TRAVEL INSURANCE
SPECIAL CONDITIONS
CHAPTER ONE. DEFINITIONS.
Art. 1. Stated in these special conditions:
1. Insurance contract (Insurance policy), called hereby for briefness "the Contract" ("the Policy") consists of General Conditions, Special
Conditions and all Annexes (if any). Subsidiary application hereby finds the Bulgarian legislation.
2. Special conditions (description of the Policy) - part of the contract which contains all specific data such as names, addresses, terms, dates, sums
and conditions as well as signatures of the parties.
3. Parties of the contract - Insurer and Insured.
4. The Insurer is insurance company Bulstrad Life JSC, Sofia 1301, 6 Sv. Sofia Str.
5. Insured is a person who concludes the contract for insurance with the Insurer and pays the premium fixed in the contract. In case the policy is on
the life of the Insured he/she is also Life insured.
6. Life insured is a person whose life is covered by the Policy.
7. Insurance term is the term in which the Insurer covers the risks defined in the Policy.
8. Insured event is an event with the Insured, which has occured within the term of the policy, and after which, according to the risks covered the
Insurer pays the sum assured or percentage from the sum assured. In this case the insurance event could be:
- accident,
- acute disease, diagnosed for the first time
9. Accident is an unforeseen, fortuitous and sudden, external to the Insured event which occurs during the policy term and against their will, and
which causes bodily injury to the Insured (internal or external injury, crack or breakage of bone, joint dislocation, tendon or muscle tear or stretch, burn or
freeze of bodily surface, poisoning, suffocation or drowning).
10. Sickness is a combination of complaints and clinical manifestations (diagnosed in licensed health institution for the first time within the term of
the policy and registered in an official medical document), which cause disability or death. The date of the sickness occurrence is considered the date of the
sickness initial diagnosis.
11. Acute disease is a disease, which occurs acutely, unforeseen and suddenly, which represents danger for the life or health of the Insured and
requires urgent and brooking no delay medical intervention.
12. Pre-existing sickness or condition is a sickness or medical condition, for which the Insured has received treatment, has sought medical advise
or has been aware of before the policy commencement.
13. Medical expenses include the following costs:
a) costs for medical examinations, tests, treatment and surgical intervention;
b) costs for drugs, remedial materials and devices and use of medical equipment;
c) hospitalization costs;
d) costs for emergency transportation of the Insured with ambulance from the place of the accident or the place where the illness started to the
nearest health centre for rendering urgent medical aid;
e) costs of repatriation of the Insured who is on inpatient treatment to a hospital in his/her country of residence;
f) costs of repatriation of the mortal remains of the Insured to his/her place of residence.
14. Unforeseen and urgent medical expenses are medical expenses, which have necessitated in result of accident or suddenly occurred acute
disease and when any inactivity could lead to:
- permanent danger for the health of the Insured;
- serious decay of physical functions;
- other serious consequences, which concern the health and the life of the Insured.
Costs of treatment of chronic diseases with symptoms similar to these ones of the acute diseases, but which have existed before the commencement
of the insurance policy are not considered unforeseen and urgent medical expenses.
CHAPTER TWO. GENERAL TERMS.
Art. 2. These Special Conditions apply to events, occurred during travel or residence of persons, between 1 and 80 years of age, outside the
territory of the Republic of Bulgaria; and in cases, when foreign persons are insured, also outside the territory of their natural residence.
Art. 3. (1) In the event of an acute illness or accident, necessitating medical treatment, the Insured or their representative are obligated to call the
Assistance Company – CORIS International, where they shall be given instructions regarding the healthcare facilities and physicians where treatment can be
carried out.
(2) Notification should be done at the 24-hour operational Call Center Service of CORIS International in Sofia.
Art. 4. (1) In the event of danger to the Insured's life or if he/she is in state of helplessness, treatment could be given at the nearest healthcare
facility.
(2) In the cases of par. (1) the Insured is obligated to notify the Assistance Company immediately after overcoming the crisis about his/her
condition and to follow the given instructions regarding further treatment.
(3) The Insured should present the original of the Insurance Policy at the healthcare facility and to the Assistance Company.
CHAPTER THREE. COVERED RISKS.
Art. 5. Depending on the coverage agreed, the following risks could be covered:
(1) Incurrence of unexpected and urgent medical expenses which are a direct and immediate consequence of occurrence of acute illness with the
Insured, and which are not a result from exclusions from the insurance coverage, and which fall within the limits of insurance responsibility.
