. However, any existing compulsory accident insurance pursuant to the Federal Law on Accident Insurance (UVG) provided by a licensed company is excluded from this calculation.

12 Daily hospital allowance

12.1Entitlement

a) HDI will pay the agreed daily hospital allowance for the duration of a doctor-prescribed, medically necessary stay in a hospital or conva-lescent home.

Instead of the daily hospital allowance, HDI will pay a maximum of half of the daily hospital allowance per day for home care (care of the accident victim at home) by trained care personnel. A require-ment for this benefit is that a hospital stay would be necessary in a doctor’s opinion, but that hospitalisation is not possible or a hospital stay has been verifiably shortened or avoided.

b) Hospitals are defined as infirmaries and psychiatric clinics managed or overseen by physicians.

Convalescent homes are defined as establishments for spa, climatic or rehabilitation treatments and convalescence holidays managed by physicians.

The stay is medically necessary if it serves the purpose of medical treatment with a view to a recovery or preventing a deterioration in the health condition. In addition, stays at convalescent homes are only covered if the insured person was in a doctor’s care before en-tering the home. Furthermore, spa treatments must be administered under a doctor’s supervision. Convalescent stays are only covered if they are carried out at a physician-led convalescent home.

12.2Benefitperiod

HDI will pay the daily hospital allowance per accident for a maximum of 1,800 days for hospital and convalescent stays combined.

For home care it will in addition assume the costs for a maximum of 200 care days per accident.

13 Daily allowance

13.1Entitlement

HDI will pay the agreed daily allowance for the duration of a med-ically certified incapacity to work, however not before the end of the waiting period stipulated in the policy, for the days taken into account by the UVG insurer and/or military insurance for calculating the daily allowance. Advance certification of incapacity will be recognised for no more than one month.

Depending on the agreement, the amount of the daily allowance may be based on earnings or set as a fixed amount in CHF.

13.2Waitingperiod The waiting period begins on the first day following the date of the

accident.

13.3Benefitperiod HDI will pay the daily allowance at a maximum until the date on

which the UVG disability pension commences in accordance with the decision of the UVG insurer.

13.4Partialincapacityforwork In the case of partial incapacity, HDI will pay a daily allowance cor-

responding to the degree of incapacity. Days of partial incapacity are counted as full days for the purpose of determining the waiting period and benefit duration.

13.5Third-partybenefits If the insured person or beneficiaries are entitled to benefits from so-

cial insurance (e.g. the Swiss old age and survivors’, disability, health, accident, unemployment or military insurance), under a (compulsory and non-compulsory) occupational pension, other indemnity insurers or a liable third party, HDI will supplement these third-party benefits up to the level of the insured person’s actual loss of earnings. HDI will pay no more than the agreed daily allowance. The above provision is also applicable to corresponding insurance institutions based in the Principality of Liechtenstein or other foreign countries.

Should HDI pay a daily allowance to cover a loss of earnings instead of another liable third party, it will subrogate the rights of the insured person or beneficiary in proportion to the benefits paid.

Should multiple insurance policies from licensed companies be in place for a daily allowance to cover loss of earnings, the insured loss of earnings under this contract will only be covered in proportion to the benefits guaranteed by all the insurers combined. However, any existing compulsory accident insurance pursuant to the Federal Law on Accident Insurance (UVG) provided by a licensed insurance company is excluded from this calculation.

The provisions in section 13.5 above do not apply if the daily allow-ance is stipulated in the policy as a fixed amount in CHF.

14 Disability

14.1Lump-sumdisabilitybenefit14.1.1Entitlement

HDI will pay the agreed lump-sum disability capital if the insured person suffers a permanent impairment of their physical or mental integrity. Any incapacity for work caused by the event is not taken into account.

14.1.2Benefitcalculation

The disability sum insured is based on the agreed insurance sum, the degree of disability and progression option.

If the insured person was already disabled prior to the accident, HDI will pay the difference between the disability sums applying to the degree of disability before and after the accident pursuant to this contract.

14.1.3Degreeofdisability

The provisions of the UVG governing impairment compensation ap-ply to the measurement of the degree of disability. In case of a partial loss or partial loss of use, the lower degree of disability will apply. Full loss of use of limbs or organs is deemed equivalent to their loss. Should multiple body parts or organs be affected by the accident, the percentages are totalled. However, the degree of disability will never exceed 100%.

