ACCIDENT INSURANCE

COMPANY: SURNE (Insurance and Pensions)

POLICY NO.: 20250320357576

GROUP: General

INSURED ACTIVITY: Students of Surf courses, during the practice of the activity itself.

SUMMARY OF SUBSCRIBED GUARANTEES

Surne, Mutual Insurance Company, guarantees, from the effective date indicated in this certificate, the risks detailed below, in accordance with the provisions of the collective policy contracted by the Policyholder.

PRODUCT: SURNE COLLECTIVE ACCIDENTS

PRODUCT

GROUP

COVERAGE

EXPIRY AGE

INSURED CAPITAL

ABSOLUTE DISABILITY (OCCUPATIONAL ACCIDENT)

1

Beneficiary: THE INSURED

76

€6,000.00

HEALTHCARE ASSISTANCE FOR OCCUPATIONAL ACCIDENT

1

Beneficiary: THE INSURED

65

€3,000.00

PARTIAL PERMANENT DISABILITY

1

Beneficiary: THE INSURED

67

€6,000.00

DEATH BY OCCUPATIONAL ACCIDENT

1

Beneficiary: IF NO BENEFICIARIES ARE DESIGNATED, THEY SHALL BE IN THE FOLLOWING PRECEDING AND EXCLUSIVE ORDER: 1) SPOUSE OR LEGALLY CONSTITUTED DOMESTIC PARTNER 2) DESCENDANTS 3) PARENTS 4) SIBLINGS 5) LEGAL HEIRS

70

€6,000.00

ANNEX: PARTIAL DISABILITY SCALE

Partial Disability according to the scale:

This refers to the compensation that, if contracted in the Specific Conditions, the Mutual Company grants should the Insured suffer a partial disability as a consequence of an accident covered by the policy.

The compensation payable in these cases will be the result of applying the following percentages to the capital agreed upon in the contract:

DESCRIPTION

% TOTAL

% Right

% Left

Total loss of arm or hand

 

60

50

Total loss of movement of the shoulder

 

25

20

Total loss of movement of the elbow

 

20

15

Total loss of movement of the wrist

 

20

15

Loss of thumb and index finger of the hand

 

30

15

Total loss of three fingers of the hand, including the thumb and index finger

 

30

15

Total loss of two of these last fingers of the hand

 

15

12

Total loss of three fingers of the hand other than the thumb or index finger

 

25

20

Total loss of the thumb and another finger of the hand other than the index

 

25

20

Total loss of the index finger and another finger of the hand other than the thumb

 

20

15

Total loss of the index finger only of the hand

 

15

10

Total loss of the middle, ring, or little finger of the hand

 

10

8

Total loss of a leg or foot

50

   

Partial amputation of a foot, including all toes

30

   

Removal of the lower jaw

30

   

Total loss of one eye or reduction of binocular vision by half

25

   

Complete and incurable deafness in both ears

40

   

Complete deafness in one ear

10

   

Total loss of movement of a hip, knee, or ankle

20

   

Shortening of a lower limb by at least five centimeters

15

   

Total loss of the big toe

10

   

Total loss of another toe

3

   

In the event that Death or Absolute Disability occurs after the payment of compensation for Partial Disability, the amounts paid by the Mutual Company will be considered as paid on account of the total sum insured for these concepts.

GENERAL CLAUSE FOR UNLIMITED HEALTHCARE ASSISTANCE IN PARTNERED CENTERS OR UP TO THE LIMIT INDICATED IN SPECIFIC CONDITIONS

HEALTHCARE ASSISTANCE FOR ACCIDENT:

This coverage provides for the following benefits in centers partnered with the insurer for an unlimited amount for a period of 12 months, or in freely chosen centers up to the maximum amount indicated in the specific conditions and for a maximum period of 12 months:

  • Medical services in a healthcare facility, including expenses derived thereof, medical tests (including complementary services prescribed by a physician during the healing process on an outpatient basis), and surgical procedures.

  • Hospitalization expenses, understood as room and board (excluding extras) at the Healthcare Center where the Insured is admitted.

