ERGO pojiovna, a.s.Vyskoilova 1481/4, Praha 4

Zpis v Obchodnm rejstku u Mstskho soudu v Praze, oddl B, vloka 2740, IO: 61858714, DI: CZ61858714

Bao him y t danh cho ngi nc ngoai - Welcome

(Welcome 170901)

Platnost od 01.09.2017

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Bo him y t dnh cho ngi nc ngoi Thng tin dnh cho nhng ngi c nh m hp ng bo him (trc khi k kt hp ng bo him)

1. Thng tin v doanh nghip bo him A) Tn thng mi v dng th php nhn ca doanh nghip bo him

ERGO pojiovna, a.s., m s doanh nghip: 618 58 714, hot ng trong lnh vc bo him v nhng lnh vc lin quan n bo him v ti bo him theo tinh thn b lut s 277/2009 Sb., v bo him, theo ni dung hin hnh.

B) a ch tr s ca doanh nghip bo him Vyskoilova 1481/4, 140 00 Praha 4, Cng ha Sc

C) ng k ti Danh b thng mi, danh b thng mi do Ta n thnh ph Praha qun l, mc B, s h s 2740 D) Tn v tr s c quan chu trch nhim thc hin gim st hot ng ca doanh nghip bo him Ngn hng quc gia Cng ha Sc, c tr s ti Na Pkop 28, 115 03 Praha 1

E) Thng tin lin lc v cch thc gii quyt cc khiu ni Bng in thoi: +420 221 585 111

Bng fax: +420 221 585 555

Bng E-mail: stiznosti@ergo.cz

Web: www.ergo.cz

Bng th: gi v a ch tr s ca doanh nghip bo him

Trc tip: ti a ch tr s ca doanh nghip bo him, cc chi nhnh

Cng c th yu cu Hip hi cc hng bo him Cng ha Sc hoc Ngn hng quc gia Cng ha Sc gip gii quyt n khiu ni.

Trong trng hp bo him nhn th, vic gii quyt cc tranh chp ca ngi tiu dng khng qua ta n s c gii quyt ti c quan c thm quyn, l Trng ti Ti chnh, Legerova 1581/69, 110 00 Praha 1, www.finarbitr.cz, v trong lnh vc cc loi bo him khc th l Thanh tra thng mi Cng ha Sc, tpnsk 567/15, 120 00 Praha 2, www.coi.cz

F) Ngn ng s dng giao tip gia cc pha tham gia hp ng ting Sc

G) Thng tin v kh nng thanh ton v tnh trng ti chnh ca doanh nghip bo him c trn trang web www.ergo.cz phn thng tin v Cng ty v ngoi ra trong Tuyn tp ti liu ca Danh b thng mi do Ta n thnh ph Praha qun l. 2. Thng tin v nhng cam kt A) nh ngha bo him y t dnh cho ngi nc ngoi i tng bo him l nhng chi ph c th chng minh lin quan n c tr ca ngi c bo him trn lnh th Cng ha Sc (tip theo ch vit tt "CH Sc") hoc lin quan n vic i li ca ngi c bo him n nhng quc gia khc trong khu vc Schengen, khi nhng chi ph ny pht sinh trong phm vi thanh ton chi ph iu tr ca ngi c bo him do hu qu ng s b bnh tt hoc tai nn v nhng chi ph lin quan n vic hi hng ca ngi c bo him.

i vi loi bo him ny m hng bo him ERGO pojiovna, a.s. cung cp, th p dng b lut s 89/2012 Sb., b lut dn s, theo ni dung hin hnh (tip theo ch vit tt OZ"), v nhng quy ch tng qut khc ca CH Sc c gi tr, iu kin bo him chung cho bo him sc khe dnh cho ngi nc ngoi - WELCOME 170901 (tip theo ch vit tt VPP"), hp ng bo him v nhng iu tha thun khc nu c. Ch nhng ngi c th c ni c tr ti Cng ha Czech mi c th k kt bo him, hoc nhng c quan phap nhn c tr s hoc chi nhnh ti Cng ho Czech khi c trch nhim mua bo him lin quan.