(2) Incurrence of unexpected and urgent medical expenses which are a direct and immediate consequence of occurrence of accident with the
Insured, and which are not a result from exclusions from the insurance coverage, and which fall within the limits of insurance responsibility.
(3) Incurrence of unexpected and urgent medical expenses for stomatological pain relief in cases of abscess, pulpitis or extraction, to the limit of
€100.
(4) Medical transportation of Bulgarian citizens to a hospital in the Republic of Bulgaria.
(5) Death of the Insured that is a direct and immediate consequence of accident with the Insured, and which is not a result of exclusions from the
insurance coverage, and which falls within the limits of insurance responsibility.
(6) Repatriation of mortal remains in case of death due to accident.
CHAPTER FOUR. EXCLUSIONS FROM THE INSURANCE COVERAGE.
Art. 6. (1) The Insurer shall not cover death or medical expenses which are caused directly or indirectly by:
1. Willful self-infliction, suicide or attempt on suicide (regardless of the state of sanity of the Insured), or attempt on murder;
2. Criminal offence or attempt on criminal offence by the Insured, death sentence execution, accident occurred while the Insured is arrested or
imprisoned;
3. War or hostilities, rebellion, power usurpation, riot or other similar social acts;
4. Nuclear explosions; radioactive radiation; radioactive, chemical or biological contamination; acts of God and all other similar events of mass
consequences;
5. AIDS, no matter how it is acquired or called, or HIV infection;
6. Self-treatment; disobedience to doctor's prescriptions;
7. Pregnancy (incl. tubal pregnancy), childbirth, abortion, contraceptive measures and sterilization and any consequent complications or diseases;
8. Battery provoked by the Insured;
9. Involvement in hazardous activities such as all kinds of motor sports, flying, air-floating, sailing and under-water sports and activities, jumps
from height, climbing requiring special equipment and speleology. The policy covers amateur sports activities only upon payment of additional premium;
10. Intake of alcohol, narcotics and other opiate or stimulative substances. Upon vehicle road accidents the legally appointed level of alcohol for the
country where the event has occurred is taken into consideration;
11. Use of weapons;
12. In result of chronic or pre-existing the travel diseases, except in cases when the symptoms are sudden, acute and immediately threaten the life of
the Insured;
13. Other events following exposure on peril, willful act or gross negligence by the Insured.
(2) The insurance shall not cover death of individuals under 14 and above 65 years.
(3) The following expenses are not included in the scope of medical expenses coverage:
1. Costs for medical examination, treatment and surgical intervention which are not administered by a licensed physician or in a licensed healthcare
facility;
2. Costs for medical examinations and tests, when no illness has been diagnosed or no accident with the Insured has been ascertained;
3. Costs relative to venereal diseases, treatment of sterility, change of sex or implantation; organ transplant, and the resulting complications or
illnesses;
4. Costs for rehabilitation, physiotherapy and kinesitherapy, as well as all expenses for additional health treatment or hydrotherapeutic recovery in
mineral baths or health homes, sanatoriums, sanitary or other similar resorts;
5. Costs for medical expenses by homeopathic persons or doctors naturalists;
6. Medical help, given by close relatives or husband/ wife;
7. Costs for medical repatriation or repatriation of mortal remains, when it was not performed by the Assistance Company CORIS International;
costs incurred after repatriation; and costs for repatriation of mortal remains, when death is due to illness;
8. All costs relative with preliminary diseases or conditions of the Insured;
9. Costs for dental treatment and setting of artificial teeth or prostheses; for making and replacing fillings; for making, replacing or repairs of
crowns or bridges;
10. Costs for treatment of the mental health and mental disorders of the Insured;
11. Costs for effective or cosmetic surgery for correction of the appearance;
12. All costs relative to experimental or research services;
13. All costs for medical examinations or observations, or diagnostic examinations that are part of routine physical examination or health check,
including vaccination, expenses for glasses, contact lenses, hearing-aids, prostheses and equipment and all other health goods and services;
14. Costs for personal comfort during stationary treatment such as: TV, radio, hairdresser's or barber's services;
15. Any part of the costs that exceeds the commonly necessary and inherent expenses that are covered in accordance with the conditions of this
policy.
16. All costs which are in direct consequence of sunburn or burn in solarium, and also all costs which are in direct consequence of sunstroke and/or
heatstroke or freezing.
17. Expenses for issuing of certificates, and expenses for translation of medical documents under Chapter Eleven.
(4). Medical costs incurred by hospitals, included in Appendix No 1 to these special conditions, are not covered by the contract.
CHAPTER FIVE. LIMITS OF RESPONSIBILITY.