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14.1.4Progressionoptions

The table below shows the benefits paid as a proportion of the agreed insurance sum for different degrees of disability.

14.1.5Pensionpayment

If the insured person has turned 70 at the time of the accident, HDI will pay a life annuity instead of the disability sum insured (see sec-tion 14.1.2). It amounts to CHF 95 per CHF 1,000 of disability com-pensation and is paid quarterly in advance. The pension takes effect once the degree of disability can be determined and any daily allow-ance payments have ceased.

14.1.6Paymentofbenefits

The disability sum insured or pension is paid once the degree of permanent disability can be determined, however no later than five years after the date of the accident.

Only the insured person is entitled to benefits.

14.1.7Impairmentcompensation

a) Benefit calculation

The impairment compensation is determined by the provisions of the UVG and is paid if the insured person suffers a permanent impair-ment of their physical or mental integrity as a result of the accident.

b) Benefits

HDI will pay the multiple of the impairment compensation insured under the policy based on the provisions of the UVG; depending on the agreement, this is related to the UVG salary and/or the surplus salary (see section 19.2).

DoD*Option

DoD*Option

DoD*Option

DoD*Option

A B C D A B C D A B C D A B C D

100 225 350 100 100 75 150 225 100 88 50 75 100 100 75 25 25 25 75 5099 222 345 100 100 74 147 220 100 87 49 73 97 99 74 24 24 24 72 4898 219 340 100 99 73 144 215 100 87 48 71 94 98 73 23 23 23 69 4697 216 335 100 99 72 141 210 100 86 47 69 91 97 72 22 22 22 66 4496 213 330 100 98 71 138 205 100 86 46 67 88 96 71 21 21 21 63 4295 210 325 100 98 70 135 200 100 85 45 65 85 95 70 20 20 20 60 4094 207 320 100 97 69 132 195 100 85 44 63 82 94 69 19 19 19 57 3893 204 315 100 97 68 129 190 100 84 43 61 79 93 68 18 18 18 54 3692 201 310 100 96 67 126 185 100 84 42 59 76 92 67 17 17 17 51 3491 198 305 100 96 66 123 180 100 83 41 57 73 91 66 16 16 16 48 3290 195 300 100 95 65 120 175 100 83 40 55 70 90 65 15 15 15 45 3089 192 295 100 95 64 117 170 100 82 39 53 67 89 64 14 14 14 42 2888 189 290 100 94 63 114 165 100 82 38 51 64 88 63 13 13 13 39 2687 186 285 100 94 62 111 160 100 81 37 49 61 87 62 12 12 12 36 2486 183 280 100 93 61 108 155 100 81 36 47 58 86 61 11 11 11 33 2285 180 275 100 93 60 105 150 100 80 35 45 55 85 60 10 10 10 30 2084 177 270 100 92 59 102 145 100 80 34 43 52 84 59 9 9 9 27 1883 174 265 100 92 58 99 140 100 79 33 41 49 83 58 8 8 8 24 1682 171 260 100 91 57 96 135 100 79 32 39 46 82 57 7 7 7 21 1481 168 255 100 91 56 93 130 100 78 31 37 43 81 56 6 6 6 18 1280 165 250 100 90 55 90 125 100 78 30 35 40 80 55 5 5 5 15 1079 162 245 100 90 54 87 120 100 77 29 33 37 79 54 4 4 4 12 878 159 240 100 89 53 84 115 100 77 28 31 34 78 53 3 3 3 9 677 156 235 100 89 52 81 110 100 76 27 29 31 77 52 2 2 2 6 476 153 230 100 88 51 78 105 100 76 26 27 28 76 51 1 1 1 3 2

14.2Disabilitypension

14.2.1Entitlement

HDI will pay the agreed disability pension if the insured person’s gainful employment is expected to be impacted permanently or for an extended period of time. The conditions for entitlement are based on the provisions of the UVG. However, the provisions concerning a complementary pension shall not apply.

14.2.2Adjustmentofthepensionforinflation

Pensions will be adjusted for inflation in line with the provisions of the UVG. However, the adjustment will be no more than 10% per year and years with less than 10% inflation cannot be compensated for by years with more than 10% inflation.

14.2.3Buyoutofpensions

The provisions of the UVG apply; HDI will always buy out disability pensions if the monthly amount is less than CHF 200.

