CEYLINCO GENERAL INSURANCE LIMITED · 2018-04-02 · EmaiL [email protected] PERSONAL ACCIIJENT...

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CEYLINCO GENERAL INSURANCE LIMITED "'". Miscellaneous Department 3rd Floor, • Ceylinco House', 69, Janadhlpathi Mawatha, Colombo 1, Sri lanka. Tel: +94 112485719 (Direcl), -1'9411 4702702 (General) Fax: +94 11 4702719 EmaiL [email protected] PERSONAL ACCIIJENT INSURA:>ICE POLICY ~O. COOI13APOOOH07 WHEREAS the insured named in the Schedule hereto has by a proposal and declaration which shall be the basis of this Contract and is deemed to be incorporated herein has applied to Ceylinco General Insurance Limited (hereinal1er called "the Company") for the insurance hereinafter contained and has paid or agreed to pay the Premium stated in the said Schedule as consideration for such insurance. NOW THIS POLICY WITNESSETH that if during the Period of Insurance the Life insun:d shall sustain bodily injury caused by accidental means \••.. hich injury shall solely and independently of any other cause result in the Insured's death or pennanent total disablement as hereinafter defined, the Company will subject to the terms. provisions, exclusions and conditions of and endorsed on this Policy pay to the Lire insured or in the event of death to the Life Insured to hisl her legal personal representative the sum or sums of money specified in the Schedule_ IN WITNESS WHEREOF this Pl1licy has been signed on behalf of CEYLlNCO GENERAL INSURANCE LIMITED at Colombo on this 27 fh l\larch 20Ut .~ • S.S M 0.. SiMI• CN''''''''' • HO.K,? MoosFC.I.C.• Ma~ 00te<:!O<• 0, WC,J, _is 'u W,rtwana •.••.CA MBA- FC M-A_ Oe~ M~o ~ 'N.O.N"9"_ f.C.I.C. 'R A.Gu""lhdakn • KDASR. .•••.••• kularatne.S,C<lIn(Hons.l 'EMM Boy*O'J<la.~B"" :0. UO DltSMI.MIl8S FD =1 FAAO • A-R.HF"",ando 'SC GGu<u!1e • MOE'" G Sapar8madu_MPSc- 'DrSD Waniq!tnltna-D.ClinPsych.,fBPsS 'CPA W'I"Y"""lo:"'" 'G.SS~"'j8rI BEng lAg'll

Transcript of CEYLINCO GENERAL INSURANCE LIMITED · 2018-04-02 · EmaiL [email protected] PERSONAL ACCIIJENT...

Page 1: CEYLINCO GENERAL INSURANCE LIMITED · 2018-04-02 · EmaiL ciccoms@ceyins.lk PERSONAL ACCIIJENT INSURA:>ICE POLICY ~O. COOI13APOOOH07 WHEREAS the insured named in the Schedule hereto

CEYLINCO GENERAL INSURANCE LIMITED "'".Miscellaneous Department3rd Floor, • Ceylinco House', 69, Janadhlpathi Mawatha, Colombo 1, Sri lanka.Tel: +94 11 2485719 (Direcl), -1'9411 4702702 (General) Fax: +94 11 4702719EmaiL [email protected]

PERSONAL ACCIIJENT INSURA:>ICEPOLICY ~O. COOI13APOOOH07

WHEREAS the insured named in the Schedule hereto has by a proposal and declarationwhich shall be the basis of this Contract and is deemed to be incorporated herein has applied toCeylinco General Insurance Limited (hereinal1er called "the Company") for the insurancehereinafter contained and has paid or agreed to pay the Premium stated in the said Schedule asconsideration for such insurance.

NOW THIS POLICY WITNESSETH that if during the Period of Insurance the Life insun:dshall sustain bodily injury caused by accidental means \••..hich injury shall solely andindependently of any other cause result in the Insured's death or pennanent total disablementas hereinafter defined, the Company will subject to the terms. provisions, exclusions andconditions of and endorsed on this Policy pay to the Lire insured or in the event of death to theLife Insured to hisl her legal personal representative the sum or sums of money specified in theSchedule_

IN WITNESS WHEREOF this Pl1licy has been signed on behalf of CEYLlNCO GENERALINSURANCE LIMITED at Colombo on this 27fh l\larch 20Ut

