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TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
TRAVEL INSURANCE CARD
SPECIFIC CONDITIONS
STARR INTERNATIONAL BRASIL SEGURADORA S.A.
Table of Contents
INTRODUCTION3
Section I3
GLOSSARY OF TECHNICAL TERMS 3
Section II8
SPECIFIC CONDITIONS 8
CLAUSE ONE - PRELIMINARY INFORMATION8
CLAUSE TWO - INSURANCE PURPOSE 9
CLAUSE THREE - INSURANCE COVERAGES 9
CLAUSE FOUR - RISKS EXCLUDED 11
CLAUSE FIVE - GRACE PERIOD AND DEDUCTIBLE 13
CLAUSE SIX - COVERAGE SCOPE 13
CLAUSE SEVEN - ACCEPTANCE CONDITIONS 13
CLAUSE EIGHT - BENEFICIARY 14
CLAUSE NINE - PERIOD IN FORCE 14
CLAUSE TEN - CAPITAL INSURED 15
CLAUSE ELEVEN - UPDATE OF THE INSURANCE VALUES 17
CLAUSE TWELVE - PREMIUM PAYMENT 18
CLAUSE THIRTEEN - PROCEDURES IN CASE OF CLAIMS 18
CLAUSE FOURTEEN - PAYMENT OF A CLAIM 20
CLAUSE FIFTEEN - MEDICAL BOARD 22
CLAUSE SIXTEEN - SURVEY OF THE INSURANCE COMPANY 22
CLAUSE SEVENTEEN - PROPORTIONAL INDEMNITY 23
CLAUSE EIGHTEEN - LOSS OF THE RIGHTS TO INDEMNITY23
CLAUSE NINETEEN - REINTEGRATION 24
CLAUSE TWENTY - CANCELLATION 24
CLAUSE TWENTY ONE - INSURANCE CHANGE 25
CLAUSE TWENTY TWO - SUBROGATION OF RIGHTS 25
CLAUSE TWENTY THREE - TERM 25
CLAUSE TWENTY FOUR - JURISDICTION 25
Section III26
SPECIFIC CONDITIONS 26
INTRODUCTION
We present the conditions of the Starr Travel Insurance that establish the operating standards
of the coverages contracted.
Note: Travel Insurance is not health Insurance! Read the contractual conditions,
observing the rights and obligations, as well as the limit of the Insured Capital hired for
each coverage.
The Insured may withdraw the contracted Insurance, since before the trip, within seven
(7) days from the date of issue of the Card or the actual payment of the first installment
payment of the premium, whichever occurs last, and may exercise his/her cancellation
rights by the same means used for hiring, without prejudice to other means available by
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Starr or its Insurance Representative.
Starr, the Insurance broker or Insurance representative will provide immediate
confirmation of receipt of the repentance manifestation, from that moment, any
possibility of collection is not allowed.
If the Insured exercises the right of cancellation within seven (7) days, any amounts paid
will be returned immediately by the same means and manner of execution of the
premium payment, without prejudice to other means or forms provided by Starr or its
Insurance representative, provided expressly accepted by the Insured.
By contracting the Insurance, the Insured expressly accepts the limitation clauses that
are in the text of these Specific Conditions.
Section I
GLOSSARY OF TECHNICAL TERMS
personal injury: event with characterized date, exclusively and directly external, sudden,
involuntary, violent, and physical injury originator, which, by itself, independent of any other
cause, has as a direct consequence of the death or permanent, total or partial disability of the
Insured, or that might require medical treatment, noting that:
a)the following options are included in this concept:
a.1) suicide, or its attempt, for indemnity purposes, will be considered as personal injury,
pursuant to legislation, in particular art. 798 of the Brazilian Civil Code;
a.2) accidents arising from environmental temperature or atmospheric influence action when
the
Insured is subject as a result of a covered accident;
a.3) accidents arising from accidental leakage of gases and vapors;
a.4) accidents resulting from kidnappings and attempted kidnappings; and
a.5)accidents resulting from anatomical or functional abnormalities of the spine, from trauma
caused exclusively by fractures or dislocations, radiologically proven.
b)the following options are excluded from this concept:
b.1)diseases, including professionals, whatever their causes are, even if caused, triggered
or aggravated, directly or indirectly by accident, except infections, septic states and
embolisms resulting from a visible wound caused as a result of a covered accident;
b.2) the consequent complications of exams, clinical or surgical treatments, when not
resulting from a covered accident;
b.3) the injuries resulting from, dependent, predisposed or facilitated by repeated
efforts or cumulative microtrauma, or with cause and effect relationship with the same,
as well as injuries classified as: Repetitive Strain Injury - RSI, Musculoskeletal Diseases
Related to Work - MSDs, Continuous Injury Trauma - LTC or similar that may be
accepted by the medical-scientific class, as well as their post-treatment consequences,
including surgical, at any time; and
b.4) situations recognized by official institutions of social security or similar, as
"accidental disability", in which the event causing the injury does not fit fully in the
characterization of disability due to personal injury.
Claim Warning: It is the immediate notification of the occurrence of an claim that the
Insured is obliged to make to the Insurance Company, by himself/herself or his/her
representative, at the time he/she becomes aware of it.
Basic Higiene Items: the set of items for basic hygiene care such as bathing, aseptic
(deodorant and alcohol gel), razor device, sanitary pads and oral hygiene (toothpaste,
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
mouthwash, toothbrush and dental floss).
Basic Clothing Items: clothes are used to cover certain parts of the body. Defined by
underwear, pants, shirt, blouse, winter shirt, shorts, socks, shoes.
Luggage: luggage means all personal belongings of the Insured, when carried by the Insured,
or when transported properly stored in closed, locked up compartment.
Insurance Card: Document issued by the Insurance Company that formalizes the acceptance
of the Insurance coverage requested by the applicant, replaces the individual policy and
avoids the proposal filling in accordance with specific legislation.
Insured Capital: It is the maximum amount to be paid or refunded to the Insured or to
his/her beneficiary on the amounts established for each coverage contracted, in the event of a
loss covered by the Insurance.
General Conditions: Set of provisions governing the same Insurance plan, establishing
rights and obligations, of the Insurance company, the insured and beneficiaries.
Special Conditions: The set of specific provisions relating to the coverages hired, which
modify and supersede the General Conditions.
Specific Conditions: These are the conditions that particularize the contract, indicating the
object, value of Insurance, characteristics, etc. The Specific Conditions are unique to each
sales contract for a particular Insurance plan, unlike the General Conditions.
Contractual Terms: The set of rules governing the hiring of Insurance, including those
contained in the Insurance Card, Specific and Special Conditions.
Broker: the Individual or entity authorized to raise and promote Insurance contracts. The
Insured may consult the registry status of his/her Insurance broker at
www.susep.gov.br, via registration number with SUSEP, full name; CNPJ or CPF
numbers.
Damage by accident: damage caused to the insured object when the coverage "Immediate
Protected Purchase" contracted due to theft or accident that requires the applicable
registration by police authority (the coverage will not include accidents resulting from simple
breakage of the object by falling, impact, weather, etc.).
Emergency: situation where the Insured needs immediate care at risk of dying.
Chronic disease: any continuous and persistent pathological procedure longer than thirty (30)
days.
Convalescence State: includes, for purposes of this Insurance, the transitional period after an
illness, in which processes the gradual recovery of strength and health, then return to the
place of residence of the insured.
Amateur or semi-professional sport: any sport whose practice is not the main source of
income of the insured.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Professional sport any kind of sport whose practice is the main source of income of the
Insured or if it results in premium.
Extreme sport: sports with a higher degree of physical risk, given the conditions of height,
speed or depth, not limited to other variants that are practiced.
Event: Any occurrence or event arising from the same cause that can be guaranteed by the
contracted Insurance.
Deductible: Value or percentage defined in the policy relating to the liability of the Insured
in compensable losses from covered claims.
Burglary: action committed to take assets, with destruction or breaking of obstacle for the
removal of the thing, or with breach of trust, or by fraud, climbing or dexterity, or by use of
false keys, or help with one or more persons, leaving traces.
Simple theft: subtract, for themselves or others, other people's assets, without threat or
violence to the person.
indemnity: the amount of the Insured Capital that the Insurance Company actually paid to
the insured or their beneficiaries as a result of a Event Covered by this Insurance.
Acceptance Technical limit: It is the basic retention value that the Insurance Company
adopts in each class or type of Insurance in which will operate, set by SUSEP, according to
CNSP guidelines, representing the maximum amount that it may retain in each individual
risk.
Suitcase: Accessory used for transporting clothes and other objects during the travel period.
Doctor: the professional legally qualified to practice medicine. The doctor as the Insured
himself, his spouse, dependents, blood relatives or the like will not be accepted, even if
entitled to exercise the practice of medicine.
Remote Media: those that allow the exchange of and/or access to information and/or any
type of data transfer via communications networks involving the use of technologies such as
the World Wide Web, telephone, cable or digital television, satellite communication systems,
among others.
Objects of Value and Electronic Equipment/Computer: sunglasses, jewelry, watches,
furs, silks, art, precious stones and articles containing gold, silver or precious metal, digital
camera, audio or video equipment, appliances and electronic games, laptops, "tablets" and
audio or video players, except mobile phones and smartphones.
Coverage Period: the period during which the insured or the beneficiaries, when appropriate,
will be entitled to the capital of the Insured contracted.
People with special needs: These are people who have significant physical, sensory or
intellectual differences arising from innate or acquired factors, permanent, which cause
difficulties in their interaction with the physical and social environment.
PET: this Insurance is for every dog or cat considered as a pet.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Premium: the amount corresponding to each of the payments intended to the cost of
Insurance.
Proponent: Person interested in hiring Insurance coverage (or coverages).
Insurance Representative: It is the legal entity that assumes the obligation to promote, in
non-eventual character and without dependence bonds, the realization of Insurance contracts
and on behalf of the Insurance company.
Insured: It is the individual on which the risk assessment will be carried out and the
Insurance will be established.
Insurance company: It is a company duly constituted and legally authorized to operate in
the country, which assumes the risks inherent to the coverages contracted, under these
Specific and Special Conditions.
Claim: Involuntary and casual event due to the risk whose coverage is provided for in
Insurance Card, and that the Insurance Company is obliged to indemnify.
Public Transport: Any land, sea or air transport operated under valid license for paid
transportation of passengers, with routes and regular schedules, including taxis with valid
license, provided that the insured is not a member of the crew.
Public transport, travelist transport means operated under valid license for paid
passenger transport are included in this definition.
The private charter transportation, individual passenger transport, such as motorcycles
and car rentals, and transport without supervision and/or private transport, as vessels,
are not included in this definition.
Urgency: cases involving personal injury, acute diseases and acute complications, including
complications in the pregnancy process, in which the Insured requires quick response, but not
characterized as an emergency and can wait for the care of emergency cases.
Travel By Air, Sea or Land: It refers to any means of air, sea or land operated under valid
license for paid passenger transport with regular routes and schedules, provided that the
insured is not a member of the crew.
The individual passenger transportation, such as motorcycles and car rentals, and
transport without supervision, as vessels, are not included in this definition.
National Travel: Displacement of the Insured between his habitual residence and the place
of destination within the country of residence. A displacement deductible longer than 100
Km of habitual residence of the Insured for land travel is applicable.
Travel Abroad: Travel Abroad is the displacement of the Insured between his country of
usual residence and the place of destination outside the country of residence. A displacement
deductible longer than 100 Km of habitual residence of the Insured for land travel is
applicable.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Insured Trip: It is the period of time between the beginning and the end of the validity of the
Insurance coverage. The travel for an indefinite period is not considered as Insured Trip,
either by travel or individually.
Term of the Insurance Card: Continuous period of time during which the Insurance Card is
in force,in which the insured is covered by this Insurance coverage.
Section II
SPECIFIC CONDITIONS
CLAUSE ONE - PRELIMINARY INFORMATION
1.1.Acceptance of this Insurance shall be subject to risk analysis.
1.2.The statements of the Insured by the Insurance Company will be provided with good faith
as well as accuracy, completeness and totality of circumstances involved, for proper risk
assessment to be guaranteed and correct establishment of the premium by the Insurance
Company.
1.3.The hiring of this Insurance will be made through an Insurance Card.
1.4.By hiring this Insurance, coverages contracted will be those expressly ratified in the
Insurance Card, any other described in these Specific Conditions is null and void
1.5.The Insured expressly accepts the limitation clauses that are in the text of these Specific
Conditions.
1.6.The registration of this plan with SUSEP does not result, by the Authority, in an incentive
or recommendation for marketing thereof.
1.7.The Insured may consult the registry status of his/her Insurance broker at
www.susep.gov.br, via registration number with SUSEP, full name; CNPJ or CPF numbers.
1.8.This Insurance is for a fixed term and the Insurance company is entitled not to renew the
Insurance on the due date, without refund of premiums paid in accordance with the
contractual terms of Insurance Card.
1.9.There is no provision for the automatic renewal of the Insurance. To purchase the
coverages for a new period, the hiring of a new Insurance Card is required.
1.10.Since this Insurance is structured in the financial system of the department, the return or
redemption of premiums to the insured or the beneficiary is not expected.
1.11.All values are expressed in local currency.
1.11.1.Exclusively for international travels, for the purpose of verification with the
authorities of the country of destination, the Insurance Card shall inform additionally
the Insured Capital converted into foreign currency.
1.12.“Note: Travel Insurance is not health Insurance! Read the contract terms,
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
observing the limits and coverages hired."
CLAUSE TWO - Insurance PURPOSE
2.1. The travel Insurance aims to ensure the Insured or his Beneficiary, an indemnity limited
to the amount of Insurance Capital hired, as established in each coverage hired in the form of
payment of the amount contracted or refund, or the provision of service in the event of
covered risks, since they are related to the travel during predetermined period, as established
in the specific Conditions, except if resulting from excluded risks.
CLAUSE THREE - Insurance COVERAGES
3.1.The coverage of this Insurance are divided into Basic Coverage and Additional
Coverage and can be contracted according to the plans provided by the Insurance Company.
3.2.The coverages chosen and their Insured capital composition criteria are indicated on the
Insurance Card, and requires the hiring of at least one of the Basic Coverage in each plan for
the validity of the Insurance Card.
3.3.The coverages will be hired according to the Insurance plan, and there is the possibility of
adding or removing a coverage alone from the contracted plan. The chosen plan will be
indicated in your Insurance Card.
3.4.The contracted coverages will apply, as appropriate, the provisions of risks excluded,
contained in clause four of these Specific Conditions and on item 4 of the Special Conditions
of the contracted coverage.
3.5.It is recommended to always refer to the Special Conditions for complete information on
the rightsof the Insured to an indemnity.
3.6.Basic coverage:
I.Medical and/or Hospital Expenses on National Travel (DMH on National Travel)
II.Dental expenses on National Travel (DO on National Travel)
III.Medical and/or Hospital Expenses (DMH )
IV.Dental Expenses on International Travel (DO on International Travel)
V.Corpse Transfer
VI.Medical Evacuation Return
VII.Medical transfer
VIII.Accidental Death during the Travel
IX.Permanent Total or Partial Disability for Accident during the Travel
3.7.Hiring of coverages referred to in items III, IV, V, VI and VII is mandatory for
Insurance plans that cover international travels.
3.8.The coverages of items I and II should be hired together.
3.9.The Corpse Transfer coverage can not be contracted separately.
3.10.The coverages referred to in items I to IV cover episodes of crisis caused by pre-existing
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
or chronic illness, when generating emergency or urgency situations, to the limit of the
Capital Insured contracted for the coverage, of expenses related to the stabilization of the
clinical situation of the insured allowing him/her to continue his/her journey or return to place
of residence, there is no coverage for continuity and control of previous treatment, check-up
and extension of prescription.
3.11.When the coverages referred to in items I to IV are contracted, medical evacuation
coverage shall be mandatorily contracted.
3.12.The coverage of item VII covers, when requested by a physician or medical staff
responsible for servicing, more than one removal, subject to the limit of the value of the
insured capital hired.
3.13.Additional coverages
I.Complementary Medical, Hospital and/or Dental Expenses on National Travel (DMHOC on
National Travel)
II.Complementary Medical, Hospital and/or Dental Expenses on International Travel
(DMHOC on International Travel)
III.Expenditure on medicines
IV.luggage Loss in Complementary Air Transport on National Travel
V.luggage Loss in Complementary Air Transport on International Travel
VI.luggage Loss in Supplemental Air Transport on National Travel
VII.luggage Loss in Supplemental Air Transport on International Travel
VIII.Delayed luggage
IX.Travel Interruption
X.Travel Cancellation
XI.Early return
XII.Protected purchase
XIII.Stay Extension
XIV.Accommodation for an accompanying person
XV.Departure Delay
XVI.Return of an accompanying person
XVII. Return of minors and persons of legal age
XVIII.Travel legal expenses
XIX.Bail Costs and Legal Expenses in Travel
XX.Travel Interruption for Multiple Reasons
XXI.Travel Cancellation for Multiple Reasons
VIII.Complementary Medical, Hospital and/or Dental Expenses on International Travel due
to amateur practice of Extreme Sports (DMHOC in amateur practice of Extreme
Sports).
XXIII.Complementary Medical, Hospital and/or Dental Expenses on International Travel
due to professional practice of Extreme Sports (DMHOC in professional practice of
Extreme Sports).
3.14.The coverages which indemnification generating event is the non-occurrence of the
insured trip can not be contracted or renewed after the date scheduled for the beginning of the
trip.
CLAUSE FOUR - EXCLUDED RISKS
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
4.1.The following events, in addition to the previous events, are excluded from the
coverage of this Insurance,occurring in direct or indirect consequence of:
a)Use of nuclear material for any purposes, including nuclear explosion provoked or
not, as well as radioactive contamination or exposure to nuclear or ionizing radiation;
b) Invasion, hostility, acts or operations of war, declared or not, chemical or
bacteriological war, civil war, guerrilla, revolution, unrest, riot, rebellion, sedition,
military coup or usurped power, mutiny or other public disturbances and resulting
therefrom;
c) Hurricanes, typhoons, tornadoes, cyclones, earthquakes, tsunamis, volcanic eruptions
and other convulsions of nature, including natural disasters;
d) Popular movements, reprisals, restrictions on free movement, strikes, explosions,
heat emanation or radiation from the transmutation or disintegration of atomic nuclei,
radioactivity or other cases oForce majeure that prevent the Insurance Company's
intervention, except military service, sports practice or acts of humanity to help others;
e) Intentionally self inflicted injury, voluntary and premeditated suicide or any
intention and attempted voluntary and premeditated suicide, regardless of the mental
health of the Insured, occurred less than two (2) years from the beginning of the Plan;
f) Travel in aircraft that do not have, in effect, the relevant airworthiness certificate;
stolen aircraft or piloted by pilots not legally qualified;
g) Flying in aircraft, except as a passenger paying plane Card in a fixed-wing aircraft
that belongs to and is operated by an airline or aircraft shipping company authorized to
provide scheduled air transport of passengers, including helicopter;
h) Damages and losses caused directly or indirectly by terrorism or terrorist act, while
the Insurance Company is required to prove with legal document, accompanied by a
detailed report that characterizes the nature of the attack, regardless of its purpose, and
provided that it has been duly recognized;
b) Illegal acts or contrary to law committed by the beneficiary, executor or
administrator or legal heirs appointed by the insured person.
a) Illicit acts practiced by the Insured, the Beneficiary or by the legal representative of
one or the other.
b) Epidemics and pandemics declared by the competent body;
c) Accidents suffered prior to the hiring of the Insurance, although manifested during
the term, or that do not include the concept of personal injury, as defined in Section
Iof the Specific Conditions;
a) Travel for the purpose of carrying out any medical examination or treatment;
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
d) Recovery or convalescence treatments, rejuvenating or aesthetic treatments, and
check-ups, and their consequences, when not authorized by the Insurance Company,
except when due to accident covered by this Insurance;
e) Treatment for sterilization, fertilization and sex change and its consequences;
f) Treatments for obesity in various forms;
g) Procedures not provided for in the Brazilian Code or International Medical Ethics
and not recognized by the National Inspection of Medicine and Pharmacy;
h) In guarantees with coverage for events arising solely from personal injury, disorders
and poisoning resulting from the action of chemicals or medicines unless prescribed by
a doctor, as a result of a covered accident;
i) The use of war instruments or firearms or participation in disputes or duels, except
death or the Insured's failure when it is derived from the use of risky means of
transportation, military service, sport practice, or acts of humanity to aid others;
j) Death or sudden acute illness of a family member (parent, sibling, spouse or children)
of the Insured, traveling companion or a relative or friend, who had a diagnosis of
terminal illness, known by the Insured, prior to the Insurance purchase.
k) Indirect losses, that is, losses that are not covered in the Insurance coverage, even if
they are related to generating event of indemnity, for example, loss of profits, revenue,
business or opportunities, if the Insured is not able to work after suffering a covered
loss.
l) Events arising from difficulties, financial incapacity, bankruptcy or insolvency of a
service provider, carrier or travel agency contracted by the Insured for his/her travel.
m) Any work accidents during his/her travel.
n) Expenses which the insured would have to pay, even without the occurrence of the
covered event, for example, food expenses when not provided in the Special or
Supplemental Conditions.
o) If the Insured does not get the vaccines required for his/her travel.
p) If the Pregnant Insured is traveling against medical advice, or acts contrary to this
recommendation.
q) If the Insured does not follow all the guidelines or advices of the Insurance Company
or service providers, especially but not limited to, the guidelines related to the return to
their country of origin.
r) From damage or loss by the visa refusal or authorization of access by the public
authority in any location.
s) All professional sports or any sport in which the Insured receives or competes for a
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
fee, prize, donation, sponsorship or financial reward of any kind;
t) Use of non-prescription medicines;
u) Coverages not hired.
