extrasure insurance terms and conditions · competitions of such special sports. competitive sports...

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EXTRASURE INSURANCE TERMS AND CONDITIONS

Insurance cover for home and family

Valid as of 4 February 2013

133 685 1 12.12

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CONTENTSThis is a translation of the original Finnish terms and conditions, which take precedence should there be any differences between the original and the translation.

PERSONAL INSURANCE ............................................................ 3Pohjola Health Insurance .............................................................. 4 Insurance cover ................................................................. 4 Medical Treatment Cover ....................................................... 4 Cost Cover ............................................................................ 5 Supplementary Medical Treatment Expenses Cover ............. 7 Dental Cover ........................................................................ 10 Fitness Cover ........................................................................11 Athletes’ Medical Treatment Cover .......................................11 Athletes’ Supplementary Medical Treatment Cover ............. 12 Athletes’ Dental Cover ......................................................... 15Pohjola Living Allowance Insurance ............................................ 15 Insurance cover .............................................................. 15 Disability Cover .................................................................... 15 Death Cover ......................................................................... 15 Daily Allowance Cover ......................................................... 16Life Insurance .............................................................................. 16Disability insurance...................................................................... 16

NON-LIFE INSURANCE ............................................................. 17Myhome insurance ...................................................................... 17Valuables insurance .................................................................... 19Small boat insurance ................................................................... 20Safety regulations ........................................................................ 20Indemnification regulations .......................................................... 21Family liability insurance.............................................................. 24Family legal expenses insurance ................................................ 25Pet insurance............................................................................... 27Animal insurance ......................................................................... 27Loss-off-use insurance ................................................................ 27Medical expenses insurance ....................................................... 28

Dog litter insurance...................................................................... 28Safety regulations in pet insurance ............................................. 28How to claim compensation under pet insurance ........................ 29Animal liability insurance ............................................................. 29Forest insurance and forest fire insurance .................................. 30Forest insurance .......................................................................... 30Forest fire insurance .................................................................... 30Safety regulations for forest insurance and forest fire insurance ............................................................................... 31Indemnification regulations for forest insurance and forest fire insurance ..................................................................................... 31

TRAVEL INSURANCE ................................................................ 32Eurooppalainen Traveller’s Incurance ......................................... 33 Insurance cover ............................................................... 33 Traveller’s Medical Treatment Cover ................................... 34 Traveller’s Disability Cover .................................................. 35 Traveller’s Death Cover ....................................................... 35 Traveller’s Daily Allowance Cover ........................................ 35 Traveller’s Crisis Cover ........................................................ 36 Travel Cancellation Cover .................................................... 36 Travel Interruption Cover .................................................... 37 Delayed Departure Cover .................................................... 39 Missed Departure Cover ...................................................... 39Luggage insurance ...................................................................... 40Travel liability insurance .............................................................. 40Legal expenses travel insurance ................................................. 40

GENERAL TERMS OF CONTRACT .......................................... 41

Please read carefully the exclusion clauses printed in bold.

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PERSONAL INSURANCEThe Extrasure insurance cover may include the following types of insurance of the person- Pohjola Health Insurance - Pohjola Living Allowance Insurance - Life insurance- Disability Insurance- Eurooppalainen Traveller’s Insurance.

The insurance cover selected for each insured person is stated in the policy.

COMMON PROVISIONS FOR PERSONAL INSURANCE

These common provisions are applied to Pohjola Health Insurance, Pohjola Living Allowance Insurance, Life Insurance and Disability Insurance.

The terms and conditions of Eurooppalainen’s Traveller’s Insurance can be found in the Travel insurance section.

1 INSURED PERSONThose insured are the persons named in the insurance policy.

2 BENEFICIARY The policyholder may name a beneficiary to whom any compensation is paid. Such a beneficiary clause and any relevant alterations to or cancellations of it must be submitted to the insurance company in writing. Compensation from Pohjola Health Insurance and Pohjola Living Allowance Insurance, with the exception of Death Cover is paid to the insured person unless the policyholder has determined another beneficiary. When the insured person is an unborn child, the beneficiary is the mother until the child’s birth.

3 VALIDITY OF INSURANCE

3.1 Terrotorial scope of validityThe insurance cover is valid throughout the world.

Compensation from Pohjola Health Insurance is, however, only paid for costs arising in Finland. If it has been separately agreed on and entered in the policy, compensation may also be paid from a specific type of Pohjola health cover for costs incurred abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

3.2 Validity during sports 3.2.1 Definition of competitive sportsBy competitive sports we mean sports games or matches arranged by a sports association or sports club and training arranged according to a training programme or other training typical of the competitive sport, regardless of the level of competitiveness or the age of the insured person. In Athletes’ Medical Treatment Cover, Athletes’ Supplementary Medical Treatment Cover and Athletes’ Dental Cover, competitive sports also include the trips directly made to and from the above games, competitions and training.

By training arranged according to a training programme we mean training carried out following either a written or verbal training plan (the coach does not have to be present).

Other training typical of the sport refers to training that supplements the main sport when done as part of preparation to games or sports.

3.2.2 Competitive sports The following do not apply to competitive sports: Pohjola Health Insurance’s Medical Treatment

Cover, Cost Cover, Supplementary Medical Treatment Expenses Cover and Dental Cover, Pohjola Living Allowance Insurance’s Daily Allowance Cover and Disability Insurance.

However, Pohjola Living Allowance Insurance’s Disability Cover and Death Cover are valid in competitive sports. Life Insurance is also valid in competitive sports.

Pohjola Health Insurance’s Athletes’ Medical Treatment Cover, Athletes’ Supplementary Medical Treatment Cover and Athletes’ Dental Cover are valid in those competitive sports which have been entered in the insurance policy. They are nevertheless never valid for high-risk sport competitions referred to in clause 3.2.4.

If separately agreed and recorded in the Disability Insurance policy, Disability Insurance is nevertheless valid in competitive sports, but never with high-risk sports defined in clause 3.2.4.

3.2.3 Special sports Pohjola Health Insurance’s Medical Treatment Cover, Cost Cover, Supplementary Medical Treatment Expenses Cover and Dental Cover, Pohjola Living Allowance Insurance’s Daily Allowance Cover and Disability Insurance do not apply to the sports listed below. In this terms and conditions, we call them special sports. The above applies regardless of whether the insured person is competing in any of the sports or not.

However, Pohjola Living Allowance Insurance’s Disability Cover and Death Cover are valid in special sports. Life Insurance is also valid in special sports.

Pohjola Health Insurance’s Athletes’ Medical Treatment Cover, Athletes’ Supplementary Medical Treatment Cover and Athletes’ Dental Cover are valid in the special sports listed below when the appropriate entry has been made in the in the insurance policy. Coverage is also extended to immediate trips to and from the place where such special sports are done. However, the insurance is not valid in competitions of such special sports. Competitive sports have been specified in clause 3.2.1.

If it has been separately agree and the appropriate entry has been made in the insurance policy with reference to Disability Insurance, the latter is nevertheless valid in all the special sports listed below. However, the insurance is not valid in competitions of such special sports. Competitive sports have been specified in clause 3.2.1.

Special sports are:- Motor sports- Combat and contact sports- The following team sports: Australian football,

rugby and lacrosse- The following winter sports: Bobsleigh, luge,

freestyle skiing and speed and downhill skiing- The following air sports: hot air ballooning, gas

ballooning, motor aviation, hang gliding and paragliding, ultralight aviation, parachuting, flying a homebuilt aircraft, gliding and motor gliding

- The following strength sports: Powerlifting, weightlifting and body building

- Scuba diving- Other special sports: BMX biking, water skiing,

bungee jumping, parasailing, skimbat and kite surfing, kite boarding, parkour, abseiling, acrobatics and free running.

3.2.4 High-risk sportsPohjola Health Insurance’s Medical Treatment Cover, Cost Cover, Supplementary Medical Treatment Expenses Cover and Dental Cover, Pohjola Living Allowance Insurance’s Daily Allowance Cover and Disability Insurance do not apply to the sports listed below. In this terms and conditions, we call them high-risk sports. The above applies regardless of whether the insured person is competing in any of the sports or not.

However, Pohjola Living Allowance Insurance’s Disability Cover and Death Cover are valid in high-risk sports. Life Insurance is also valid in high-risk sports.

Pohjola Health Insurance’s Athletes’ Medical Treatment Cover, Athletes’ Supplementary Medical Treatment Cover and Athletes’ Dental Cover are valid in the high-risk sports listed below which have been entered in the insurance policy. Coverage also extends to immediate trips to and from training of the sport and in competitions in the sport. Competitive sports have been specified in clause 3.2.1.

If it has been separately agree and the appropriate entry has been made with reference to Disability Insurance, the latter is nevertheless valid in all the high-risk sports listed below. This means that Disability Insurance will also be valid in competitions of high-risk sports. Competitive sports have been specified in clause 3.2.1.

High-risk sports are:- American football - Mixed Martial Arts- Wrestling- Off piste skiing - Ice and rock climbing- Ice and mountain climbing- Strength athletics - Downhill biking- Downhill skating- Ocean sailing- BASE jumping- Hiking in uninhabited areas - Wildwater canoeing- Freediving- Other sports where the risks are at similar level.

3.3 Effect of the insured’s age on validityThe insurance cover will expire at the end of the insurance period during which the insured person reaches the age of 100. However, Life Insurance and Disability Insurance and Pohjola Living Allowance Insurance’s Daily Allowance Cover end before that as specified in their terms and conditions. Moreover, Pohjola Health Insurance’s Dental Cover ends in terms of illnesses earlier, as specified in the insurance policy.

4 ACCIDENT AND EXCLUSIONS

4.1 Accident An accident is a sudden, external occurrence which is beyond the control of the insured person and which causes bodily injury.

The following are also considered to be accidents: unintentional drowning, heatstroke, sunstroke, frostbite, injury caused by a considerable variation in atmospheric pressure, gas poisoning sustained by the insured person, and poisoning caused by a substance taken inadvertently.

4.2 Exertion and limitations thereto Pohjola Health Insurance’s Athletes’ Medical Treatment Cover and Athletes’ Supplementary Medical Treatment Cover taken out in case of accidents will also compensate a strain or rupture of a muscle or tendon verified by a doctor that was caused in connection with an exertion when doing a competitive sport, high-risk sport or special sport referred to in the insurance policy and which has been given medical treatment within 14 days of the strain or rupture.

Costs caused by exertion will be compensated for up to six week from the beginning of treatment. These costs may include one MRI examination. Surgical operations are not compensated.

The compensation of strain or rupture injury has the same restrictions as with accidents. Injuries that are not covered under clause 4.3 will not be covered if caused by an exertion, either. Clause 4.4 is also

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applied to injuries caused by exertion the same way as to accidents.

4.3 Injuries which are not coveredThe concept ‘accident’ does not include injury caused by- an event arising from an illness, defect or

injury of the insured- operation, treatment or other medical

procedure, unless the procedure is undertaken for the treatment of an injury coverable under the same insurance

- poisoning due to medicine, alcohol or other intoxicant used by the insured or due to a substance taken as food

- Injury to a tooth or dentures caused by biting, even if an external factor has contributed to the damage

- suicide or attempted suicide.

Infectious diseases caused by a bite or sting are not compensated as an accident.

We will not compensate as an accident a hernia of the intervertebral disk, abdominal or inguinal hernia, a rupture of an Achilles tendon, long head of biceps tendon or rotator cuff, or recurrent dislocation unless the injury was caused by an accident that would also cause injury to healthy tissues.

4.4 Effect of illness, injury, defect or degeneration not related to the accident

The insurance does not cover illness, injury, defect or degeneration of the musculoskeletal system which are not related to an accident, even if they were symptomless before the accident.

If the above factors not related to the accident have materially contributed to the emergence of the injury or its delayed recovery after the accident, compensation is only paid insofar as the expenses, disability or permanent handicap are deemed to have been caused by the accident. This restriction does not apply to the Death Cover included in Pohjola Living Allowance Insurance.

4.5 Extension for accidents This clause is applied to Pohjola Health Insurance’s Medical Treatment Cover, Cost Cover and Supplementary Medical Treatment Expenses Cover if the insured person was 60 years old more at the time of the accident.

Accident expenses are also compensated when an accident has taken place because of an illness, defect or injury. However, expenses for the illness,

defect or injury are not compensated as accident expenses.

Costs caused by an accident are compensated in addition to a period in which conventional medicine considers that recovery should have been made for another four months at the most, when an illness, defect, injury or musculoskeletal degeneration unrelated to the accident has make recovery take longer. We do not compensate as accident costs any costs that are the result of delayed recovery owing to illness, defect, injury or musculoskeletal degeneration.

Costs caused by an accident are compensated for a maximum of four months, when an illness, defect, injury or musculoskeletal degeneration that is unrelated to the accident has materially contributed to the accident occurring. However, costs of an illness, defect, injury or musculoskeletal degeneration that materially contributed to the accident will not be compensated as accident costs.

5 REASONABLENESS OF EXPENSES If it becomes evident that the expenses for which indemnity is claimed clearly exceed the generally accepted and reasonable level, the insurance company has the right to lower the amount of indemnity but not, however, under the reasonable level.

6 RISK AREAS, WAR, NUCLEAR ACCIDENT AND FLIGHT ACCIDENT

6.1 Pohjola Health Insurance and Pohjola Living Allowance Insurance

Compensation is not paid if the accident occurred or the insured person fell ill in a country or part of the country which the Ministry for Foreign Affairs of Finland recommends avoiding travelling to or which the Ministry for Foreign Affairs of Finland recommends leaving. However, this exclusion will not apply - during ten days from the date of such

recommendation if the insured person has arrived in the country or a part of the country described above before the Ministry for Foreign Affairs’ recommendation, unless a major war is concerned or the insured person has participated in the war or an armed conflict or the insured person has participated in peace-keeping operations organised by the United Nations, the European Union or another community or organisation, or some other military operation

- if the insured person’s illness, injury or death is

not due to the reason why the Ministry for Foreign Affairs issued its recommendation.

Cover is not provided for any illness, injury or death caused by a war or armed conflict in Finland. This exclusion will not apply during the 10 days from the beginning of armed operations, unless a major war is concerned or the insured person participated in a war or armed conflict.