  • Transfers and displacements, which solely includes expenses for urgent transfer from the accident site to the healthcare center where necessary medical attention must be received, up to a maximum of €6,000. Transportation services 061 and/or 112 are excluded.

  • Emergency assistance, comprising those expenses derived from necessary urgent care and first aid.

  • Physical rehabilitation expenses, including physiotherapy and similar services, which the Insured must use by medical prescription during the healing process, excluding rehabilitation at home or in a pool.

  • Expenses derived from osteosynthesis material, understood as any element used for the synthesis or joining of bone ends, to fuse joint elements, or for the surgical induction of joint ankylosis, up to an economic limit for this concept of €1,200.

Unless otherwise indicated in the Special Conditions, the following ARE NOT covered:

  • Pharmaceutical expenses.

  • Expenses for auxiliary elements (crutches, wheelchairs, and similar items).

  • Expenses for orthopedic, dental, optical, or acoustic materials and prostheses.

  • Expenses derived from differential diagnostic tests or second opinions.

  • Expenses for treatments involving stem cell cultures or growth factors, as well as hyaluronic acid infiltrations.

  • Expenses derived from organ/tissue transplantation from a living or deceased donor.

Not included within the policy coverage are possible new complementary diagnostic or therapeutic techniques that may emerge in the healthcare spectrum of Medicine. In any case, the Insurer, following its traditional standard, will incorporate them into its policy when their utility and effectiveness are proven.

Risk Delimitation: events excluded from the insurance

No compensation will be granted, as they are not the object of the contract and are not covered by the Mutual Company, for the following events:

  • Non-accidental traumatic injuries, such as: muscle pulls, tears or strains, contractures, tendonitis, overexertion, twists, and sprains; in general, all those injuries that do not meet the definition of an accident (trauma due to a violent, external, sudden cause beyond the insured's will).

  • Events that are not considered accidents according to the definition of an accident, as well as those that violate any legal provision.

  • Accidents due to the voluntary use of drugs or narcotics or drunkenness, as previously described, or occurring in a state of mental derangement or sleepwalking.

  • Self-inflicted injuries, and suicide or attempted suicide, caused consciously or unconsciously.

  • Events resulting from nuclear reaction or radiation, interventions involving high-voltage electrical currents, as well as radioactive contamination.

  • Events legally considered extraordinary.

  • Consequences of wars or similar operations.

  • Accidents occurring as a consequence of practicing any sport professionally. For these purposes, professional practice of a sport is understood as individual or collective practice under the organization and supervision of a sports Federation, Body, or Club, which constitutes the person's livelihood.

  • Practice of risky sports; considered risky are:

  • Martial arts, boxing, karate, and physical combat.

  • Aerial sports in general (parachuting, balloon ascents, hang gliding, microlights, gliders, and similar).

  • Scuba diving using breathing apparatus.

  • Motoring and motorcycling.

  • Mountaineering, climbing, including glacier traversing and caving, rafting, and bungee jumping.

  • Derived from the practice of bullfighting and bull runs.

  • Horse riding and polo.

  • Practice of big game hunting.

 

  • Illnesses of any nature, including myocardial infarction and cerebrovascular events, as well as bodily injuries that may result from them and consecutive to operations performed by the Insured on themselves.

  • Sunstroke, frostbite, or other effects of atmospheric temperature, unless they are a consequence of an accident.

  • Aneurysms, varicose veins, all types of hernias and their consequences, as well as muscle strains (cervical and lumbago), whatever the cause.

  • Intoxications or poisoning from the ingestion of food products in general.

  • Infectious diseases (unless the pathogen enters the body through an injury caused by an accident covered by the policy), including sleeping sickness, malaria, yellow fever, and syncope, fainting spells, strokes, or epileptic seizures, as well as injuries that may result from them.

  • Injuries caused by X-rays, radium, and its compounds, unless they are the consequence of a treatment applied to the Insured as a result of an accident guaranteed in this contract.

  • Accidents caused by the Insured's participation in duels, challenges, bets, or brawls, unless, in the latter case, the Insured acts in legitimate self-defense (and this is declared by a final court ruling). Also excluded are injuries caused by the Insured's criminal acts or resulting from reckless imprudence or gross negligence.