14.2.4Third-partybenefits

If the insured person or beneficiaries are entitled to third-party bene-fits, HDI will supplement these benefits up to the level of the insured person’s actual loss of earnings. At most, HDI will pay the agreed pension.

Third-party benefits include, for example, those of social and private insurers in Switzerland and abroad, pension funds of any kind and statutory benefits. Fixed-sum insurance benefits are excluded.

Table of 14.1.4: Benefit in % of insurance sum DoD* = Degree of disability

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15 Death

15.1Lump-sumdeathbenefit

15.1.1Entitlement

HDI will pay the agreed lump-sum death benefit if the insured person dies.

The lump-sum death benefit will be no more than CHF 20,000 for insured individuals who have not yet turned 16 or are over the age of 70 on the date of the accident.

Should the insured person die within five years of an accident as a consequence of the accident, HDI will pay the sum insured in the event of death, less any disability compensation already paid for the same accident.

15.1.2Eligiblebeneficiaries

The insured person may deviate from the arrangements below and designate or exclude beneficiaries by notifying HDI in writing. Such a declaration may be revoked or amended at any time by written noti-fication to HDI. If there is no such special designation, the following shall be the sole valid beneficiaries, in this order:

• a surviving spouse or registered partner;

If the marriage or registration of the partnership took place after the accident, an entitlement shall exist if the marriage or partner-ship had lasted for at least two years at the date of death of the insured person.

• an unrelated partner (including same-sex partners) who had an uninterrupted common law marriage in the same household as the deceased in the last five years prior to their death;

• children in equal shares;

This shall also include children whose long-term care and upbring-ing were being provided by the insured person at the time of the accident without payment.

• parents.

The beneficiaries are listed in order of priority, with each category excluding the categories below.

If none of the beneficiaries are available, only the funeral expenses not covered by the UVG insurer or military insurance will be reim-bursed up to 10% of the lump-sum death benefit, subject to a max-imum of CHF 20,000.

Eligible beneficiaries of an insured person shall receive the benefits even if they refuse their inheritance. The benefits will not enter into the estate of the deceased.

15.2Survivors‘pension

15.2.1Entitlement

HDI will pay the agreed survivors’ pension if the insured person dies. The conditions for entitlement are based on the provisions of the UVG. However, a divorced spouse or former partner in a partnership that has been dissolved is not entitled to a survivors’ pension and the provisions governing a complementary pension shall not apply.

15.2.2Partner’spension

a) All of the following requirements must be met in order for a partner’s pension to be paid:

• Partners of the opposite or same sex must have verifiably lived in a joint household on an uninterrupted basis for at least the last five years prior to the death of the insured person, or they verifi-ably lived in a joint household at the time of death of the insured person and the surviving partner is responsible for the maint- enance of at least one joint child.

• Neither partner was married or in a registered or other partnership at the time of death of the insured person.

• The partners are not related to one another.

• The surviving partner does not receive any other spouse’s, widow’s, widower’s or partner’s pension from a previous marriage or regis-tered or other partnership.

b) Amount and duration of the partner’s pension

The amount and duration of the partner’s pension shall be governed by the provisions on survivors’ pensions under the UVG. The date on which the joint household has existed for five years or the date of birth of the partners’ child living in the joint household shall apply instead of the date of marriage.

c) Obligation

The surviving partner must provide all documents necessary for prov-ing a claim to the partner’s pension.

15.2.3Third-partybenefits

If the insured person or beneficiaries are entitled to third-party bene-fits, HDI will supplement these benefits up to the level of the insured person’s actual loss of earnings. At most, HDI will pay the agreed pension.

Third-party benefits include, for example, those of social and private insurers in Switzerland and abroad, pension funds of any kind and statutory benefits. Fixed-sum insurance benefits are excluded.

15.2.4Adjustmentofthepensionforinflation

Pensions will be adjusted for inflation in line with the provisions of the UVG. However, the adjustment will be no more than 10% per year and years with less than 10% inflation cannot be compensated for by years with more than 10% inflation.

15.2.5Buyoutofpensions The provisions of the UVG shall apply. HDI will always buy out sur-

vivors’ pensions if the monthly amount is less than CHF 200.