Cover is not provided for any illness, injury or death caused by a nuclear accident as described in the Nuclear Liability Act, or caused by material, equipment or weapons based on nuclear reaction or ionising radiation, regardless of where the nuclear accident occurred.

Compensation is not paid from Pohjola Health Insurance or Pohjola Living Allowance Insurance if an illness, injury or death has been caused in hobby or professional aviation to a pilot or other member of the flight crew or person carrying out duties related to a flight.

6.2 Life and Disability InsuranceCover is not provided from Life or Disability Insurance for any illness, injury or death caused by a war or armed conflict. This exclusion will not apply during the 10 days from the beginning of armed operations, unless a major war is concerned or the insured person participated in a war or armed conflict.

If an extension for war risk has been agreed on separately and an entry of this has been made in the Life Insurance policy, Life Insurance will be valid also in case of war or armed conflict. Extending the cover to include war risk does not, however, extend the cover for a major war or situations in which the insured person participated in the war or an armed conflict.

Moreover, cover is not provided from Life and Disability Insurance if any illness, injury or death was caused by a nuclear accident as described in the Nuclear Liability Act, or caused by material, equipment or weapons based on nuclear reaction or ionising radiation, regardless of where the nuclear accident occurred.

7 APPLICABILITY OF GENERAL TERMS AND CONDITIONS

The general terms and conditions are applied in all insurance policies.

Pohjola Health Insurance1 INSURANCE COVER The following types are insurance are available:- Medical Treatment Cover- Cost Cover - Supplementary Medical Treatment Expenses

Cover- Dental Cover- Fitness Cover- Athletes’ Medical Treatment Cover- Athletes’ Supplementary Medical Treatment

Cover - Athletes’ Dental Cover.


2 MEDICAL TREATMENT COVER

2.1 Key contents of insurance cover Insurance can be taken in case of

A in case of accidents and illnesses This option compensates expenses to the

insured person caused by accident or illness as specified in these terms and conditions.

B accidents and the following illnesses - strain or rupture of tendon, tendinitis or

degeneration of tendon - muscle strain or rupture - intervertebral disk, abdominal, umbilical or

groin hernia - rupture of meniscus in the knee - dislocation of joint or kneecap.

This option compensates expenses to the insured person caused by accident or illness listed above as specified in these terms and conditions.

C in case of accidents This option compensates expenses to the

insured person only caused by an accident as specified in these terms and conditions.

The insurance policy indicates which of the three options above has been chosen.

Compensation will be paid only if the expenses have incurred during the validity of the insurance. If the expenses are caused by an accident, the accident must also have occurred during the validity of the insurance.

Expenses are coverable as far as they do not grant or would not have granted entitlement to compensation under the Health Insurance Act, Motor Liability Insurance Act, Employment Accidents Act, Patient Injury Act or other legislation.

During the validity of the insurance cover, expenses are covered up to a maximum compensation indicated in the insurance policy. The maximum compensation is subtracted with all compensation paid from the insurance. Insurance coverage ends when the maximum amount of compensation has been paid.

The deductible stated in the insurance policy will be deducted from coverable expenses. The deductible is determined on the basis of the date on which compensation is claimed for.

Compensation is only paid for examination carried out or treatment provided in Finland or for an acquisition made in Finland. If it has been separately agreed and the appropriate entry has been made in the policy, such examinations, treatments or acquisitions may also be covered abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions

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will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

2.2 Coverable expenses The condition for compensation to be paid is that it concerns an illness or injury that is coverable under Medical Treatment Cover. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable:- fees for examination and treatment procedures

carried out by physicians and health care professionals at their practice or clinic

- costs for medicinal products and wound dressings sold at pharmacies

- daily hospital charges. If it has been separately agreed on and entered in the policy that expenses incurred abroad will also be compensated, the number of daily hospital charges specified in the insurance policy will be compensated

- costs of the first orthopaedic brace or bandage if no more than two weeks have elapsed from a coverable operation or accident as a result of which such a brace of bandage is required. These expenses are only covered up to EUR 500 per operation or accident

- rental costs of forearm or underarm crutches.

When the insured is a child, the coverable expenses are specified in clause 2.2.1.

2.2.1 Coverable expenses when the insured is an unborn child When the insured is an unborn child, this clause applies until the child is born.

The condition for compensation to be paid is that it concerns an illness or injury that is coverable under Medical Treatment Cover. What is more, the illness or injury examination or treatment must have been prescribed by a doctor and be in accordance with generally accepted medical practice. Moreover, the examination or treatment must be caused by pregnancy alone and necessary by the child’s health.

Of these expenses, we cover the mother’s pre-natal - public health care outpatient clinic fees - costs for medicinal products and wound

dressings sold at pharmacies - public health care daily hospital charges.

2.3 Expenses which are not coveredExpenses are not compensated if they are caused by - examination or treatment provided by a

physiotherapist, chiropractor, osteopath, naprapathy practitioners, masseur or equivalent health care professional

- acupuncture or lymphatic therapy - examination or treatment by a nutritional

therapist or equivalent health care professional - examination or treatment by an occupational

or speech therapist, psychologist, neuropsychologist or other equivalent health care professional

- psychotherapy or equivalent examination or treatment

- examination or treatment by a dentist, specialised dentist, dental hygienist or denturist

- pregnancy, childbirth, termination of pregnancy or examination or treatment of infertility or from complications caused by these events or conditions

- refractive error operation or other treatment or aid relating to the correcting of refractive errors

- examination or treatment by an optician or equivalent health care professional

- purchase of micronutrient, mineral or vitamin preparations, unless they are considered medicinal products

- purchase of nutritional products including clinical nutritional products

- basic creams or lotions or equivalent, unless they are used for treating an accidental injury

- purchase of anthroposophic or homeopathic products

- examination or treatment related to outward appearance or looks

- examinations or treatments related to breast reduction or enlargement, skin peeling or dermabrasion or the lifting or rejuvenation of eyelids, areas around the eyes or other facial feature

- medicinal treatment of obesity, liposuction, gastric bypass or sleeve operation or other weight-loss surgery or other obesity examination and treatment

- varicose vein removal or other varicose vein treatment

- treatment whose primary reason is to improve the person’s quality of life; this includes medication that enhances sexual performance. This restriction is not applied, however, in case of medicinal products that have been compensated under the Health Insurance Act

- abuse of medicine or the use of alcohol or other intoxicants

- treatment of an addiction to drugs, alcohol, medicine, nicotine or other similar substance, or from treatment of other types of addiction

- medical equipment or other aids, orthotic insole or other insole or artificial limb (but the rental costs of forearm or underarm crutches are compensated)

- orthopaedic brace or bandage, unless it was the first of either that was acquired within two weeks of a coverable operation or accident. In cases like this, too, these expenses are only covered up to EUR 500 per operation or accident

- treatment for snoring, unless the treatment concerns sleep apnoea verified by means of sleep registration

- mole removal - examination made or treatment given in the

insured person’s home, other house call and other than a practice or clinic

- spending time or staying at a place providing rehabilitation services or any actual services used

- services of a unit providing social welfare or residential services even though they may also include health care services.

Indirect expenses, such as travel, accommodation or meal expenses are not compensated.

Expenses are not compensated if the right by law to compensation has been lost owing to a neglect of some insurance responsibility.

Expenses are not compensated if the same expense has already been compensated or if compensation has been sought from another cover or insurance policy.

Expenses that are not indemnified when the insured person in an unborn child are listed in clause 2.3.1.

2.3.1 Non-coverable expenses when the insured is an unborn child When the insured is an unborn child, this clause applies until the child is born.

Pre-natal expenses are not compensated if they are caused by- childbirth- examination or treatment by a dentist,

specialised dentist, dental hygienist or denturist


- purchase of micronutrient, mineral or vitamin preparations, unless they are considered medicinal products

- purchase of anthroposophic or homeopathic products.

Neither are expenses covered if they are caused by the insured child’s mothers abuse of medicinal product or use of alcohol or intoxicant.

The above expenses are not covered even if an examination and treatment that cause these expenses were necessary for the unborn child.




2.4 Filing a claim 2.4.1 Notification of illness or accidentThe claimant shall submit to the insurance company a written clarification of any illnesses, accidents, examinations, treatments and aids. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information in order to settle the claim.

Fees charged by doctors for medical statements are not compensated as loss inquiry costs. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.

2.4.2 ReceiptsThe claimant must pay the treatment expenses him/herself and claim reimbursement of the expenses under the Health Insurance Act. Claims under the Health Insurance Act must be submitted to the Social Insurance Institution within six months of paying the medical treatment expenses. The claimant must upon request provide the insurance company with the original receipt for the reimbursement paid by the Social Insurance Institution, plus copies of original receipts submitted to the Social Insurance Institution. Originals of the receipts for expenses which have not been reimbursed under the Health Insurance Act or some other law must also be submitted upon request to the insurance company.

2.5 Other applicable terms and conditionsThe common provisions for personal insurance are applied.

3 COST COVER

3.1 Key contents of insurance coverThe following types of cover may be selected- doctors’ fees and examination expenses or- general practitioners’ fees and examination

expenses and - surgery and special examination expenses.

The insurance policy shows which of the above have been chosen.

The above expenses may be coverable

A in case of accidents and illnesses In this option we compensate expenses specified

below caused by the insured person’s accident or illness.

B in case of accidents In this option we compensate expenses specified

below caused by the insured person’s accident.

It has been entered in the insurance policy which option has been chosen.

3.2 Entitlement to compensationCompensation will be paid only if the expenses have incurred during the validity of the insurance. If the expenses are caused by an accident, the accident must also have occurred during the validity of the insurance.

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Each expense has a maximum compensation limit. Any compensation paid will reduce the remaining amount of indemnity that may be paid. Once the maximum compensation has been reached, coverage ends.


Compensation is only paid for examination carried out or treatment provided in Finland or for an acquisition made in Finland. If it has been separately agreed and the appropriate entry has been made in the policy concerning a certain type of expense, such examinations, treatments or acquisitions may also be covered abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

3.3 Coverable expenses3.3.1 Doctors’ fees and examination expensesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable for doctors’ fees and examination expenses. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable:- fees for examinations and treatment at a general

practitioner’s or specialist’s practice or clinic- fees for examinations performed by health care

professionals at their practice or clinic prescribed by a GP or specialist.

Expenses are not compensated if they are caused by - surgical procedure or endoscopy- MRI examination or computed tomography - medicinal product or other product- orthopaedic brace or bandage, wound

dressing, orthotic insole or other insole or other equipment or instrument

- medicinal aid or artificial limb- daily hospital charges.

In addition to the above, restriction in section 3.4 also apply. 3.3.2 General practitioners’ fees and examination expenses The condition for compensation to be paid is that it concerns an illness or injury that is coverable for GP fees and examination expenses. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable:- fees for examinations and treatment at a general

practitioner’s practice or clinic- fees for examinations performed by health care

professionals at their practice or clinic prescribed by a GP.

Expenses are not compensated if they are caused by - examinations or treatment provided by a

specialist

- surgical procedure or endoscopy- MRI examination or computed tomography - medicinal product or other product- orthopaedic brace or bandage, wound

dressing, orthotic insole or other insole or other equipment or instrument

- medicinal aid or artificial limb- daily hospital charges.

In addition to the above, restriction in section 3.4 also apply. 3.3.3 Surgery and special examination expenses The condition for compensation to be paid is that it concerns an illness or injury that is coverable for surgery and special examination expenses. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable: - fees for surgical operations - daily hospital charges immediately related to

surgery. If it has been separately agreed on and entered in the policy that expenses incurred abroad will also be compensated, the number of daily hospital charges specified in the insurance policy will be compensated

- costs of the first orthopaedic brace or bandage if no more than two weeks have elapsed from a coverable operation as a result of which such a brace of bandage is required. These expenses are only covered up to EUR 500 per operation

- fees for up to three medical consultations related to a surgical operation; these include the post-operative check-up and fees for any treatment provided in this check-up and also any examinations prescribed by the doctor during the same consultation. MRI and CT scans are, however, compensated as follows:

- fees for MRI and CT scans. A total of three MRI and CT scans will be compensated during one insurance period. If the insured has more such scans during an insurance period, any in excess of three are not compensated

- fees for endoscopy- fees for two medical consultations per each

coverable MRI or CT scan or endoscopy.

Expenses are not compensated if they are caused by- medicinal products or other products

unless they have been administered during coverable surgery or examination

- wound dressings, orthotic insoles or other insoles or other equipment or instruments

- first orthopaedic brace or bandage unless more than two weeks have elapsed from a coverable operation as a result of which such a brace of bandage is required. In cases like this, too, these expenses are only covered up to EUR 500 per operation or accident.

- medical equipment or artificial limb (but the rental costs of forearm or underarm crutches are compensated if needed after a coverable surgical operation)

- refractive error operation - gastric bypass or sleeve operation or other

weight-loss surgery- daily hospital charges unless they are

immediately related to a coverable operation.

In addition to the above, restriction in section 3.4 also apply.

3.4 Expenses which are not coveredThis clause applies to all Cost Cover costs, that is doctors’ fees and examination expenses, general practitioners’ fees and examination expenses and surgery and special examination expenses.

Expenses are not compensated if they are caused by - examination or treatment provided by a

physiotherapist, chiropractor, osteopath,

naprapathy practitioners, masseur or equivalent health care professional


therapist or equivalent health care professional

- examination or treatment by an occupational or speech therapist, psychologist, neuropsychologist or other equivalent health care professional

- psychotherapy or equivalent examination or treatment

- examination or treatment by an optician or equivalent health care professional


- pregnancy, childbirth, termination of pregnancy or examination or treatment of infertility or from complications caused by these events or conditions



- obesity examination or treatment, such as liposuction or gastric bypass or sleeve operation


- treatment primarily meant to enhance the quality of life



- treatment for snoring, unless the treatment concerns sleep apnoea verified by means of sleep registration

- mole removal - examination made or treatment given in the

insured person’s home, other house call and other than a practice or clinic







Fees charged by doctors for medical statements are not compensated as loss inquiry costs. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.

