Chairman Decision No. (953) of 2021 Concerning the Implementation of the Outbound Travel Insurance Policy Model

FINANCIAL REGULATORY AUTHORITY
Chairman
Decision No. (953) of 2021
Dated 15/6/2021
Concerning the Implementation of the Outbound Travel Insurance Policy Model

Chairman of the Financial Regulatory Authority Having reviewed Law No. 131 of 1948 issuing the Civil Code, and Law No. 10 of 1981 concerning supervision and control of insurance in Egypt and its executive regulations and amendments, and Law No. 10 of 2009 concerning the regulation of supervision on non-banking financial markets and instruments, and Presidential Decree No. 192 of 2009 issuing the Statute of the Financial Regulatory Authority, and the Board of Directors of the Authority Decision No. 144 of 2018 concerning the collection of a fee of one in a thousand for services related to the review and approval of new insurance policy models or modifications to existing models and its amendments, and the Minister of Interior Decision No. 676 of 2021 concerning the amendment of Decision No. 63 of 1959 implementing some provisions of Law No. 97 of 1959 concerning passports, and the Authority Decision No. 698 of 2021 concerning the establishment of the Egyptian Outbound Travel Insurance Syndicate, and the memorandum of the Central Administration for Insurance Product Approval on this matter.

Decided

( Article One )
The attached Travel Care Insurance Policy model is approved, and the Egyptian Outbound Travel Insurance Syndicate shall administer it in accordance with its statutes.

( Article Two )
This Decision shall be published in the Egyptian Gazette, and on the websites of the Authority and the Syndicate, and shall be enforced as of the date 1/7/2021.

d. Mohamed Omran
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Travel Care Insurance Policy No. ( ..... )
Based on the personal data of the insured named in the policy schedule, provided to the Travel Insurance Syndicate (hereinafter referred to as "the Syndicate") recorded in the passport, which constitutes the basis of the contract and an integral part of this policy, and after payment of the premium stated in the policy schedule, and according to the terms, definitions, and exclusions contained in or attached to the policy, the Syndicate undertakes to compensate the insured person or beneficiaries in the manner and within the limits specified hereinafter. The Syndicate undertakes to provide immediate urgent assistance to the insured in the event of a sudden accidental accident or emergency illness suffered by him during the insurance period while traveling and staying outside the Arab Republic of Egypt, in accordance with the terms, conditions, exclusions, requirements, and coverage limits contained in this policy or attached to it. It is expressly known and agreed that the insurance coverages granted under this policy are valid only for trips that do not exceed each trip by 90 consecutive days during the validity period of the passport, whereas stays or travels abroad exceeding 90 days in a single trip are outside the scope of coverage granted under this policy. The Syndicate shall not be liable for any compensation for persons under 30 days of age or over 85 years of age at the time of the damage.

Benefits Table

	Coverages	Coverage Limits
1	Medical expenses and hospital stay costs.	30,000 euros or its equivalent in other currencies, with the first 100 euros or its equivalent in other currencies to be borne by the insured.
2	Transportation costs or repatriation of the insured to the country of residence in case of illness or accident to the insured.	Actual expenses.
3	Costs of repatriating the corpse to the country of residence in case of death of the insured.	Actual expenses.

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Definitions
Insured: The holder of the policy named in the policy schedule.
The Syndicate: The Egyptian Outbound Travel Insurance Syndicate.
Usual Country of Residence: The Arab Republic of Egypt.
Treating Physician: The physician to whom the insured turns at the time of the accident or illness, whether in the hospital or the physician's outpatient clinic. The Syndicate's Physician: The physician appointed by the Syndicate to follow up on the insured's condition or the physician of the medical assistance company. Insurance Period: Any period during which the insured travels abroad for a period not exceeding 90 days in a single trip, during the validity period of his passport.

Coverages
The Syndicate undertakes under this policy to cover the following cases:

1. Medical care due to an accident or illness of the insured: If the insured suffers from an emergency illness, including infection with the coronavirus (COVID-19) or a sudden accident, the Syndicate shall bear the usual and reasonable costs of hospitalization and treatment inside or outside the hospital, including surgical operations, fees of the treating physician, and medications prescribed by the treating physician.
   The maximum liability of the Syndicate per person: 30,000 euros (thirty thousand euros) or its equivalent in other currencies, with the first 100 euros or its equivalent in other currencies to be borne from the value of any claim.
2. Transportation costs / or repatriation of the insured to the country of residence: If the insured suffers from an emergency illness or sudden physical accident, the Syndicate undertakes to bear all expenses to transport the insured by ambulance or by any other means considered more suitable for his condition (according to what the treating physician or the Syndicate's physician decides).