16UVGdifferencecoverageIf UVG difference cover has been taken out, reductions or refusals of benefits by the UVG insurer or military insurance in the event of ac-cidents that are due to gross negligence, extraordinary risks or hazards (with the exception of accidents that are caused deliberately) will be covered. This is without prejudice to section 10 of these General Condi-tions of Insurance.

If the benefits are payable by a liable third party or their representa-tive, these benefits will be deducted in full from the benefits payable by HDI.

HDI is entitled (but not obliged) to buy out pension benefits it owes at their present value at any time, as a result of which all claims arising from the insured accident lapse.

For pension benefits, there will in no case be any extra payment as an inflation adjustment.

Additionalinsurancebenefits

17 Insurance of continued salary payments after deathHDI will assume the employer’s statutory duty of continued salary pay-ments for the policyholder as defined by Art. 338, para. 2 of the Swiss Code of Obligations (OR). This benefit will only be paid if this insurance contract also provides for a lump-sum death benefit, a survivors’ pen-sion or a daily allowance.

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18 Insurance for the consequences of earlier accidents18.1Entitlement

If the insured person suffers a relapse as the result of an earlier accident or if the delayed effects of an earlier accident worsen, HDI will provide insurance benefits if the following requirements have been met:

• The insured person must have been employed by the policyholder for at least three months at the time of the relapse or deterioration in the delayed effects of an earlier accident.

• The treatment costs and/or daily allowance must also be insured under this contract.

18.2Benefits

HDI will pay the following expenses from the date of the first benefit claimed, however for no longer than two years:

18.2.1Treatmentcosts• outpatient medical treatment;• treatment in the general ward of a hospital;• medically prescribed after-treatment;• the tools, objects and aids necessary for recuperation;• the necessary travel and transports.

These benefits will be calculated based on the provisions of the UVG. The maximum benefit is CHF 100,000.

18.2.2Dailyallowance

If the insured person is unable to work during medical treatment, from the third day of incapacity and for a maximum of two years, HDI will reimburse a daily allowance of 80% of the insured UVG salary that the insured person earned immediately prior to the interruption of work at the policyholder’s company. Section 13.4 applies analo-gously in case of partial incapacity.

18.3Third-partybenefits

The benefits pursuant to section 18.2 will not be provided:

• if the treatment costs are payable by the UVG insurance, military insurance, a compulsory health insurance, the Swiss federal dis-ability insurance, a liable third party or a foreign insurer;

• if the insured loss of salary pursuant to section 18.2.2 suffered by the insured person is reimbursed at a rate of 80% or more by the UVG insurer and/or military insurance, a foreign insurer or the Swiss federal disability insurance. If all of these benefits com-bined amount to less than 80% of the loss of salary suffered by the insured person during their incapacity, HDI will reimburse the difference.

19Determinationofinsuredbenefitsbasedoninsured earnings

19.1Calculationbasis The hospital daily allowance and daily allowance are calculated

based on the insured daily earnings. Lump-sum disability and death benefits are calculated based on the

insured annual earnings. The insured earnings are determined based on the provisions of the

UVG, consisting of both the UVG salary and the surplus salary.

19.2Allowableearnings

Depending on the agreement, earnings consist of the following:• the UVG salary, i.e. the earnings insured pursuant to the UVG;• the surplus salary, i.e. the portion of total earnings subject to the

AHV (including earnings in kind) in excess of the UVG salary;• the total salary, i.e. the UVG and surplus salary combined.

Provided there is no agreement to the contrary, the allowable earn-ings shall be limited to CHF 300,000 per insured person per year. For one and the same insured person, this limit applies to both salary components together in the case of combined UVG/surplus salary insurance, and to the surplus salary alone if only the surplus of salary is insured.

For persons insured voluntarily under the UVG insurance of the in-sured company, the insured earnings shall comprise the earnings stated in the policy and agreed in advance as the insured earnings; in case of combined UVG/surplus salary insurance, the maximum UVG salary shall always be considered the UVG salary. This rule shall also apply to other persons designated by name for whom insured earn-ings have been agreed in the policy in advance.

20 Set-offagainstliabilityclaimsThe benefits paid under this accident insurance will be set off against the liability claims of the insured person or their survivors against the policyholder or other employees.