3.5.2 ReceiptsThe claimant must pay the treatment expenses him/herself and claim reimbursement of the expenses under the Health Insurance Act. Claims under the Health Insurance Act must be submitted to the Social Insurance Institution within six months of paying the medical treatment expenses. The claimant must upon request provide the insurance company with

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the original receipt for the reimbursement paid by the Social Insurance Institution, plus copies of original receipts submitted to the Social Insurance Institution. Originals of the receipts for expenses which have not been reimbursed under the Health Insurance Act or some other law must also be submitted upon request to the insurance company.


4 SUPPLEMENTARY MEDICAL TREATMENT EXPENSES COVER

4.1 Key contents of insurance cover The following types of cover may be selected - Musculoskeletal therapy expenses - Functional therapy expenses- Psychotherapy expenses - Expenses for home health care- Home help expenses- Special expenses- Expenses for home adaptations - Expenses for end-of-life care.


Each of the above cost covers can be chosen in case of



B accidents and the following illnesses - strain or rupture of tendon, tendinitis or

degeneration of tendon - muscle strain or rupture - intervertebral disk, abdominal, umbilical or

groin hernia - rupture of meniscus in the knee - dislocation of joint or kneecap

This option compensates expenses to the insured person caused by accident or illness listed above as specified in these terms and conditions.

C in case of accidents This option compensates expenses to the

insured person only caused by an accident as specified in these terms and conditions.

The insurance policy indicates which of the three options above has been chosen for each cost.



Each expense has a maximum compensation limit intered in the insurance policy. Any compensation paid will reduce the remaining amount of indemnity that may be paid. Once the maximum compensation has been reached, coverage ends.

The deductible stated in the insurance policy will be deducted from coverable expenses. The deductible is determined on the basis of the date on which compensation is claimed for. The above does not apply to home help expenses, its deductibles are detailed under its own heading.

Compensation is only paid for examination carried out or treatment provided in Finland or for a service provided or acquisition made in Finland.

If it has been separately agreed and the appropriate entry has been made in the policy concerning a certain type of expense, such expenses are covered even if they have incurred abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

4.2 Coverable and non-coverable expenses4.2.1 Musculoskeletal therapy expenses The condition for compensation to be paid is that the expenses for musculoskeletal therapy are included for the particular illness or injury. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of such expenses, we compensate examinations and treatments provided by a physiotherapist, osteopath, chiropractor or a naprapathy practitioner approved by the Finnish National Supervisory Authority for Welfare and Health (Valvira).

The insurance policy indicates the maximum number of examinations and treatments per insurance period are compensated. Any examinations of treatments exceeding the maximum will not be compensated.

Expenses are not compensated if they are caused by- medical equipment or other aids, treatment

device, orthotic insole or other insole - purchase of supports or bandages.




4.2.2 Functional therapy expenses The condition for compensation to be paid is that the expenses for functional therapy are included for the particular illness or injury. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of such expenses, we compensate examinations and treatments provided by a functional or speech therapist or neuropsychologist approved by the Finnish National Supervisory Authority for Welfare and Health (Valvira).

The insurance policy indicates the maximum number of examinations and treatments per insurance period are compensated. Any examinations of treatments exceeding the maximum will not be compensated.


device, orthotic insole or other insole - purchase of supports or bandages- child’s speech development concerning

the forming of a letter or letters and their pronunciation.




4.2.3 Psychotherapy expensesPsychotherapy expenses are covered in cases where an illness or bodily injury has also resulted in mental symptoms. What is more, the examination and treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the mental symptoms resulting from a coverable illness or bodily injury.

We cover costs for psychotherapy given by a psychotherapist approved by the Finnish National Supervisory Authority for Welfare and Health (Valvira).

If psychotherapy comes in the form of couple, family or group therapy, only the insured person’s part of the therapy is compensated.

The insurance policy indicates the maximum number of psychotherapy sessions per insurance period are compensated. Any sessions exceeding this maximum will not be compensated.

Expenses are not covered if they were caused by the treatment of an addiction to drugs, alcohol, medicine, nicotine or other similar substance, or from treatment of other types of addiction.




4.2.4 Expenses for home health careThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under home health care. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question. Examinations must be made and treatment provided by a professional employed by a local service provider.

Of these expenses, the following expenses are coverable - examinations carried out and treatments

provided by a medical doctor or nurse in the insured person’s home or other place

- one phone consultation with a doctor following a home call

- first-aid medication given by a doctor in examinations or treatments described above.

Expenses are not compensated if they are caused by - examination or treatment other than in the

insured person’s home, such as a clinic or hospital

- medicinal product or other product bought at a pharmacy

- acupuncture or lymphatic therapy - psychotherapy or equivalent examination or

treatment - examination or treatment by a dentist or

specialised dentist- pregnancy, childbirth, termination of

pregnancy or examination or treatment of

8

infertility or from complications caused by these events or conditions



- obesity examination or treatment- treatment primarily meant to enhance the

quality of life - abuse of medicine or the use of alcohol or

other intoxicants - treatment of an addiction to drugs, alcohol,

medicine, nicotine or other similar substance, or from treatment of other types of addiction





4.2.5 Home help expenses4.2.5.1 General information Compensation is paid for carer and home cleaning expenses as specified in these terms and conditions.

The condition for compensation to be paid is that it concerns an illness or injury that is coverable under home help expenses.

The insurance policy indicates to what extent carer expenses are compensated per insurance event. The same information is included on home cleaning expenses. Expenses are never compensated in excess of the maximum compensation set for home help expenses.

A qualifying period has been specified for each insurance event. This qualifying period does not apply to home cleaning expenses. In the case of child care services, each continuous home care period has a qualifying period which begins on the first day when the insured person was in home care under doctor’s orders. As to the services of a personal carer, the qualifying period begins on the first day when the insured person is in home care following surgery, and cannot manage alone at home without help.

4.2.5.2 Carer expenses Compensation is paid either for child care or personal carer services.

4.2.5.2.1 Child care servicesWe cover expenses for child care services obtained through a service provider as a result of a child who is normally in day care outside the home must under doctor’s orders be cared for illness or injury at home.

Expenses are covered up to the hours that the child would have been in day care outside the home had it not been for the coverable illness or injury but never for more than 10 hours per day.

If a carer is looking after more than one child at the same time, the insured child’s part is compensated.

Expenses are not covered if- the service provider does not have a

business ID issued by the authorities - the same expense has already been

compensated or if compensation has been sought from another cover or insurance policy.

4.2.5.2.2 Services of a personal carer We cover expenses for the services of a personal carer obtained through a service provider because

the insured person who is of school age or older has had an operation for a coverable illness or injury and cannot manage on his own at home without help.

The expenses of a personal carer are covered to the extent that the carer has helped the insured person after being discharged from hospital in necessary daily activities.

Expenses are covered for up to three months per insurance event and for no more than 10 hours per day.

Expenses are not covered if the expense or service need is caused by- pregnancy, childbirth, termination of

pregnancy or examination or treatment of infertility or from complications caused by these events or conditions

- treatment related to outward appearance or looks

- treatments related to breast reduction or enlargement, skin peeling or dermabrasion or the lifting or rejuvenation of eyelids, areas around the eyes or other facial feature

- liposuction, gastric bypass or sleeve operation or other weight-loss surgery or other obesity treatment







Moreover, expenses are not covered if - the service provider does not have a

business ID issued by the authorities - the right by law to compensation has been

lost owing to a neglect of some insurance responsibility

- the same expense has already been compensated or if compensation has been sought from another cover or insurance policy.

4.2.5.3 Home cleaning expenses We cover expenses for cleaning of an adult insured person’s home by a service provider if the insured has been on a continuous sick leave on doctor’s orders for at least a fortnight. Expenses are covered for up to four hours of cleaning for each new week of illness.

Compensation for cleaning expenses is not paid if the expense or need for the service is the result of:- pregnancy, childbirth, termination of

pregnancy or examination or treatment of infertility or from complications caused by these events or conditions

- treatment related to outward appearance or looks

- treatments related to breast reduction or enlargement, skin peeling or dermabrasion or the lifting or rejuvenation of eyelids, areas around the eyes or other facial feature

- liposuction, gastric bypass or sleeve operation or other weight-loss surgery or other obesity treatment




- treatment of an addiction to drugs, alcohol, medicine, nicotine or other similar substance, or from treatment of other types of addiction.





4.2.6 Special expensesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under special expenses. What is more, the illness or injury examination or treatment must have been prescribed by a doctor and provided by a health care professional. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable: - expenses for procedures to treat cosmetic skin

defects that are the result of a coverable illness or accident

- expenses for procedures to remove symptomatic moles

- expenses for breast reduction operation if the operation was performed because their size caused physical symptoms of illness

- expenses for the removal of varicose veins or other treatment related to varicose veins when they have caused pigment changes on the skin, lesions or daily swelling despite treatment with compressions socks or stockings

- the above coverable procedures include any daily hospital charges. If it has been separately agreed on and entered in the policy that expenses incurred abroad will also be compensated, the number of daily hospital charges specified in the insurance policy will be compensated

- expenses for examination or treatment carried out by a nutritional therapist. Up to give examinations and treatments provided by a nutritional therapist are compensated during an insurance period. Any examinations of treatments exceeding the maximum will not be compensated

- expenses for the rental of medicinal aids, treatment devices, furniture and equipment

- expenses for medicinal aids, treatment devices and exercise equipment. The above medicinal aids and devices are compensated up to EUR 200 per insurance period

- expenses for clinical nutritional products sold at a pharmacy that were prescribed by a doctor, provided these are coverable as medical expenses under the Health Insurance Act for the treatment of a coverable illness or injury. Following the deduction of the sum that was already compensated under the Health Insurance Act, we compensate half of the sum left for the insured to pay.

Coverable expenses do not include- expenses for examinations or treatments

performed by doctor or other health care professional before a coverable procedure

- expenses for examinations or treatments performed by doctor or other health care professional following a coverable procedure or hospital treatment immediately after a coverable procedure

- expenses for medicinal products and wound dressings sold at pharmacies

- expenses for orthopaedic brace or bandage - expenses for spectacles, sunglasses or

contact lenses- rental costs for forearm or underarm

crutches, unless the need for them is caused by a procedure coverable from special expenses

- expenses for services of a unit providing social welfare or residential services even though they may also include health care services.

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Expenses are not compensated if the same expense has already been compensated or if compensation has been sought from another cover or insurance policy. 4.2.7 Expenses for home adaptations4.2.7.1 GeneralExpenses are compensated according to these conditions if the insured receives a permanent or temporary disability as a result of a coverable illness or injury.

Permanent functional disability refers to a medically assessed general handicap which the insured has incurred through illness or injury and which, according to medical prognosis, is unlikely to be healed. A permanent functional disability must also have continued for at least three months, before any assessment for home adaptation will be entered upon.

By temporary functional disability we refer to what is medically assessed as a temporary disability caused by a coverable illness or injury that prevents the insured from managing daily activities on their own.

Expenses are coverable as far as they do not grant or would not have granted entitlement to compensation under the Health Insurance Act, Motor Liability Insurance Act, Employment Accidents Act, Patient Injury Act, Act on disability services (380/1987), Social Welfare Act or other legislation.

4.2.7.2 Home adaptation and home fixturesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under home adaptation expenses. A further requirement is that the home adaptations and acquisition of home fixtures are the result of this illness or injury and prescribed by a doctor. Home adaptations and the acquisition of home fixtures must be necessary for the insured person to manage normal daily activities independently and to live at home.

Of these expenses, the following expenses are coverable- widening of doorways, expenses for the

removal of thresholds and any other obstacles in the home, and expenses for support handles installed in the home

- building of disabled ramps and bannisters in other than blocks of flats

- bathroom and lavatory adaptations - lighting changes- change of surface materials at home because of

serious allergy- adaptations to fixtures and fixed building and

interior decoration materials- any necessary lifting or alarm equipment and

other fixtures, including the installation- evaluation, design, any building permissions and

supervision for the above adaptations.

Home adaptations and home fixture expenses are compensated - only for one flat on the basis of all the illnesses

and injuries the insured person is suffering from when the level of permanent disability is being evaluated. Compensation will no longer be paid on the basis of the above illnesses and injuries for the same flat once two years has elapsed since a doctor ordered the adaptations to be made and the fixtures to be acquired. Compensation will not be paid for other flats on the basis of the above illnesses and injuries

- only for one flat and for up to EUR 2,000 on the basis of all the illnesses and injuries the insured person is suffering from when the level of temporary disability is being evaluated. Compensation will no longer be paid on the

basis of the above illnesses and injuries for the same flat once two years has elapsed since a doctor ordered the adaptations to be made and the fixtures to be acquired. Compensation will not be paid for other flats on the basis of the above illnesses and injuries.

If the insured has another illness or injury later, any compensation will be paid for new adaptations as specified above.

If the insured moves into a new home, home adaptations or the acquisition or installation are not compensated that were already compensated in the previous home, even if this need arose from a new illness or injury. Home adaptations and acquisition and installation of fixtures are compensated in terms of construction and building materials to the same level as the home otherwise is.

The insured is responsible for ordering the home adaptations and fixtures and construction and installation supervision.

Coverable expenses do not include- in situations in which, on the basis of the Act

on disability services (380/1987), the insured has been diagnosed to require continuous institutional care

- renovation, adaptations or extension or flat or house that increase the floor area

- holiday home adaptation that enhance its quality or constructions

- any adaptation outside the flat except for disabled ramps and bannisters in other than blocks of flats

- any home adaptations or installation of home fixtures in any other than the insured person’s home or holiday home

- any expenses caused by correction of a design, foundation, installation and construction error and damage caused by such an error

- anything caused by mould allergy- cases in which any right by law to

compensation has been lost owing to a neglect of some insurance responsibility

- cases in which the same expense has already been compensated or if compensation has been sought from another cover or insurance policy.

The insured person’s travel or accommodation costs are not compensated.

It must be a professional working for a service provider operating near the insured person’s home who carries out any home adaptations and installation of fixtures.

If a home is bought only after the injury, no such expenses are compensated which should already have been taken into consideration when selecting a home a building a new one in light of existing personal limitations.