Notwithstanding the provisions set out above, claims resulting from the use of risky
means of transportation, military service, sport practice, or acts of humanity to aid
others are covered by this Insurance.
CLAUSE FIVE - GRACE PERIOD AND DEDUCTIBLE
5.1. The deductible, where applicable, has the Insured's share value set in the particular
conditions of each contracted coverage.
5.2. There will be no grace period for events resulting from injury.
5.3. After the beginning of the insured trip and for events not resulting from personal
injuriess, it is expected the application of the grace period of seventy-two (72) hours in the
case of hiring of the following coverages:
I.Medical and/or Hospital Expenses on National Travel (DMH on National Travel)
II.Dental expenses on National Travel (DO on National Travel);
III.Medical and/or Hospital Expenses on International Travel (DMH on International Travel);
IV.Dental Expenses on International Travel (DO on International Travel)
V.Medical Evacuation Return
VI.Medical transfer
VII.Complementary Medical, Hospital and/or Dental Expenses on National Travel (DMHOC
on National Travel);
VIII.Complementary Medical, Hospital and/or Dental Expenses on International Travel
(DMHOC on International Travel).
5.4. The application of the grace period is also provided for when the insured commits
suicide within the first two years of initial validity of the Card, according to art. 798 of the
Civil Code.
5.5. The maximum limit that an Insurance plan may establish as grace period is two years,
such grace period can not exceed half of the term, except the provisions of paragraph 5.4
above.
CLAUSE SIX - COVERAGE TERRITORIAL SCOPE
6.1.the coverage territorial scope is the globe of the Earth, subject to the purpose of this
Insurance.
CLAUSE SEVEN - ACCEPTANCE CONDITIONS
7.1. The hiring of this Insurance will be made through Insurance Card upon verbal request of
the interested after the issue of the Insurance Card.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
7.2. The demonstration made with the use of remote means is similar to the verbal request of
the interested.
7.3. If hiring the Insurance Card will take effect after the beginning of the insured travel,
Insurance validity will occur at 12 AM of the Insurance contract date, except for the
guarantees which generating event of the indemnification is the non-occurrence of the insured
travel (Travel cancellation, Travel Cancellation for Multiple Reasons), which in this case
they can not be contracted.
7.4. The Insurance Contract is proven with the submission of the Insurance Card, in its
absence, by a document proving the payment of the premium or discharge confirmation of
Insurance premium sent by the Insurance company or its representative with the use of
remote means.
7.5. In case of inclusion of children under 14, the offering and hiring of the coverage related
to reimbursement of expenses is exclusively permitted.
7.6. The issue of Insurance Card confirms the acknowledgment, acceptance and agreement of
the Insured of the particular conditions of this Insurance.
CLAUSE EIGHT - BENEFICIARY
8.1. The beneficiary is the person previously designated by the Insured, who should be paid
indemnity in the event of a covered loss.
8.1.1. When there is more than one beneficiary, the percentage of the Insured Capital that will
be allocated to each beneficiary should be stipulated at the time of appointment. In the
absence of indication of percentage, indemnity will be paid in equal parts.
8.1.2. In the absence of the appointed beneficiary, or iFor any reason the appointment made
does not prevail, indemnity will be paid half to the spouse not legally separated, and the rest
will be paid to the legal heirs of the insured, subject to the order of hereditary vocation.
8.1.2.1. Pursuant to Article 1829 of the Civil Code, the legal succession is made in the
following order:
I.to the descendants, in competition with the surviving spouse, unless married with the late
under the regime of universal community of property or the mandatory separation of
goods (article 1640, sole paragraph); or if under the regime of partial community
property, the author of the inheritance has not left private property;
II.to the ascendants in competition with the spouse;
III.to the surviving spouse;
IV.to collateral relatives.
8.1.3. In the absence of the persons above, beneficiaries are those who claim the payment of
Insurance and prove that the death of the Insured deprived them of the means of subsistence.
8.1.4. For coverage related to the reimbursement of expenses, the beneficiary will be the
insured, entitled to the replacement of cash payment with the payment for goods and services
provided by the Insurance Company.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
8.1.5.The beneficiary is not entitled to the capital stipulated when the insured commits
suicide within the first two years of the initial term of the Card, pursuant to art. 798 of
the Civil Code.
ARTICLE NINE - TERM
9.1. Individual coverage of this Insurance will start and end at 12 AM of dates in the
Insurance Card.
9.2. Coverages for Travel Cancellation, Travel Cancellation for Multiple Reasons, Travel
Cancellation for Any Reason, Travel Reschedule for Multiple Reasons andTravel Reschedule
for any Reason, the start of operation will occur from the date of receipt of the premium, and
the termination will occur when the travel starts.
9.3. For other types of coverage, the start date will coincide with the start of the travel and
will end on arrival at destination or return to the place of beginning of the trip origin, as set
out in Insurance Card.
9.3.1. It is considered as the beginning of the travel the moment the Insured departures to
begin his/her journey, and it is considered as the end date of the travel, when the Insured
return to the place of origin or the end date of term established in the Insurance card,
whichever occurs first.
9.4. The term of the Insurance may not exceed two (2) years, convering the start and end date
indicated in the Insurance card pursuant to the Insurance contract.
9.5.If the insured return in advance of the insured travel, the Insurance is cancelled from
his/her arrival at the place of origin of the travel, covering any claims incurred prior to the
cancellation.
9.6. In case of impossibility of return of the Insured by a covered event, the term of all
coverages will be extended automatically until the return of the Insured to the place of
domicile or the beginning of the travel.
9.7. At the end of the Insurance term, the risk coverage will cease automatically, respecting
the period of the full premium paid for the unexpired risks, noting that the Insurance
cancellation for the end of the term will occur automatically, without refund of premiums
paid.
CLAUSE TEN - CAPITAL INSURED
10.1. For purposes of this Insurance, Insured Capital is the maximum amount to be paid or
refunded duethe value set for each current coverage on the date of occurrence of the event.
10.2. It is considered as the date of the event for the purpose of determining the Insured
Capital:
a.Medical and/or Hospital Expenses on National Travel (DMH on National Travel): the date
of the medical care.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
b.Dental expenses on National Travel (DO on National Travel): the date of dental care.
c.Medical and/or Hospital Expenses on International Travel (DMH on International
Travel): the date of the medical care.
c.Dental expenses on International Travel (DO on International Travel): the date of dental
care.
e.For the Corpse Transfer coverage: the date of death.
f.For the Medical Evacuation return coverage: the date of the medical care.
g.For Medical Transfer coverage, the date of removal or transfer of the Insured.
h.For Travel Accidental Death coverage: the date of the accident.
i.For Total or Partial Permanent Disability due to Travel Accident coverage: the date of
the accident.
j. Medical, Dental and/or Hospital Expenses on National Travel (DMHOC on National
Travel): the date of the medical care.
k. Medical, Dental and/or Hospital Expenses on International Travel (DMHOC on
International Travel): the date of the medical care.
l.Expensescoveragewith medicines: the date of the medical care.
m. For coverage of luggage Loss in Complementary Air Transport on National
Travel:the date of registration made to the legal authority.
n. For coverage of luggage Loss in Complementary Air Transport on International
Travel: the date of registration made to the legal authority.
o.For coverage of luggage Loss in Complementary Air Transport on National Travel:the
date of registration made to the legal authority.
p. For coverage of luggage Loss in Complementary Air Transport on International
Travel:the date of registration made to the legal authority.
q. For luggage Delay coverage: the date of the registration made to the legal authority.
r. For Travel Interruption coverage: the date of the interruption communication protocol by
the travel service provider.
s. For Travel Cancellation coverage: the date of cancellation registration protocol by the
travel service provider.
t.Early Return coverage: the date of occurrence of return.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
u.For the Protected Purchase coverage: the date of the registration made to the legal
authority.
v. For Stay Extension coverage: the date of the medical care.
w. For coverage for the Accommodation of an accompanying person: the date of the
medical care.
x. For Departure delay coverage: the date of registration of the complaint with the transport
authorities.
y. For coverage of the Return of the accompanying person: the date of the return travel of
the Insured.
z. For coverage of Return of Minors and Persons of Legal Age: the date of the return
travel.
aa. For coverage of Legal Expenses in Travel: the date of the accident.
bb. For coverage of Bail Costs and Legal Expenses in Travel: The date of payment of the
bail to the police authority.
cc. For coverage of Travel Interruption for Multiple Reasons: the date of the interruption
communication protocol by the travel service provider.
dd. For coverage of Travel Cancellation for Multiple reasons: the date of cancellation
registration protocol by the travel service provider.
ee. For coverage of Medical, Hospital and/or Dental Expenses on International Travel due to
amateur practice of Extreme Sports (DMHOC in amateur practice of Extreme Sports):
the date of the accident.
ff. For coverage of Medical, Hospital and/or Dental Expenses on International Travel due to
professional practice of Extreme Sports (DMHOC in professional practice of Extreme
Sports): the date of the accident.
10.3. For the purposes of determining the date of the event, consider the date indicated on the
document provided by the issuing authority.
10.4. Any payment of indemnity for such Insurance shall be made in national currency.
10.5. Exclusively for International Travels, the Insured Capital of all the coverages
provided for the refund or payment of indemnity related to expenses incurred abroad
will be established in foreign currency. The remaining amounts shall be established in
national currency.
CLAUSE ELEVEN - UPDATE OF THE Insurance VALUES
11.1. There will be no restatement of capital amounts insured and premiums for Insurance
hired, with similar validity or less a year.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
11.2. The capital values insured and Insurance premiums over the term of one year will be
updated annually based on the accumulated variation of the IPCA/IBGE index occurred
between the 14th and the 2nd month preceding the month of adjustment.
11.2.1. When the premium payment frequency is annual or in cash, the insured capital will
also be updated by the IPCA/IBGE, from the date of the last update of the premium until the
date of occurrence of the respective generating event.
11.2.2. In the event of termination or prohibition of IPCA/IBGE as value update index, the
Insurance Company will use the index that will replace it.
CLAUSE TWENTY - PREMIUM PAYMENT
12.1. The Premium must be paid in a lump sum, or in installments, in national currency until
the day scheduled for maturity indicated on the Insurance Card.
12.2. Failure to pay the premium until the day provided for in the Insurance card will result in
automatic termination of coverage, and there is no possibility of reactivation of the coverage.
12.2.1.It should be mentioned that if the deadline for the payment of the premium
matches with a day that the banks do not work, the payment can be made on the first
business day in which the bank is open.
12.3. The payment of premiums by the representative of Insurance on behalf of the Insurance
company, can be done by charging procedure regularly used by the same in their main
activity, such as booklets, slips or credit card invoices, provided that the amount allocated to
the premium is perfectly identified, as well as the date and form of the corresponding
discharge.
12.4. The Insurance representative is forbidden to collect any value beyond the established by
the Insurance Company and due to it, for Insurance Premium purposes.
12.4.1. If the Insurance representative receives any amount that is due with the Premium,
must be obliged to highlight the premium value of each Insured on the document used in the
collection.
12.5. Any indemnity only becomes due after the premium payment is made to the Insurance
representative or the Insurance Company.
12.6. The absence of the transfer to the Insurance company by the legal entity responsible for
the collection of premiums will not cause any damage to the insured with regards to
coverages and other rights covered by the Card.
12.7.Any premium payment for such Insurance shall be made in national currency.
12.7.1.In the case of international travels, when there are insured capital contracted in foreign
currency, the premium to be paid by the Insured of these coverages will be converted to Real
by using the last sale exchange rate of the Insurance issue currency issued by the Central
Bank of Brazil on the contracting date.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
CLAUSE THIRTEEN - PROCEDURES IN CASE OF CLAIMS
13.1. In case one of the events covered occur, the Insured or his Beneficiary will use the
services network authorized by the Insurance Company in the location of the travel
destination through a toll-free call available twenty four (24) hours with service in
Portuguese, indicated on the Insurance Card.
13.1.1. If the Insured or his Beneficiary do not use the network services authorized by the
Insurance Company, the insured or his Beneficiary will submit the documents of item 13.5.,
as defined in these particular conditions.
13.1.2. The claim may be reported immediately by the insured, the beneficiary or his
representative, by the toll-free call available twenty four (24) hours with service in
Portuguese, as specified in the Insurance Card.
13.1.3. The Insured may check the list of accredited network services related to the coverage
through toll-free call available twenty four (24) hours by the phone number indicated on the
Insurance Card.
13.1.4. The use of the accredited network services mentioned in item 13.1 does not require
prior authorization by the Insurance company.
13.1.5. Indication of hospital service providers accredited per organization that uses an
internationally recognized method, if any, is included in the list referred to in item 13.1.1.
13.2. The failure to contact the toll-free phone provided by the Insurance company and/or the
use of professional and/or authorized service network, as well as the cost of remote means
such as the transfer of data via communication networks involving the use of technologies,
the Insured or beneficiary may opt for service providers at their criteria, as long as legally
qualified, the Insurance company is responsible for the reimbursement of expenses up to a
maximum of Insured Capital hired.
13.3. The reimbursement amount, limited to the Insured Capital, should be compatible with
those practiced in the market for the provision of services on the location of the claim.
13.4. The basic documents to use the network services authorized by the Insurance Company
are the Identity Card, CPF and passport of the Insured to the respective provider.
13.5. When the authorized service network is not used, the following basic documents must
be submitted for the payment of indemnity, expense reimbursement or replacement of goods:
I. Insured:
•RG;
•CPF;
• Birth or Marriage Certificate;
• Proof of address;
• Notice of Claim Form, provided by the Insurance Company, which should be completed by
the insured or beneficiary;
• Authorization Form for Credit in a Current Account.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
II.Beneficiary:
• Parents: RG, CPF and Proof of Address;
• Spouse: Marriage Certificate, RG, CPF and Proof of Address;
• Partner: RG and CPF and proof of dependency in the Work Permit or Income tax return,
with the INSS and Portfolio;
• Children: Birth Certificate, RG, CPF and Proof of Address, as follows:
- Children or beneficiaries under the age of sixteen (16) years are adequately represented
jointly by their parents, with family power; in the absence or incapacity of one, the other will
represent. In the absence of both, the minor will be represented by the guardian or trustee, as
provided by law;
- Children or beneficiaries aged less than sixteen (16) and less than eighteen (18) years will
be duly assisted together by their parents, with family power; in the absence or incapacity of
one, the other will assist. In the absence of both, the minor will be assisted by the guardian or
trustee, as provided by law.
III.Authorization Form for Credit in a Current Account.
13.6.For the purposes of receipts, the following documents are accepted:
a.Spouse: Marriage Certificate and spouse's ID card.
b.Partner: Note on the Work Permit and Dependent Proof in the INSS and Identity Card of
the partner.
c. Children: Birth Certificate.
d. Other kinships: Identity Card and Birth Certificate
e. Residence: Water or Electricity bill
f. In the case of occurrences to the person accompanying the Insured: copy of ID card, CPF,
proof of address, copy of the travel contract, vouchers, airline tickets, lodging
vouchers of the Insured and the accompanying person.
CLAUSE FOURTEEN - PAYMENT OF A CLAIM
14.1. The indemnities related to this Insurance will be made in Brazil in local currency and a
single installment to the Insured, or, according to the coverage, the provision of services. In
case of death, the indemnities will be paid to beneficiaries.
14.2. The costs for proving the claim are paid by the insured, with the exception of the tests
requested by the Insurance Company, or by measures determined by the Insurance Company.
The translation costs shall be borne by the Insurance Company.
14.3. In case of medical evacuation, the Insurance Company reserves the right to promote the
contact between its team and the local doctor and, if necessary, its personal physician, in
order to determine the need for removal.
14.4. In the event of Total Permanent Disability by Accident, followed by death as a result of
the same accident, without time for payment of indemnity, the value will be paid in
accordance with Beneficiary Clause of Clause Eight of these Particular Conditions.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
14.5. The indemnity for death and permanent disability does not accumulate. If after paying
indemnity for permanent disability, the death of the Insured is confirmed as a result of the
same accident, the Insurance Company will pay the indemnity due to the death coverage, less
the amount already paid for permanent disability.
14.6. The indemnities related to the same generating event covered by more than one of the
coverages contracted must accumulate, unless otherwise specified in the particular
conditions.
14.7.The steps or actions that the Insurance Company practice after receipt of the
communication event does not matter per se, in recognition of the obligation to pay any
indemnity.
14.8. The payment of indemnity for coverage does not mean recognition of coverage for any
other coverage involving the same generating event.
14.9. In cases of justifiable doubt as to the recognition of the Claim, the Insurance Company
may request other documents or clarifications deemed necessary.
14.10. The indemnity, if due, shall be paid within thirty (30) days from the date of receipt by
the Insurance Company of all documents necessary to prove or the elucidate the event, and
will be subject to adjustment by the positive variation of IPCA/IBGE from the event date
until the payment date by the Insurance Company, in the event of non-compliance with the
payment deadline of the monetary obligation.
14.10.1. The update, when applied, will be made based on the variation found between the
last index published before the date of enforceability of the pecuniary obligation and that
published immediately prior to the date of the effective payment.
14.10.2.In the event of termination or prohibition of IPCA/IBGE as value update index, the
Insurance Company will use the index that will replace it.
14.10.3.If there is new documentation request, the deadline for payment of claims will
be suspended, thus the term will be counted again from the working day after the day
the requirements are fully met.
14.10.4. Payment of Indemnities or appropriate reimbursement will be made by the Insurance
Company, subject to the rules and limits set by these Contract Conditions.