.~• S.SM 0.. SiMI• CN''''''''' • HO.K,? MoosFC.I.C.• Ma~ 00te<:!O<• 0, WC,J, _is 'u W,rtwana •.••.CA MBA- FC M-A _ Oe~ M~o ~'N.O.N"9"_ f.C.I.C. 'R A.Gu""lhdakn • KDASR. .•••.•••kularatne.S,C<lIn(Hons.l 'EMM Boy*O'J<la.~B"" :0. UO DltSMI.MIl8S FD =1 FAAO• A-R.HF"",ando 'SC GGu<u!1e • MOE'" G Sapar8madu_MPSc- 'DrSD Waniq!tnltna-D.ClinPsych.,fBPsS 'CPA W'I"Y"""lo:"'" 'G.SS~"'j8rI BEng lAg'll

Page 2: CEYLINCO GENERAL INSURANCE LIMITED · 2018-04-02 · EmaiL ciccoms@ceyins.lk PERSONAL ACCIIJENT INSURA:>ICE POLICY ~O. COOI13APOOOH07 WHEREAS the insured named in the Schedule hereto

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COVERAGE

BODILY INJUHY Caused by Accidental means which injury shall solely and independentlyof any other cause results in :~

Heoetit A Accidental Death and or PermanentTotal Disablement occurring withinT\\"e1ve(12) months of bodily injury

DEFINITlOI\S

The scale of compensation isstated in the Table afBenents foraccidental Death and PemlanentTotal Disablement

'Bodily Injury' shaH mean injury suffered by the insured any\vhcre in the Geographical Limitsof Sri Lanka caused solely and direclly by accidental means and shall exclude hodily injurycaused by sickness. disease or medical disorder.

SPF:CIAL PROVISIONS

I. Disappearance

Il \\!ill be presumed that death has occurred if the Insured has been missing for twelve(12) consecutive months and the Company has e.'\amined all available evidenceprovided to support the conclusion that death was caused by an accident covered bythis Policy. If at any time atter payment has been made by the Company for suchclaim. the Insured is found to be living. full refund shall be made to the Company.

2. Exposure

If as a result of an accident covered by this Policy. the Insured is unavoidablyexposed to the natural elements and as a result of such exposure suffers any loss asspecified in this Policy. such specific loss \vill be covered subject to the terms of thisPolicy.

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EXCLlJSIO:>lS

The Company shall not be liable for claims directly or indirectly caused by or which resultsfrom:

1. The Insured engaging in or taking pari in :.

a. armed forces. naval or air force service or operations;h. rock climbing or mountaineering necessitating the use of ropes or guides.

potholing. hang gliding, bungee jumping. parachuting or any kind of raceother than on foot

c. criminal act or any illegal activities.

2. The insured being etTected by intoxicating liquor or a drug unless the drug is takenunder the direction of a legally qualified medical practitioner provided such direction isnot for the treatment of drug addiction.

J. Provoked murder or assault. intentional self.in.iury. suicide or any attempt threat at\vhilc sane or insane.

4. Pre- existing physical or mental defcl.:1or infirmity or any other pre- existing conditions.

5. Deliberate exposure to exceptional danger (except in an attempt to sa',.:chwnan life).

6. Direct participation in riot or civil commotion. war. invasion. acts of foreign enemies.hostilities (whether war be declared or not). civil war. rebellion. insurrection ormilitary or usurped pmwr.

7. An act (v.:hether on behalf of any organisation. body or persons or group of persons)calculated or directed towards the overthrow or influencing of the Government de jureor de facto or any provincial or local authority with force or by means of fear.terrorism or violence.

8. Ionizing. radiation or contamination by raJio-31.:tivity [rom any nuclear fud or fromany nuclear \vaste from the l.:ombustion of nuclear fuel. For the purpose of thisexclusion combustion shall include any self-sustaining pwcess ofnudear fission.

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TABLE OF BE:'iEFITSDEATH AND l'ERMAi'iENT DISABLEMENT

I.

2.

Accidental Death

Permanent Disablement

DCSCI'"iptioll of Disablement

The Capital Sum as per the limit decidedby the customerThe follov,:ing percentages of the CapitalSum as per the Policy Schedule attached

Percentage ofCapital Sum

Loss oflWO limbsLoss of both hands. or of all fingers and both thumbsTotal ParalysisTotal InsanityInjuries resulting in being pemlanently bedridden

Any other injury causing pemlanent total disablementTotal & Irrevocable loss of all sight in both eyes

Loss of Ann at ShoulderLoss of Ann between Shoulder and Elbow

Loss of Arm bet\\'een Elbov •.' and WristLoss of hand at WristLoss of leg - at hip bCl\••..ccn knee & hip

- below kneeTotal & irrevocable loss all sight in one eyeLoss of f{)ur lingers and thumb of one handLoss of Speech

100%100%100%100%100%

100%100%

50%50%

50%50%

50%50%50%50%

Pennanent total loss of Lise of member shall be treated as loss of member. Loss of speech shallmean total permanent inability to communicate verbally.