4.2.7.3 Aids required for daily life, home appliances, equipment and safety devices The condition for compensation to be paid is that it concerns an illness or injury that is coverable under home adaptation expenses. A further requirement is that the acquisition of aids, home appliances, equipment and safety devices are the result of this illness or injury and prescribed by a doctor. The aids, home appliances, equipment and safety devices must be necessary in order that the insured may move about independently, communicate with others or manage some other activity in his work or leisure time.

Of these expenses, the following expenses are coverable- aids, home appliances and equipment- devices that increase his personal safety and

safe living.

Expenses for aids, home appliances and equipment are compensated - in the case of permanent disability for up to

EUR 10,000 on the basis of all the illnesses and injuries the insured person is suffering from when the level of permanent disability is being evaluated

- in the case of temporary disability for up to EUR 1,000 on the basis of all the illnesses and injuries the insured person is suffering from when the level of temporary disability is being evaluated.

Expenses for devices that increase the insured person’s personal safety and safe living are compensated - in the case of permanent disability for up to EUR

3,000 on the basis of all the illnesses and injuries the insured person is suffering from when the level of permanent disability is being evaluated

- in the case of temporary disability for up to EUR 500 on the basis of all the illnesses and injuries the insured person is suffering from when the level of temporary disability is being evaluated.

If the insured has another illness or injury later, any compensation will be paid for aids required for daily life, home appliances, equipment and safety devices as specified above.

The insured person is responsible for the ordering and installation supervision of aids required for daily life, home appliances, equipment and safety devices.

Coverable expenses do not include - in situations in which, on the basis of the Act


- cases in which any right by law to compensation has been lost owing to a neglect of some insurance responsibility


Expenses are not compensated if they are caused by- motor vehicle or motor vehicle part purchase

or motor vehicle alteration or improvement- software in computer data media.


It must be a professional working for a service provider operating near the insured person’s home who installs the aids required for daily life, home appliances, equipment and safety devices.

4.2.8 Expenses for end-of-life careThe requirement for compensation is that a doctor has made end-of-life care decision. A further condition is that it concerns an illness or injury that is coverable under end-of-life care. The examination or treatment procedures must be prescribed by a doctor and in accordance with generally accepted medical practice and necessary in terms of the coverable illness or injury in question.

Of these expenses, the following are coverable: - daily hospital charge for the duration of end-

of-life care. If it has been separately agreed on and entered in the policy that expenses incurred abroad will also be compensated, the number of daily hospital charges specified in the insurance policy will be compensated

- expenses for home health care examinations or treatment by a doctor or health care professional during end-of-life care.

- expenses for supplies needed during end-of-life care in home health care, and medicinal products, basic creams and clinical nutritional products sold at a pharmacy

- expenses for the rental of aids, equipment and appliances needed for end-of-life care at home.

We also compensate expenses for the services of a personal carer obtained through a service provider

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when the need for such a carer is caused by the fact that the insured person cannot according to the doctor manage during end-of-life care with personal daily activities without help.

Expenses are not covered if- they are caused by services of a unit

providing social welfare or residential services even though they may also include health care services.

- the service provider does not have a business ID issued by the authorities

- the right by law to compensation has been lost owing to a neglect of some insurance responsibility


Indirect expenses, such as the insured person’s travel, accommodation or meal expenses are not compensated.


4.3.2 Documentation on services and service providersThe claimant must send to the insurance company written documentation on the carer services related to end-of-life care, and child, carer and cleaning services included in home help expenses. You must also send documentation on the service providers by filling in the insurance company’s loss report accompanied by any other relevant receipts.

4.3.3 Documentation on home adaptation reasons and expensesThe claimant must submit to the insurance company written documentation of a permanent or temporary disability, home adaptation, the home’s fixtures and any aids, home appliances, equipment and safety devices needed for daily activities. This must be done in a manner separately approved by the insurance company.

4.3.4 Loss inquiry costsClaimant must acquire said documentation and information and medical statements and submit them to the insurance company at their own expense, unless otherwise specified in the terms and conditions concerning Supplementary Medical Treatment Expenses Cover.

4.3.5 Medical treatment expense receipts The claimant must pay the treatment expenses him/herself and claim reimbursement of the expenses under the Health Insurance Act. Claims under the Health Insurance Act must be submitted to the Social Insurance Institution within six months of paying the medical treatment expenses. The claimant must upon request provide the insurance company with the original receipt for the reimbursement paid by the Social Insurance Institution, plus copies of original receipts submitted to the Social Insurance Institution. Originals of the receipts for expenses which have not been reimbursed under the Health Insurance Act or some other law must also be submitted upon request to the insurance company.

4.3.6 Receipts for expenses concerning home adaptations Claimant must first pay for any expenses concerning home adaptations and subsequently claim compensation pursuant to the Act on disability services (380/1987), either from the municipality or other party responsible for the expenses. Claimant must upon request submit to the insurance company either the municipality’s or other responsible party’s decision or other documentation of the compensation it has paid. Originals of the receipts for expenses which have not been reimbursed

under the Act on disability services or some other law must also be submitted upon request to the insurance company.

4.3.7 Compensation receipts of the services Claimant must first pay any end-of-life carer expenses, and child care, carer and cleaning expenses that fall under home help. Claimant must, upon request, send the insurance company the original receipts.

4.4 Other applicable terms and conditionsThe common provisions for personal insurance are applied to Supplementary Medical Treatment Expenses Cover.

5 DENTAL COVER

5.1 Key contents of insurance coverInsurance can be taken in case of



B in case of accidents This option compensates expenses to the

insured person caused by an accident as specified in these terms and conditions.






Compensation is only paid for examination carried out or treatment provided in Finland or for an acquisition made in Finland. If it has been separately agreed and the appropriate entry has been made in the policy, such examinations, treatments or acquisitions may also be covered abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

5.2 Coverable expensesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under Dental Cover. What is more, the illness or injury examination or treatment must have been prescribed by a dentist. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable:

accident - expenses for examinations and treatment by a

dentist, specialised dentist, dental hygienist or denturist

- expenses for a fixed dental prosthetic or dentures made by a dentist or denturist, or removable dental prosthetics or implant-supported dental prostheses

- costs for medicinal products sold at pharmacies

Illness- examinations and treatment concerning the first

dental prosthetic of a missing tooth - expenses for a fixed dental prosthetic or dentures

made by a dentist or denturist, or removable dental prosthetics or implant-supported dental prostheses when they concern the first dental prosthetic of a missing tooth

- expenses for medicinal products sold at a pharmacy, when the medicine is related to prosthetic treatment.

5.3 Expenses which are not coveredExpenses are not compensated if they are caused by - preventative care- filling a cavity or root canal treatment, unless

related to an accident - orthodontic treatment or mouthguard - crown, unless in cases of accident - dental prosthetic renewal, unless in cases of

accident- physiotherapy - examination or treatment of jaw bones or

joints - dental check-up, local anaesthetic or medical

medicinal product if they are not related to treatment that is otherwise covered

- tartar removal - cosmetic dental treatment- tooth extraction, unless prosthetic treatment

is also included, or in cases of accident.




Injury caused by biting to a tooth or dentures is not coverable, even if an external factor has contributed to the damage.

5.4 Filing a claim 5.4.1 Notification of illness or accidentThe claimant shall submit to the insurance company a written clarification of any illnesses, accidents, examinations and treatments. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information in order to settle the claim.

The fee for a doctor’s statement is compensated only if the insurance company has specifically requested for one. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.



11

6 FITNESS COVER

6.1 Key contents of insurance coverCoverage may be chosen against expenses caused by the following services- fitness tests and expert services - fitness tests.


Compensation will not be paid unless a doctor or some other health care professional recommends the insured to do exercise as treatment for an illness, injury or factor that threatens the insured person’s health.

Compensation will be paid only if the expenses have incurred during the validity of the insurance.



6.2 Fitness tests and expert services6.2.1 Fitness testsCompensation is only paid for fitness tests carried out by Pohjola Insurance Ltd’s partners and only refer to bicycle ergometer fitness test according to Pohjola’s instructions, either using a multi-stage or three-stage testing method.

Only the expenses of one fitness test per insurance period will be compensated. Only up to three fitness tests will be compensated on the basis of all the illnesses, injuries or factors that threaten the insured person’s health that the insured had at the time when exercise was recommended.

6.2.2 Expert services If fitness test expenses are coverable, we compensate expenses per each coverable fitness test that is the result of 1. basic medical check-up by a GP and any

laboratory tests he may prescribe, but no more than EUR 160, or

2. the services of a nutritional therapist, but only up to EUR 160, or

3. personal, individual gym or exercise guidance, but only up to EUR 160.

Expenses are covered per each coverable fitness test only under item 1, 2 or 3. If, during a single insurance period, the insured uses services under more than one of the items above, compensation is only paid under one of them.

Expenses are coverable as far as they do not grant or would not have granted entitlement to compensation under the Health Insurance Act.

Compensation is only paid for expert services provided in Finland.

6.3 Fitness testsCompensation is only paid for fitness tests carried out by Pohjola Insurance Ltd’s partners and only refer to bicycle ergometer fitness test according to Pohjola’s instructions, either using a multi-stage or three-stage testing method.

Only the expenses of one fitness test per insurance period will be compensated. Only up to three fitness tests will be compensated on the basis of all the illnesses, injuries or factors that threaten the insured person’s health that the insured had at the time when exercise was recommended.

6.4 Exclusions No compensation is paid if an illness, injury of factor threatening the insured person’s health is the result of abuse of medicine or the use of alcohol or other intoxicants.



6.5 Filing a claim 6.5.1 Documentation on fitness tests and expert servicesClaimant must submit to the insurance company written documentation indicating that a doctor or other health care professional has recommended exercise to the insured as treatment for an illness, injury or factor threatening his/her health. This must be done in a manner separately approved by the insurance company. If requested, you must also provide additional information in order to settle the claim.

Fees charged by doctors or other health care professionals for medical statements are not compensated as loss inquiry costs. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.

6.5.2 ReceiptsClaimant must first pay the expenses for fitness tests and expert services. Claimant must, upon request, send the insurance company the original receipts.


7 ATHLETES’ MEDICAL TREATMENT COVER

7.1 Key contents of insurance cover Athletes’ Medical Treatment Cover is valid in those competitive sports and high-risk sports that have been entered in the insurance policy. Athletes’ Medical Treatment Cover is valid in special sports if so indicated in the insurance policy. Clause 3.2 (Validity in sports) in the general conditions of the common provisions of personal insurance specifies in more detail about the validity of Athletes’ Medical Treatment Cover in sports.

Insurance can be taken in case of

A accidents and the following illnesses - abdominal, umbilical or groin hernia - rupture of meniscus in the knee - dislocation of joint or kneecap - shin splints, or medial tibial stress syndrome - stress fracture - tennis elbow, or lateral epicondylitis - golfer’s elbow, or medial epicondylitis - inflammation or rupture of Achilles tendon - inflammation of shoulder tendons - bursitis - plantar fasciitis.

This option compensates expenses to the

insured person caused by accident or exertion that occurred when doing a sport entered in the insurance policy or illness when doing a sport listed in the insurance policy.

B accidents This option compensates expenses to the

insured person caused by accident or exertion that occurred when doing a sport entered in the insurance policy.

The insurance policy indicates which option above has been chosen.

Compensation will be paid only if the expenses have incurred during the validity of the insurance. If the expenses are caused by an accident, the accident must also have occurred when doing a sport entered in the insurance policy during the validity of the insurance. If the expenses are caused by an exertion, the exertion must also have occurred when doing a sport entered in the insurance policy during the validity of the insurance.




Compensation is only paid for examination carried out or treatment provided in Finland or for an acquisition made in Finland. If it has been separately agreed and the appropriate entry has been made in the policy, such examinations, treatments or acquisitions may also be covered abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

7.2 Coverable expensesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under Athletes’ Medical Treatment Cover. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable:- fees for examination and treatment procedures

carried out by physicians and health care professionals at their practice or clinic


- daily hospital charges. If it has been separately agreed on and entered in the policy that expenses incurred abroad will also be compensated, the number of daily hospital charges specified in the insurance policy will be compensated

- costs of the first orthopaedic brace or bandage if no more than two weeks have elapsed from a coverable operation or accident as a result of which such a brace of bandage is required. These expenses are only covered up to EUR 500 per operation or accident.

- rental costs of forearm or underarm crutches.


physiotherapist, chiropractor, osteopath, naprapathy practitioners, masseur or equivalent health care professional


therapist or equivalent health care professional- examination or treatment by an occupational

or speech therapist, psychologist, neuropsychologist or other equivalent health care professional

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- medicine abuse - purchase of micronutrient, mineral or vitamin

preparations, unless they are considered medicinal products


- basic creams or lotions or equivalent, unless they are used for treating an accidental injury




- orthopaedic brace or bandage, unless it was the first of either that was acquired within two weeks of a coverable operation or accident. In cases like this, too, these expenses are only covered up to EUR 500 per operation or accident.

- examination made or treatment given in the insured person’s home, other house call and other than a practice or clinic





7.4 Filing a claim 7.4.1 Notification of illness, accident or exertionThe claimant shall submit to the insurance company a written clarification of any illnesses, accidents, exertions, examinations, treatments and aids. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information in order to settle the claim.

Fees charged by doctors for medical statements are not compensated is loss inquiry costs. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.



8 ATHLETES’ SUPPLEMENTARY MEDICAL TREATMENT COVER

8.1 Key contents of insurance cover Athletes’ Supplementary Medical Treatment Cover is valid in those competitive sports and high-risk sports that have been entered in the insurance policy. Athletes’ Supplementary Medical Treatment

Cover is valid in special sports if so indicated in the insurance policy. Clause 3.2 (Validity in sports) in the general conditions of the common provisions of personal insurance specifies in more detail about the validity of Athletes’ Supplementary Medical Treatment Cover in sports.

The following types of cover may be selected - musculoskeletal therapy expenses - functional therapy expensesexpenses for home health care- special expenses - home help expensesexpenses for home adaptations.


Each of the above cost covers can be chosen in case of

A accidents and the following illnesses - abdominal, umbilical or groin hernia - rupture of meniscus in the knee - dislocation of joint or kneecap - shin splints, or medial tibial stress syndrome - stress fracture - tennis elbow, or lateral epicondylitis - golfer’s elbow, or medial epicondylitis - inflammation or rupture of Achilles tendon - inflammation of shoulder tendons - bursitis - plantar fasciitis.