14.11. The reimbursement or payment of indemnity related to expenses incurred abroad will
be made in national currency, respecting the Insured Capital of each contracted coverage, as
established in its Card, which shall be converted using the sale exchange rate oForeign
currency by the Central Bank of Brazil and adjusted for inflation in accordance with specific
legislation, based on the date:
I. of the actual payment made by the insured in the case of coverage that provides for the
reimbursement of expenses; or
II. of the event, for the purpose of determining the insured capital, when it is related to a
coverage that provides for the payment of the Insured Capital.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
14.11.1. Alternatively the provisions in section 14.11 above, provided that requested by the
insured or the beneficiary, reimbursement or payment of compensation related to expenses
incurred abroad may be settled in foreign currency, if the insured or the beneficiary is still
abroad on the effective settlement date.
14.12.In the case of underage beneficiaries, the indemnity will be paid as follows:
a.People under the age of sixteen (16) years: indemnity will be paid to the legally appointed
representative on behalf of the minor insured;
b.People age of sixteen (16) to eighteen (18) years, exclusive: the indemnity is paid to the
Insured minor, duly assisted by his/her father, mother (when they have the parental rights) or,
finally, by their guardian or trustee.
14.13. In addition to the update provided for in section 10.14, the indemnity amount will be
increased by default interest of one percent (1%) per month when the settlement period
exceeds the maximum period described in section
14.10. from the first day after the end of that period.
14.14.The payment of amounts related to monetary correction and interest on arrears shall be
made regardless of notice or judicial intervention, at once, along with the other amounts of
the Insurance.
CLAUSE FIFTEEN - MEDICAL BOARD
15.1. If there are disagreements about the cause, nature and extent of injuries, diseases and
the evaluation of related disability, the establishment of a medical board consisting of three
members, one appointed by the Insurance Company, another by the Insured and a third, tie-
breaker, chosen by the two nominees, will be proposed by the Insurance Company, through
written correspondence, within fifteen (15) days of the defense date.
15.2. Each party will pay the doctor's fees that has designated; the third will be paid in equal
parts by the Insured, Insured and the Insurance Company.
15.3. The constitution deadline for medical board will be a maximum of fifteen (15) days
from the indication date of the member appointed by the Insured.
15.4. The disability pension granted by official social security institutions, or the like, does
not characterize the state of permanent disability. In case of impossibility of realization of
expertise due to the disappearance of symptoms or disability condition, the Insurance
company will return the documentation, and the Insured will not be entitled to receive any
indemnity.
CLAUSE SIXTEEN - SURVEY OF THE INSURANCE COMPANY
16.1. In all notifications of hospital stays, corroborative medical expertise of the event may
be held and the number of days in hospital, and analysis of medical and hospital expenses.
16.2. The Insured by proposing the hiring of Insurance, authorizes the medical expertise of
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
the Insurance Company to have access to all clinical and surgical data, undertake home or
hospital visit and request and conduct medical examinations. The matter will be treated as
confidential and the results obtained, including reports of the examinations, will be available
only to the Insured, his/her doctor and the Insurance Company.
16.3. If any kind of fraud is proven, the Insurance Company will suspend the indemnity
payment, and will file legal proceedings aiming at the reimbursement of any expenses
incurred and indemnities paid, without prejudice to the appropriate civil and criminal actions.
CLAUSE SEVENTEEN - PROPORTIONAL INDEMNITY
17.1. If the Insured has more than one Insurance, with this Insurance Company or another,
guaranteeing some of the compensable expenses of the Insurance, except for the coverages
which the generating event of the indemnification is the death or disability of the insured, the
Insurance Company's liability for the coverage will be equal to the amount obtained by
apportionment of the total expenditures made in proportion to the limits Insured for the
coverage in all Insurances in force on the date of the Claim.
CLAUSE EIGHTEEN - LOSS OF THE RIGHTS TO INDEMNITY
18.1.The Insurance Company will not pay any indemnity under this Insurance, if any of
the options below are made by the Insured, his/her agents or beneficiaries:
a) false and incomplete statements, omitting circumstances that may affect the
Insurance acceptance or the premium rate. If the inaccuracy or omission in the
statements does not arise from bad faith of the insured, the Insurance Company may:
a) In the case of non-occurrence of the claim:
I.Cancel the Insurance, withholding the installment proportional to the elapsed time
from the premium originally agreed; or
II. by agreement between the parties, allow the continuity of Insurance and charge the
appropriate premium difference or restrict the contracted coverage.
2) In the event of occurrence of a Claim with partial payment of the Insured Capital:
I.cancel the Insurance, after the indemnity payment, withholding the installment
calculated proportionally to the elapsed time from the premium originally agreed, plus
the applicable difference; or
II. by agreement between the parties, allow the continuity of Insurance and charge the
appropriate premium difference or deducting the amount to be paid to the insured or
the beneficiary or restricting the contracted coverage for future risks.
III.in the event of a Claim occurring with full payment of the Insured Capital, cancel
the Insurance after the indemnity payment, deducting the appropriate premium
difference from the amount to be compensated.
b)fraud, proven fraud attempt, bad faith, willful misconduct or breach of the agreed
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
obligations in these Special Conditions;
c) attempt to prevent or impede any examination or diligence of the Insurance
Company in the elucidation of the accident and its consequences;
d) failure or delay of the Insurance premium payment, subject to the period
corresponding to the premium already paid;
e) Intentional risk aggravation. The Insured shall inform the Insurance Company, as
soon as possible, any fact likely to aggravate the covered risk, under penalty of losing
the right to coverage, in case it is proved that it remained in silence in bad faith.
f) Negligent, reckless or high risk Acts;
18.2.The Insurance Company, provided it does so within 15 (fifteen) days after receiving
the notice of risk aggravation, may give notice in written form its decision to cancel the
Insurance card or, by agreement between the parties, to restrict the contracted
coverage.
18.3.The cancellation of the Insurance card will only be effective 30 (thirty) days after
the notice, and premium difference shall be refunded, calculated in proportion to the
period underway.
18.4. In the event of continued Insurance, the Insurance Company may charge the
appropriate premium difference.
CLAUSE NINETEEN - REINTEGRATION
19.1.In the case of the following coverages: Medical and/or Hospital Expenses on National
Travel (DMH on National Travel), Dental expenses on National Travel (DO on National
Travel), Medical and/or Hospital Expenses on International Travel (DMH on International
Travel), Dental Expenses on International Travel (DO on International Travel), Medical,
Hospital and/or Dental Expenses on International Travel due to amateur practice of Extreme
Sports (DMHO in amateur practice of Extreme Sports), Medical, Hospital and/or Dental
Expenses on International Travel due to professional practice of Extreme Sports (DMHO in
professional practice of Extreme Sports), Total or Partial Permanent Disability by accident on
a Travel and Total or Partial Permanent Disability by accident on public transport on the
road, the Insured Capital will be automatically reinstated after each claim without charging
additional premium.
19.2. In other cases, the coverage of the Insured Capital involved for the affected items will
be reduced by the amount equivalent to the indemnity paid from the date of the claim, being
the Insured not entitled to a refund of the Premium corresponding to such reduction.
CLAUSE TWENTY - CANCELLATION
20.1. The Insurance can be canceled at any time by agreement between the insured and
Insurance Company, respecting the period of validity corresponding to the premium paid.
20.2. The Insurance coverage ends:
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
a) In case of death of the Insured;
b) failure to pay the premium as set out in clause 12a;
c) the failure to comply with any provision of the conditions applicable to this
Insurance;
d) If there is fraud, negligence or fraudulent practice by the Insured, upon contract
signature or during the term of the Insurance;
e) With the indemnity payment for permanent total disability by accident, with the
consequent return of any amounts paid after this date, duly adjusted for inflation;
f) When the Insured, upon written request to the Insurance Company, requests the
cancellation of the Insurance, respecting the criteria established by law, and according
to section Introduction of these Contract Conditions;
g) When the Insurance Company cancels the Insurance, as provided by Clause 18 - Loss
of the Rights to Indemnity.
20.3. The Insurance can not be canceled by the Insurance Company during the period of
validity on the grounds of change of risk nature.
20.4. Subject to the period corresponding to the premium paid, the Insurance shall
automatically terminate at the end of the Card validity period or upon termination of the
travel, if occurred on a date prior to the validity period.
CLAUSE TWENTY ONE - INSURANCE CHANGE
21.1. No change of the Insurance will be valid unless made in writing and provided there is
an agreement of both contracting parties.
21.2.The presumption that the Insurance Company has become aware of circumstances which
do not appear in the documents mentioned in this Specific Conditions, and those that have not
been communicated subsequently as set forth in these conditions, is not valid.
CLAUSE TWENTY TWO - RIGHTS OF SUBROGATION
22.1. The Insured irrevocably assigns to the Insurance Company all rights to actions that are
applicable to the insured against natural or legal persons who are perpetrators of the damage
up to the amount indemnified by the Insurance Company.
22.2. To achieve these objectives, the Insured undertakes to formalize the assignment
instrument to the Insurance Company, being obliged to take all necessary legal acts and to
provide all the cooperation required.
CLAUSE TWENTY THREE - TERM
23.1. The terms are those determined by law, which for purposes of this Insurance plan, is
one (1) year from the date of the covered event.
CLAUSE TWENTY FOUR - JURISDICTION
24.1.The Court of the City of the Insured is elected to resolve any questions or disputes
arising from these Specific Conditions.
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Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
CLAUSE TWENTY FOUR - SPECIAL CONDITIONS
25.1. The Court of the City of the Insured is elected to resolve any questions or disputes
arising from these Specific Conditions.
Section III
SPECIFIC CONDITIONS
Medical and/or Hospital Expenses on National Travel
(DMH on National Travel)
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of costs or the provision of services
limited to the amount of the Insured Capital hired, medical and/or hospital expenses incurred
by the Insured for his/her treatment under medical supervision, caused by personal injury or
sudden and acute illness occurred during the national travel period and once out of their city
of residence, with a displacement higher than one hundred kilometers (100 km) in the
case of land travel.
1.1.1. This warranty covers the episodes of crisis caused by pre-existing or chronic disease,
when it generates clinical emergency or urgency, to the limit of Insured Capital hired. Only
the expenses related to the stabilization of the clinical situation of the Insured that enable
him/her to continue his/her journey or return to place of residence, are covered.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical
care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The amount of the applicable Insurance deductible will expressly consist of the
Insurance Card, and corresponds to the plan chosen by the Insurance Representative
from the following:
Plans Deductible in R$
A Without
deductible
B 150.00
C 300.00
D 400.00
E 600.00
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
F 900.00
G 1,200.00
H 1,500.00
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1. The following events of direct or indirect consequence are excluded from DMH
coverage on National Travel, beyond the provisions of Clause Four of the Specific
Conditions:
a) Convalescent situations (after medical discharge) and the costs of accompanying
persons;
b) Devices that refer to orthoses of any nature and permanent prostheses, such as
artificial limbs, hearing aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers,
except the leased chair, items used during hospitalization for medical reasons, unless the
prosthesis for the loss of natural teeth.
c) Delivery and/or complications of pregnancy;
d) The continuity and control of previous treatment to the insured travel, and the extent
of prescription.
e) Experimental procedures, elective or diagnostic investigation procedures; or any
plastic surgery except reconstructive surgery necessary for the Insured to return home
due to a covered personal injury.
f) expenses or costs related to treatment or non-emergency surgery, or that the insured
can perform after returning his/her home.
g) Extra expenses for hospital accommodation in private apartments, unless
recommended by the medical team.
h) Any rescue costs (search and rescue) charged by public or private entities, except the
expenses for medical repatriation.
i) If the Insured refuses to return home, all costs incurred after discharge or after the
Insured is declared by the medical team that he/she in a position to return.
j) Any treatment or medication the Insured needs after discharge or after return to the
place of residence. k) Expenses for services for which the insured does not need to pay
or already included in the contracted services for his/her travel. l) Expenditure on the
acquisition of orthoses or prostheses, such as artificial limbs, hearing aids, contact
lenses, lenses, eyeglasses, wheelchairs or walkers, except the lease chair, items used
during hospitalization for medical reasons .
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
m) Preventive, elective, routine examinations and/or "check-ups".
n) Travel expenses in order to perform any type of medical examination or treatment.
o) Treatments of psychiatric disorders (mental, mood and metabolic).
5.ELIGIBILITY
5.1. For DMH warranty on National Travel, all individuals within the age range defined in
the Insurance contract at the time of contracting the Insurance are eligible.
6. INSURED CAPITAL RETURN
6.1. The Insured Capital concerning this coverage will be fully reinstated automatically after
the occurrence of each Covered Event, without charging additional Premium.
7. DESCRIPTION OF THE CLAIM
7.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Medical and/or Hospital Expenses on National Travel (DMH on National
Travel), the date of the medical care is considered as the date of the event, upon the
settlement of claims.
8. PROCEDURES IN THE EVENT OF A CLAIM
8.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
8.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
8.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
8.4. If the Insured is entitled to reimbursement of medical expenses from any other
source or Insurance, the Insurance Company will refund the difference between the
amount of expenditure and the amount to which the insured is entitled to
reimbursement, limited to the Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of
his/her traveling companions must immediately contact the Call Center of the
Insurance Company.
9. BASIC DOCUMENTATION FOR CLAIM NOTICE
9.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
• Report of the physician responsible for the care, attesting the occurrence of the covered
event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Copy of the hospital records and invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
Dental expenses on National Travel (DO on National Travel)
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of costs or the provision of services
limited to the amount of the Insured Capital hired, dental expenses incurred by the Insured for
his/her treatment under supervision of a qualified professional, caused by personal injury or
sudden and acute illness occurred during the national travel period and once out of their city
of residence, with a displacement higher than one hundred kilometers (100 km) in the case of
land travel.
1.1.1. This warranty covers the episodes of crisis caused by pre-existing or chronic disease,
when it generates clinical emergency or urgency, to the limit of Insured Capital hired. Only
the expenses related to the stabilization of the clinical situation of the Insured that enable
him/her to continue his/her journey or return to place of residence, are covered.
1.1.2.This warranty does not cover the cost of medications after discharge or medical
care.
1.1.3.The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The amount of the applicable Insurance deductible will expressly consist of the
Insurance Card, and corresponds to the plan chosen by the Insurance Representative
from the following:
Plans Deductible in R$
A Without
deductible
B 150.00
C 300.00
D 400.00
E 600.00
F 900.00
G 1,200.00
H 1,500.00
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1.The following events of direct or indirect consequence are excluded from DO
coverage on National Travel, beyond the provisions of Clause Four of the Specific
Conditions:
a) Convalescent situations (after medical discharge) and the costs of accompanying
persons;
b) Any kind of elective and/or routine treatment;
c) Devices that refer to orthoses of any kind and permanent prosthesis, except
prostheses for the loss of natural teeth by trauma.
d) The continuity and control of previous treatment to the insured travel, and the extent
of prescription.
e) Experimental procedures, elective or diagnostic investigation procedures; or any
plastic surgery except reconstructive surgery necessary for the Insured to return home
due to a covered personal injury.
f) expenses or costs related to treatment or non-emergency surgery, or that the insured
can perform after returning his/her home.
g) Extra expenses for hospital accommodation in private apartments, unless
recommended by the professionals that provided the care.
h) Any rescue costs (search and rescue) charged by public or private entities, except the
expenses for medical repatriation.
i) If the Insured refuses to return home, all costs incurred after discharge or after the
Insured is declared by the professionals that he/she in a position to return.
j) Any treatment or medication of the Insured needs after discharge or after returning
to the place of residence.
k) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her trip.
l) Expenditure on travel for the purpose of carrying out any dental examination or
treatment.
5.ELIGIBILITY
5.1. For DO warranty on National Travel, all individuals within the age range defined in the
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Insurance contract at the time of contracting the Insurance are eligible.
6. INSURED CAPITAL RETURN
6.1. The Insured Capital concerning this coverage will be fully reinstated automatically after
the occurrence of each Covered Event, without charging additional Premium.
7. DESCRIPTION OF THE CLAIM
7.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Dental Expenses on National Travel (DO on National Travel), the date of the
medical care is considered as the date of the event, upon the settlement of claims, from the
date of the dental treatment.
8. PROCEDURES IN THE EVENT OF A CLAIM
8.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
8.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
8.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
8.4. If the Insured is entitled to reimbursement of dental expenses from any other source
or Insurance, the Insurance Company will refund the difference between the amount of
expenditure and the amount to which the insured is entitled to reimbursement, limited
to the Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of
his/her traveling companions must immediately contact the Call Center of the
Insurance Company.
9. BASIC DOCUMENTATION FOR CLAIM NOTICE
9.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses.
• Dental report of the professional responsible for the care, attesting the occurrence of the
covered event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Invoice of the expenses incurred.
• Document of the discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
Medical and/or Hospital Expenses on International Travel (DMH on International
Travel)
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of costs or the provision of services
limited to the amount of the Insured Capital hired, medical and/or hospital expenses incurred
by the Insured for his/her treatment under medical supervision, caused by personal injury or
sudden and acute illness occurred during the International travel period, as defined in the
Specific conditions of this Insurance, with a displacement higher than one hundred kilometers
(100 km) in the case of land travel.
1.1.1. This warranty covers the episodes of crisis caused by pre-existing or chronic disease,
when it generates clinical emergency or urgency, to the limit of Insured Capital hired. Only
the expenses related to the stabilization of the clinical situation of the Insured that enable
him/her to continue his/her journey or return to place of residence, are covered.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical
care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.PREGNANT WOMEN
2.1. This coverage extends to events related to pregnancy until the week 28 of pregnancy.
2.2. These events are not included in the same Insured Capital contracted for this
warranty, refund and/or provision of services, even under medical supervision, to the
newborn.
IMPORTANT: It is essential that the pregnant woman travels with the written consent
of her doctor.
3.DEDUCTIBLE
3.1. This coverage is subject to the application of the deductible.
3.2. The amount of the applicable Insurance deductible will expressly consist of the Insurance
Card, and corresponds to the plan chosen by the Insurance Representative from the following:
Plans Deductible in R$ Deductible in
US$*
A Without
deductible
Without
deductible
B 150.00 50.00
C 300.00 100.00
D 600.00 200.00
E 900.00 300.00
F 1,200.00 400.00
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
G 1,500.00 500.00
* For insurances in foreign currency
4.BENEFICIARY
4.1. The Beneficiary is the Insured.
5. EXCLUDED RISKS
5.1. The following events of direct or indirect consequence are excluded from DMH
coverage on International Travel,
beyond the provisions of Clause Four of the Specific Conditions:
a) Convalescent situations (after medical discharge) and the costs of accompanying
persons;
b) Devices that refer to orthoses of any nature and permanent prostheses, such as
artificial limbs, hearing aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers,
except the leased chair, items used during hospitalization for medical reasons, unless the
prosthesis for the loss of natural teeth.
c) The continuity and control of previous treatment to the insured trip, and the extent of
prescription.
d) Gestation above the week 28, its consequences and complications;
e) Experimental procedures, elective or diagnostic investigation procedures; or any
plastic surgery except reconstructive surgery necessary for the Insured to return home
due to a covered personal injury.
f) expenses or costs related to treatment or non-emergency surgery, or that the insured
can perform after returning his/her home.
g) Extra expenses for hospital accommodation in private apartments, unless
recommended by the medical team.
h) Any rescue costs (search and rescue) charged by public or private entities, except the
expenses for medical repatriation.
i) If the Insured refuses to return home, all costs incurred after discharge or after the
Insured is declared by the medical team that he/she in a position to return.
j) Any treatment or medication of the Insured needs after discharge or after return to
the place of residence.
k) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her trip.
l) Expenses on the acquisition of orthoses or permanent prostheses, such as artificial
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
limbs, hearing aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers, except the
lease chair, items used during hospitalization due to medical recommendation. m)
Preventive, elective, routine examinations and/or "check-ups".
n) Travel expenses in order to perform any type of medical examination or treatment or
abortion treatment.
o) Treatments of psychiatric disorders (mental, mood and metabolic).