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to a suitable medical center for his condition or from one hospital to another or repatriating him to his usual place of residence if necessary.
Transport to any medical center in the country of residence shall in all cases be decided by the Syndicate's physician or any other physician determined in coordination with the treating medical center.
3. Costs of repatriating the corpse to the country of residence in case of death of the insured: If the insured dies while traveling, the Syndicate shall bear the actual expenses to repatriate the corpse for burial in the usual country of residence.
All insurance coverages are subject to the limits stipulated in the policy schedule.

General Conditions

1. When submitting any claim, it is a prerequisite for the liability of the Syndicate that the insured complies with all conditions of this policy.
2. In the event of any claim under this policy, the insured must do the following:

• Contact the medical assistance company by telephone as soon as possible to notify of any claim and specify the required assistance.
• Provide all information related to the claim at his own expense.
• Not admit any liability or make promises of payment of any kind.

3. The Syndicate shall not be liable for refunding any medical expenses that the insured claims to recover without obtaining prior approval from it or from the medical assistance company mentioned in the policy schedule, and the insured is obliged to deliver all official invoices and medical reports to the Syndicate.
4. Loss of rights: All rights of the insured arising from this policy are forfeited in the following cases:

• Violation by the insured or his representative of laws or regulations if it involves a felony or misdemeanor.
• The right of the insured or beneficiaries to claim compensation for the incident subject of this claim is forfeited if the insured or his representative provided misleading information about this incident or involved fraud, or reinforced the compensation request with fraudulent information, or if the incident was staged.

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4. Competent Courts: All disputes that may arise from the interpretation or implementation of this policy shall fall under the jurisdiction of the Egyptian courts within the jurisdiction of which the entity that issued this policy is located.
5. Statute of Limitations: The coverage under this policy is subject to the statute of limitations in accordance with the provision of Article (752) of the Egyptian Civil Code.

General Exclusions
This policy does not cover the following:

1. Any acts involving fraud, fraudulent acts, criminal acts, gross negligence, or intentional acts by the insured.
2. Acts or behaviors resulting from the insured being in a state or act involving insanity, imbecility, or loss of self-control due to mental illness or suicide.
3. Unusual natural phenomena such as floods, earthquakes or tremors, soil subsidence or collapse, volcanic eruptions, hurricanes, falling meteorites and shooting stars, or any other weather or geological phenomena.
4. Terrorism, rebellion, riot, disturbances, and civil disobedience.
5. Injury or illness resulting from military operations during war or security maintenance during peacetime.
6. Wars, whether declared or not, and/or any international conflicts or interventions.
7. Nuclear radiation.
8. Any injury or illness that befalls the insured person while participating in competitions, bets, challenges, or in cases of self-defense.
9. Chronic or pre-existing diseases or injuries prior to this insurance.
10. Actual participation of the insured in competitions, sports games, tests, and training.

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11. Actual participation of the insured in car races, matches, hunting, horse riding, boxing, use of balloons or parachutes, navigation in international waters using an unauthorized means of transport as public transport, underwater diving, and motorcycles.
12. Injuries or illnesses resulting from practicing sports activities.
13. Residents abroad permanently and students and learners abroad.
14. Use by the insured of unauthorized means of transport as public transport.
15. Any assistance arranged by the insured or his representative without prior approval from the medical assistance company, except in cases of extreme necessity.
16. Diseases or medical conditions resulting from the intentional use of alcohol, drugs, toxic substances, narcotics, or medications taken without a medical prescription.
17. Prosthetic devices, glasses, contact lenses, hearing aids, and artificial limbs.
18. Pregnancy and childbirth care and related conditions, including medical services and supplies.
19. Illegal travel or travel by illegal means.
20. Countries for which a decision has been issued by the competent authorities prohibiting travel to them.
21. Travelers for Hajj and Umrah.
22. The Syndicate shall not provide assistance or compensation for the following cases:

• Cases that began before the commencement of this insurance.
• Travel with the intention of receiving treatment.
• Cases for which treatment is not approved if the insured was under health care or medical treatment during the 12 months prior to travel.
• Treatment costs in the insured's usual country of residence.

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FINANCIAL REGULATORY AUTHORITY
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Policy Schedule
Policy No. :
Contractor Name :
Insured Name :
Address :
Insured Passport No. :
Insurance Period: Days from / / to / /

Premium
Egyptian Pounds
Net Premium
Half of the Relative Stamp
Specific Tax
Supervision and Control Fee
Review and Approval Services Fee 0.1%
Policy Rights Guarantee Fund Contribution 0.2% Issuance Expenses Total Premium Due

Important Information for the Insured During the Trip

1. If you encounter health problems while traveling within the coverage of this policy, you can immediately contact one of the numbers listed below, please clarify the name, the issued policy number, and the type of assistance or service required.
2. 24-hour emergency telephone, 365 days a year:

• Europe
• Rest of the world
• Fax
• You can also communicate via email or any other means approved by the medical assistance company.

Dated at: / /

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