This option compensates expenses to the insured person caused by accident or exertion that occurred when doing a sport entered in the insurance policy or illness when doing a sport listed in the insurance policy.

B accidents This option compensates expenses to the

insured person caused by accident or exertion that occurred when doing a sport entered in the insurance policy.

The insurance policy indicates which of the options above has been chosen for each cost.

Compensation will be paid only if the expenses have incurred during the validity of the insurance. If the expenses are caused by an accident, the accident must also have occurred when doing a sport entered in the insurance policy during the validity of the insurance. If the expenses are caused by an exertion, the exertion must also have occurred when doing a sport entered in the insurance policy during the validity of the insurance.


Each expense has a maximum compensation limit. Any compensation paid will reduce the remaining amount of indemnity that may be paid. Once the maximum compensation has been reached, coverage ends.

The deductible stated in the insurance policy will be deducted from coverable expenses. The deductible is determined on the basis of the date on which compensation is claimed for. The above does not apply to home help expenses, its deductibles are detailed under its own heading.

Compensation is only paid for examination carried out or treatment provided in Finland or for a service provided or acquisition made in Finland.

If it has been separately agreed and the appropriate entry has been made in the policy concerning a certain type of expense, such expenses are covered even if they have incurred abroad. In cases like

this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

8.2 Coverable and non-coverable expenses8.2.1 Musculoskeletal therapy expenses The condition for compensation to be paid is that the expenses for musculoskeletal therapy are included for the particular illness or injury. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of such expenses, we compensate examinations and treatments provided by a physiotherapist, osteopath, chiropractor or a naprapathy practitioner approved by the Finnish National Supervisory Authority for Welfare and Health (Valvira).

The insurance policy indicates the maximum number of examinations and treatments per insurance period which are compensated. Any examinations or treatments exceeding the maximum will not be compensated.






8.2.2 Functional therapy expenses The condition for compensation to be paid is that the expenses for functional therapy are included for the particular illness or injury. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of such expenses, we compensate examinations and treatments provided by a functional or speech therapist or neuropsychologist approved by the Finnish National Supervisory Authority for Welfare and Health (Valvira).

The insurance policy indicates the maximum number of examinations and treatments per insurance period which are compensated. Any examinations or treatments exceeding the maximum will not be compensated.






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8.2.3 Expenses for home health careThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under home health care. What is more, the illness or injury examination or treatment must have been prescribed by a doctor. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question. Examinations must be made and treatment provided by a professional employed by a local service provider. Of these expenses, the following expenses are coverable- examinations carried out and treatments

provided by a medical doctor or nurse in the insured person’s home or other place

- one phone consultation with a doctor following a home call

- first-aid medication given by a doctor in examinations or treatments described above.

Expenses are not compensated if they are caused by- examination or treatment other than in the

insured person’s home, such as a clinic or hospital

- medicinal product or other product bought at a pharmacy

- acupuncture or lymphatic therapy - medicine abuse - examination or treatment related to outward

appearance or looks- examination or treatment by a dentist or

specialised dentist - services of a unit providing social welfare or

residential services even though they may also include health care services.



8.2.4 Home help expenses8.2.4.1 General information Compensation is paid for carer and home cleaning expenses as specified in these terms and conditions.

The condition for compensation to be paid is that it concerns an illness or injury that is coverable under home help expenses which has been entered in the insurance policy.

The insurance policy indicates to what extent carer expenses are compensated per insurance event. The same information is included on home cleaning expenses. Expenses are never compensated in excess of the maximum compensation set for home help expenses which has been entered in the insurance policy.

A qualifying period has been specified for each insurance event. This qualifying period does not apply to home cleaning expenses. In the case of child care services, the qualifying period for each continuous home care period which begins on the first day when the insured person was in home care under doctor’s orders. As to the services of a personal carer, the qualifying period begins on the first day when the insured person is in home care following surgery, and cannot manage alone at home without help.

8.2.4.2 Carer expenses Compensation is paid either for child care or personal carer services.

8.2.4.2.1 Child care servicesWe cover expenses for child care services obtained through a service provider as a result of a child who is normally in day care outside the home must under doctor’s orders be cared for illness or injury at home.

Expenses are covered up to the hours that the child would have been in day care outside the home had it not been for the coverable illness or injury but never for more than 10 hours per day.

If a carer is looking after more than one child at the same time, the insured child’s part is compensated.

Expenses are not covered if- the service provider does not have a

business ID issued by the authorities - the same expense has already been

compensated or if compensation has been sought from another cover or insurance policy.

8.2.4.2.2 Services of a personal carerWe cover expenses for the services of a personal carer obtained through a service provider because the insured person who is of school age or older has had an operation for a coverable illness or injury and cannot manage on his own at home without help. The expenses of a personal carer are covered to the extent that the carer has helped the insured person after being discharged from hospital in necessary daily activities.

Expenses are covered for up to three months per insurance event and for no more than 10 hours per day.

Expenses are not covered if the expense or service need is caused by- medicine abuse - treatment related to outward appearance or

looks- services of a unit providing social welfare or

residential services even though they may also include health care services.





8.2.4.3 Home cleaning expenses We cover expenses for cleaning of an adult insured person’s home by a service provider if the insured has been on a continuous sick leave on doctor’s orders for at least a fortnight. Expenses are covered for up to four hours of cleaning for each new week of illness.

Compensation for cleaning expenses is not paid if the expense or need for the service is the result of medicine abuse.





8.2.5 Special expensesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under special expenses. What is more, the illness or injury examination or treatment must have been prescribed by a doctor and provided by a health care professional. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable illness or injury in question.

Of these expenses, the following are coverable: - expenses for procedures to treat cosmetic skin

defects that are the result of a coverable illness or accident

- daily hospital charges immediately related to the removal of coverable cosmetic defects. If it has been separately agreed on and entered in the policy that expenses incurred abroad will also be compensated, the number of daily hospital charges specified in the insurance policy will be compensated

- expenses for an orthopaedic brace or bandage needed by the insured to do a sport following a coverable illness or accident

- expenses for the rental of medicinal aids, treatment devices, furniture and equipment related to a coverable illness or accident

- expenses for medicinal aids, treatment devices and exercise equipment related to a coverable illness or accident. The above medicinal aids and devices are compensated up to EUR 200 per insurance period.

Coverable expenses do not include- expenses for examinations or treatments

performed by doctor or other health care professional before a coverable procedure

- expenses for examinations or treatments performed by doctor or other health care professional following a coverable procedure or hospital treatment immediately after a coverable procedure

- expenses for medicinal products and wound dressings sold at pharmacies

- expenses for spectacles, sunglasses or contact lenses

- rental costs for forearm or underarm crutches, unless the need for them is caused by a procedure coverable from special expenses

- expenses for services of a unit providing social welfare or residential services even though they may also include health care services.




8.2.6 Expenses for home adaptations8.2.6.1 General informationExpenses are compensated according to these conditions if the insured receives a permanent or temporary disability as a result of a coverable illness or injury.

Permanent functional disability refers to a medically assessed general handicap which the insured has incurred through illness or injury and which, according to medical prognosis, is unlikely to be healed. A permanent functional disability must also have continued for at least three months, before any assessment for home adaptation will be entered upon.

By temporary functional disability we refer to what is medically assessed as a temporary disability caused by a coverable illness or injury that prevents the insured from managing daily activities on their own.

Expenses are coverable as far as they do not grant or would not have granted entitlement to compensation under the Health Insurance Act, Motor Liability Insurance Act, Employment Accidents Act, Patient Injury Act, Act on disability services (380/1987), Social Welfare Act or other legislation.

8.2.6.2 Home adaptation and home fixturesThe condition for compensation to be paid is that it concerns an illness or injury that is coverable under home adaptation expenses. A further requirement is that the home adaptations and acquisition of home fixtures are the result of this illness or injury and prescribed by a doctor. Home adaptations and the acquisition of home fixtures must be necessary for the insured person to manage normal daily activities independently and to live at home.

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Of these expenses, the following expenses are coverable- widening of doorways, expenses for the

removal of thresholds and any other obstacles in the home, and expenses for support handles installed in the home

- building of disabled ramps and bannisters in other than blocks of flats

- bathroom and lavatory adaptations - lighting changes- change of surface materials at home because of

serious allergy- adaptations to fixtures and fixed building and

interior decoration materials- any necessary lifting or alarm equipment and

other fixtures, including the installation- evaluation, design, any building permissions and

supervision for the above adaptations.

Home adaptations and home fixture expenses are compensated - only for one flat on the basis of all the illnesses

and injuries the insured person is suffering from when the level of permanent disability is being evaluated. Compensation will no longer be paid on the basis of the above illnesses and injuries for the same flat once two years has elapsed since a doctor ordered the adaptations to be made and the fixtures to be acquired. Compensation will not be paid for other flats on the basis of the above illnesses and injuries

- only for one flat and for up to EUR 2,000 on the basis of all the illnesses and injuries the insured person is suffering from when the level of temporary disability is being evaluated. Compensation will no longer be paid on the basis of the above illnesses and injuries for the same flat once two years has elapsed since a doctor ordered the adaptations to be made and the fixtures to be acquired. Compensation will not be paid for other flats on the basis of the above illnesses and injuries.

If the insured has another illness or injury later, any compensation will be paid for new adaptations as specified above.

If the insured moves into a new home, home adaptations or the acquisition or installation are not compensated that were already compensated in the previous home, even if this need arose from a new illness or injury.

Home adaptations and acquisition and installation of fixtures are compensated in terms of construction and building materials to the same level as the home otherwise is.

The insured is responsible for ordering the home adaptations and fixtures and construction and installation supervision.

Coverable expenses do not include- in situations in which, on the basis of the Act


- renovation, adaptations or extension or flat or house that increase the floor area

- holiday home adaptation that enhance its quality or constructions

- any adaptation outside the flat except for disabled ramps and bannisters in other than blocks of flats

- any home adaptations or installation of home fixtures in any other than the insured person’s home or holiday home

- any expenses caused by correction of a design, foundation, installation and construction error and damage caused by such an error

- anything caused by mould allergy- cases in which any right by law to

compensation has been lost owing to a neglect of some insurance responsibility



It must be a professional working for a service provider operating near the insured person’s home who carries out any home adaptations and installation of fixtures.

If a home is bought only after the injury, no such expenses are compensated which should already have been taken into consideration when selecting a home a building a new one in light of existing personal limitations.

8.2.6.3 Aids required for daily life, home appliances, equipment and safety devices

The condition for compensation to be paid is that it concerns an illness or injury that is coverable under home adaptation expenses. A further requirement is that the acquisition of aids, home appliances, equipment and safety devices are the result of this illness or injury and prescribed by a doctor. The aids, home appliances, equipment and safety devices must be necessary in order that the insured may move about independently, communicate with others or manage some other activity in his work or leisure time.

Of these expenses, the following expenses are coverable- aids, home appliances and equipment- devices that increase his personal safety and

safe living.

Expenses for aids, home appliances and equipment are compensated - in the case of permanent disability for up to


- in the case of temporary disability for up to EUR 1,000 on the basis of all the illnesses and injuries the insured person is suffering from when the level of temporary disability is being evaluated.

Expenses for devices that increase the insured person’s personal safety and safe living are compensated - in the case of permanent disability for up to


- in the case of temporary disability for up to EUR 500 on the basis of all the illnesses and injuries the insured person is suffering from when the level of temporary disability is being evaluated.

If the insured has another illness or injury later, any compensation will be paid for aids required for daily life, home appliances, equipment and safety devices as specified above.

The insured person is responsible for the ordering and installation supervision of aids required for daily life, home appliances, equipment and safety devices.

Coverable expenses do not include - in situations in which, on the basis of the Act


- cases in which any right by law to compensation has been lost owing to a neglect of some insurance responsibility


Expenses are not compensated if they are caused by- motor vehicle or motor vehicle part purchase

or motor vehicle alteration or improvement- software in computer data media.


It must be a professional working for a service provider operating near the insured person’s home who installs the aids required for daily life, home appliances, equipment and safety devices.

8.3 Filing a claim 8.3.1 Notification of illness, accident or exertionThe claimant shall submit to the insurance company a written clarification of any illnesses, accidents, exertions, examinations, treatments and aids. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information in order to settle the claim.

8.3.2 Documentation on services and service providersThe claimant must send to the insurance company written documentation on child, carer and cleaning services included in home help expenses. You must also send documentation on the service providers by filling in the insurance company’s loss report accompanied by any other relevant receipts.

8.3.3 Documentation on home adaptation reasons and expensesThe claimant must submit to the insurance company written documentation of a permanent or temporary disability, home adaptation, the home’s fixtures and any aids, home appliances, equipment and safety devices needed for daily activities. This must be done in a manner separately approved by the insurance company.

8.3.4 Loss inquiry costsClaimant must acquire said documentation and information and medical statements and submit them to the insurance company at their own expense, unless otherwise specified in the terms and conditions concerning Supplementary Medical Treatment Expenses Cover.

8.3.5 Medical treatment expense receipts The claimant must pay the treatment expenses him/herself and claim reimbursement of the expenses under the Health Insurance Act. Claims under the Health Insurance Act must be submitted to the Social Insurance Institution within six months of paying the medical treatment expenses. The claimant must upon request provide the insurance company with the original receipt for the reimbursement paid by the Social Insurance Institution, plus copies of original receipts submitted to the Social Insurance Institution. Originals of the receipts for expenses which have not been reimbursed under the Health Insurance Act or some other law must also be submitted upon request to the insurance company.

8.3.6 Receipts for expenses concerning home adaptations Claimant must first pay for any expenses concerning home adaptations and subsequently claim compensation pursuant to the Act on disability services (380/1987), either from the municipality or other party responsible for the expenses. Claimant must upon request submit to the insurance company either the municipality’s or other responsible party’s decision or other documentation of the compensation it has paid. Originals of the receipts for expenses which have not been reimbursed under the Act on disability services or some other law must also be submitted upon request to the insurance company.

8.3.7 Compensation receipts of the services Claimant must first pay any child care, carer and cleaning expenses that fall under home help. Claimant must, upon request, send the insurance company the original receipts.