6.ELIGIBILITY
6.1. For DMH warranty on International Travel, all individuals within the age range defined
in the Insurance contract at the time of contracting the Insurance are eligible.
7. INSURED CAPITAL RETURN
7.1. The Insured Capital concerning this coverage will be fully reinstated automatically after
the occurrence of each Covered Event, without charging additional Premium.
8. DESCRIPTION OF THE CLAIM
8.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Medical and/or Hospital Expenses on International Travel (DMH on
International Travel), the date of the medical care is considered as the date of the event, upon
the settlement of claims.
9. PROCEDURES IN THE EVENT OF A CLAIM
9.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
9.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
9.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
9.4. If the Insured is entitled to reimbursement of medical expenses from any other
source or Insurance, the Insurance Company will refund the difference between the
amount of expenditure and the amount to which the insured is entitled to
reimbursement, limited to the Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of
his/hertraveling companions must immediately contact the Call Center of the Insurance
Company.
10. BASIC DOCUMENTATION FOR CLAIM NOTICE
10.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses.
• Report of the physician responsible for the care, attesting the occurrence of the covered
event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Copy of the hospital records and invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
Dental Expenses on International Travel (DO on International Travel)
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of costs or the provision of services
limited to the amount of the Insured Capital hired, dental expenses incurred by the Insured for
his/her treatment under the supervision of a qualified professional, caused by personal injury
or sudden and acute illness occurred during the International travel period, as defined in the
Specific conditions of this Insurance, with a displacement higher than one hundred kilometers
(100 km) in the case of land travel.
1.1.1. This warranty covers the episodes of crisis caused by pre-existing or chronic disease,
when it generates clinical emergency or urgency, to the limit of Insured Capital hired. Only
the expenses related to the stabilization of the clinical situation of the Insured that enable
him/her to continue his/her journey or return to place of residence, are covered.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical
care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The amount of the applicable Insurance deductible will expressly consist of the Insurance
Card,and corresponds to the plan chosen by the Insurance Representative from the following:
Plans Deductible in R$ Deductible in
US$*
A Without
deductible
Without
deductible
B 150.00 50.00
C 300.00 100.00
D 600.00 200.00
E 900.00 300.00
F 1,200.00 400.00
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
G 1,500.00 500.00
* For insurances in foreign currency
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1.The following events of direct or indirect consequence are excluded from DO
coverage on International Travel, beyond the provisions of Clause Four of the Specific
Conditions:
a) Convalescent situations (after medical discharge) and the costs of accompanying
persons;
b) Any kind of elective and/or routine treatment;
c) Devices that refer to orthoses of any kind and permanent prosthesis, except
prostheses for the loss of natural teeth by trauma.
d) The continuity and control of previous treatment to the insured travel, and the extent
of prescription.
e) Experimental procedures, elective or diagnostic investigation procedures; or any
plastic surgery except reconstructive surgery necessary for the Insured to return home
due to a covered personal injury.
f) expenses or costs related to treatment or non-emergency surgery, or that the insured
can perform after returning his/her home.
g) Extra expenses for hospital accommodation in private apartments, unless
recommended by the professionals that provided the care.
h) Any rescue costs (search and rescue) charged by public or private entities, except the
expenses for medical repatriation.
i) If the Insured refuses to return home, all costs incurred after discharge or after the
Insured is declared by the professionals that he/she in a position to return.
j) Any treatment or medication of the Insured needs after discharge or after returning
to the place of residence.
k) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her trip.
l) Expenditure on travel for the purpose of carrying out any dental examination or
treatment.
5.ELIGIBILITY
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
5.1. For DO warranty on International Travel, all individuals within the age range defined in
the Insurance contract at the time of contracting the Insurance are eligible.
6. INSURED CAPITAL RETURN
6.1. The Insured Capital concerning this coverage will be fully reinstated automatically after
the occurrence of each Covered Event, without charging additional Premium.
7. DESCRIPTION OF THE CLAIM
7.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Dental Expenses on International Travel (DO on International Travel), the date
of the medical care is considered as the date of the event, upon the settlement of claims, from
the date of the dental treatment.
8. PROCEDURES IN THE EVENT OF A CLAIM
8.1. It is recommended that the Insured contact the call center immediately to receive the
provision of necessary services.
8.2. The impossibility of contact with the toll-free phone provided by the Insurance company
and/or the use of professional and/or authorized service network, the insured or beneficiary
may choose other service providers as long as they are legally qualified.
8.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and special
conditions of Insurance.
8.4. If the Insured is entitled to reimbursement of medical expenses from any other source or
Insurance, the Insurance Company will refund the difference between the amount of
expenditure and the amount to which the insured is entitled to reimbursement, limited to the
Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of his/her
traveling companions must immediately contact the Call Center of the Insurance Company.
9. BASIC DOCUMENTATION FOR CLAIM NOTICE
9.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses.
• Dental report of the professional responsible for the care, attesting the occurrence of the
covered event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
Corpse Transfer
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1. PURPOSE
1.1. It consists of the compensation through reimbursement of expenses or provision of
relevant services, limited to the Insured Capital contracted, of expenditure with the release
and transport of the Insured's corpsefrom the site of occurrence of the event covered to the
usual place of residence of the Insured or burial place, including all procedures and objects
indispensable to the Corpse Transfer.
1.2. Covered expenses are as follows:
1. Embalming;
2. Cremation;
3. Providing common bier or coffin;
4. Transfer of the remains until the origin destination of the travel.
4.1. The transfer will be made by the most appropriate type of transportation by the
most direct and economical route as possible.
IMPORTANT: If the Insured's family opts for the Insured's corpsecremation,
Insurance will transport the urn with the ashes.
2. BENEFICIARY
2.1. Beneficiary will be defined in Clause Eight of the Specific Conditions.
3. EXCLUDED RISKS
6.1.The following events of direct or indirect consequence are excluded from Corpse Transfer
coverage, beyond the provisions of Clause Four of the Specific Conditions:
a) any cost incurred for the transport of his/her remains and related services that have
not been pre-approved or pre-arranged by the Insurance Company;
b) Replacement of funerary urn after transfer by the Insurance Company.
c) Suicide in the first two years of the initial validity of the Card, according to art. 798 of
the Civil Code.
d) When there is intervention of funeral homes or third parties without prior consent of
the Insurance Company, this will be exempt of any responsibility for the transfer of the
insured's body remains.
4. ELIGIBILITY
4.1. For the Corpse Transfer coverage, all individuals aged in the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Corpse
Transfer coverage, the date of death is considered as the date of the event, upon the
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Invoice and detailed expense voucher with corpse transfer, where appropriate;
• Police Report issued by police authority, if applicable;
• Autopsy reports, when due to accidental death;
• National driver's license in case of accident with vehicle driven by the Insured;
• Work Accident Release (CAT), as applicable.
Medical Evacuation
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the Insured Capital contracted, the expenses of the Insured's return
transfer to the place of origin of the travel his/her home, as defined in the contractual
conditions, provided that determined by the doctor legally qualified, if the Insured is not in a
position to return as regular passenger for reasons of illness or accident covered.
1.1.1. The Insurance Company will arrange the medical evacuation with autonomy as to the
routes, form and means of transport to be used. The medical repatriation will be carried out
by the most direct route possible and by the means most compatible with the health status of
the insured.
1.1.2. Covered expenses are only those authorized by the Insurance Company, and are
limited to the amount of the Capital Insured contracted for this warranty.
1.1.3. The continuation of treatment after medical repatriation will be the responsibility of the
Insured.
IMPORTANT: It will also be included in this coverage, the transfer from the hotel to
the airport in vehicle compatible with the health status of the insured.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from Medical
Evacuation coverage, beyond the provisions of Clause Four of the Specific Conditions:
a) Any rescue costs (search and rescue) charged by public or private entities.
b) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her trip.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
c) Taxi fees, except the taxi used to help the Insured instead of an ambulance to take
him to or from the hospital.
4. ELIGIBILITY
4.1. For the Medical Evacuation coverage, all individuals aged in the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
Medical Evacuation coverage, the date of medical care is considered as the date of the event,
upon the settlement of claims.
6. PROCEDURES IN THE EVENT OF A CLAIM
6.1. It is recommended that the Insured contact the call center immediately to receive the
provision of necessary services.
6.2. The impossibility of contact with the toll-free phone provided by the Insurance company
and/or the use of professional and/or authorized service network, the insured or beneficiary
may choose other service providers as long as they are legally qualified.
6.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and special
conditions of Insurance.
6.4. If the Insured is entitled to reimbursement of medical expenses from any other source or
Insurance, the Insurance Company will refund the difference between the amount of
expenditure and the amount to which the insured is entitled to reimbursement, limited to the
Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of
his/her traveling companions must immediately contact the Call Center of the
Insurance Company.
7.BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Travel tickets and/or invoice;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Vouchers and/or original receipts of expenses with the transfer, where applicable.
• Report of the physician responsible for the care, attesting the occurrence of the covered
event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Invoice and detailed expense voucher with the transfer;
• Document of the medical discharge with date, start time and end time of the admission;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
• Letter with brief summary of what happened containing the Insurance card data.
• Police Report issued by police authority, if applicable;
• National driver's license in case of accident with vehicle driven by the Insured;
• Work Accident Release (CAT), as applicable.
Corpse Transfer
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the Insured Capital contracted, the expenses of the Insured's removal or
transfer to the nearest clinic or hospital under good conditions to provide the medical care, for
reasons of illness or accident covered.
1.1.1. The Insurance Company will arrange the medical removal with autonomy as to the
routes, form and means of transport to be used. The medical removal will be carried out by
the most direct route possible and by the means most compatible with the health status of the
insured.
1.1.2. Covered expenses are only those authorized by the Insurance Company, and are limited
to the amount of the Capital Insured contracted for this warranty.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from Medical
Transfer coverage, beyond the provisions of Clause Four of the Specific Conditions:
a) any expenses of the transfer of the accompanying person who are traveling with the
Insured.
b) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her trip.
c) Taxi fees, except the taxi used to help the Insured instead of an ambulance to take
him to or from the hospital.
4. ELIGIBILITY
4.1. For the Medical Transfer coverage, all individuals aged in the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
Medical Transfer coverage, the date of removal of transfer of the Insured is considered as the
date of the event, upon the settlement of claims.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
6. PROCEDURES IN THE EVENT OF A CLAIM
6.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
6.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
6.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
6.4. If the Insured is entitled to reimbursement of medical expenses from any other
source or Insurance, the Insurance Company will refund the difference between the
amount of expenditure and the amount to which the insured is entitled to
reimbursement, limited to the Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of
his/her traveling companions must immediately contact the Call Center of the
Insurance Company.
7. BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses with the transfer;
• Report of the physician responsible for the care, attesting the occurrence of the covered
event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
• Police Report issued by police authority, if applicable;
• National driver's license in case of accident with vehicle driven by the Insured;
• Work Accident Release (CAT), as applicable.
Accidental Death during the Travel
1. PURPOSE
1.1. Consists of the payment of the Insured Capital to the beneficiary indicated in the
Insurance Card, at once, in case of death of the insured covered by personal injury during the
travel period.
1.1.1. For Insured younger than fourteen (14) years, this warranty is only intended for the
reimbursement of funeral expenses, which must be proven by the submission of corroborative
original notes, which can be replaced at the discretion of the Insurance Company, with other
satisfactory evidence, observing that the cost of acquisition of land, deposits or graves are not
covered.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
2. BENEFICIARY
2.1. Beneficiary will be defined in Clause Eight of the Specific Conditions.
3. EXCLUDED RISKS
3.1.The events below are excluded from Accidental Death during Travel coverage,
beyond the provisions of Clause Four of the Specific Conditions:
a) Cost of acquisition of land, deposits or graves.
4. ELIGIBILITY
4.1. For Accidental Death during Travel warranty, all individuals within the age range
defined in the Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
Accidental Death during Travel coverage, the accident date is considered as the date of the
event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or travel
operator where the travels were hired;
• Death certificate;
• Police Report issued by police authority, if applicable;
• Autopsy reports, when due to accidental death;
• National driver's license in case of accident with vehicle driven by the Insured;
• Work Accident Release (CAT), as applicable.
Permanent Total or Partial Disability for Accident during the Travel
1. PURPOSE
1.1.It consists of the payment of indemnity to the insured, limited to the insured capital
contracted, in case of loss, reduction or total, partial or permanent functional disability, all or
part of a limb or organ, due to injury suffered by the Insured, caused by personal injury
during the travel period.
1.1.1. If, after paying the indemnity for permanent disability by accident, the death of the
Insured is confirmed as a result of the same accident, the amount already paid for permanent
disability shall be deducted from the amount of the Insured Capital for death if this coverage
is contracted. The beneficiary shall be entitled to indemnity for death even if the Insurance is
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
already canceled due to indemnity for permanent total disability.
1.1.2. Permanent disability must be proved by a medical statement submitted to the Insurance
Company.
1.1.3. The disability pension granted by official social security institutions, or the like, does
not characterize the state of permanent disability.
1.1.4. The Insurance Company reserves the right to submit the Insured medical examinations
or other complementary examinations by professionals indicated by it to prove the occurrence
of disability, its permanent nature, extent and degree.
2. CALCULATION OF INDEMNITY
2.1. Upon completion of treatment, or if the therapeutic resources available for recovery are
exhausted, and if the permanent disability is discovered upon the final discharge, the
Insurance Company will pay the indemnity according to the percentages set forth in the
"Table for Indemnity Calculation in case of Total or Partial permanent disability caused by
Accident":
PERMANENT
DISABILITY
TABLE FOR INDEMNITY CALCULATION IN
CASE OFPERMANENT DISABILITY
% ON
INSURED
CAPITAL
Total loss of vision in both eyes 100
Total loss of use of both upper limbs 100
Total loss of use of both lower limbs 100
Total loss of use of both hands 100
TOTAL Total loss of the use of an upper limb and lower limb
Total loss of use of one hand and one foot 100
Total loss of use of both feet 100
Total and incurable mental alienation 100
100
Total loss of vision in one eye 30
Total loss of vision in one eye when the insured no
longer has the other 70
eye
Total incurable deafness of both ears 40
PARTIAL Total incurable deafness in one ear 20
MISCELLANEOUS Incurable muting 50
Non-consolidated fracture of the lower jaw (mandible) 20
Immobility of the cervical spinal segment 20
Immobility of the thoraco-lumbosacral spinal segment
25
DISABILITY
PERMANENT
TABLE FOR INDEMNITY CALCULATION IN
CASE OF PERMANENT DISABILITY
% ON
INSURED
CAPITAL
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
PARTIAL
UPPER
LIMBS
Total loss of the use of one of the upper limbs
Total loss of use of one hand
Non-consolidated fracture of one of upper arms
Non-consolidated fracture of one of the radio-ulnar
segments
Total ankylosis of one shoulder
Total ankylosis of one elbow (ulna)
Total ankylosis of one fist
Total loss of the use of a thumb, including metacarpal
Total loss of use of one thumb, excluding the
metacarpal
Total loss of the use of the distal phalanx of the thumb
Total loss of the use of one of the forefingers
Total loss of the use of a pinky finger or one of the
fingersmedium
Total loss of the use of one of the ring fingers
Total loss of the use of any phalange, excluding the
thumb phalanges:
indemnity equivalent to 1/3 of the value of the
respective finger
70
60
50
30
25
25
20
25
18
09
15
12
09
Total loss of the use of the lower limbs 70
Total loss of use of one foot 50
Non-consolidated fracture of a femur 50
Non-consolidated fracture of one of the tibioperoneal
segments
Non-consolidated fracture of the kneecap (patella)
25
Non-consolidated fracture of a foot 20
Total ankylosis of one knee 20
Total ankylosis of one ankle 20
Total ankylosis of a hip 20
PARTIAL Partial loss of one foot, that is, the loss of all fingers and 20
LIMBS a part of the same foot
LOWER Amputation of the first finger 25
Amputation of any other finger 10
Total loss of the use of a phalanx of the 1st finger:
indemnity equivalent to 1/2, and the other fingers,
equivalent to 1/3 of the respective finger.
Shortening of the lower limbs:
* Five (5) centimeters or more
03
* 4 (four) centimeters 15
* Three (3) centimeters 10
* less than three (3) centimeters: 06
without
Indemnity
2.2. If the functions of the injured limb or organ are not abolished completely, indemnity for
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
partial loss is calculated by applying the degree of functional reduction presented at the
percentage specified in the plan for its total loss.
2.3.In the absence of accurate indication of the degree of functional reduction shown, and
such degree being classified as maximum, medium or low, the indemnity is calculated based
on the percentages of 75%, 50% and 25%, respectively.
2.4. In cases not specified in the plan, indemnity is established based on the permanent
reduction of physical capacity of the Insured, regardless of their profession.
2.5. When the same accident results in a disability of more than one limb or organ, the
indemnity should be calculated by adding up the percentages, the total can not exceed one
hundred percent (100%).
2.6. In the event of two or more injuries in the same limb or organ, the sum of the
corresponding percentages may not exceed the indemnity provided for your total loss.
2.7. For indemnity purposes, the loss or greater functional reduction of a limb or organ
already defective before the accident, should be deducted from the degree of permanent
disability.
2.8. The Insured Capital in case of partial disability will be automatically reinstated after each
claim, without additional premium collection.
2.9. Payment of Capital regarding this coverage only becomes due from the date of
verification and consequent recognition of invalidity by the Insurance Company.
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
a) the consequent complications of exams, clinical or surgical treatments, when not
resulting from a covered accident;
b)diseases, including professionals, whatever their causes are, even if caused, triggered
or aggravated, directly or indirectly by accident, except infections, septic states and
embolisms resulting from a visible wound;
c) the loss of teeth and aesthetic damage.
5.ELIGIBILITY
5.1. For warranties of Permanent Total or Partial Disability caused by Accident during
Travel, all individuals within the age range defined in the Insurance contract, in good health
and able to exercise professional activity at the time of contracting the Insurance, are
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
eligible.
6. DESCRIPTION OF THE CLAIM
6.1. For the indemnity calculation purposes and the Insurance Company's liability for the
Permanent Total or Partial Disability caused by Accident during Travel, the accident date is
considered as the date of the event, upon the settlement of claims.
7. BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause thirteen, the
beneficiary must provide the following basic documents:
• Medical report with a description of the condition, procedures performed, the degree of
disability and permanent nature;
• Copy of the complementary exams with description of permanent disability;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or travel
operator where the travels were hired;
• Police Report issued by police authority in which the location and description of the claim,
date and time should be specified in details;
• National driver's license in case of accident with vehicle driven by the Insured;
• Work Accident Release (CAT), as applicable.
Complementary Medical and/or Hospital Expenses on National Travel (DMH on
National Travel)
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the amount of the Insured Capital hired, complementary medical, hospital
and/or dental expenses to the Insured, i.e. expenses not covered by the basic coverage of
Medical and/or Expenses Hospital on National Travel (DMH on National Travel) or the
Basic Coverage of Dental Expenses on National Travel (DO on National Travel).