The aggregate of all percentages payable in respect of anyone accident shall not exceed 100%.In the event of a total of 100% having been paid. all insurance hereunder shall immediatelycease to be in force. All other losses smaller than 100%. if having been paid shall reduce thecoverage under Benefit (A) by that amount from the date of accident until the expiration of thePolicy.

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CONDITIONS

This Policy and the Schedule shall be read together as one contract and any words orexpressions to \vhk:h a specific meaning has been attached in any part of this policy or of theSchedule shall bear such specific meaning whercver it may appear.

I. NOTICE

Every notice or communication to the Company shall be in writing and sent to theCompany. No alterations in the terms of this Policy. nor any endorsement thereon.will be held valid unless the same is signed or initiated by an authorisedrepresentative of the Company.

2. CONIlITlON PRECEDEl\T TO LIABILITY

The due observance and the fulfillment of the terms, provisions and conditions of thisPolicy by the Insured and in so far as they rdate to anything to be done ()f compliedwith by the insured shall be conditions precedent 10 any liability of the Company.

3. MISREPRESNTA TlON/FRAUD

If the proposal or declaration of the Insured is untrue in any respect or if any materialfact affecting the risk be incorrectly slated herein or omitted therefrom. or if thisinsurance. or any renewal thereof shall have been obtained through any misstatement.misrepresentation ()r suppression. or if any claim made shall be fraudulent orexaggerated. or if any false declaration or statement shall be made in support thereof.than in any of these cases. this Policy shall be void.

~. CHAl"GF: IN RISK

The Insured shall give inunediate notice in writing to the Company of any change inhis or her occupation. business. duties or pursuits and pay any additional premiumthat may be required by the Company.Before each renewal of the Policy. the Insured must notify the Company in \••.-riting ofany injUl)'. disease. physical defect or infirmity of which the Insured has becomeaware or been affected.

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5. CLAIMS PROCEDURE

In the event of an accident \vithin the meaning of this policy. notice thereof in writingmust be given as soon as possible to the Company. When notice is not received\\'ithin 7 days after the occurrence of any event a fair and reasonable explanation forthe delay must be given. otherwise the claim will not be admitted. The Company shallunder no circumstance be under any liability in respect of any event unless noticethereof be given to the Company within three calendar months of its occurrence orcommencement. In the event of death immediate notice must be sent to the Company.All Certificates. infonnation and evidence required by the Company shall befurnished at the expense of the insured or any claimant hereunder and shall be suchfonn and of such nature as the Company shall prescribe. within 180 days from the dateof accident. if not received \vithin 180 days claim will be treated as No claim.

The Medical Officer or other representative of the company shall be allowed to seeand examine the insured person!s at all reasonable times as often. and in such manneras he may require.

The Company shall in lhe case of the death of the Insured person/s be entitled to h<lvea post mortem examination at its own expense. No compensation shall becomepayable unless the insured person/s shall have entered under the care of a qualifiedmedical practitioner.

No Assignee of this policy shall be entitled to benefit hereunder except that p<lyablein respect of death.

6. NON-ASSIGNMENT

This policy is non-assignable and the Company shall not recognise or be affected byany trust change lien or assignment relating to this Policy. Any receipt or dischargewhich the Insured or his/her legal personal representative may grant to the Companyfor any capital sum or compensation under this Polic),' shall be deemed a final Hlldcomplete discharge of all liability of the Company in respect of an)' and every injuryor contingency (including death) resulting to the insured in consequence of theaccident whether resulting before or aller the date ofsueh receipt or discharge.

7. CANCELLATION

The Company may be notice in writing 10 the insured under registered letter to his orher last known address given seven (7) days notice of their intention to tenninate thisPolicy shall be deemed a proportion of the Premium correspondence to tht: unexpiredPeriod of Insurance. By like notice to the Company the Insured may. at any timecancel this Policy. in which case the Company will retain the customary short periodpremium for the time the Policy has been in force.

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8. LEGAL PROCEEIJINGS

No action at Law or in equity shall be brought to recover on this Policy prior toexpiration of sixty (60) days after \\Titten proof of loss has been furnished inaccordance with the requirements ofrhis Policy. No such action shall be brought afterthe expiration of one year aftcr the time written proof of loss is required to befurnished.