8.4 Other applicable terms and conditionsThe common provisions for personal insurance are applied to Athletes’ Supplementary Medical Treatment Cover.

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9 ATHLETES’ DENTAL COVER

9.1 Key contents of insurance coverAthletes’ Dental Cover is valid in those competitive sports and high-risk sports that have been entered in the insurance policy. Athletes’ Dental Cover is valid in special sports if so indicated in the insurance policy. Clause 3.2 (Validity in sports) in the general conditions of the common provisions of personal insurance specifies in more detail about the validity of Athletes’ Dental Cover in sports.

This insurance compensates expenses to the insured person caused by accident that occurred when doing a sport entered in the insurance policy.

Compensation will be paid only if the accident occurred and the expenses have incurred during the validity of the insurance.




Compensation is only paid for examination carried out or treatment provided in Finland or for an acquisition made in Finland. If it has

been separately agreed and the appropriate entry has been made in the policy, such examinations, treatments or acquisitions may also be covered abroad. In cases like this, the Finnish healthcare professional referred to in the terms and conditions will be replaced by a corresponding healthcare professional of the country in question, approved by the country’s equivalent to the Finnish National Supervisory Authority for Welfare and Health.

9.2 Coverable expensesExpenses are covered provided that the examination and treatment of the injury is performed or prescribed by a dentist. The examination or treatment procedures must also be in accordance with generally accepted medical practice and necessary for the treatment of the coverable injury in question.

Of these expenses, the following expenses are coverable- examinations and treatment by a dentist,

specialised dentist, dental hygienist or denturist- medicinal products sold at pharmacies- fixed dental prosthetic or dentures made by

a dentist or denturist, or removable dental prosthetics or implant-supported dental prostheses.

9.3 Expenses which are not coveredExpenses are not compensated if they are caused by - physiotherapy - dental check-up, local anaesthetic or medical

medicinal product if they are not related to treatment that is otherwise covered

- cosmetic dental treatment.




Injury caused by biting to a tooth or dentures is not coverable, even if an external factor has contributed to the damage.

9.4 Filing a claim 9.4.1 Notification of an accidentThe claimant shall submit to the insurance company a written clarification of any accidents, examinations and treatments. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information in order to settle the claim.

The fee for a doctor’s statement is compensated only if the insurance company has specifically requested for one. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.



Pohjola Living Allowance Insurance1 INSURANCE COVER The following types are insurance are available:- Disability Cover- Death Cover- Daily Allowance Cover.


2 DISABILITY COVER

2.1 Key contents of insurance coverThe right to compensation arises if the insured suffers permanent handicap caused by an accident which occurred during the validity of the cover and the permanent handicap has continued for three months, with the cover being valid throughout that time.

Permanent handicap refers to a medically assessed general handicap which the insured has incurred through an injury and which, according to medical prognosis, is unlikely to be healed. In determining the handicap, only the nature of the injury is taken into account. The individual circumstances of the injured person, such as his/her profession or leisure-time pursuits, do not affect the determination of the handicap.

The degree of handicap is determined in accordance with the handicap classification decree by the Ministry of Social Affairs and Health on the basis of the Empoyment Accidents Act valid when the accident occurred. Injuries are divided into handicap classes 1-20, with class 20 corresponding to full handicap and class 1 to the smallest coverable handicap.

The benefit for full, permanent handicap as per class 20 is paid as a lump sum equal to the sum entered in the insurance policy valid at the time the

accident occurred. For partial, permanent handicap, the benefit is paid as a lump sum equal to as many twentieths of the sum as indicated by the handicap class.

A handicap is considered permanent once it has been medically diagnosed as such, and this can be done no sooner than three months and no later than three years after the accident. The cover must be valid at this time.

If the degree of handicap changes by at least two handicap classes before three years have elapsed since the accident, the amount of benefit must be revised correspondingly provided the Disability Cover is still valid. However, no benefit already paid will be recovered.

The benefit will be paid under the insurance terms and conditions valid at the time of the accident.

2.2 ExclusionsNo benefit is paid for the psychic consequences of an accident.

2.3 Filing a claim The claimant must notify the insurance company of the accident in writing by filling in the insurance company’s loss report accompanied by any other relevant documentation.

In order for the handicap benefit to be processed, the claimant must send upon request an E Doctor’s statement to the insurance company, describing the handicap. The fee for a doctor’s statement is compensated only if the insurance company has specifically requested for one.


3 DEATH COVER

3.1 Key contents of insurance coverThe right to compensation arises if the insured dies as a result of an accident which occurred during the validity of the cover.

The compensation is the sum entered in the insurance policy valid at the time of the accident.


3.2 ExclusionsThe benefit is not paid if the insured dies after three years have elapsed since the accident occurred. Nor is any benefit paid for the psychic consequences of the accident.

3.3 Filing a claim The claimant must notify the insurance company of the accident in writing.

For the processing of death benefit, the claimant must provide the insurance company with a death certificate for the insured and official extracts from the population register, or equivalent, on beneficiaries. The insurance company must also be sent, upon request, further documentation by the authorities on the cause of death.

Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.


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4 DAILY ALLOWANCE COVER

4.1 Key contents of insurance coverThe right to compensation arises if the insured who is in an employment relationship becomes unable to work as a result of an accident which occurred during the validity of the cover.

A daily compensation to the amount that was entered in the insurance policy on the date of the accident will be paid for days when the insured is fully unable to do the work he has been employed to do, and when work disability is only partial, the amount corresponding to the amount of work disability will be paid. Compensation will only be paid for the days when the cover is valid.

An insured will be considered fully unable to work if owing to an accident that occurred while the cover was valid, he is – judged on medical grounds – unable to perform any of his usual work duties. An insured will be considered partly unable to work if owing to an accident that occurred while the cover was valid, he is – judged on medical grounds – unable to perform some of his usual work duties.

The benefit is paid for as many days as the disability continues in excess of the qualifying period mentioned in the policy. The deductible will be subtracted once per each accident. The qualifying period begins on the first day of the disability as stated by a physician.

Benefit for any single accident is paid up to the maximum period stated in the policy.


The cover expires at the end of the insurance period during which the insured reaches 70 years of age.

4.2 ExclusionsCompensation will not be paid - psychic consequences of an accident- if the insured is not in an employment

relationship when the accident occurs.

Life Insurance

1 KEY CONTENTS OF INSURANCE COVER

The right to benefits arises if the insured dies during the validity of the insurance.

The insurance may be taken out for single persons or for couples (joint life insurance).

The compensation is the amount of compensation in the insurance policy at the time of death.

In the case of joint life insurance, the benefit is paid only once, when either one of those insured dies. If those insured die simultaneously, each one’s beneficiary is entitled to half of the amount of compensation.

Single-person insurance cover expires at the end of the insurance period during which the insured reaches 70 years of age.

Joint life insurance expires if either one of those insured dies or at the end of the insurance period during which either one of those insured reaches 70 years of age. The insurance continues for the survivor or under 70-year-old insured as single cover with the same amount of compensation.

The insurance cover is Death Cover.

2 RESTRICTIONNo benefit is paid if the insured has committed suicide within a period of one year from the beginning of the insurance.

3 FILING A CLAIM The claimant must submit to the insurance company a death certificate for the insured, official extracts from the population register, or equivalent, on beneficiaries and an address for payment of the benefit.

4 OTHER APPLICABLE TERMS AND CONDITIONS

The common provisions for personal insurance are applied.

Disability Insurance

1 KEY CONTENTS OF INSURANCE COVER

The right to disability benefit arises if the insured suffers permanent loss of working capacity due to illness or injury during the validity of the insurance and the permanent disability has continued for three months while the insurance is still valid. The prerequisite for compensation payment is that compensation has been claimed when the insured person was alive.

Insured persons are considered to suffer permanent loss of working capacity if they, owing to an illness or injury, are permanently unable to do their previous work and probably any other work which, considering their age and professional skills, can be considered suitable to them and which will ensure a reasonable living.

The insured is not considered to suffer permanent loss of working capacity solely on the grounds that he/she is entitled to early disability pension or some other pension paid on the basis of reduced working capacity.

The compensation amount is the sum entered in the insurance policy. The amount of compensation is determined according to the date on which entitlement to the benefit is established.

The insurance expires when the right to the compensation arises or at the end of the insurance period during which the insured reaches 63 years of age.

The insurance coverage is Permanent Disability Cover.

2 EXCLUSIONSNo benefit is paid if the disability is caused by- abuse of alcohol or medicine or use of an

intoxicant- attempted suicide within a period of one year

from the beginning of the insurance.

3 FILING A CLAIM For payment of compensation, the claimant must provide the insurance company with a medical certificate on permanent disability and an address for payment of the benefit.

4 OTHER APPLICABLE TERMS AND CONDITIONS

The common provisions for personal insurance are applied.

4.3 Filing a claim The claimant must notify the insurance company of the journey and accident in writing and any current work relationships by filling in the insurance company’s loss report accompanied by any other relevant documentation.

For the purposes of having the daily benefit application processed, the claimant must submit to us documentation showing the disability period and the reason for the disability. A tax card must also be sent to us for the payment of the benefit.



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NON-LIFE INSURANCEThe Extrasure insurance cover may include the following types of insurance:– MyHome insurance– valuables insurance– small boat insurance– family liability insurance– family legal expenses insurance– pet insurances

– animal insurance – loss-of-use insurance – medical expenses insurance – dog litter insurance – animal liability insurance

– forest insurance– forest fire insurance– luggage insurance

– travel liability insurance and – legal expenses travel insurance

The insurance cover selected for each type of property and the types of liability and legal expenses insurance are indicated in the insurance policy.

The terms and conditions of luggage insurance, travel liability insurance and legal expenses travel insurance are stated in the travel insurance section.

NUCLEAR ACCIDENT AND WARThe insurance does not cover any loss or damage caused by– a nuclear accident referred to in the Nuclear

Liability Act, or caused by material, equipment or weapons based on nuclear reaction or ionising radiation, regardless of where the nuclear accident occurred

– war or armed conflict.

Myhome insurance1 THOSE INSUREDThose insured are the policyholder and the persons residing permanently in the same household as the policyholder.

2 PLACE OF INSURANCE AND VALIDITY AT THE PLACE OF INSURANCE

2.1 BuildingThe insurance of a building is valid at the location of the building in the place of insurance specified in the insurance policy.

2.2 Parts of rented and owner-occupied flats‘Parts of a flat’ refer to fixed machinery and equipment related to residental use of a rented or owner-occupied flat; floor, wall and ceiling coverings, structures and fixed interior decoration.

The insurance for parts of a flat is valid in the rented or owner-occupied flat, specified in the insurance policy, which constitutes the place of insurance for these parts.

2.3 Moveable property2.3.1 Home and holiday-home contentsInsurance for home or holiday-home contents is valid in the residential building or holiday home specified in the insurance policy. In addition, the insurance is valid in buildings of a maximum of 12m², excluding sauna buildings, related to use of this residential building or holiday home and located on the same grounds as the building or holiday home. This residential building or holiday home and the buildings related to its use stated above constitute the place of insurance for the home and holiday-home contents.

Restriction:For buildings of less than 12m², indemnity accounts for a maximum of 10% of the maximum compensation for damage caused to moveable property in these buildings specified in the home and holiday-home contents policy.

2.3.2 Moveable property in the adjacent and sauna buildingThe insurance for the adjacent and sauna building contents is valid in the adjacent and sauna building, specified in the insurance policy, which constitutes the place of insurance for these contents.

2.3.3 Moveable property in other buildingsThe insurance for moveable property in buildings other than detached houses, holiday homes, outbuildings and saunas is valid in the building, specified in the insurance policy, which constitutes the place of insurance for the property in other buildings.

2.3.4 Moveable property in rented and owner-occupied flatsThe insurance for moveable property in rented or owner-occupied flats is valid in the flat specified in the insurance policy and the storage space related to the use of the flat, which constitute the place of insurance for the moveable property.

Exclusion:In the case of damage to property which at the time of loss was kept in an attic, cellar or other storage space outside a rented or owner-occupied flat or in a common storage space for sports and recreational equipment, the maximum amount of compensation payable per loss event is 10 per cent of the maximum indemnity specified in the insurance policy for the home and holiday-home contents.

2.3.5 Stored moveable propertyThe insurance for stored moveable property is valid in the building, specified in the insurance policy, which constitutes the place of insurance for the moveable property.

2.4 Other property The insurance for other property is valid in the building, specified in the insurance policy, which constitutes the place of insurance for the property.

3 VALIDITY OF THE INSURANCE FOR MOVEABLE PROPERTY OUTSIDE THE PLACE OF INSURANCE

3.1 Main ruleThe insurance is valid elsewhere in Finland or in the other Nordic countries up to a maximum total of EUR 5,000, for moveable property intended for household use and transferred from the place of insurance temporarily.

The upper limits of indemnity above apply even if the property is included in several insurance policies providing the same benefit.

3.2 RemovalWhen the insured moves from a permanent residence to another, the contents insurance is effective outside the place of insurance in Finland up to the maximum indemnity for home or holiday-home contents specified in the insurance policy for two months of the date of removal.

3.3 Theft of moveable property kept in a motor vehicle, trailer, boat, boot, pannier or tent

Theft of moveable property kept in a motor vehicle, trailer, boat, the outer boot of a vehicle or a trailer, a vehicle pannier or tent is indemnified up to a maximum of EUR 1,000 per insurance event.

If, however, such property is more than a straight-line distance of 50 kilometres from the residence, place of work, place of study and holiday home of the insured, the maximum indemnity will be determined under 3.1 above.

In the case of moving house, the maximum indemnity is determined under 3.2 above.

4 INSURED PROPERTYThe object of insurance is the property stated in the insurance policy.

4.1 BuildingWhere the object of insurance is a building, the cover includes fixed machinery and equipment related to use of the building and the following related items serving the building and located in the building or on the same property as the building:– electrical and other cables, conductors and

pipes extending as far as the connection with the municipal or other public mains

– oil tanks– heating fuel up to an amount corresponding to

one year’s consumption.