1.1.1. Only events arising from events covered by Insurance for basic coverage of Medical
and/or Hospital Expenses on National Travel (DMH on National Travel) or the basic
coverage of dental expenses on National Travel (DO on National Travel), whose generating
event is not a pre-existing disease, are included in this coverage.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
2.2. The amount of the applicable Insurance deductible will expressly consist of the
Insurance Card, and corresponds to the plan chosen by the Insurance Representative
from the following:
Plans Deductible in R$
A Without
deductible
B 150.00
C 300.00
D 400.00
E 600.00
F 900.00
G 1,200.00
H 1,500.00
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1.The events occurring as a direct or indirect consequence of the following during the
travel period are excluded from DMHOC coverage on National Travel for non-pre-
existing diseases, beyond the provisions of Clause Four of the Specific Conditions:
a)Any type of cancer or cancer treatment, its complications or consequences, even if not
diagnosed before the start of the travel;
b)Any chronic heart disease, its complications or consequences, known by the insured
or or not, even if not diagnosed before the start of the travel;
c) Any blood pressure or hypertension and its complications or consequences.
d) Diabetes, its complications or consequences if not diagnosed before the travel;
c) Complications of pregnancy and/or delivery;
f) Prenatal treatment or control;
g) Treatment of pregnancy, including provision of services related to the diagnosis and
treatment of infertility or other problems related to fertility, birth control, including
surgical interventions and device for this purpose, induced abortions, medical expenses
and any other type related to the newborn (when childbirth and its consequences do not
occur directly from personal injury);
h) Newborns, including premature, during the insured travel;
i) Renal failure or hemodialysis, complications or consequences, even if not diagnosed
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
before the travel;
j) Any type of transplant that the Insured has undergone within a period of one
hundred eighty (180) days prior to contracting the Insurance, including, but not limited
to transplant during the insured travel; k) Any surgical procedure to which the Insured
has undergone within a period of ninety (90) days prior to contracting the Insurance,
even if the Insured is in definitive medical discharge;
l) Hematological diseases, complications or consequences if not diagnosed before the
travel; m) Neurological diseases, complications or consequences not diagnosed before
the travel;
n) Convalescent situations (after medical discharge) when returning to the country of
origin, and the costs of accompanying persons;
o) Sexually transmitted diseases including HIV.
p) Mental disorders, including neuroses, psychoses, or any psychological illness and
their consequences.
q) Alternative medicines such as acupuncture, homeopathy, chiropractic and shiatsu,
bach flower or floral therapy. r) Devices that refer to orthoses of any kind and the
permanent prosthesis, except prostheses for the loss of natural teeth; s) Expenses
incurred with pre-existing conditions at the time of contracting the Insurance, known
by the Insured and not declared in the respective Card. t) The practice of sports and
activities listed below:
1. Disputes or interscholastic or academic championships;
2. Travel to remote areas or particularly dangerous areas, with or without a guide;
3. Any activity involving weapons;
4. "Rafting" with difficulty degree 4 or above;
5. Sailing on the high seas;
6. Diving, unless the insured has a "PADI certification" (or similar qualification), or if
the Insured dives under the supervision of a qualified instructor. In the case of
exceptions, the Insured shall be covered if he/she complies with the maximum depth
specified in its certification or twelve (12) meters, whichever is less, and is accompanied;
7.Scuba Diving;
8. Disputes in motor vehicles, including preparatory training or classification;
9. Racing and motorcycling, motocross, boogies, even in competition;
10. Mountain climbing, rappelling, or outdoor climbing, involving the use of specific
equipment, including, but not limited to, "crampons", picks, bolts, ropes and other
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
anchoring equipment;
11. Hiking or travels above 3,000 meters;
12. Winter sports, including, but not limited, toboggans, sleds, "bobsleigh", ice hockey,
water skiing, wave runner, ride quads, snow mobiling and "heli-skiing" outside the
regulated track;
13. Horse riding, polo and other equestrian activities;
14. Combat sports such as boxing and martial arts;
15.Rugby;
16. Circus acrobatics;
17. "Canyoning", "spelunking", "base jumping" or cliff jumping;
18. Endurance sports and/or sports requiring high physical demands, for example,
marathons, triathlons or biatlohs;
19. Hang-gliding or paragliding;
20. Aviation Sports;
21. Parachuting, "skydiving" or "bungee jumping";
22. Surfing, Windsurfing, Kite surfing, water skiing or "Jet ski";
23. Hunting or shooting sport.
24. Balloon practices or ride.
5.ELIGIBILITY
5.1. For DMHOC warranty on National Travel, all individuals within the age range defined in
the Insurance contract at the time of contracting the Insurance are eligible.
6. DESCRIPTION OF THE CLAIM
6.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Complementary Medical, Hospital and/or Dental Expenses on National Travel,
the date of the medical care is considered as the date of the event, upon the settlement of
claims.
7. PROCEDURES IN THE EVENT OF A CLAIM
7.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
7.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
7.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
7.4. If the Insured is entitled to reimbursement of medical expenses from any other
source or Insurance, the Insurance Company will refund the difference between the
amount of expenditure and the amount to which the insured is entitled to
reimbursement, limited to the Insured Capital of this warranty.
8. BASIC DOCUMENTATION FOR CLAIM NOTICE
8.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Travel tickets and/or invoice;
• Passport copy;
• Vouchers and/or original receipts of expenses.
• Report of the physician/dentist responsible for the care, attesting the occurrence of the
covered event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Copy of the hospital records and invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the amount of the Insured Capital hired, complementary medical, hospital
and/or dental expenses to the Insured, i.e. expenses not covered by the basic coverage of
Medical and/or Expenses Hospital on International Travel (DMH on International Travel) or
the Basic Coverage of Dental Expenses on National Travel (DO on International Travel).
1.1.1. Only events arising from events covered by the Insurance for the basic coverage of
Medical and/or Hospital Expenses in International Travel (DMH on International Travel) or
the Dental Expenses in International Travel (DO on International Travel) whose generating
event is not a pre-existing disease are included in this coverage.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical
care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.PREGNANT WOMEN
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
2.1. This warranty extends to events related to pregnancy until the week 28 of pregnancy due
to hospitalizations covered by Insurance for basic coverage of Medical and/or Hospital
Expenses in National Travel (DMH on National Travel) or the basic coverage of Dental
Expenses in International Travel (DO on International Travel).
3.DEDUCTIBLE
3.1. This coverage is subject to the application of the deductible.
3.2. The amount of the applicable Insurance deductible will expressly consist of the
Insurance Card, and corresponds to the plan chosen by the Insurance Representative
from the following:
Plans Deductible in R$ Deductible in
US$*
A Without
deductible
Without
deductible
B 150.00 50.00
C 300.00 100.00
D 600.00 200.00
E 900.00 300.00
F 1,200.00 400.00
G 1,500.00 500.00
* For insurances in foreign currency
4.BENEFICIARY
4.1. The Beneficiary is the Insured.
5. EXCLUDED RISKS
5.1. The events of direct or indirect consequence of the following, during the travel
period, are excluded from DMHOC onInternational Travel for non-pre-existing
diseases is excluded from the coverage,beyond the provisions of Clause Four:
a)Any type of cancer or cancer treatment, its complications or consequences, even if not
diagnosed before the start of the travel;
b)Any chronic heart disease, its complications or consequences, known by the insured
or or not, even if not diagnosed before the start of the travel;
c) Any blood pressure or hypertension and its complications or consequences.
d) Diabetes, its complications or consequences if not diagnosed before the travel;
e) Births that occur after the week 28 of pregnancy (i.e., normal, surgical induced
delivery and others), including any complications when not resulting from the personal
injury covered;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
f) Prenatal treatment or control;
g) Treatment of pregnancy, including provision of services related to the diagnosis and
treatment of infertility or other problems related to fertility, birth control, including
surgical interventions and device for this purpose, induced abortions, medical expenses
and any other type related to the newborn (when childbirth and its consequences do not
occur directly from personal injury);
h) Newborns, including premature, during the insured travel;
i) Renal failure or hemodialysis, complications or consequences, even if not diagnosed
before the travel;
j) Any type of transplant that the Insured has undergone within a period of one
hundred eighty (180) days prior to contracting the Insurance, including, but not limited
to transplant during the insured travel; k) Any surgical procedure to which the Insured
has undergone within a period of ninety (90) days prior to contracting the Insurance,
even if the Insured is in definitive medical discharge;
l) Hematological diseases, complications or consequences if not diagnosed before the
travel; m) Neurological diseases, complications or consequences not diagnosed before
the travel;
n) Convalescent situations (after medical discharge) when returning to the country of
origin, and the costs of accompanying persons;
o) Sexually transmitted diseases including HIV.
p) Mental disorders, including neuroses, psychoses, or any psychological illness and
their consequences.
q) Alternative medicines such as acupuncture, homeopathy, chiropractic and shiatsu,
bach flower or floral therapy. r) Devices that refer to orthoses of any kind and the
permanent prosthesis, except prostheses for the loss of natural teeth; s) Expenses
incurred with pre-existing conditions at the time of contracting the Insurance, known
by the Insured and not declared in the respective Card. t) The practice of sports and
activities listed below, except for the coverages covering the Death or Disability:
1. Disputes or interscholastic or academic championships;
2. Travel to remote areas or particularly dangerous areas, with or without a guide;
3. Any activity involving weapons;
4. "Rafting" with difficulty degree 4 or above;
5. Sailing on the high seas;
6. Diving, unless the insured has a "PADI certification" (or similar qualification), or if
the Insured dives under the supervision of a qualified instructor. In the case of
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
exceptions, the Insured shall be covered if he/she complies with the maximum depth
specified in its certification or twelve (12) meters, whichever is less, and is accompanied;
7.Scuba Diving;
8. Disputes in motor vehicles, including preparatory training or classification;
9. Racing and motorcycling, motocross, boogies, even in competition;
10. Mountain climbing, rappelling, or outdoor climbing, involving the use of specific
equipment, including, but not limited to, "crampons", picks, bolts, ropes and other
anchoring equipment;
11. Hiking or travels above 3,000 meters;
12. Winter sports, including, but not limited, toboggans, sleds, "bobsleigh", ice hockey,
water skiing, wave runner, ride quads, snow mobiling and "heli-skiing" outside the
regulated track;
13. Horse riding, polo and other equestrian activities;
14. Combat sports such as boxing and martial arts;
15.Rugby;
16. Circus acrobatics;
17. "Canyoning", "spelunking", "base jumping" or cliff jumping;
18. Endurance sports and/or sports requiring high physical demands, for example,
marathons, triathlons or biatlohs;
19. Hang-gliding or paragliding;
20. Aviation Sports;
21. Parachuting, "skydiving" or "bungee jumping";
22. Surfing, Windsurfing, Kite surfing, water skiing or "Jet ski";
23. Hunting or shooting sport.
24. Balloon practices or ride.
6.ELIGIBILITY
6.1. For DMHOC warranty on International Travel, all individuals within the age range
defined in the Insurance contract at the time of contracting the Insurance are eligible.
7. DESCRIPTION OF THE CLAIM
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
7.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Complementary Medical, Hospital and/or Dental Expenses in International
Travel (DMHOC on International Travel), the date of the medical care is considered as the
date of the event, upon the settlement of claims.
8. PROCEDURES IN THE EVENT OF A CLAIM
8.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
8.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
8.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
8.4. If the Insured is entitled to reimbursement of medical expenses from any other
source or Insurance, the Insurance Company will refund the difference between the
amount of expenditure and the amount to which the insured is entitled to
reimbursement, limited to the Insured Capital of this warranty.
9. BASIC DOCUMENTATION FOR CLAIM NOTICE
9.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Travel tickets and/or invoice;
• Passport copy;
• Vouchers and/or original receipts of expenses.
• Report of the physician/dentist responsible for the care, attesting the occurrence of the
covered event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Copy of the hospital records and invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
Expenditure on medicines
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of costs with medicines, limited to
the amount of the Insured Capital hired, incurred by the Insured for his/her treatment under
supervision of a doctor, caused by personal injury or sudden acute illness occurred during the
travel period and the Insured is outside his city of residence, with a displacement higher
than one hundred kilometers (100 km) in the case of land travel.
1.1.1. This Insurance covers only the expenses with medicines after hospital discharge
or medical care, prescribed by the doctor who provided care to the Insured by one of
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
the coverage of average expenses and/or hospital expenses of this Insurance.
1.1.2. The reimbursement will be limited to the Capital Insured.
1.1.3. The value of the Insured Capital is indicated in the Insurance Card.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from Expenses
with Medicines coverage, beyond the provisions of Clause Four of the Specific
Conditions:
a) Any kind of elective and/or routine treatment;
b) Expenses or costs related to treatment or non-emergency treatment, or that the
insured can perform after returning his/her home.
4. ELIGIBILITY
4.1. For warranty of Expenses with Medicines, all individuals within the age range defined in
the Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Expenses with Medicines, the date of medical care is considered as the date of
the event, upon the settlement of claims.
6. PROCEDURES IN THE EVENT OF A CLAIM
6.1. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
6.2. If the Insured is entitled to reimbursement of expenses from any other source or
Insurance, the Insurance Company will refund the difference between the amount of
expenditure and the amount to which the insured is entitled to reimbursement, limited
to the Insured Capital of this warranty.
7. BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Medical prescription;
• Vouchers and/or original receipts of expenses with the purchase of medicines.
• Letter with brief summary of what happened containing the Insurance card data.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1. PURPOSE
1.1. Payment of an indemnity in addition to the amount of indemnity already paid to the
Insured by the Airline responsible for transport, due to all the luggage loss, occurred during
air transport inherent on the national travel, whenever losses exceed the amount of the
indemnity paid by the Airline responsible for transport, limited to the amount of insured
capital defined in the Card and discounting any amounts eventually paid in advance to the
Insured.
1.1.1. To calculate the indemnity, multiply the weight of the luggage dispatched by the
kilogram unit value dispatched reported in the Insurance Card (Insured Capital per kilogram
of luggage), deducting the indemnity value paid by the airline, in case of positive result, it
will be paid to the Insured.
1.1.2. The actual loss or effective damage to the luggage will only be covered if it occurs
between the time the luggage is delivered to the authorized airline staff to be shipped, and at
the time it is returned to the passenger at the end of the travel.
1.1.3. It is essential that regular Airline has assumed the responsibility for the loss of
luggage and has paid the indemnity proposed by the Airline to the passenger so that the
effective Supplemental compensation for loss of luggage provided for in this guarantee
is paid.
1.1.4. It is recommended that the Insured informs the Insurance Company within
twenty four (24) hours in order to find the luggage.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from the
coverage of Luggage Loss in Complementary National Air Transport, beyond the
provisions of Clause Four of the Specific Conditions:
a) Displacements prior to the dispatch of luggage for domestic travel.
b) The failure to submit the PIR - Property Irregularity Report, Copy of the Ticket of
the Luggage dispatched and Copy of the indemnity voucher received from the Airline.
c) Hand luggage;
d) Depreciation and normal wear of objects;
e) Damage resulting from confiscation, seizure or destruction by order of fact or law
authority;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
f) Damage to glasses, contact lenses, and any oral apparatus;
g) Jewelry, furs, watches, securities, policies;
h) Money of any nature, checks, bonds and any other securities representing values and
estimated value of any goods of the heritage of the Insured;
i) Losses occurred with Insured acting as operator or member of the crew of the means
of transport that lead to the Claim;
j) Damage to luggage and/or partial absences of contents;
k) Goods borrowed or rented;
l) Goods abandoned, even temporarily, in a public place;
m) Loss, theft or damage to luggage not reported to the airline or shipping company
within 24 hours after discovery of the loss or theft.
n) Loss, theft or damage of mobile phones (including "smartphones", tablets and
accessories), even if granted by third parties for use during the travel, or other
equipment of any kind.
o) Medications;
p) The damage caused by fraudulent use of their credit or debit cards.
q) Losses without proof of receipt or proof of ownership.
r) Any loss, theft or money damages, documents (including passport, identity card,
driving license or entry visa), credit cards, including prepaid credit cards, jewelry,
financial value of securities of any kind, travelers checks, title, and data recorded on
tapes, cards, discs,USB or any other type of memory device.
s) Luggage withholdings through customs, police or other authorities.
t) Loss of personal property in sports or leisure activities.
u) Damage or loss of sports equipment during use (including clothing and accessories).
v) Personal items of luggages sent in advance or with another person, sent by post,
delivery services or sent separately; or given to someone else to care that is not a
member of the traveling group, or a person authorized in hotel or representative of the
transport company.
w) Physical damage to luggage, such as shell, zipper, traveling wheels, etc.
x) Compensation or delay of luggage at the airport of the city of domicile, where the
travel was originated.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
4. ELIGIBILITY
4.1. For warranty of Luggage Loss on Complementary Air Transport on National Travel, all
individuals within the age range defined in the Insurance contract at the time of contracting
the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Luggage Loss on Complementary Air Transport in National Travel, the date of
registration made to the legal authority is considered as the date of the event, upon the
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Loss or damage evidential report issued by the transport company responsible (PIR
- Property Irregularity Report), airline tickets and tickets of the luggage dispatched.
• Proof of purchase of tickets.
• Copy of the compensation voucher received by the airline.
Baggage Loss in Complementary Air Transport in International Travel
1. PURPOSE
1.1. Payment of an indemnity in addition to the amount of indemnity already paid to the
Insured by the Airline responsible for transport, due to all the baggage loss, occurred during
air transport inherent in the international tour, whenever losses exceed the amount of the
indemnity paid by the Airline responsible for transport, limited to the amount of insured
capital defined in the Card and discounting any amounts eventually paid in advance to the
Insured.
1.1.1. To calculate the indemnity, multiply the weight of the luggage dispatched by the
kilogram unit value dispatched reported in the Insurance Card (Insured Capital per kilogram
of luggage), deducting the indemnity value paid by the airline, in case of positive result, it
will be paid to the Insured.
1.1.2. The actual loss or effective damage to the luggage will only be covered if it occurs
between the time the luggage is delivered to the authorized airline staff to be shipped, and at
the time it is returned to the passenger at the end of the travel.
1.1.3. It is essential that regular Airline has assumed the responsibility for the loss of luggage
and has paid the indemnity proposed by the Airline to the passenger so that the effective
Supplemental compensation for loss of luggage provided for in this guarantee is paid.
1.1.4. It is recommended that the Insured informs the Insurance Company within twenty four
(24) hours in order to find the luggage.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from the
coverage of Luggage Loss in Complementary International Air Transport, beyond the
provisions of Clause Four of the Specific Conditions:
a) National Travel and/or previous trips to dispatch luggage for international travel.
b) The failure to submit the PIR - Property Irregularity Report, Copy of the Ticket of
the Luggage dispatched and Copy of the indemnity voucher received from the Airline.
c) Hand luggage;
d) Depreciation and normal wear of objects;
e) Damage resulting from confiscation, seizure or destruction by order of fact or law
authority;
f) Damage to glasses, contact lenses, and any oral apparatus;
g) Jewelry, furs, watches, securities, policies;
h) Money of any nature, checks, bonds and any other securities representing values and
estimated value of any goods of the heritage of the Insured;
i) Losses occurred with Insured acting as operator or member of the crew of the means
of transport that lead to the Claim;
j) Damage to luggage and/or partial absences of contents; k) Goods borrowed or rented;
l) Goods abandoned, even temporarily, in a public place; m) Loss, theft or damage to
luggage not reported to the airline or shipping company within 24 hours after discovery
of the loss or theft. n) Loss, theft or damage of mobile phones (including
"smartphones", tablets and accessories), even if granted by third parties for use during
the travel, or other equipment of any kind.
o) Medications;
p) The damage caused by fraudulent use of their credit or debit cards. q) Losses without
proof of receipt or proof of ownership.
r) Any loss, theft or money damages, documents (including passport, identity card,
driving license or entry visa), credit cards, including prepaid credit cards, jewelry,
financial value of securities of any kind, travelers checks, title, and data recorded on
tapes, cards, discs,USB or any other type of memory device.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
s) Luggage withholdings through customs, police or other authorities.
t) Loss of personal property in sports or leisure activities.
u) Damage or loss of sports equipment during use (including clothing and accessories).
v) Personal items of luggages sent in advance or with another person, sent by post,
delivery services or sent separately; or given to someone else to care that is not a
member of the traveling group, or a person authorized in hotel or representative of the
transport company.
w) Physical damage to luggage, such as shell, zipper, traveling wheels, etc.
x) Compensation or delay of luggage at the airport of the city of domicile, where the
travel was originated.