Art. 7. In case of death of the Insured as a direct consequence of an accident, if it is covered according to the conditions of this contract, the
Iinsurer shall pay the sum assured for death due to accident.
Art. 8. (1) In case of incurrence of unexpected and urgent medical expenses the Insurer shall be responsible only for the actually incurred medical
expenses that do not exceed the sum assured for medical expenses.
(2) If the Insured did not command the services of Assistance Company, the Limit of Responsibility of the Insurer is to the amount of €150.
Art. 9. If there are other insurance contracts that provide the Insured with analogous cover for medical expenses, the Insurer shall be liable
proportionally for the incurred expenses and his share in any kind of expenses shall be equal to the amount of that kind of expenses divided by number of
contracts covering that kind of expenses, but not exceeding the limit, stated in the Policy.
Art. 10. The Insurer shall cover the unexpected and urgent medical expenses that are incurred within the first 15 days after the insurance event.
Art. 11. The Insurer and/ or the Assistance Company do not bear responsibility for delay or non-fulfillment of their obligations, if those are caused
by strikes, explosions, demonstrations, restrictions in free moving, sabotage, terrorism, civil war or war, consequences of radioactive radiation or any other
unexpected hindrance.
CHAPTER SIX. CONCLUSION AND TERM OF THE INSURANCE POLICY.
Art. 12. The Insurance policy is concluded for one person and/ or the members of their family; or else for an organized group of people, in which
case a list of the Insured persons is attached to the policy, and becomes an inseparable part of it.
Art. 13. The personal data of the Insured is obligatory stated in the Policy – name, address, PIN.
Art. 14. The Insurance coverage is valid for the term, stated in the Policy. If not stated otherwise, the Policy becomes valid at 00.00 hours of the
day, following the conclusion date.
CHAPTER SEVEN. BENEFICIARIES.
Art. 15. In case of death due to accident Beneficiaries are the Insured’s heirs at law, inscribed in an inheritance certificate.
Art. 16. In case of incurrence of unexpected and urgent medical expenses as a result of accident or acute disease the Beneficiary is the Assistance
Company.
CHAPTER EIGHT. TERMINATION AND CHANGES IN THE INSURANCE POLICY.
Art. 17. The Insurance policy is terminated with the expiration of the agreed upon term.
Art. 18. (1) Insurance policy, which has not become effective, i. e. the coverage term has not started effectively, can be terminated upon a request
of the Insured, and part of the insurance premium is returned, provided all of the following conditions are met:
1. The term of the policy is no less than 15 (fifteen) days;
2. The Request for return of insurance premium, along with the original of the policy is submitted to the nearest office of Bulstrad Life iJSC, no
later than three days after the effective start of the coverage term of the policy.
(2) Insurance policy, which has become effective, i. e. the coverage term has already started can be terminated upon a request of the Insured, and
part of the insurance premium is returned, provided all of the following conditions are met:
1. The term of the policy is no less than 1 (one) month;
2. There is no claim filed on this Policy;
3. The travel is stopped owing to circumstances beyond the control of the Insured;
4. The Request for return of insurance premium, along with the original of the policy is submitted to the nearest office of Bulstrad Life iJSC, no
later than three days after the return of the Insured in the country.
(3) In all other cases beyond those, stated in par. (1) and (2), the Insurer does not owe a return of the premium or of part of it.
CHAPTER NINE. ASSISTANCE COMPANY.
Art. 19. (1) Assistance Company is the company that on the basis of a contract with the Insurer, in the case of necessity for the Insured to incur
unexpected and urgent medical expenses, refers the Insured to the nearest appropriate health facility for getting medical services, and pays the incurred
medical expenses subject to the conditions and limits of this Policy.
(2) The Assistance Company under this policy is CORIS International.
CHAPTER TEN. OBLIGATIONS OF THE INSURED TO INFORM THE ASSISTANCE COMPANY.
Art. 20. (1) The Insured is obliged to inform the Assistance Company within 48 hours after the occurrence of the insurance event on herein-stated
telephone. The Insured has to submit to the Assistance Company/Insurer this insurance policy, documents proving the date of the insurance event and all
other documents required by the Assistance Company/Insurer.
(2) If the Insured did not inform the Assistance Company in the term stated in par. (1), they are obliged to inform the Insurer within 7 days of the
occurrence of the insurance event.
Art. 21. If the Insured does not fulfill the requirements of the above paragraphs, the Insurer becomes free of any obligation whatsoever to pay the
claim.
CHAPTER ELEVEN. DOCUMENTS REQUEST UPON FILING A CLAIM.
Art. 22. When the expenses, incurred for treatment of acute disease or accident with the Insured, which are not result from exclusions of the
insurance coverage and step within the limit of insurance responsibility, are paid by the Insured, they are obliged to present the following documents in
original:

short exposé of the circumstances regarding the occurrence of the event;

original of the Insurance policy;

medical report with the exact diagnosis and the treatment carried out;

prescriptions, receipts (invoices) for paid medical expense, medicine bought, etc.
Art. 23 (1) All medical documents have to be issued by licensed medical facilities (hospital, clinic, consulting room, etc.), or by certified medical
specialists.
(2) If necessary the Insured should present a certified translation of the documents.
Art. 24. In case of claims for death due to accident, the following documents need to be presented:

death certificate;

testimonial letter, proving the cause of death, issued by a doctor or clinic;

document (act, protocol), issued by a competent body, proving the occurrence of the event;

inheritance certificate.
Art. 25. When necessary, in order to define the grounds and the amount of the insurance payment, the Insurer preserves the right to request other
documents.
CHAPTER TWELVE. INSURANCE DATA CONFIDENTIALITY.
Art. 26. Information constituting confidentiality as stated in the Insurance Code, could be disclosed to the person who is a party of an insurance
legal relationship or is having rights stemming from the insurance legal relation by virtue of a law or a contract, or by virtue of other specific statement in a
law.
CHAPTER THIRTEEN. ARBITRATION.
Art. 27. The Bulgarian legislation shall be applied to any issues not stated in this policy. Any arguments shall be settled by the parties by mutual
agreement and, if the parties cannot reach such an agreement, they shall refer to the competent Bulgarian court.
CHAPTER FOURTEEN. OTHER CONDITIONS
These Special Conditions have been affirmed by the Board of Directors of Bulstrad Life Insurance JSC with Minutes No.73/03.12.2003 and
approved by the Financial Supervision Commission with Letter No. 22-02-03/24 from 22.12.2003, modified and supplemented by the Management Board
with Minutes No.4/16.09.2005, modified by the Management Board with Minutes No.6/14.10.2005, modified and supplemented by the Management Board
with Minutes No.46/29.01.2008, modified and supplemented by the Management Board with Minutes No.87/29.03.2012.
The English text of the policy is a translation from the original Bulgarian text. The Bulgarian text shall always prevail.
Dear Doctor,
The holder of the present insurance is covered according to the terms of the policy. Please contact the nearest CORIS office or CORIS in Paris. The
addresses of CORIS offices are attached to the policy booklet. We kindly request to enclose one copy of this policy with your invoice and send it to the
nearest CORIS office.
Thank you for your attention,
Bulstrad Life Insurance JSC / CORIS International Assistance Company
Appendix No 1
1.
2.
Лечебно заведение/Medical provider
Ada Privet Hospital
Universal Hospitals Group
Държава/Country
Турция/Turkey
Турция/Turkey