If the insured building is a residential building or holiday home, the insurance also covers– the following property on the grounds of the

building related to the use of the insured building, up to EUR 7,000:

– ordinary fixed structures – wells including their equipment and – root cellars, open shelters, light-built structures

and buildings of a maximum of 12 m2, excluding sauna buildings

– the soil on the grounds of the building and the garden.

The grounds of the building refer to the immediate surroundings of the residential building or holiday home in the possession of the insured, up to a maximum of one hectare.

Restrictions:The object of insurance excludes jetties, beach constructions and structures, swimming pools, bathing tubs, free-standing pools, fountains and their equipment, the subsoil pipes of the property or the foundations of the building below the ground slab with the exception of the pad foundations and footings.

4.2 Construction and renovationThe insurance covers the buildings specified in the insurance policy also when they are under construction or renovation.

When a private person insures a building which is being constructed for his/her use or ownership and is being constructed or renovated mainly by himself/herself, the following property will also be covered by the insurance during construction or renovation: – Building materials which are intended to be

transferred to the place of insurance are covered by the insurance from the moment the liability for them under the terms of the sales contract transfers to the policyholder, provided that the materials are transferred to the place of insurance within one week from the transfer of liability.

– Building materials which are removed from the place of insurance are covered by the insurance for a continuous period of no more than six (6) months from the date of removal.

– The on-site clothing and tools of outside workers performing the construction or renovation, any temporary site buildings and hired and borrowed machines and equipment are covered by the insurance up to a total of EUR 5,000. Damage caused by fire to this property is

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compensated under the cover for fire and natural phenomenon. In addition, loss of or damage to property covered under crime cover is indemnified under crime cover, if the crime cover is included in the insurance.

– The insured person’s own tools used for construction or renovation on the construction or renovation site are covered by the insurance up to a total of EUR 5,000. Damage caused by fire to these tools is compensated under the cover for fire and natural phenomenon. In addition, loss of or damage to property covered under crime cover is indemnified under crime cover, if the crime cover is included in the insurance.

4.3 Parts of rented and owner-occupied flats ‘Parts of a flat’ refer to fixed machinery and equipment related to residential use of a rented or owner-occupied flat; floor, wall and ceiling coverings, structures and fixed interior decoration.

The insurance includes, up to the maximum indemnity specified in the insurance policy:- parts of a flat for the maintenance of which, under

the Finnish Housing Companies’ Act, the owner (shareholder) of a flat is responsible

- extensions of the owner’s maintenance liability laid down in the Articles of Association or decided by the shareholders’ meeting, and

- parts of the flat that the owner has installed or built himself, or has had made.

Exclusions: Damage to parts of a flat is covered only when the owner of the building is not liable to repair the damage.

4.4 Structures on the grounds and gardenStructures on the grounds of a detached house or holiday home can be insured through a supplementary agreement and at an additional premium.

Structures on the grounds of a rented or owner-occupied flat can be insured through a supplementary agreement and at an additional premium.

The grounds of a building refers to the immediate surroundings of the insured detached house, holiday home, rented flat or owner-occupied flat in the sole possession of the insured, up to a maximum of one hectare.

4.5 Moveable property4.5.1 Home contentsHome contents refer to household effects owned by the insured.

The insured home contents also include– cash, other payment instruments and securities

of each of those insured up to a maximum of EUR 500;

– pets usually kept inside the home up to EUR 1,500

– rowing boats specifically manufactured for use as rowing boats, up to EUR 1,500

– outboard motors of a maximum of 3.7 kW (5 hp) up to a maximum total of EUR 1,500

– tools used in gainful employment, up to a total of EUR 5,000, owned by those insured and used by them in the capacity of private individuals in private or public employment or in a private firm

– garden tractors and motorised hobby vehicles with a maximum design speed of 15 km per hour, up to a maximum total of EUR 5,000.

Home contents also comprise leased or borrowed property for household use which, if owned by the insured, would be included in his/her home contents to be insured.

Restrictions:Tools used in gainful employment exclude stock-in-trade, raw materials, product samples or advertising material.

In respect of damage caused to garden tractors and motorised hobby vehicles, only damage covered under fire cover or the cover for natural phenomena is indemnified. In addition, loss of or damage to property covered under crime cover and pipeline leakage cover is indemnified if the crime cover and pipeline leakage cover is included in the insurance.

Indemnity for damage caused to leased or borrowed moveable property is paid only if the damage is not indemnified by other insurance.

4.5.2 Holiday-home contentsHoliday-home contents refer to household effects owned by the insured.

The insured holiday-home contents also include– boats manufactured for use as rowing boats, up

to EUR 1,500– outboard motors of a maximum of 3.7 kW (5 hp)

up to a maximum total of EUR 1,500– garden tractors and motorised hobby vehicles

with a maximum design speed of 15 km per hour, up to a maximum total of EUR 5,000.

Holiday-home contents also include leased or borrowed property for household use which, if owned by the insured, would be included in his/her holiday-home contents.

Restrictions:In respect of damage caused to garden tractors and motorised hobby vehicles, only damage covered under fire cover or the cover for natural phenomena is indemnified. In addition, loss of or damage to property covered under crime cover and pipeline leakage cover is indemnified if the crime cover and pipeline leakage cover is included in the insurance.

Indemnity for damage caused to leased or borrowed moveable property is paid only if the damage is not indemnified by other insurance.

4.5.3 Moveable property in the adjacent and sauna buildingMoveable property in adjacent and sauna buildings refers to household effects owned by the insured.

It also comprises leased or borrowed property for household use which, if owned by the insured, would be included in his/her insured moveable property in the adjacent and sauna building.

Restriction:Indemnity for damage caused to leased or borrowed moveable property is paid only if the damage is not indemnified by other insurance.

4.5.4. Moveable property in other buildingsMoveable property in other buildings than detached houses, holiday homes, outbuildings or saunas refers to property intended for household use which is kept in the building specified in the insurance policy.

4.5.5 Stored moveable propertyStored moveable property refers to property intended for household use which has been temporarily transferred to the place of insurance specified in the insurance policy.

Exclusion:A single stored object is insured for up to EUR 5,000.

4.5.6 Other propertyOther property refers to separately specified property not included in the insurance for moveable property in a rented or owner-occupied flat, in the insurance for moveable property in a detached house, holiday home, outbuilding or sauna, nor in the insurance for stored moveable property.

4.6 Property not covered by the insuranceProperty not covered by the insurance includes:– tools used in gainful employment which

– are used or owned by a general partnership, a limited partnership, a limited liability company, an association or other organisation

– have come into the possession of the insured on the basis of a public or private employment or assignment

– data, files or programs contained in IT equipment with the exception of freely obtainable software packages

– manuscripts, dissertations, theses and the like

– equipment which does not conform to safety regulations and regulations issued by the authorities, and other property the possession or use of which violates existing legislation

– other motorised vehicles such as the garden tractors and motorised hobby vehicles specified in clauses 4.5.1 and 4.5.2 of these insurance terms and conditions, unless otherwise separately agreed in the insurance policy

– caravans or other trailers, watercraft or aircraft, nor any parts or accessories of these or of any motorised vehicles

– electric current and water.

5 COVERABLE INSURANCE EVENTS

5.1 Coverable insurance eventsThe insurance covers direct material damage caused to the insured property by the insurance events described below, if such an event was sudden and unforeseeable and the insurance cover, on the basis of which said damage can be compensated, was valid at the time when the insurance event occurred.

Whether an insurance event is unforeseeable or not is subject to an objective assessment, on the basis of the cause of the loss, not on the basis of the consequence of the loss.

The insurance always includes cover for fire and natural phenomenon. In addition, the following cover types are available for the insurance:– Crime– Equipment breakage– Pipeline leakage – Breakage and loss

The insurance policy shows the cover types selected for the insured property.

5.1.1 Fire and natural phenomenonUnder the fire and natural phenomenon cover, the insurance covers fire damage or loss caused by – fire which has suddenly and unforeseeably

broken out– by a sudden and unforeseeable rising of soot

from a fireplace or heating unit– sudden and unforeseeable explosion.

Under the fire and natural phenomenon cover, the insurance covers damage or loss due to a natural phenomenon caused by a sudden and unforeseeable – storm wind, whirlwind, downdraft in a

cumulonimbus cloud or similar, exceptionally strong wind or gust of wind

– freshwater or saltwater flooding– movement of ice due to freshwater or saltwater

flooding– rise in the water level of rivers, lakes and seas if

the rise is due to storm wind– direct strike of lighting causing mechanical

destruction of the insured property– heavy rain to the building and moveable property

inside the building– exceptionally heavy hailstorm.

By freshwater flooding we here refer to an exceptional water level rise in a river, lake, ditch or brook caused by gale-force winds, exceptionally heavy rain, melting snow, or ice and slush dams.

By saltwater flooding, on the other hand, we refer to an exceptionally high rise of the sea level caused

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by gale-force winds, change in air pressure or flow in the Danish straits.

By an exceptionally high rise of freshwater or saltwater levels we mean such a rise caused by gale-force winds or water level that is likely to occur only once every 50 years or less frequently. A flood caused by a permanent rise in mean water line, normal variation of water level or waves is not considered exceptional.

5.1.2 CrimeCrime cover indemnifies for loss or damage caused by sudden and unforeseeable theft, robbery, burglary or vandalism.

Vandalism refers to damage or loss caused wilfully by a party other than the insured.

5.1.3 Equipment breakageUnder the equipment breakage cover, the insurance covers breakage of machinery, equipment or pipework caused primarily by an internal breakage of said machinery, equipment or pipework due to a sudden and unforeseeable electrical phenomenon or for a sudden and unforeseeable mechanical reason.

5.1.4 Pipeline leakageThe insurance covers leakage damage caused by liquid escaping suddenly and in an unforeseeable manner directly from a building’s fixed pipework or a fixed pipework related to the use of the building, or from an operating device connected to it.

The pipework or operating device from which leakage originates is excluded from this cover.

5.1.5 Breakage and lossUnder the breakage and loss cover, the insurance covers loss caused by breakage or loss of property due to a sudden and unforeseeable external reason, provided that said loss has not been defined as being coverable under the fire and natural phenomenon, crime, equipment breakage or pipeline leakage cover. Whether the other cover was valid on the occurrence date of an insurance event has no relevance.

Under the breakage and loss cover, the insurance will never cover any damage or loss caused by fire, natural phenomenon, theft, robbery, burglary, vandalism or the internal breakage of machinery, equipment or pipework, or by liquid escaping from a building’s fixed pipework or from an operating device connected to it.

6 LOSSES EXCLUDED FROM COVERThe insurance does not cover

6.1 loss of or damage to the object itself caused by wear and tear, rusting, corrosion, spoiling, moulding, rotting, the spread of fungus, smell,

material fatigue or other equivalent gradual phenomenon

6.2 loss or damage caused by frost heaving, subsidence or land movement

6.3 damage caused to a building or its contents caused by freshwater or saltwater flooding or a consequent moving of ice if the building was constructed without permission specified by law or contrary to permission that was issued

6.4 loss or damage caused by the weight or movement of ice or snow. This exclusion does not apply to movement of ice due to freshwater or saltwater flooding.

6.5 loss of or damage to horticultural, agricultural or forestry products or garden plants caused by natural conditions

6.6 loss or damage caused by insects, rats, mice, moles, squirrels, hares or rabbits

6.7 loss or damage caused by a pet through chewing, tearing or scratching

6.8 loss of or injury to an insured pet with the exception of its accidental death or necessary destruction due to an accident

6.9 loss or damage caused by commercial blasting, quarrying or piling. Loss or damage covered under the insurance is, however, indemnified to the extent that the policyholder shows that the party found to be responsible is unable to meet its liability to make good the loss.

6.10 loss or damage caused by property disappearing or being left behind, even if the property is later found broken or it is established that the property has been lost

6.11 loss caused by theft, the exact time, circumstances and place of which cannot be determined

6.12 loss of or damage caused wilfully or through gross negligence by the insured’s tenant or a person residing permanently in the same household as the tenant

6.13 loss or damage indemnified under guarantee, legislation or other agreement, or from public fund

6.14 loss or damage caused to an object resulting from the incorrect use of the object

6.15 loss or damage caused by breakage of sports equipment or sports gear while being used for its intended purpose

6.16 loss or damage caused to computer hardware or software, when the loss or damage is due to malfunction, faultiness or non-performance of data or software

6.17 defective design, foundation, installation or construction or any damage caused by such defective design, foundation, installation or construction

6.18 loss or damage caused by liquid leaking through the water insulation in the structures or through the joint of pipes and structures, such as between a floor gully and a raising piece, or loss caused by liquid when the loss is caused by an unapproved connection

6.19 servicing or maintenance expenses incurred

6.20 loss or damage caused by condensation water

6.21 loss or damage caused by roof leakage, unless the leakage is due to a storm wind damaging the roof or some other sudden and unforeseeable external cause

6.22 loss caused by theft of moveable property kept out of doors other than a bicycle, pram, boat, a motor locked to a boat, garden furniture, barbecuegrill, garden tractors or motorised hobby vehicles.

6.23 theft of money, other payment instruments, securities or valuables kept in a motor vehicle, boat, trailer, the outer boot of a motor vehicle or trailer, the pannier of a vehicle or in a tent. Valuables include, among other things, jewellery, precious metal objects, furs, valuable collections and works of art.

6.24 theft of optical instruments, electronic equipment and electric tools kept in a trailer, the outer boot of a motor vehicle or trailer, the pannier of a vehicle or in a tent. However, this exclusion does not apply to theft of optical instruments, electronic equipment and electric tools from caravans.

7 SAFETY AND INDEMNIFICATION REGULATIONS

If a loss or damage is coverable under the terms and conditions above, the insurance is subject to the safety regulations described herein.

Any indemnity is calculated on the basis of the indemnification regulations specified on subsequent pages.

Valuables insurance

1 TERRITORIAL SCOPE OF VALIDITYThe insurance is valid throughout the world.

2 PROPERTY INSUREDThe objects of insurance are tools used in gainful employment, objects of value, electronic equipment, non-motorised sports equipment, optical instruments, musical instruments or furs, for instance, which are specified in the insurance policy.

Freely obtainable software packages intended for use in IT equipment can be included in the insurance cover.

Restriction:The insurance does not cover data files contained in IT equipment.