4. ELIGIBILITY
4.1. For warranty of Luggage Loss on Complementary Air Transport on International Travel,
all individuals within the age range defined in the Insurance contract at the time of
contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Luggage Loss on Complementary Air Transport in International Travel, the date
of registration made to the legal authority is considered as the date of the event, upon the
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Loss or damage evidential report issued by the transport company responsible (PIR
- Property Irregularity Report), airline tickets and tickets of the luggage dispatched.
• Proof of purchase of tickets.
• Copy of the compensation voucher received by the airline.
1. PURPOSE
1.1. Payment to the Insured of an additional indemnity to the amount indemnified by the
Airline, limited to the amount of the Insured Capital hired and indicated in the Insurance
card, in case of total luggage loss, which occurred during air transport inherent on the
national travel, discounting any amounts eventually paid in advance to the Insured.
1.1.1. The described indemnity is per person and total volume lost and will be provided up to
the maximum limit per passenger, regardless of the number of events that may occur during
the term of Insurance. When two or more people share the same lost piece of luggage, the
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
payment of the indemnity indicated above will be made proportionately.
1.1.2. The actual loss of the luggage will only be covered if it occurs between the time the
luggage is delivered to the authorized airline staff to be shipped, and at the time it is returned
to the passenger at the end of the travel.
1.1.3. It is essential that regular Airline has assumed the responsibility for the loss of luggage
and has paid the indemnity proposed by the Airline to the passenger so that the effective
indemnity for loss of luggage provided for in this guarantee is paid.
1.1.4. The actual loss of luggage will be covered only if it is informed immediately to the
airline before leaving the baggage claim and/or the airport, where such missing was
confirmed, and the Insured must submit written evidence of that absence through "P.I.R"
form. (Property Irregularity Report).
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from the
coverage of Luggage Loss in Supplemental National Air Transport, beyond the
provisions of Clause Four of the Specific Conditions:
a) Displacements prior to the dispatch of luggage for domestic travel.
b) The failure to submit the PIR - Property Irregularity Report, Copy of the Ticket of
the Luggage dispatched and Copy of the indemnity voucher received from the Airline.
d) Depreciation and normal wear of objects;
d) Damage resulting from confiscation, seizure or destruction by order of fact or law
authority;
e) Damage to glasses, contact lenses, and any oral apparatus;
f) Jewelry, furs, watches, securities, policies;
g) Money of any nature, checks, bonds and any other securities representing values and
estimated value of any goods of the heritage of the Insured;
h) Losses occurred with Insured acting as operator or member of the crew of the means
of transport that lead to the Claim;
i) Damage to luggage and/or partial absences of contents;
j) Goods borrowed or rented;
k) Goods abandoned, even temporarily, in a public place;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
l) Loss, theft or damage to luggage not reported to the airline or shipping company
within 24 hours after discovery of the loss or theft.
m) Loss, theft or damage of mobile phones (including "smartphones", tablets and
accessories), even if granted by third parties for use during the travel, or other
equipment of any kind.
o) The damage caused by fraudulent use of their credit or debit cards.
p) Losses without proof of receipt or proof of ownership.
q) Any loss, theft or money damages, documents (including passport, identity card,
driving license or entry visa), credit cards, including prepaid credit cards, jewelry,
financial value of securities of any kind, travelers checks, title, and data recorded on
tapes, cards, discs,USB or any other type of memory device.
r) Luggage withholdings through customs, police or other authorities.
s) Loss of personal property in sports or leisure activities. t) Damage or loss of sports
equipment during use (including clothing and accessories).
u) Personal items of luggages sent in advance or with another person, sent by post,
delivery services or sent separately; or given to someone else to care that is not a
member of the traveling group, or a person authorized in hotel or representative of the
transport company.
v) Physical damage to luggage, such as shell, zipper, traveling wheels, etc.
w) Compensation or delay of luggage at the airport of the city of domicile, where the
travel was originated.
4. ELIGIBILITY
4.1. For warranty of Luggage Loss on Complementary Air Transport on National Travel, all
individuals within the age range defined in the Insurance contract at the time of contracting
the Insurance are eligible, since they are in good health and able to exercise professional
activity at the time of hiring Insurance.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Luggage Loss on Complementary Air Transport in Complementary National
Travel, the date of registration made to the legal authority is considered as the date of the
event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
• Police report or similar document issued by the responsible authority;
• Loss or damage evidential report issued by the transport company responsible (PIR
- Property Irregularity Report), airline tickets and tickets of the luggage dispatched.
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travels were hired.
• Copy of the compensation voucher received by the airline.
Baggage Loss in Complementary Air Transport on International Travel
1. PURPOSE
1.1. Payment to the Insured of an additional indemnity to the amount indemnified by the
Airline, limited to the amount of the Insured Capital hired and indicated in the Insurance
card, in case of total luggage loss, which occurred during air transport inherent in the national
travel, discounting any amounts eventually paid in advance to the Insured.
1.1.1. The described indemnity is per person and total volume lost and will be provided up to
the maximum limit per passenger, regardless of the number of events that may occur during
the term of Insurance. When two or more people share the same lost piece of luggage, the
payment of the indemnity indicated above will be made proportionately.
1.1.2. The actual loss of the luggage will only be covered if it occurs between the time the
luggage is delivered to the authorized airline staff to be shipped, and at the time it is returned
to the passenger at the end of the travel.
1.1.3. It is essential that regular Airline has assumed the responsibility for the loss of luggage
and has paid the indemnity proposed by the Airline to the passenger so that the effective
indemnity for loss of luggage provided for in this guarantee is paid.
1.1.4. The actual loss of luggage will be covered only if it is informed immediately to the
airline before leaving the baggage claim and/or the airport, where such missing was
confirmed, and the Insured must submit written evidence of that absence through "P.I.R"
form. (Property Irregularity Report).
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from the
coverage of Luggage Loss in Supplemental International Air Transport, beyond the
provisions of Clause Four of the Specific Conditions:
a) National Travel and/or previous trips to dispatch luggage for international travel.
b) The failure to submit the PIR - Property Irregularity Report, Copy of the Ticket of
the Luggage dispatched and Copy of the indemnity voucher received from the Airline.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
d) Depreciation and normal wear of objects;
d) Damage resulting from confiscation, seizure or destruction by order of fact or law
authority;
e) Damage to glasses, contact lenses, and any oral apparatus;
f) Jewelry, furs, watches, securities, policies;
g) Money of any nature, checks, bonds and any other securities representing values and
estimated value of any goods of the heritage of the Insured;
h) Losses occurred with Insured acting as operator or member of the crew of the means
of transport that lead to the Claim;
i) Damage to luggage and/or partial absences of contents;
j) Goods borrowed or rented;
k) Goods abandoned, even temporarily, in a public place;
l) Loss, theft or damage to luggage not reported to the airline or shipping company
within 24 hours after discovery of the loss or theft.
m) Loss, theft or damage of mobile phones (including "smartphones", tablets and
accessories), even if granted by third parties for use during the travel, or other
equipment of any kind.
o) The damage caused by fraudulent use of their credit or debit cards.
p) Losses without proof of receipt or proof of ownership.
q) Any loss, theft or money damages, documents (including passport, identity card,
driving license or entry visa), credit cards, including prepaid credit cards, jewelry,
financial value of securities of any kind, travelers checks, title, and data recorded on
tapes, cards, discs,USB or any other type of memory device.
r) Luggage withholdings through customs, police or other authorities.
s) Loss of personal property in sports or leisure activities.
t) Damage or loss of sports equipment during use (including clothing and accessories).
u) Personal items of luggages sent in advance or with another person, sent by post,
delivery services or sent separately; or given to someone else to care that is not a
member of the traveling group, or a person authorized in hotel or representative of the
transport company.
v) Physical damage to luggage, such as shell, zipper, traveling wheels, etc.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
w) Compensation or delay of luggage at the airport of the city of domicile, where the
travel was originated.
4. ELIGIBILITY
4.1. For warranty of Luggage Loss on Supplemental Air Transport on International Travel, all
individuals within the age range defined in the Insurance contract at the time of contracting
the Insurance are eligible, since they are in good health and able to exercise professional
activity at the time of hiring Insurance.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Luggage Loss on Supplemental Air Transport on International Travel, the date of
registration made to the legal authority is considered as the date of the event, upon the
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Police report or similar document issued by the responsible authority;
• Loss or damage evidential report issued by the transport company responsible (PIR
- Property Irregularity Report), airline tickets and tickets of the luggage dispatched.
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travels were hired.
• Copy of the compensation voucher received by the airline.
Baggage Loss in Supplemental Air Transport on National Travel
1. PURPOSE
1.1. Payment of expenses for purchases of personal items, due to the delay caused to the
luggages of the Insured, provided under the responsibility of the transportation company,
proven by submitting the PIR - Property Irregularity Report.
The Insurance Company shall indemnify the Insured when the luggage has not arrived, and
delivered to the Insured by the shipping company, after the minimum waiting time specified
in the Insurance card, for example, after 6 hours, provided that the place of departure is not
the residence of the Insured.
1.1.1. The indemnity is limited to the payment of expenses with the purchase of essential
items of clothing and toiletries for the duration of the delay.
1.1.2. This coverage refers only to scheduled flights of airlines, however, the charter flights
are not covered in this manner.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1.1.3. This benefit is valid only during the course of the insured trip and since proven by
submitting the PIR - Property Irregularity Report.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from Lugagge
Delay coverage, beyond the provisions of Clause Four of the Specific Conditions:
a) In the event of confiscation or seizure of luggage by the Customs or other government
authority;
b) When the Insured act as operator or crew member in the means of transport that
caused the event;
c) If the insured fails to notify the shipping company by completing the irregularity
report, before leaving the place of landing;
d) If the insured fails to take the necessary measures to safeguard or recover lost
luggage.
e) Liquids and alcoholic and non-alcoholic beverages in general;
f) Perfumes, anti-aging and rejuvenating cream, jewelry, watches, makeup, bags,
backpacks, caps and hats, sunglasses, coats, scarf, sweater, gloves, boots, thermal
clothes, shaving machines, including and not limited to Basic Clothing Items, Basic
Items of Personal Hygiene and Objects of Value and Electronic Equipment/Computer
of the Specific Conditions.
4. ELIGIBILITY
4.1. For warranty of Luggage Delay, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Luggage Damages, the date of registration made to the legal authority is
considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the Claim Notice and reimbursement of expenses, in addition to the documents listed
in item 16 of the Specific Conditions, the beneficiary must provide the following basic
documents:
• Loss evidential report issued by the transport company responsible (PIR - Property
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
Irregularity Report);
• Original luggage ticket,
• Original invoices, the amounts spent on buying clothes and toiletries.
Travel Interruption
1. PURPOSE
1.1. It consists of the reimbursement, limited to the insured capital, the costs of acquisition of
tour packages and/or travel and exchange services, such as transportation and lodging, since
bought before the travel, if the insured is obliged to cancel the insured travel already started.
1.1.1. The Insurance Company shall indemnify the following expenses:
a) reimburse non-refundable part of the costs of transportation, lodging, excursions,
sightseeing tours and tourist activities that the insured has paid or agreed to pay, in contracts
that can not be canceled or only provide for a partial refund;
b) hosting (only daily fees, without extras and meals0 in establishments of the same type as
the insured had contracted), where necessary, until his/her return to the place of origin.
1.1.2. In the case of group travel, previously reported in hiring, the Insurance Company also
must indemnify the costs of the other members of the insured group.
1.1.3. In the covered event occurrence that prevents the Insured to continue his/her
journey, the coverages will apply to occurrences that have as sole and exclusive
consequence:
a) death or hospitalization due to personal injury or sudden acute illness occurred after
the start and during the travel period;
b) death or hospitalization due to personal injury or declared sudden acute illness of the
spouse, parents, siblings or children of the Insured during the travel period, after
started;
c) the receipt of non-extendable summons in court, for the Insured appear before the
Court, provided that the receipt of such summons occurs during the travel period, after
started;
d) the Insured's quarantine decree by the competent health authority, since the decree
occurs during the travel period, after started.
1.1.4. The limit of coverage is proportional to the days of his/her trip, from the
interruption date to the date of return to the place of origin.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
3.1.The events below are excluded from Travel Disruption coverage, beyond the
provisions of Clause Four of the Specific Conditions:
a) the failure to submit a copy of the service contract of the travel agency or operator
listing the penalties and costs to be borne by the Insured.
b) Plastic Surgery and its consequences, including those derived from congenital
problems. Restorative plastic surgeries resulting from personal injury covered occurred
in the Insurance are covered;
c) Aesthetic treatment and obesity in any forms, as well as surgery and periods of
convalescence related to it;
d) Hospitalizations for routine physical examination or any other examination without
problems in normal health;
e) Hospitalizations when the patient is not under legally qualified medical care;
f) Chronic diseases and/or diseases pre-existing to the Insurance hiring not stated on the
Card, if provided, known by the Insured, as well as aggravation, consequences and
sequels.
g) Hospitalizations in institutions for care of mentally disabled, that is, an institution
primarily dedicated to the treatment of psychiatric diseases, including subnormality; or
the psychiatric department of a hospital, place for seniors, rest homes, nursing homes
and the like, clinics or place for recovering addicts to alcohol and drugs,
hydrotherapeutic health institutions or natural healing clinics, nursing home for
convalescents, special unit of Hospital used primarily as a place for addicts to drugs or
alcohol, or as a health institution for convalescent or rehabilitation, Weight Loss Clinic
and SPA.
4. ELIGIBILITY
4.1. For warranty of Travel Disruption, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Travel
Disruption coverage, the the date of the interruption communication protocol by the travel
service provider is considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions,the beneficiary must provide the following basic documents:
• Death Certificates (of the Insured, spouse, parent, sibling or child of the insured, as
applicable);
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
• Medical report and copy of complementary examinations that prove the hospital admission
(of the Insured, spouse, parent, sibling or child of the insured, as applicable);
• Family tie proof (of the spouse, parent, sibling or child of the insured, as applicable);
• Copy of the summons and judicial proceedings;
• Copy of the court quarantine ruling specifying the cause and admission conditions;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or travel
operator where the travels were hired;
• Copy of the service contract of the travel agency listing the penalties and costs to be borne
by the Insured.
Travel Cancellation
1. PURPOSE
1.1. It consists of the reimbursement, limited to the insured capital, the costs of acquisition of
tour packages and/or travel services, such as transportation and lodging, in the occurrence of
a covered event that prevents the Insured from traveling.
1.1.1. The Insurance Company shall indemnify the non-refundable part of the costs of
transportation, lodging, excursions, sightseeing tours and activities that the insured already
paid until the Insurance contract date, or has formally entered into a commitment to pay up to
the date of the initial contract, in contracts that can not be canceled, or only provide for a
partial refund.
1.1.2. The minimum period for hiring this coverage is fifteen (15) days immediately
preceding the date of the insured travel.
1.1.3. In the case of group travel, previously reported in hiring, the Insurance Company also
must indemnify the costs of the other members of the insured group.
1.1.4. The occurrences that have the following exclusive consequences will be covered:
b) death or hospitalization due to personal injury or declared sudden acute illness of the
Insured before the travel period;
b) death or hospitalization due to personal injury or declared sudden acute illness of the
spouse, parents, siblings or children of the Insured before the travel period;
c) the receipt of non-extendable summons in court, for the Insured appear before the
Court, provided that the receipt of such summons occurs after the travel hiring and
before the travel;
d) the Insured's quarantine decree by the competent health authority, since the decree is
subsequent to the hiring of the travel and before the same.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
3. EXCLUDED RISKS
3.1.The events below are excluded from Travel Cancellation coverage, beyond the
provisions of Clause Four of the Specific Conditions:
a) Incurred on a date prior to the contracting of Insurance, or occurring after the
beginning of the Insurance term, as known by the Insured on the hiring date.
b) the failure to submit a copy of the service contract of the travel agency or operator
listing the penalties and costs to be borne by the Insured.
c) Plastic Surgery and its consequences, including those derived from congenital
problems. Restorative plastic surgeries resulting from personal injury covered occurred
in the Insurance are covered;
d) Aesthetic treatment and obesity in any forms, as well as surgery and periods of
convalescence related to it;
e) Hospitalizations for routine physical examination or any other examination without
problems in normal health;
f) Hospitalizations when the patient is not under legally qualified medical care;
g) Chronic diseases and/or diseases pre-existing to the Insurance hiring not stated on
the Card, if provided, known by the Insured, as well as aggravation, consequences and
sequels.
h) Hospitalizations in institutions for care of mentally disabled, that is, an institution
primarily dedicated to the treatment of psychiatric diseases, including subnormality; or
the psychiatric department of a hospital, place for seniors, rest homes, nursing homes
and the like, clinics or place for recovering addicts to alcohol and drugs,
hydrotherapeutic health institutions or natural healing clinics, nursing home for
convalescents, special unit of Hospital used primarily as a place for addicts to drugs or
alcohol, or as a health institution for convalescent or rehabilitation, Weight Loss Clinic
and SPA.
4. ELIGIBILITY
4.1. For warranty of Travel Cancellation, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Travel
Cancellation coverage, the the date of the interruption cancellation protocol by the travel
service provider is considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Death Certificates (of the Insured, spouse, parent, sibling or child of the insured, as
applicable);
• Medical report and copy of complementary examinations that prove the hospital admission
(of the Insured, spouse, parent, sibling or child of the insured, as applicable);
• Family tie proof (of the spouse, parent, sibling or child of the insured, as applicable);
• Copy of the summons and judicial proceedings;
• Copy of the court quarantine ruling specifying the cause and admission conditions;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or travel
operator where the travels were hired;
• Copy of the service contract of the travel agency listing the penalties and costs to be borne
by the Insured.
Early Return
1. PURPOSE
1.1. It is the provision of an air travel ticket, or payment of fine due to the rebooking of the
ticket already purchased by the Insured, which is less costly, business class, for the return of
the Insured to the country of residence if the Insured is prevented from completing the
insured travel due to illness, accident or death of his/her traveling companion, family member
or family member of his/her traveling companion, or due to illness or accident of the insured,
or even if the medical team of the location the Insured is and the medical team appointed by
the Insurance Company determine the need to anticipate the period of stay of the Insured due
to personal injury covered or sudden acute illness occurring during the Insured Travel.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The events below are excluded from the Insured Return coverage, beyond the provisions
of Clause Four of the Specific Conditions:
4. ELIGIBILITY
4.1. For warranty of Insured Return, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
Insured Return coverage, the date of the return is considered as the date of the event, upon the
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• original proof of purchase of return flight ticket, business class.
• complete medical report or death certificate;
• the service contract of the travel organizers, as determined by Embratur;
• in case of cancellation of the travel due to the Insured's traveling companion or family
member, documents will be required to prove the family tie.
Protected purchase
1. PURPOSE
1.1. Payment of an indemnity to the insured in case of theft or damage by accident, occurred
during the travel period, of the new product purchased by the Insured during the travel. The
indemnity shall correspond to 85% of the amount indicated in the invoice of the good and
proven by submission of the copy of the Credit Card Bill, limited to the Insured Capital hired.