9. ARIlITRA nON

All differences arising out of this Policy shall be referred to the decision of anArbitrator. to be appointed in \\-Titing by the parties in difference. or if they cannotagree upon a single Arbitrator. to the decision of two disinterested persons asarbitrators. of whom one shall be appointed in writing by each of the parties. withinone calendar monrh after having been required so to do in writing by other party. Incase either party shall refuse or fail to appoint an Arbitrator within olle calendarmonth atter receipt of notice in \\:riting requiring an appointment. the other party shallbe at liberty to appoint a sole arbitrator. and in case of disagreement bet\veen thearbitrators. the difference shall be referred to the decision of an Umpire who shallhave been appointed by them in \vriting before entering on the reference and who shallsit with the Arbitrators and preside at their meetings. The death of any party shall notrevoke or affect the authority or powers of the arbitrators or umpire respectively and inthe event of the death of an arbitrator or umpire. another shall in each case beappointed in his stead by the pany or arbitrators (as the case may be) by whom thearbitrator. arbitrators or umpire making the award. and it is hereby expressly, stipulatedand declared that it shall be a condition precedent to any right of action or suit uponthis Policy that the award by such arbitrator.arbitrators or umpire shall be tirst obtained.If the Company shall disclaim liability to the insured for any claim hereunder and suchclaim shall not within t\vdve calendar 1110nthsfcom the date of such disclaimer havebeen referred to arbitration under the provision herein contained then the claim shallfor all purposes be deemed to have been abandoned and shall not thereafter berecoverable hereunder.

10. PREMIUM WARRANTY

It is a fundamental and absolute sp~cial conditiun of this contract of insurance that thepremium due must be paid and received by the Company within seven (07) days fromthe inception date of this Policy/EndorsemenURenewal Certificate.

IMPORTANT

TilE INSUREIJ SHALl. READ TillS POLlCY CAREFUl.LY, ANIJ IF ANY ERROROR MISIJESCRlI'nON 8E FOUNIJ IlEREIN, OR IF THE COVER IJE NOT INACCORIJANCE WITH TilE WISHES OF TilE INS{;REIJ, AIJVICE SHOULD ATONCE IJE GIVEN TO TilE COMPANY.

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POLICY NO

THE INSURED

NAME

ADDRESS

SCHEDULE

C00113AP0004907

Dialog Axiata PLC

No. 475. Union Place, Colombo 02

OCCUPATION OR PROFESSION : Telecommunication Services Provider

INSURED PERSON I S

LIFE INSURED

NAME

ADDRESS

OCCUPATION} Dialog Pre-paid and Post-paid customers who will be

registering through SMS with Dialog Axiata Pic anddeclared monthly by Dialog to Ceylinco General Insurance Limited

(This Insurance is subject to Political Risk Exclusion Endorsement and Cyber Clause as attached.)

PERIOD OF INSURANCE One Year From: 01.042018 To: 01.09.2018

CAPITAL SUM INSURED & BENEFITS (PER PERSON)

BENEFIT A

PREMIUM(PER MONTH)

AGE LIMIT

ACCIDENTAL DEATH AND PERMANENT DISABLEMENT(Capital Sum - Option 1-Rs, 1,OOO,OOO.QO, Option 11-RS.2,OOO,OOO.OO andMaximum Option 111-Rs. 5.000.000.00 Depending on the scheme selectedand premium paid by the life insured named in the schedule)

Option 1- Rs.301. +TaxesOption 11-Rs.601- +TaxesOption 111-Rs.150/- +Taxes

18 Years to 70 Years

CEYLINCO GENE -~URANCE LIMITEDe.1a\ I

Page 9: CEYLINCO GENERAL INSURANCE LIMITED · 2018-04-02 · EmaiL ciccoms@ceyins.lk PERSONAL ACCIIJENT INSURA:>ICE POLICY ~O. COOI13APOOOH07 WHEREAS the insured named in the Schedule hereto

Political Risks Exclusion Endorsement

Notwithstanding any provision tc :~e ~~ntrary within this i~surar.ce O~ any endorsementthereto it is agreed that this insurance ex=l~des loss, damage, cos: or expense ofwhatsoeve~ nature di~ect:y or indirectly ca~s8d by, ~~sultin3 from or in conr.ectionwith any of the followir.g regardless of any otr.er cause or ~vent contrlbu~ingconcurrently or ir.any other seq~ence to the loss:

1. War, invasion, acts of foreign enemies, hOstilities or warlike operations(whether war be declared or not), civil war. Permanent or temporarydispossession resulting from confisca:io~, commandeering or requisition by anylawfully constituted authorit.y. Mut.iny, clvil commetion assu:!li~lgtheproportions cf or amoun:ing to a popular =ising, :=~bal rislng, mil~taryrising, insu,rrecticn, strike, rio:, reoell~or., revolu,:ien, military or l..:surpedpower, martial 1a\"Ior- state of siege or a:1Y of the events or causes whichdete~~ine the proclamation or mair.tenance o~ martial law or state of siege;

2. Any act at terrorism.

For t!1e purpose of this endorse!:Ie:1ta" act et terrorism :near:san a-:t, 2ncludJ.!lgbut ~et limited to the use ot =o~ce or violence anc/or tt~ th!~at :hereo:, ofany person or group(s) or persons wtel!1er ac~in; alone or on betalf of cr i"connection '..•it!1 an organizat:len(s) or gOVlo::!T,ment(s),committed for politicd;',religious, ideological, or ethnic purposes or reasons includi~g the intentionto the influence any government and/or to put the public, or any section of thepublic, in fear.

Thi.o;:endorsement also excludes loss, damage, cost or expenses of ....'hatsoever naturedirectly or indirectly causee by, result1ng frem or in cennection with a~y action taken ir.contro:ling, preventing, suppressir.g or in any way ~elaLing tc (1) ~~d/o~ (2) dbove.

7~is endorse~ent shall be paramount and shall everride anything contained in thisinsurance inconsistent therewith. However, if the ~nsured has obtained Riots & Strike andTerrorism cover by payment of the additional premium, tl:ecoverage granted will be subjectto the relevant endorse~ents attached and any liabilities whatsoever under such specificext.ensions shall be devolved solely upon tlleCEYLINCO GENEFJI.LINSUAANCE LII1ITEiJ.

Subject otherwise to the terms, ccnd:tior-.5and eX':;"";Jtionsof t:Je .•..-1-[;inwrit:er, policy.

CEYLINCO GENERAL INSURANCE LIMITED

.....uthorize

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CLAUSE IRADIOACTIVE CONTAMINATION, CHEMICAL, BIOLOGICAL, BID-CHEMICAL AND

ELECTROMAGNETIC WEAPONS EXCLUSION CLAUSE

This clause shall be paramount and shall ove~ride anything contained in this ir.suranceinconsistent therewith.

1. In no case shall this ir.suraoce cover loss damage lIability or expense d:rec-ly orindirectly caused by or ccntributed :0 by or arIsing fro~.

:;'.1 ionising radiatior.s trom or contmdnation by radioactivity from o;l}" :Juclea.::fuel or from any nuclear waste or fro~ the combustion of :luclear fuel.

:.2 the radioactive,?roperties of anynuclear ccmpcnent

toxic, explosive or other hazardous ornuclear installation, reactor or otherthereof.

contam:.nati:1gnuclear assembly or

1.3 any weapon or device employir.g atom~c or ~~clear fission a~d/or :~SlOr. or ~therlike reaction or radioactive force cr matter.

1.4. the radioactive, toxic, explosive OI ath"r hazardous or contamlnati:-lgproperties of a:-IYradioactive matter. The exclusion in this sub-clause does notextend to radioactive isotopes, other than nuclear fuel, when such isotopes arebeing prepared, carried, stored or used for commercial, agricult~ra~, ~edical,scientific er Otf.er simi:ar. peaceful purpose5.1:

1.5 any chemical, biological, bio-chemical release or expos~re of any ~ind, orelectromag~et~c weapon.

CYBER ATTACK EXCLUSION CLAUSE

1.1 Subject only to clause 1.2 below, in no case shall this insurance COver lossdamage liability or ex~ense direct_y or injirectly caused by or Contributed to byor arising frorr,the use or operat~on, as a ~eans for ~nflicti~g har~, of anycomputer, computer system, co~puter soft~are prograrrme, ~alicious COd8, computervirus cr process or any other electronic system.

1.2 Where this claUse is endorsed on policies covering risks 0: war, civil war,revolution, rebellion, insurrection, or civil strike arising there~rom, or anyhostile act by or against 3 belligerent power, or terrorism or any person actingfrom a political motive, Clause 1.1 5hall r.ot operate to exclude losses (\~hichwould otherwise be covered) arising :~om the use of any computer, computer systemor corr.puter so:'"t •..lare programr:\€' or a:;y ether electror:ic sYSteIT'. in the launch andlorguidance systerr.and lor firing mechar:i$rr.of dfly \~eapon or missile

CEYLINCO NSURANCE LIMITED