B) Nhng ngi khng th bo him c Nhng ngi sau y khng th k kt bo him:

mailto:info@ergo.czhttp://www.ergo.cz/http://www.coi.cz/http://www.ergo.cz/

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a) ngi b ri lon thn kinh nng - thuc trong nhm ny c bit l nhng tn tht thn kinh dn n hn ch th cht nng, hoc hn ch cc hot ng sinh hot v cng vic hng ngy. c coi thuc trong nhm bnh ny l cc giai on khc nhau ca bnh a x cng, teo c x cng (ALS), Morbus Parkinson, tnh trng sau t qu b hn ch kh nng c ng, ng kinh, xut hin cc m mi (khi u) ca h thn kinh trung ng, vim a dy thn kinh dn n hn ch kh nng c ng, chn thng no hoc ty sng nghim trng dn n hn ch kh nng c ng, trm cm, co git bt tnh v chng mt; b) nhng ngi b bnh tm thn - thuc trong nhm ny ch yu bao gm ri loi tm thn hng cm v trm cm, ri lon tm thn phn lit v hoang tng, Morbus Alzheimer v nhng dng khc ca bnh mt tr nh, hi chng Psychoorganic , hi chng Down, nc trong no (no ng thy), t k; c) nhng ngi c nhng bnh v hn ch sau y: ic (c hai bn), m (c hai bn), t lit, nghin ma ty v ru v b ph thuc nng vo cc loi thuc, x gan, ung th, cc khi u c tnh (ng th), TBC, lc mu thn, nhim HIV, AIDS.

C) Phm vi bo him bao ph C th m phn bo him trong phm vi "chm sc y t ton din", c cung cp trn quy m tng t nh bo him y t cng cng, th nhng c nhng im m phn loi tr bo him v mc gii hn thc hin tr bi thng bao him. Nh vy bo him khng m bo vic thanh ton trong phm vi cng nh mc nh bo him y t cng cng, v cng khng ging bo him cho trng hp bnh tt theo iu 2847 v nhng iu khon khc ca b lut dn s, theo ni dung hin hnh. Cng c th m phn bo him trong phm vi chm sc sc khe khi " cn thit v cp bch". Phm vi bo him c tnh theo gi bo him c la chn.

D) Loi tr khi phm vi bo him Trong khun kh bo him, khng cung cp tr tin bi thng bo him cho: iu tr bnh tt, chn thng v cc nhm chn on khc tn ti trc thi im bo him; chm sc y t m c cng dn CH Sc cng khng c tr khi h tham gia bo him y t cng cng theo tinh thn cc c ch php l rng buc ni chung; chm sc y t cung cp cho ngi c bo him ti c s y t khi thng thng c s y t khng cung cp chm sc y t cho cng dn CH Sc khi h tham gia bo him y t cng cng theo tinh thn cc c ch php l rng buc ni chung ngoi tr khi tnh mng b e da nguy kch (v d ti mt s phng khm t nhn...); chi ph cho nhng thuc men m ngi c bo him mua m khng c n ca bc s; chi ph iu tr thm m v hu qu ca n, th tc phu thut hoc iu tr; ch to v sa cha cc b phn gi, ning rng, knh, knh p trng, thit b nghe v dng c h tr tng t; ph thai, tr khi b e da n tnh mng hoc sc khoe ca ngi ph n hoc thai nhi pht trin b khim khuyt v yu t gen, tc l nhng trng hp ph thai c l do chnh ng trn phng din y khoa; iu tr v sinh hoc him mun v th tinh nhn to; th tc y khoa v hu qu ca n nu nh ngi c bo him n CH Sc hoc i nc ngoi vi mc ch thc hin th tc y khoa ; chi ph iu tr cho ngi thn ca ngi c bo him (v d chng, v, cha m); iu tr ti cc trung tm ngh mt v dng bnh v cc bin php phc hi chc nng; chi ph pht sinh iu tr nhng hu qu do p dng phng php iu tr m khng c gii chuyn mn y t coi l lege artis; iu tr nhng bnh tt, tai nn v hu qu ca chng b gy ra do chin tranh hoc do tham gia cc cuc biu tnh, t tp chng i hoc cc cuc ri lon khc; iu tr chn thng pht sinh khi li xe c gii m khng c giy php thch hp (giy php li xe), nu nh chng xy ra ngoi lnh th CH Sc; ch v vn chuyn bng my bay cu thng tr khi vic vn chuyn c dch v h tr ph duyt trc; l ph iu tit v ph ph; iu tr do c lin quan n hnh vi gy ra hnh ng phm php hoc hnh vi cn c tnh cht phm vi cnh, nu nh chng xy ra ngoi lnh th CH Sc; iu tr do hu qu t t hoc th t t, nu nh chng xy ra ngoi lnh th CH Sc; c tnh gy ra bnh tt hoc thng tch, nu nh chng xy ra ngoi lnh th CH Sc ; v nhng thng tch xy ra do nh hng ca ru, ma ty v cc cht hng thn, nu nh chng xy ra ngoi lnh th CH Sc.