1.1.1. Only portable electronics product purchased by credit card at the travel period, which
will be reported within 24 hours of the date of the event, will be covered.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The amount of the applicable Insurance deductible will expressly consist of the Insurance
Card, and corresponds to the plan chosen by the Insurance Representative from the following:
Plans Deductible in % of the
indemnity
A 15%
B 20%
C 25%
D 30%
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1.The following events of direct or indirect consequence are excluded from this
coverage, beyond the provisions of Clause Four of the Specific Conditions:
a) theft without violence or serious threat or committed by people known by the
Insured;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
b) any intentional act - intended - by the Insured;
c) acts carried out by people known by the Insured, relatives or not;
d) simple theft;
e) theft or robbery of any accessories separately or together;
f) theft, if the goods are stolen from a car left neglected without proper safety measures;
g) loss or disappearance of good.
5.ELIGIBILITY
5.1. For warranty of the Purchase Immediately Protected, all individuals within the age range
defined in the Insurance contract at the time of contracting the Insurance are eligible.
6. DESCRIPTION OF THE CLAIM
6.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Protected Purchase, the date of registration made to the legal authority is
considered as the date of the event, upon the settlement of claims.
7. BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Invoice purchase with specification of each acquired object;
• Police Report issued by police authority in which the location and description of the claim,
date and time should be specified in details.
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services to the Insured if it is unable to continue his/her travel or return home or place of
origin of the travel due to medical determination, resulting from personal injury or sudden
acute illness occurred during the travel period, limited to a maximum of 10 nights in hotel
and meals, as set forth in the Insurance Card, with the same type of accommodation than the
originally contracted for the trip, limited to the Insured Capital hired.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The provisions of Clause Four of the Specific Conditions are excluded from the
Coverage:
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
4. ELIGIBILITY
4.1. For warranty of Stay Extension, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Stay
Extension coverage, the date of medical care is considered as the date of the event, upon the
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Medical report and copy of complementary tests that prove the sudden acute illness, when
applicable;
• Police Report issued by police authority in which the location and description of the
accident, date and time should be specified in details, when applicable;
• Proof of purchase of Accommodation daily fees for the period of the extension;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travel was originally contracted.
Accommodation of the Accompanying Person
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services to the insured of the value of the costs of one (1) companion by medical
determination, resulting from personal injury or sudden acute illness occurred with the
Insured during the travel period, since traveling alone or with dependent minors or of age,
limited to a maximum of 10 nights in hotel and meals, of the same type of accommodation
that the insured is staying, limited to the Insured Capital hired.
1.1.1. For purposes of this coverage, "minor dependents or dependents of legal age"
means the persons aged less than fifteen (15) years or greater than seventy five (75)
years of age which are under the sole responsibility of the Insured during the travel.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1. In addition to the provisions of Clause 4 of the Specific Conditions, the reimbursement
for extra expenses as minibar consumption, meals, parking or any other expenses incurred by
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
the insured, is excluded.
4. ELIGIBILITY
4.1. For warranty of Accommodation of the Accompanying Person, all individuals within the
age range defined in the Insurance contract at the time of contracting the Insurance are
eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
Accommodation of the Accompanying Person coverage, the date of medical care is
considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Medical report and copy of complementary tests that prove the sudden acute illness, when
applicable;
• Police Report issued by police authority in which the location and description of the
accident, date and time should be specified in details, when applicable;
• Proof of purchase of accommodation and food for the companion;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travel was originally contracted.
Departure Delay
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of accommodation, transfers, food,
and telephone expenses of the Insured, which have not been paid to the regular shipping
company, resulting from the departure delay longer than six (6) hours, as indicated on the
boarding ticket during the insured travel, limited to the Insured Capital hired.
1.1.1. Events resulting from the following are covered:
a) any severe weather conditions which result in late arrival or scheduled flight departure, or
land and sea shipping;
b) The reimbursement amount of transfers and telephone expenses is limited to 50% of the
Insured Capital coverage;
c) any labor issues that interfere with scheduled flight departure or arrival, as strikes,
demonstration or protests;
d) any sudden defects, not expected, of the aircraft regular airline and that prevent the
scheduled flight landing or takeoff.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1.1.2. Coverage is exclusively for flights, land and sea boarding in scheduled carriers, charter
transport or any other is not covered.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The following events of direct or indirect consequence are excluded from this coverage,
beyond the provisions of Clause Four of the Specific Conditions:
a) The Insured has not checked in at the recommended time;
b) A statement of the transport company or the competent authority stating the cause and
duration of the delay of the insured travel is not submitted.
c) the Insured becomes aware of something, prior to contracting the Insurance, which can
cause a delay.
d) Any loss arising from the fact that the Insured has refused a transport alternative offered by
the service provider;
e) Delays caused by the shipping company, including its employees.
f) Losses due to mechanical problems, failures or equipment defects of the shipping company
hired.
g) Any claim arising from natural disaster.
h) Any claim arising from epidemic, pandemic, strikes, civil unrest, riot or commotion.
i) Shipping Delay in case of prior public disclosure or known by the Insured prior to
departure of the period of his/her trip. j) Events and works on public roads, as an religious,
political party, social act, when promoted by declared entity of public utility as legislation in
force, public demonstrations through marches, parades, or public meetings to prevent the
displacement of Insured; civic character of manifestations of notorious social recognition. k)
Traffic impediment in land transport routes (vehicle traffic). l) Mergers, bankruptcy, airline's
bankruptcy and/or termination of activities, case of overselling of tickets (overbooking). m)
The events covered by the coverage Loss of Air Connection or Boarding.
4. ELIGIBILITY
4.1. For warranty of Departure Delay, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
Departure delay coverage, the date of registration of the complaint with the transport
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
authorities is considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Copy of the boarding pass with the indication of the transport time;
• A copy of the notification/registration with the public transport company officials detailing
the transportation schedule and the new schedule of the late departure specifying the causes,
when available;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travels were hired.
• Original vouchers of the costs of transfer, lodging, meals and telephone charges.
Return of the Accompanying Person
1. PURPOSE
1.1. It consists of the compensation through reimbursement of expenses or provision of
relevant services, limited to the amount of the Insured Capital hired, expenses on the return
transfer of the companion of the Insured to the place of residence or origin of the travel,
caused by death or medical evacuation of the Insured occurred during the travel period.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The provisions of Clause Four of the Specific Conditions are excluded from the
Coverage:
4. ELIGIBILITY
4.1. For warranty of Return of the Accompanying Person, all individuals within the age range
defined in the Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Return
of the Accompanying Person coverage, the date of the return travel of the Insured is
considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
• Certificate or Death Certificate of the Insured, if applicable;
• Police Report issued by police authority in which the location and description of the
accident, date and time should be specified in details, when applicable;
• Voucher of purchase of the air ticket of business class, for the return travel;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travel was originally contracted.
Return of minors and persons of legal age
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the amount of the Insured Capital hired, the costs of the transfer of one (1)
companion for the return of a person younger than fifteen (15) years or older than seventy-
five (75) years, who are under the sole responsibility of the Insured during the travel to the
place of residence or origin of the travel, caused by the death or hospitalization of the insured
occurred during the travel period.
1.1.1. People with special needs are included in this clause.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The provisions of Clause Four of the Specific Conditions are excluded from the
Coverage:
4. ELIGIBILITY
4.1. For warranty of Return of Minors and Persons of Legal Age, all individuals within the
age range defined in the Insurance contract at the time of contracting the Insurance are
eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Return of Minors and Persons of Legal Age, the date of the return travel is
considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Death Certificate of the Insured, if applicable;
• Medical Report and a copy of proof of hospitalization of the insured, if applicable;
• Police Report issued by police authority in which the location and description of the
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
accident of the Insured, with date and time should be specified in details, when applicable;
• Proof of expenses for the return of the Minor or Person of Legal Age;
• Invoices and receipts evidencing the payments made to the travel agency and/or tour
operator where the travel was originally contracted.
• Copy of the service contract of the travel agency listing the minors under the responsibility
of the Insured.
Travel legal expenses
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the amount of the Insured Capital hired, the costs of legal fees for legal
assistance of the Insured due to accident occurred during the travel.
1.2. This coverage provides for indemnity only if the insured suffer legal proceedings,
excluding any lawsuit by the Insured.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The provisions of Clause Four of the Specific Conditions are excluded from the
Coverage:
4. ELIGIBILITY
4.1. For warranty of Travel legal expenses, all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Travel
legal expenses coverage, the accident date is considered as the date of the event, upon the
settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Police Report issued by police authority in which the location and description of the
accident of the Insured, with date and time should be specified in details, when applicable;
• Invoice of all legal expenses and detailed report of the procedures and expenses listed;
• Copy of the service contract of the travel agency specifying the start and end date as well as
the places of origin and destination, if applicable.
Bail Costs and Legal Expenses in Travel
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1. PURPOSE
1.1. It consists of the reimbursement, limited to the amount of the Insured Capital hired, of
incurred legal expenses, as well as the bail amount arbitrated by the police to release the
Insured, arising from arrest warrant or improper detention agreed during the travel.
2. BENEFICIARY
2.1. The Beneficiary is the Insured.
3. EXCLUDED RISKS
3.1.The provisions of Clause Four of the Specific Conditions are excluded from the
Coverage:
4. ELIGIBILITY
4.1. For warranty of Travel legal and bail expenses, all individuals within the age range
defined in the Insurance contract at the time of contracting the Insurance are eligible.
5. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for Travel
legal and bail expenses coverage, the date of payment of the bail to the police authority is
considered as the date of the event, upon the settlement of claims.
6. BASIC DOCUMENTATION FOR CLAIM NOTICE
6.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Police Report issued by police authority in which the location and description of the
accident of the Insured, with date and time should be specified in details, when applicable;
• Invoice of all legal expenses and detailed report of the procedures and expenses listed;
• Proof of bail paid to the police authority;
• Copy of the service contract of the travel agency specifying the start and end date as well as
the places of origin and destination, if applicable.
Bail Costs and Legal Expenses in Travel
1. PURPOSE
1.1. It consists of the indemnity by refunding the Insured or his/her beneficiary the Insured
Capital of unrecoverable losses with deposits and prepaid expenses for the travel, less the
deductible and limited to the amount of the Insured Capital hired, Insured Capital must meet
the contract conditions signed by the Insured with the travel agency and/or tour operator
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
(including cancellation and/or interruption policies if applicable) following the interruption of
the travel by any of the following reasons exposed:
1. Death or diagnosis of serious disease not known by the Insured when the travel begins and
that causes hospitalization or makes the locomotion impossible, generating a state of
incapacity that prevents the continuation of travel. It is considered as serious illness the first
diagnosis of the following diseases/procedures: cancer, stroke, acute myocardial infarction
and BYPASS, terminal renal failure and organ transplantation.
2. Death or hospitalization of the spouse, parent, brother or son of the Insured, occurred
during the period of the travel.
3. Summons of the Insured, received during the travel period resulting in the interruption of
the travel due to the immediate return of the Insured to comply with the summons.
4. Period of quarantine imposed on the Insured ordered by the health authority during the
travel period and resulting in the immediate interruption of the same.
5. Occurrence of damage caused by fire, theft or force of nature in residential or commercial
property dependencies of habitual use of the Insured, making them uninhabitable and
inevitably justifying the holder's presence on site, provided that occurred during the period of
the travel and that causes the immediate interruption of the same.
6. Membership Invitation to participate as a member of the official elections of the country of
origin, provided that occurred during the period of travel and causes the immediate
interruption of the same.
7. Judicial convocation of the Insured as a tutor in adoption of minor(s) occurred during the
period of the travel and that causes the immediate interruption of the same.
8. Disorders in pregnancy of the Insured or the Insured spouse, occurred during the period of
the travel and that causes the immediate interruption of the same.
9. Involuntary unemployment of the Insured occurred during the period of the travel without
cause provided that an employment has been maintained for a minimum of twelve (12)
consecutive months with the same employer and that causes the immediate interruption of the
travel.
10. Insured convocation for an organ transplant occurred during the period of the travel and
that causes the immediate interruption of the same.
11 .Any of the causes listed above occurred to the Insured's companion. It is understood as
accompanying person sharing the same travel with the insured, i.e., same date, same
accommodation place, same tour package and since the same coverage is hired, provided this
person has the Insurance card of the same Insurance company.
12.Kidnapping of the insured, spouse, parent(s), brother(s) or child of the insured, which
occurred during the period of the travel.
13.Theft of luggage or documents of the insured during the period of the travel and which
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
causes the immediate interruption of the same.
14. Appointment of the Insured for office tenure in public service or new employer without
any bond with the previous (subsidiaries, affiliates or subsidiaries) since proven upon
submission of records in the Work Permit and since that occurred during the period of travel
and provided that the insured was not aware until the start date of the travel and that causes
the immediate interruption of the same.
15.Transfer of the Insured workplace (to another distant state or municipality to at least 500
km from the previous site), through formal and emergency communication occurred during
the period of the travel and that causes the immediate interruption of the same.
16. Award of the Insured in public draw for the continuation of the travel for free.
17. The insured's detention by police authority as a result of criminal process, which took
place during the period of the travel and which causes the immediate interruption of the same.
18. Judicial summons of the insured for filing the divorce proceedings, which took place
during the period of the travel and which causes the immediate interruption of the same.
19. Grant of scholarship to the insured, during the period of the travel and which causes the
immediate interruption of the same.
20. Passport or visa denied.
21. Pregnancy occurred after purchasing the Insurance, and can not travel during the travel
period due to the advancement of pregnancy.
22. Holiday cancellation by the Employer, persons self-employed or not employed under
CLT scheme are excluded.
23. Repetition or educational catch-up that prevent the Insured from traveling.
24. Change of employment by the insured's birth.
25. Statement of war, military coup in the country of destination.
26. Natural disasters preventing the landing in the country of destination.
27. Death of person of the host family that will host the traveller or passenger.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The amount of the applicable Insurance deductible will expressly consist of the Insurance
Card,and corresponds to the plan chosen by the Insurance Representative from the following:
Plans Deductible in % of the
indemnity
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
A Without deductible
B 15%
C 20%
D 25%
E 30%
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1.The events of direct or indirect consequence of any wrongful act are excluded from this
coverage, beyond the provisions of Clause Four of the Specific Conditions.
5.ELIGIBILITY
5.1. For coverage of Travel Interruption for Multiple Reasons, all individuals within the age
range defined in the Insurance contract at the time of contracting the Insurance are eligible.
6. DESCRIPTION OF THE CLAIM
5.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Travel Interruption for Multiple Reasons, the date of the interruption
communication protocol by the travel service provider is considered as the date of the event,
upon the settlement of claims.
7. BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• In case of Accidental Death, death certificate and supporting documents in the case of a
spouse, parent(s), brother(s) or son(s) of the Insured;
• In case of diagnosis of serious illness: copy of all examinations and medical report with the
description and date of the first diagnosis of the disease of the Insured;
• In the event of hospitalization of the spouse, parent(s), brother(s) or son(s) of the Insured:
copy of the medical report which led to the hospitalization, copy of all tests performed,
medical record copy and copy of the documents proving the kinship condition;
• In case of the court summons of the Insured: a copy of the summons and judicial
proceedings;
• In the case of quarantine decree imposed on the Insured: a copy of the health authority
statement;
• In case of damage caused by fire, theft or force of nature in residential property or
commercial premises of habitual use of the Insured: proof of police authority and proof of
ownership or possession of the property;
• In case of Insured appointment to participate as a member of the official elections of the
country of origin: copy of the appointment document with the date and place;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
• In the case of judicial summons of the insured as a tutor in adoption process of minors: copy
of the summons and judicial proceedings;
• In the case of disorders in pregnancy of the Insured or the Insured's spouse: copy of the
medical report, a copy of the medical tests and documents proving the spouse condition when
applicable;
• In the event of involuntary unemployment of the Insured: copy of the employer notice and
of the Work Permit;
• In case of Insured appointment for organ transplant: copy of the summons and medical
description, copy of examinations and hospital medical records;
• In the case of kidnapping of the Insured, spouse, parent(s), brother(s) or son(s) of the
Insured: a copy of the police report and documents proving kinship condition;
• In case of theft of documents or luggage of the Insured: a copy of the police report;
• In case of Insured appointment to a public office or new employer: copy of the
communication addressed to the Insured, copy of the Official Gazette with the appointment
of possession to the Insured or copy of the Work Permit, as applicable;
• In case of Insured's workplace transfer: copy of the proof of current address, employer's
statement indicating the new destination or area, and copy of Work Permit with the
registration of transfer;
• In case of award of the Insured in the draw: copy of the proof of participation in the draw
and award, copies of vouchers and accommodation
• In the case of arrest of the Insured: mandate copy issued by the police authority, copy of the
police report or lawsuit that led to the arrest;
• In the case of summons of the Insured to conduct the divorce process: copy of the
summons/subpoena and copy of the lawsuit
• In the case of granting scholarship to the Insured: copy of the communication, registration
copy of the selection process and proof of enrollment in the institution that has granted the
scholarship.
• In case of passport or visa denied: notification copy of denied passport or visa.
• Pregnancy occurred after purchasing the Insurance, and that during the travel period can not
travel due to the advancement of pregnancy: evidence and medical report.
• Holiday cancellation by the Employer, persons self-employed or not employed under CLT
scheme are excluded: Employer document (CLT) reporting the cancellation of the holiday.
• Repetition or educational catch-up that prevent the Insured from traveling: document
proving the repetition or educational catch-up (Report Card)
• Employment Change due to birth of the Insured: new employer contract.
• Statement of war, military coup in the country of destination: declaration of the public body.
• Natural disasters that prevent the landing in the destination country: public body statement;
• Host family member's death that will host the traveler or passenger: death certificate;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or travel
operator where the travels were hired;
• Copy of the service contract of the travel agency listing the penalties and costs to be borne
by the Insured.
Travel Interruption for Multiple Reasons
1. PURPOSE
1.1. It consists of the indemnity by refunding the Insured or his/her beneficiary of
unrecoverable loss of deposits and prepaid expenses for the travel, that the Insured has paid
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
until the Insurance contract date, or has formally entered into a commitment to pay up to the
date of the initial contract, less the deductible and limited to the amount of the Insured
Capital hired, and complying with the contract conditions signed by the Insured with the
travel agency and / or tour operator ( including cancellation policies of same where
applicable) following the cancellation of the travel for any of the reasons set out below:
1. Death or diagnosis of serious disease not known by the Insured when the travel is hired and
that causes hospitalization or makes the locomotion impossible, generating a state of
incapacity that prevents the beginning/continuation of travel. It is considered as serious
illness the first diagnosis of the following diseases/procedures: cancer, stroke, acute
myocardial infarction and BYPASS, terminal renal failure and organ transplantation.
2. Death or hospitalization of the spouse, parent(s), brother(s) or son(s) of the Insured,
occurred after contracting the travel, and making it impossible to start or cause interruption of
the travel hired prior to the date of the event.
3. Judicial Summons of the Insured, received after contracting the travel and preventing the
start or causing interruption of the same.
4. Period of quarantine imposed on the Insured ordered by the health authority after
contracting the travel and preventing the start or causing interruption of the same.
5. Occurrence of damage caused by fire, theft or force of nature in residential or commercial
property dependencies of habitual use of the Insured, making them uninhabitable and
inevitably justifying the holder's presence on site, provided that occurred after the travel
hiring and that causes the immediate interruption of the same.
6. Membership Invitation to participate as a member of the official elections of the country of
origin, provided that occurred after contracting the travel and preventing the start or causing
interruption of the same.
7. Judicial Summons of the Insured as a tutor in adoption of minors occurred after
contracting the travel and preventing the start or causing interruption of the same.
8. Disorders in pregnancy of the Insured or the Insured spouse, occurred after the hiring of
the travel and preventing the start or causing interruption of the same.