21 Aircrafthijackingsandsimilareventsa) Should insurance cover for an insured person end

• during an imprisonment following the hijacking of an aircraft on which the insured person was travelling;

• during an involuntary stay following a parachute jump to save the person’s life or following an emergency landing or

• during the direct return trip home or onward travel to the original destination following imprisonment or an involuntary stay,

it will remain valid beyond the expiry date for a period of no more than one year from the date of the hijacking, parachute jump or emergency landing.

b) The exclusions pursuant to section 10 with regard to warlike events and riots do not apply to accidents suffered by the insured person

• aboard an aircraft, provided the accident is caused by persons who were also on board or by dangerous materials smuggled onto the aircraft;

• during imprisonment following the hijacking of an aircraft, dur-ing an involuntary stay following a parachute jump to save the person’s life or an emergency landing or on the subsequent direct return trip home or onward travel to the original destination. The time limit pursuant to a) above shall also apply.

c) However, should a war break out, the insurance cover pursuant to b) will end 48 hours after the outbreak of hostilities in the country in which the aircraft is located at the time. However, if the imprisonment, parachute jump or emergency landing has already occurred, the sec-ond bullet point under b) above will only expire at the end of one year.

d) The extension of cover pursuant to a) and b) above shall apply pro-vided that the insured person was not actively or through incitement involved in the relevant events.

Premiums

22 Premium calculationThe premium is calculated based on

• the insured person’s salary as determined by AHV rules and the pro-visions of the UVG;

• the number of insured persons and/or the number of days of employment.

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23 Advancepremiumandpremiumadjustmenta) At the beginning of every insurance year, the policyholder is re-

quired to pay the provisional premium (advance premium), which corresponds as closely as possible to the assumed final premium. The payment deadline is 30 days from the due date.

b) The premium is adjusted at the end of each insurance year or when the contract ends. To this end, HDI will send the policyholder a form on which to report the particulars required for preparing the pre-mium adjustment.

Any premium supplement resulting from this adjustment is payable within 30 days of HDI’s request for payment. Any premium rebate will be paid out to the policyholder by HDI within the same period after establishing the final premium. The premium supplement or premium rebate will be waived by the contractual parties for amounts of less than CHF 20.

HDI is entitled to verify the information provided by the policyholder. The policyholder shall allow HDI to inspect all applicable documents (payslips, receipts, etc.) for this purpose.

c) HDI may adjust the advance premium from the beginning of an insurance year to reflect a change in circumstances.

24 Flat-ratepremiumThe premium is only considered to be a flat-rate premium if it was expressly agreed as such. The payment deadline is 30 days from the due date.

25 Payment in instalmentsIf payment in instalments has been agreed, instalments that fall due during the insurance year are deemed only to have been deferred, subject to section 26.

26ReimbursementIf the contract is cancelled before the end of an insurance year, HDI will reimburse the share of the premium paid for the remaining insurance period and will not collect future instalments. The provisions concern-ing final adjustment of the premium pursuant to section 23 remain unaffected.

However, the premium for the current insurance period is due in full if in the event of a partial loss the policyholder cancels the contract within one year of the start of the contract.

27 ChangeinthepremiumtariffShould there be a change in the material scope or level of the premium tariff for UVG supplementary insurance and/or the insurance benefits prescribed under the UVG, HDI may demand an amendment of the contract with effect from the following insurance year.

To this end, HDI will notify the policyholder of the new contractual pro-visions no later than three months before the end of the insurance year. The policyholder is entitled to terminate the portion of the contract affected by the amendment or the entire contract as at the end of the current insurance year. HDI must receive the termination no later than the last day of the insurance year in order for it to be valid. Should the policyholder fail to terminate the contract, this shall be deemed to be an approval of the contractual amendment.

Surplus share

28 Surplus shareShould the policy include surplus sharing, the policyholder will receive the contractual share of any surplus at the end of the agreed adjust-ment period.

The surplus is determined by deducting the insurance benefits paid for claims arising during the adjustment period from the premium ap-plicable to the adjustment period. In the process, pension benefits are included at their present value.

The length of the adjustment period, applicable premium and surplus share will be stipulated in the policy. The adjustment is made once the premiums due in the adjustment period have been paid and any claims have been settled. Any loss is not carried forward to the new adjustment period.

If, after the adjustment has been completed, benefit claims are subse-quently made or payments are issued which fall within the adjustment period that has ended, a new surplus sharing statement will be issued. HDI may reclaim surplus shares that have already been paid out.