Khng cung cp tr tin bi thng bo him trong trng hp ngi c bo him t chi thi hnh vic hi hng, iu tr hoc kim tra y t cn thit c thc hin bi bc s do doanh nghip bo him hoc nh cung cp cc dch v h tr ca doanh nghip bo him ch nh.

Khng cung cp tr tin bi thng bo him khi b tai nn pht sinh ra trong qu trnh nhy d v ln d, nhy t trn cao xung c d, khi s dng cc my bay khng ng c, tu ln, my bay siu nh, tu con thoi, nhy bungee, bay trn kinh kh cu, thy phi c; ngoi ra vic bo him khng bao gm bi thng cho nhng tai nn xy ra khi phi cng, nhng thnh vin khc on bay v nhng ngi khc thc hin nhim v, khi h thc hin nhim v ca mnh bng my bay; vic bo him cng khng p dng cho nhng trng hp bi ln k c khi c kh nn, leo ni, leo vch , xung t thc bng va thc nc, i b, cho thuyn trn dng sng cun cun, cho xung, leo ni, trt tuyt ngoi khu vc quy nh, motocross va cc cuc thi m t, karate, taakwondo, aikido, kung fu, judo, box, kic-box ...vv.

Bo him khng p dng cho cc hot ng th thao ca cc vn ng vin chuyn nghip.

Trong gi bo him Welcome Komplex, p dng thi gian ch i ba thng tnh t thi im bt u bo him cho vic chm sc y t lin quan n vic mang thai v tm thng tnh t thi im bt u bo him cho sinh v chm sc y t sau , iu c ngha l vic mang thai ca ngi c bo him v vic chm sc lin quan n thi k thai nghn khng phi l s kin bo him nu nh thai r rng xut hin trc khi ht ba thng bo him v vic sinh xy ra trc khi ht tm thng bo him v c chm sc hu sn tip theo lin quan n vic sinh .

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E) Thi hn hiu lc ca hp ng bo him, thi k bo him Bo him bt u hnh thnh vo ngy v gi c ghi trong hp ng bo him nh l thi im bt u bo him v i vi nhng hp ng bo him c k kt bng phng php t xa th c tha thun l iu ny ch c gi tr trong trng hp l thanh ton ph bo him ln u tin trc thi im bt u c bo him v thng qua vic thanh ton ph bo him ln u tin hp ng bo him c chp thun t pha bn mua bo him trong phm vi xut. Nu khng, s khng dn n k kt hp ng bo him. Hp ng bo him cng c coi nh l Giy chng nhn bo him Vic bo him c k kt cho khong thi gian nht nh v kt thc vo ngy v thi gian ghi trong hp ng bo him nh l Kt thc bo him Thi k bo him trng vi thi gian bo him m phn k kt bo him Khng th k kt bo him c gi tr thi gian ngc li.

Thi gian bo him ti thiu ca gi Welcome Standard v Welcome Plus l 1 thng, ca gi Welcome Komplex l 4 thng v ca gi Welcome Baby v Welcome Dt+ l 12 thng.

F) Phng php chm dt bo him, rt khi hp ng bo him Bo him s chm dt: do tha thun gia bn mua bo him v doanh nghip bo him; ht thi hn bo him; khng cn quyn li c th bo him; ht nguy c bo him; ngy mt ca ngi c bo him hoc ngy gii th ca c quan php nhn khng c ngi tha k hp php, v/hoc t vong hoc gii th ca bn mua bo him da theo iu 7 khon 4 ca VPP; ht ba thng k t ngy k hp ng bo him nhng vn cha c s ng r rng ca ngi c bo him, nu nh s ng ny l cn thit theo cc quy ch php l chung; ngy t chi bi thng bo him t pha doanh nghip bo him da theo iu 5 khon 5 ca VPP.

Ngoi ra vic bo him cng c th kt thc do hy hp ng t pha doanh nghip bo him v bn mua bo him. Bn mua bo him v doanh nghip bo him c th kt thc hp ng bo him vi thi hn tm ngy kt thc hp ng trong vng hai thng k t ngy k kt hp ng bo him hoc vi thi hn mt thng kt thc hp ng trong vng ba thng k t ngy thng bo s kin bo him. Ngoi ra bn mua bo him c th kt thc hp ng bo him vi thi hn tm ngy kt thc hp ng, nu nh doanh nghip bo him vi phm nguyn tc bnh ng khi xc nh mc ph bo him hoc khi tnh ton mc bi thng bo him; trong vng mt thng k t ngy ng s nhn c thng bo v vic chu