9. Involuntary unemployment of the Insured occurred during the travel hiring, without cause
provided that an employment has been maintained for a minimum of twelve (12) consecutive
months with the same employer and that prevents the beginning or causes the immediate
interruption of the travel.
10. Insured convocation for an organ transplant occurred after the travel hiring and that
prevents its beginning, and causes the immediate interruption of the same.
11 .Any of the causes listed above occurred to the Insured's companion. It is understood as
accompanying person sharing the same travel with the insured, i.e., same date, same
accommodation place, same tour package and since the same assistance is hired.
12.Kidnapping of the insured, spouse, parent(s), brother(s) or child of the insured occurred
within 15 days before the travel contracted.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
13.Theft of luggage or documents of the insured occurred within 48 hours before the travel
contracted and that precludes its beginning.
14. Appointment of the Insured for office tenure in public service or new employer without
any bond with the previous (subsidiaries, affiliates or subsidiaries) since proven upon
submission of records in the Work Permit and since that occurred after the travel hiring and
provided that the insured was not aware until the hiring date of the travel and that prevents
the beginning or causes the immediate interruption of the travel.
15.Transfer of the Holder workplace (to another state or municipality distant at least 500 km
from the previous site), through formal and emergency communication occurred after the
travel hiring and that prevents the beginning or causes the immediate interruption of the
travel.
16. Award of the Insured in public draw for the free travel.
17. The insured's detention by police authority as a result of criminal process, which took
place after the travel hiring and that prevents the beginning or causes the immediate
interruption of the travel.
17. Judicial Summons of the insured for filing of the divorce proceedings, which took place
after the hiring of the travel and that prevents the beginning or causes the immediate
interruption of the travel.
19. Grant of scholarship to the insured, after the hiring of the travel and that prevents the
beginning or causes the immediate interruption of the travel.
20. Passport or visa denied.
21. Pregnancy occurred after purchasing the Insurance, and can not travel during the travel
period due to the advancement of pregnancy.
22. Holiday cancellation by the Employer, persons self-employed or not employed under
CLT scheme are excluded.
23. Repetition or educational catch-up that prevent the Insured from traveling.
24. Change of employment by the insured's birth.
25. Statement of war, military coup in the country of destination.
26. Natural disasters preventing the landing in the country of destination.
27. Death of person of the host family that will host the traveller or passenger.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
2.2. The amount of the applicable Insurance deductible will expressly consist of the Insurance
Card,and corresponds to the plan chosen by the Insurance Representative from the following:
Plans Deductible in % of the
indemnity
A Without deductible
B 15%
C 20%
D 25%
E 30%
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1.The following events are excluded from this coverage, beyond the provisions of
Clause Four of the Specific Conditions:
a) Incurred in direct or indirect result of any wrongful act;
b) Incurred on a date prior to the contracting of Insurance, or occurring after the
beginning of the Insurance term, as known by the Insured on the hiring date.
5.ELIGIBILITY
5.1. For coverage of Travel Cancellation for Multiple Reasons, all individuals within the age
range defined in the Insurance contract at the time of contracting the Insurance are eligible.
6. DESCRIPTION OF THE CLAIM
6.1. For the indemnity calculation purposes and the Insurance Company's liability for
coverage of Travel Cancellation for Multiple Reasons, the date of the cancellation
communication protocol by the travel service provider is considered as the date of the event,
upon the settlement of claims.
7. BASIC DOCUMENTATION FOR CLAIM NOTICE
7.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• In case of Death, death certificate and supporting documents in the case of a spouse,
parent(s), brother(s) or son(s) of the Insured;
• In case of diagnosis of serious illness: copy of all examinations and medical report with the
description and date of the first diagnosis of the disease of the Insured;
• In the event of hospitalization of the spouse, parent(s), brother(s) or son(s) of the Insured:
copy of the medical report which led to the hospitalization, copy of all tests performed,
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
medical record copy and copy of the documents proving the kinship condition;
• In case of the court summons of the Insured: a copy of the summons and judicial
proceedings;
• In the case of quarantine decree imposed on the Insured: a copy of the health authority
statement;
• In case of damage caused by fire, theft or force of nature in residential property or
commercial premises of habitual use of the Insured: proof of police authority and proof of
ownership or possession of the property;
• In case of Insured appointment to participate as a member of the official elections of the
country of origin: copy of the appointment document with the date and place;
• In the case of judicial summons of the insured as a tutor in adoption process of minors: copy
of the summons and judicial proceedings;
• In the case of disorders in pregnancy of the Insured or the Insured's spouse: copy of the
medical report, a copy of the medical tests and documents proving the spouse condition when
applicable;
• In the event of involuntary unemployment of the Insured: copy of the employer notice and
of the Work Permit;
• In case of Insured appointment for organ transplant: copy of the summons and medical
description, copy of examinations and hospital medical records;
• In the case of kidnapping of the Insured, spouse, parent(s), brother(s) or son(s) of the
Insured: a copy of the police report and documents proving kinship condition;
• In case of theft of documents or luggage of the Insured: a copy of the police report;
• In case of Insured appointment to a public office or new employer: copy of the
communication addressed to the Insured, copy of the Official Gazette with the appointment
of possession to the Insured or copy of the Work Permit, as applicable;
• In case of Insured's workplace transfer: copy of the proof of current address, employer's
statement indicating the new destination or area, and copy of Work Permit with the
registration of transfer;
• In case of award of the Insured in the draw: copy of the proof of participation in the draw
and award, copies of vouchers and accommodation
• In the case of arrest of the Insured: mandate copy issued by the police authority, copy of the
police report or lawsuit that led to the arrest;
• In the case of summons of the Insured to conduct the divorce process: copy of the
summons/subpoena and copy of the lawsuit;
• In the case of granting scholarship to the Insured: copy of the communication, registration
copy of the selection process and proof of enrollment in the institution that has granted the
scholarship;
• In the case of bankruptcy of the Travel Operator, Travel Agency or Travel Service Provider,
public document that formalizes and confirms the condition of bankruptcy of the contractor;
• In case of passport or visa denied, the official document;
• If pregnancy occurs after buying Insurance the medical report indicating the start date of
pregnancy and reason to travel;
• For Holiday Cancellation by the Employer the document of the company evidencing the
cancellation of the holiday.
• In case of passport or visa denied: notification copy of denied passport or visa.
• Pregnancy occurred after purchasing the Insurance, and that during the travel period can not
travel due to the advancement of pregnancy: evidence and medical report.
• Holiday cancellation by the Employer, persons self-employed or not employed under CLT
scheme are excluded: Employer document (CLT) reporting the cancellation of the holiday.
• Repetition or educational catch-up that prevent the Insured from traveling: document
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
proving the repetition or educational catch-up (Report Card)
• Employment Change due to birth of the Insured: new employer contract.
• Statement of war, military coup in the country of destination: declaration of the public body.
• Natural disasters that prevent the landing in the destination country: public body statement;
• Host family member's death that will host the traveler or passenger: death certificate;
• Proof of purchase of airline tickets/accommodation or valid travel contract;
• Invoices and receipts evidencing the payments made to the travel agency and/or travel
operator where the travels were hired;
• Copy of the service contract of the travel agency listing the penalties and costs to be borne
by the Insured.
Travel Cancellation for Multiple Reasons
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the amount of the Insured Capital hired, medical, hospital and/or dental
expenses incurred by the Insured for their treatment under medical supervision, caused
exclusively by the practice of amateur sport, in case of personal injury during the travel
abroad and once the exit from his/her country of domicile is confirmed with a displacement
higher than one hundred kilometers (100 km) in the case of land travel.
1.1.1. This warranty covers the following sports:
a) Disputes or interscholastic or academic championships;
b) Travel to remote areas or particularly dangerous areas, with or without a guide;
c). Any activity involving weapons;
d) "Rafting" with difficulty degree 4 or above;
e) Sailing on the high seas;
f) Diving, unless the insured has a "PADI certification" (or similar qualification), or if the
Insured dives under the supervision of a qualified instructor. In the case of exceptions, the
Insured shall be covered if he/she complies with the maximum depth specified in its
certification or twelve (12) meters, whichever is less, and is accompanied;
g)Scuba Diving;
h) Disputes in motor vehicles, including preparatory training or classification;
i) Racing and motorcycling, motocross, boogies, even in competition;
j) Mountain climbing, rappelling, or outdoor climbing, involving the use of specific
equipment, including, but not limited to, "crampons", picks, bolts, ropes and other anchoring
equipment;
k) Hiking tours or above 3,000 meters;
l) Winter sports, including, but not limited, toboggans, sleds, "bobsleigh", ice hockey, water
skiing, wave runner, ride quads, snow mobiling and "heli-skiing" outside the regulated track;
m) Horse riding, horse riding, polo and other equestrian activities;
n) Combat sports such as boxing, and martial arts;
o)Rugby;
p) Circus acrobatics;
q) "Canyoning", spelunking or "spelunking", "base jumping" or cliff jumping; r) Endurance
sports and/or sports requiring high physical demands, for example, marathons, triathlons or
biatlohs; s) Hang-gliding or paragliding;
t) Aviation Sports;
u) Parachuting, "skydiving" or "bungee jumping";
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
v) Surfing, Windsurfing, Kite surfing, water skiing or "Jet ski";
w) Hunting or sport shooting.
x) Balloon practice or ride.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical
care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The value of the deductible when the deductible is applied consist of the Individual
Insurance Card applicable to the Insurance, and corresponds to the plan chosen by the
Insurance Representative from the following options:
Plans Deductible in R$ Deductible in
US$*
A Without
deductible
Without
deductible
B 150.00 50.00
C 300.00 100.00
D 600.00 200.00
E 900.00 300.00
F 1,200.00 400.00
G 1,500.00 500.00
* For insurances in foreign currency
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1. The events, occurring in direct or indirect consequence of the following, are
excluded from DMHO Endurance Sport coverage,beyond the provisions of Clause 4 of
the Specific Conditions:
a) Convalescent situations (after medical discharge) and the costs of accompanying
persons;
b) Devices that refer to orthoses of any nature and permanent prostheses, such as
artificial limbs, hearing aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers,
except the leased chair, items used during hospitalization for medical reasons, unless the
prosthesis for the loss of natural teeth;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
c) The continuity and control of previous treatment to the insured trip, and the extent of
prescription;
d) Experimental procedures, elective or diagnostic investigation procedures; or any
plastic surgery except reconstructive surgery necessary for the Insured to return home
due to a covered personal injury;
e) expenses or costs related to treatment or non-emergency surgery, or that the insured
can perform after returning to his/her home;
f) Extra expenses for hospital accommodation in private apartments, unless
recommended by the medical team;
g) Any rescue costs (search and rescue) charged by public or private entities, except the
expenses for medical repatriation;
h) If the Insured refuses to return home, all costs incurred after discharge or after the
Insured is declared by the medical team that he/she in a position to return;
i) Any treatment or medication of the Insured need after returning to the place of
residence;
j) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her travel.
l) Expenses on the acquisition of orthoses or prostheses, such as artificial limbs, hearing
aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers, except the lease chair,
items used during hospitalization for medical reasons ;
k) Preventive examinations and "check-ups";
m) Travel expenses in order to perform any type of medical examination or treatment;
n) Semi-Professional or Professional Sports Practice.
5.ELIGIBILITY
5.1. For warranty of Medical, Hospital and/or Dental Expenses on International Travel
(DMHO on International Travel), all individuals within the age range defined in the
Insurance contract at the time of contracting the Insurance are eligible.
6. INSURED CAPITAL RETURN
6.1. The Insured Capital concerning this coverage will be fully reinstated automatically after
the occurrence of each Covered Event, without charging additional Premium.
7. DESCRIPTION OF THE CLAIM
7.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Medical, Hospital and/or Dental Expenses in International Travel due to amateur
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
practice of Extreme Sports (DMHO in amateur practice of Extreme Sports), the date of the
accident is considered as the date of the event, upon the settlement of claims.
8. PROCEDURES IN THE EVENT OF A CLAIM
8.1. It is recommended that the Insured contact the call center immediately to receive
the provision of necessary services.
8.2. The impossibility of contact with the toll-free phone provided by the Insurance
company and/or the use of professional and/or authorized service network, the insured
or beneficiary may choose other service providers as long as they are legally qualified.
8.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and
special conditions of Insurance.
8.4. If the Insured is entitled to reimbursement of medical expenses from any other
source or Insurance, the Insurance Company will refund the difference between the
amount of expenditure and the amount to which the insured is entitled to
reimbursement, limited to the Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of
his/her traveling companions must immediately contact the Call Center of the
Insurance Company.
9. BASIC DOCUMENTATION FOR CLAIM NOTICE
9.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses.
• Report of the physician/dentist responsible for the care, attesting the occurrence of the
covered event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Copy of the hospital records and invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.
Complementary Medical, Hospital and/or Dental Expenses on International Travel due
to amateur practice of Extreme Sports (DMHOC in amateur practice of Extreme
Sports).
1. PURPOSE
1.1. It consists of the indemnity through reimbursement of expenses or provision of relevant
services, limited to the amount of the Insured Capital hired, medical, hospital and/or dental
expenses incurred by the Insured for their treatment under medical supervision, caused
exclusively by the practice of amateur sport, in case of personal injury during the travel
abroad and once the exit from his/her country of domicile is confirmed with a displacement
higher than one hundred kilometers (100 km) in the case of land travel.
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
1.1.1. This warranty covers the following sports:
a) Travel to remote areas or particularly dangerous areas, with or without a guide;
b) Any activity involving weapons;
c) "Rafting" with difficulty degree 4 or above;
d) Sailing on the high seas;
e) Diving, unless the insured has a "PADI certification" (or similar qualification), or if the
Insured dives under the supervision of a qualified instructor. In the case of exceptions, the
Insured shall be covered if he/she complies with the maximum depth specified in its
certification or twelve (12) meters, whichever is less, and is accompanied;
f)Scuba Diving;
g) Disputes in motor vehicles, including preparatory training or classification;
h) Racing and motorcycling, motocross, boogies, even in competition;
i) Mountain climbing, rappelling, or outdoor climbing, involving the use of specific
equipment, including, but not limited to, "crampons", picks, bolts, ropes and other anchoring
equipment;
j) Hiking tours or above 3,000 meters;
k) Winter sports, including, but not limited, toboggans, sleds, "bobsleigh", ice hockey, water
skiing, wave runner, ride quads, snow mobiling and "heli-skiing" outside the regulated track;
l) Horse riding, polo and other equestrian activities;
m) Combat sports such as boxing, and martial arts;
n) Rugby;
o) Acrobatics circus;
p) "Canyoning", spelunking or "spelunking", "base jumping" or cliff jumping;
q) Endurance sports and/or sports requiring high physical demands, for example, marathons,
triathlons or biatlohs;
r) Hang-gliding or paragliding;
s) Aviation Sports;
t) Parachuting, "skydiving" or "bungee jumping";
u) Surfing, Windsurfing, Kite surfing, water skiing or "Jet ski";
v) hunting or sport shooting.
w) Balloon practices or ride.
1.1.2. The reimbursement or the provision of services will be limited to the Insured Capital.
1.1.3. This warranty does not cover the cost of medications after discharge or medical
care.
1.1.4. The value of the Insured Capital is indicated in the Insurance Card.
2.DEDUCTIBLE
2.1. This coverage is subject to the application of the deductible.
2.2. The value of the deductible when the deductible is applied consist of the Individual
Insurance Card applicable to the Insurance, and corresponds to the plan chosen by the
Insurance Representative from the following options:
Plans Deductible in R$ Deductible in
US$*
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
A Without
deductible
Without
deductible
B 150.00 50.00
C 300.00 100.00
D 600.00 200.00
E 900.00 300.00
F 1,200.00 400.00
G 1,500.00 500.00
* For insurances in foreign currency
3. BENEFICIARY
3.1. The Beneficiary is the Insured.
4. EXCLUDED RISKS
4.1. The events, occurring in direct or indirect consequence of the following, are
excluded from DMHO Endurance Sport coverage,beyond the provisions of Clause 4 of
the Specific Conditions:
a) Convalescent situations (after medical discharge) and the costs of accompanying
persons;
b) Devices that refer to orthoses of any nature and permanent prostheses, such as
artificial limbs, hearing aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers,
except the leased chair, items used during hospitalization for medical reasons, unless the
prosthesis for the loss of natural teeth;
c) The continuity and control of previous treatment to the insured trip, and the extent of
prescription;
d) Experimental procedures, elective or diagnostic investigation procedures; or any
plastic surgery except reconstructive surgery necessary for the Insured to return home
due to a covered personal injury;
e) expenses or costs related to treatment or non-emergency surgery, or that the insured
can perform after returning to his/her home;
f) Extra expenses for hospital accommodation in private apartments, unless
recommended by the medical team;
g) Any rescue costs (search and rescue) charged by public or private entities, except the
expenses for medical repatriation;
h) If the Insured refuses to return home, all costs incurred after discharge or after the
Insured is declared by the medical team that he/she in a position to return;
i) Any treatment or medication of the Insured need after returning to the place of
residence;
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
j) Expenses for services for which the insured does not need to pay or already included
in the contracted services for his/her travel.
l) Expenses on the acquisition of orthoses or prostheses, such as artificial limbs, hearing
aids, contact lenses, lenses, eyeglasses, wheelchairs or walkers, except the lease chair,
items used during hospitalization for medical reasons ;
l) Preventive examinations and "check-ups";
m) Travel expenses in order to perform any type of medical examination or treatment.
5.ELIGIBILITY
5.1. For warranty of DMHO Professional Endurance Sports, all individuals within the age
range defined in the Insurance contract at the time of contracting the Insurance are eligible.
6. INSURED CAPITAL RETURN
6.1. The Insured Capital concerning this coverage will be fully reinstated automatically after
the occurrence of each Covered Event, without charging additional Premium.
7. DESCRIPTION OF THE CLAIM
7.1. For the indemnity calculation purposes and the Insurance Company's liability, for the
coverage of Medical, Hospital and/or Dental Expenses in International Travel due to
Professional practice of Extreme Sports (DMHO in Professional practice of Extreme Sports),
the date of the accident is considered as the date of the event, upon the settlement of claims.
8. PROCEDURES IN THE EVENT OF A CLAIM
8.1. It is recommended that the Insured contact the call center immediately to receive the
provision of necessary services.
8.2. The impossibility of contact with the toll-free phone provided by the Insurance company
and/or the use of professional and/or authorized service network, the insured or beneficiary
may choose other service providers as long as they are legally qualified.
8.3. Expenses paid by the Insured shall be duly justified, pursuant to the specific and special
conditions of Insurance.
8.4. If the Insured is entitled to reimbursement of medical expenses from any other source or
Insurance, the Insurance Company will refund the difference between the amount of
expenditure and the amount to which the insured is entitled to reimbursement, limited to the
Insured Capital of this warranty.
Warning: If a hospitalization is required for more than 24 hours, the Insured or one of his/her
traveling companions must immediately contact the Call Center of the Insurance Company.
9. BASIC DOCUMENTATION FOR CLAIM NOTICE
TRAVEL INSURANCE CARD | SPECIFIC CONDITIONS
Travel Insurance Card
SUSEP Proceeding no.: 14414.900226/2015-11 | October /2016
9.1. For the claim notice, in addition to the documents listed in clause 13 of the Special
Conditions, the beneficiary must provide the following basic documents:
• Vouchers and/or original receipts of expenses.
• Report of the physician/dentist responsible for the care, attesting the occurrence of the
covered event and specifying the description of the pathology and procedures performed;
• Copy of additional exams with Invoice and detailed proof of the expenses incurred;
• Copy of the hospital records and invoice of the expenses incurred.
• Document of the medical discharge with date, start time and end time of the admission;
• Letter with brief summary of what happened containing the Insurance card data.