The entitlement to surplus sharing lapses if the contract is cancelled before the end of the adjustment period.

Claims

29ObligationsShould an accident be likely to result in a claim for insurance benefits,

• a licensed doctor or dentist must be involved as soon as possible to ensure professional care. The insured person must follow the instruc-tions of the treating physician or dentist or the medical support staff commissioned by them. The insured person is obliged to undergo an examination by the doctors commissioned by HDI;

• the policyholder or beneficiary must notify HDI in writing within 30 days. Furthermore, the beneficiary must do everything they can to help clear up the insured event and its consequences;

• HDI is entitled to demand additional documents and information, in particular medical certificates. The beneficiary grants HDI the right to request such documents and information directly and at its own expense. The beneficiary hereby releases the doctors who have treated the insured person from maintaining patient confidentiality with respect to HDI.

In the event of death, HDI must be notified early enough so that it can request an autopsy at its own expense if the death may have been the result of something other than the accident. The autopsy may not be conducted if the insured person‘s spouse or registered partner or, if there is no spouse or registered partner, the parents or children of full age object, or if the insured person has issued a corresponding declaration of intent.

30 Consequences of a breach of contractIf the duties pursuant to section 29 are culpably breached and the ex-tent or assessment of the consequences of the accident are adversely affected as a result, HDI may reduce its benefits accordingly, unless the policyholder, insured person or beneficiary can prove that the breach of contract did not influence the consequences and assessment of the accident.

Term of the contract and right of termination

31 Term of the contracta) At the end of the agreed term, the contract will be automatically

renewed by one year, unless it is terminated at least three months prior to its expiry.

b) Notice of termination will have been duly given if it is received by HDI or the policyholder no later than the last day before commence-ment of the three-month notice period.

c) If the term of the contract is less than one year, the contract will automatically lapse on the defined expiry date.

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32 Increase or decrease in risk

If, during the course of this policy, there is a change in a significant circumstance communicated in the application or in any other way (in particular the nature of the insured business or occupation, profession of the insured person) and this change causes a material increase in risk, the policyholder must notify HDI of this immediately in writing. If the policyholder fails to provide such notification, HDI will no longer be bound by the contract for the subsequent period. If the policyholder has complied with the duty of notification, the increased risk will be covered.

HDI will not be released from its duty to provide insurance cover if the policyholder proves that non-compliance was the result of an oversight and that the notification was made immediately upon discovering the lapse.

However, HDI shall be entitled to terminate the contract with two weeks’ notice within 14 days of receiving notification. Any additional premium will be due from the date on which the risk increases.

In the event of a reduction of risk, HDI will reduce the premium accord-ingly as from the receipt of written notification from the policyholder.

If the policyholder takes over a similar business in place of the previous business within one year, this will not affect the continuation of the insurance. However, the policyholder must inform HDI of the change immediately so that the policy can be amended to correspond with the new circumstances.

33 Rightofterminationintheeventofaclaim

a) After every claim for which a benefit is payable, the policyholder may terminate the contract no later than the date on which the policyholder is informed of the disbursement. The insurance cover lapses 14 days after receipt of the termination by HDI.

b) HDI expressly waives its legal right to terminate the contract in the event of a claim, except in the case of attempted or actual insurance fraud. Should HDI terminate the contract for this reason, it will lapse 14 days after receipt of the termination by the policyholder.

Miscellaneous

34 Non-negligentbreachofcontract

In case of a breach of the duties incumbent upon the policyholder or beneficiary, the penalties provided for in the General Conditions of In-surance will not be applied if the breach can be deemed non-negligent based on the circumstances.

35 Assignment of claims

The entitlement to insured benefits may be neither transferred nor pledged prior to being definitively determined without the express approval of HDI.

36Notifying HDI

All notifications must be sent to the Swiss domicile of HDI. Termination and rescission notices must be received there prior to the deadline.

37 Placeofperformanceandjurisdiction

HDI may be prosecuted for claims arising from this insurance con-tract at the Swiss domicile of the policyholder or beneficiary or at the domicile of HDI.

The principal place of business for the entire Swiss business is Zurich branch/Switzerland.

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HDI Global SEZurich branch/SwitzerlandDufourstrasse 468008 ZurichPhone +41 44 265 47 47Fax +41 44 265 47 48CHE-111.964.227 HR