3 COVERABLE INSURANCE EVENTSThe insurance indemnifies for any direct material damage caused by some sudden and unforeseeable occurrence during the validity of the insurance.

4 LOSSES EXCLUDED FROM COVERThe insurance does not cover:– loss of or damage to an object caused by

breakage resulting from a defect in the object or from the incorrect use of the object

– loss or damage caused by the ordinary use of the object, insufficient covering, wear and tear, scratching, chafing, corrosion or other comparable gradual phenomenon

– loss or damage caused by breakage of sports equipment or sports gear while being used for its intended purpose

– loss or damage caused by insects, rats, mice, moles, squirrels, hare or rabbits

– costs incurred through repair and maintenance

– loss or damage indemnified under guarantee, legislation or other agreement, or from public funds.

– loss caused by the object disappearing or being left behind.

The insurance does, however, cover direct material damage arising from the object disappearing or being left behind, provided that the exact time, place and circumstances of the loss can be defined, that the loss was noticed at the place where it occurred and that an outsider was demonstrably and immediately informed of the loss.


If a loss or damage is coverable under the insurance terms and conditions, the insurance is subject to the safety regulations below.

The sum insured for the object entered in the valuables insurance policy, which is the maximum amount of indemnity, will be raised by the value of similar objects acquired during the insurance period. The increase is at most 30% of the sum insured of each property item.

The indemnity is otherwise calculated as described herein.

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Small boat insurance

1 TERRITORIAL SCOPE OF VALIDITYThe insurance is valid in the Nordic countries.

2 PROPERTY INSUREDThe objects of insurance are the boat and the motor of a maximum of 14.8 kW (20 hp) specified in the insurance policy.

3 COVERABLE INSURANCE EVENTSThe insurance indemnifies for any direct material damage caused during the validity of the insurance by

– outbreak of fire– lightning that has struck the boat directly– explosion– theft– malicious damage– storm with a wind velocity of at least 20 metres

per second– running aground, scraping bottom, collision– traffic accident during transport.


If a loss or damage is coverable under the insurance terms and conditions, the insurance is subject to the safety regulations below.

The deductible is not subtracted in loss due to theft if a burglar alarm system approved by insurance companies has operated as it should or if the boat has been equipped with an electronic or mechanic anti-theft device approved by insurance companies. Otherwise the indemnity is calculated on the basis of the indemnification regulations specified on subsequent pages.

Safety regulations

1 SIGNIFICANCE OF SAFETY REGULATIONS

The insured must comply with the safety regulations given in the insurance policy, insurance terms and conditions or other instructions in writing. If the insured fails to comply with the safety regulations, any indemnity payable to him/her may be reduced or denied under section 6 of the General Terms of Contract.

2 FIRE SAFETY

2.1 Electrical appliances, heating equipment and warning devices

The safety of fireplaces, flues and fire walls must be continuously monitored. They must not be taken into use before approval by the fire or building authorities. Defective fireplaces, flues or fire walls must not be used before they have been inspected and approved for continued use by the fire or building authorities.

Chimney sweeping must be performed in such a way that fireplaces and flues are swept once a year, irrespective of the fuel used. The fireplaces and flues of holiday homes that are not in use all year round must be swept once every three years. The chimney sweep must have further qualification for chimney sweeps.

The safety distances prescribed for sauna stoves must be taken into account when choosing their position. Clothes or other combustible material must not be dried above a sauna stove or in the immediate vicinity of such a stove.

The electric current in domestic appliances must be switched off after use. When the building is left unoccupied, the electric current, especially that of a cooker, iron or other domestic appliance posing a fire hazard, must be switched off.

The safety distances prescribed for individual temporary heating devices must be taken into account in locating the devices. Heaters with glowing surfaces or unprotected electric heaters with a filament resistor must not be placed in dusty spaces or used contrary to their purpose. Heating devices must not be covered.

Alongside standard fittings, only devices approved may be used for heating motors, power transmitters, the interior and other parts of a vehicle. Approved devices are:– CE-approved devices operated by mains current

and specifically meant for use in vehicles. Internal heaters for vehicles have protected filaments and usually bear the text “Internal vehicle heater”. Adequate circulation of air must be ensured for interior heaters.

– other CE approved devices approved by the Insurance Companies’ Committee for Automobile Repairs.

Placing a cover in the space between the bonnet and the engine is not permitted.

The surface temperature of heating equipment used for heating a motor vehicle shelter may not exceed +125o C. The use of oil, gas or paraffin oil heating equipment or stoves in a motor vehicle shelter is forbidden.

All dwellings, residential buildings and holiday homes must be equipped with operable smoke detectors in accordance with the directions of the authorities. Each storey in a dwelling place, including any basement levels and attics connected to it, must be equipped with at least one smoke detector/alarm. A house or a flat must have one smoke detector/alarm for each 60m² or part thereof.

2.2 Smoking and open firesSmoking is forbidden in dusty places, places containing flammable materials and in places where flammable liquids, gases or explosives are stored or handled.

Smoking in bed is forbidden.

Making an open fire without the necessary permit is forbidden. Open fires must be continuously supervised and extinguished with special care.

Open fire or a hot-air blower may not be used to thaw out piping.

Materials that could be used to start a fire must be kept out of children’s reach.

Owing to the risk of smouldering, ashes must be handled with special care. In a building and its vicinity, ashes removed from a fireplace must be kept in a non-combustible lidded container until they have fully cooled.

Burning candles and outdoor candles must be supervised. They must be placed on an non-flammable base so that flammable material cannot be ignited by a flame or heat.

2.3 Work involving risk of firePersons engaged in work involving risk of fire in places which constitute a fire risk must take special care and observe the following instructions where applicable:– Before work involving risk of fire is started, clean

and protect the work site and the surrounding area. Remove any flammable material and protect any nearby flammable structures.

– Make sure that a welding blanket, sufficient initial extinguishing equipment and a pressure hose are at hand.

– Make sure that the surrounding area is watered down if necessary.

– Make sure that a sufficient fire watch is kept while the work is under way and for a minimum of two hours after the work has been completed.

Work involving risk of fire refers to work which produces sparks or where a gas flame, other naked flame or a hot-air blower is used. Such work includes welding, flame and disk cutting, metal grinding, soldering, heating, waterproofing and roof work.

Repair work using a naked flame or open fire or glowing or spark-producing equipment may not be carried out in a motor vehicle shelter or a shelter for moveable property.

2.4 Flammable liquids and gases, highly flammable substances and explosives

Flammable liquids and gases, highly flammable substances and explosives shall be stored according to regulations given by the fire authorities, and smoking or use of naked flames is not permitted when handling these substances. Moreover, spark-producing equipment must not be kept in the vicinity of these substances. Valves and couplings of liquefied gas devices shall be checked for any leaks regularly and at least once a year. Equipment used for handling highly inflammable liquids must be stored in such a way after use that they cannot cause a fire even if they self-ignite.

3 PROTECTIVE MEASURES AGAINST THEFT AND BURGLARY

3.1 Property in buildings, in the home, in accommodation facilities and related storage spaces and stored property

The doors, windows, hatches and other entrances to storage spaces for moveable property must be closed in a manner providing protection against theft and burglary. The closing must be effected in such a way that the storage space cannot be entered without damaging the structures or locks of the storage space. When property is stored, valuables must be placed or covered in such a way that they cannot be seen by an outsider, unless he/she breaks into the storage space. Valuables include jewellery, precious metal objects, furs, valuable collections and works of art.

Keys to the home, accommodation facilities or storage spaces must not be left or hidden in the vicinity of these spaces. The lock must be changed immediately or re-keyed if there is cause to believe that the key is held by an unauthorised person.

When property is kept in a hotel room, passenger cabin or similar accommodation space, any valuables or objects or equipment worth more than EUR 800 must be kept in a fixed and separately locked space. Valuables include jewellery, precious metal objects, furs, valuable collections and works of art.

3.2 Property outside buildings, the home, accommodation facilities and related storage spaces

Property accompanying the insured must be continuously supervised. The insured must not leave his/her accompanying property or luggage unattended in public places such as streets, bus and railway stations, marketplaces, restaurants, shops, lobbies of hotels or other accommodation establishments, beaches, sports fields, public conveyances or popular tourist sites and public assemblies.

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Any accompanying property left unsupervised must be stored in a locked, fixed storage space which cannot be entered without damaging the structures or locks of the storage space.

When storing moveable property in a motor vehicle, trailer, boat, outside boot of a vehicle or trailer or pannier of a vehicle, these must be locked. The property must also be placed or covered in such a way that it cannot be seen by an outsider, unless he or she breaks into the storage space. The boot or pannier must be locked or fastened to the vehicle or trailer in such a way that it cannot be unfastened without using tools. A trailer used for storing property must be locked with a device which prevents it from being coupled to a drawing vehicle or locked in such a way that it is clearly difficult to move.

Garden tractors and motorised hobby vehicles must be stored in a manner which provides protection against theft in a closed, locked storage space, or they must be locked with a steering lock or using a chock latch, chain shackle or cable head intended for the prevention of unauthorised use of the vehicle.

When storing a child’s pram and a barbecue grill outside a building, home, accommodation facilities or related storage spaces, they must be kept under supervision or be locked in such a way that they are clearly difficult to move.

Property must not be left in tents without supervision.

In public conveyances, valuables must be carried as hand luggage. Valuables include, among other things, jewellery, precious metal objects, furs, valuable collections and works of art.

Cash, other payment instruments and securities must not be left in a hotel room, passenger cabin or similar accommodation, and they must be carried as hand luggage in public conveyances.

Bank, credit or similar payment cards must not be kept in the same place as their respective codes or be used in such a way that an unauthorised person may discover the code.

3.3 Further regulations concerning sports and leisure equipment

Bicycles shall be protected against theft by a properly functioning safety lock.

If skis, snowboards or other sports equipment covered by luggage insurance have to be left unsupervised out of doors or in public areas, they

must be locked to a stand intended for this purpose, or to other suitable fixture.

3.4 Boats, their motors and accessoriesA boat must be stored in a manner which provides protection against theft in a closed, locked storage space or locked to a fixed mooring using a chain and padlock with a steel shackle.

When storing a boat outside, the outboard motor and any fittings belonging to the boat must be locked to the boat, which in turn must be locked in a manner described above.

A motor removed from a boat must be stored in a locked storage space.

4 PROTECTION OF PROPERTY FROM LOSS DUE TO LEAKAGE

In order to prevent frost and leakage damage to water pipes and HEPAC equipment, the building must be heated sufficiently. If a building is left without supervision during the cold season for more than a week, the main valve must be closed or the water pump turned off. If a building is not heated at all during the cold season, all the water must be run out of the pipes and any heating, water supply and air conditioning equipment, in addition to ensuring that the main valve outside the building is closed or the water pump turned off.

Oil tanks and related oil pipelines in the real estate must, for the first time, be checked in the tenth year of use and subsequently, steel tanks every five years and other tanks every ten years. Heating oil must be removed from tanks which are no longer in use, the equipment must be neutralised and the feed connection must be removed before the beginning of the subsequent heating period.

Washing machines must always be connected to the water mains by an individual cut-off valve and an approved pressure-proof filling hose. The outlet hose must be connected tightly to the waste water system or the operation of the washing machine must otherwise be supervised. The cut-off valve for a pressurised water feed pipe to a washing machine must be closed when the wash programme has finished. The policyholder must supervise that the hose connections are in good repair and that the hoses have no kinks.

When installing a dish washer, a suitable safe tray must be installed under it.

Any goods stored in a cellar which are liable to suffer from humidity or moisture shall be kept at a minimum of 10 cm from the floor surface.

5 PROTECTION OF PROPERTY FROM LOSS DUE TO FLOOD

Rainwater and melting snow, that is, urban runoff, must be prevented from entering buildings by means of water insulation and other drainage methods, such as using landscaping to divert water away from buildings, and with ditches, French drains, rainwater gullies and pumping stations.

The lot must be connected to a municipal urban runoff network if such is available.

The ditches and French drains must be kept operational and checked annually.

The sewage system must be kept operational and the sewer pumps maintained.

Any goods in stores situated below the ground level, making them susceptible to humidity or moisture, must be kept at a minimum of 10 cm from the floor surface.

The safety regulations specified in the insurance policy or otherwise referred to in the insurance contract must be followed.

6 OTHER REGULATIONSThe instructions for use issued by the manufacturer, seller or importer of the product must be observed.

Fragile objects must be carried as hand luggage in public conveyances.

Corrosive and staining substances and bottles and packages containing liquids must be packed safely and separately from other accompanying property.

If an object has been damaged or lost in transit or during storage, the damage or loss must be duly reported to and a claim filed with a representative of the haulage or transport company.

Buildings and machinery must be maintained in a condition which complies with the Building Act, building regulations and occupational safety regulations.

Indemnification regulations1 HOW TO CLAIM INDEMNITY

1.1 Notification of an insurance eventThe claimant must immediately notify the insurance company of the insurance event. This can be done by filling in the insurance company’s notification form.

The claimant must provide the insurance company with the documents and information necessary for the assessment of the insurance company’s liability. These include documents and information which confirm the occurrence of loss, the extent of the loss, and the recipient of indemnity. Examples of such documents are a police investigation report or notice of a crime, a receipt for the acquisition of the damaged object, abstract of title and account of mortgage holders. A crime must be reported to the police at the location of the crime without delay.

1.2 Documents and the cost of obtaining them

The police investigation report must be supplied to the insurance company upon request. The company indemnifies for the fees arising from the police investigation reports and other official documents which are required for handling the claim and which the company has requested.

When the insured claims indemnity for a loss due to theft of a bicycle, the notification form submitted to the insurance company must be accompanied by the police official’s copy of the crime report filed.

The insurance company will indemnify for the costs arising from any repair cost estimate it may require.

1.3 Examination of loss or damage and safekeeping of the damaged object

The insurance company must be given the opportunity to assess the loss or damage before the repairwork is started. Any assessment of loss or damage by the insurance company does not imply that the insurance will indemnify for the loss or damage.

A damaged object must not be disposed of without special reason. Spectacles broken beyond repair must be given to the company when submitting the claim.

2 UPPER LIMITS OF INDEMNITYThe upper limit of the insurance company’s liability to indemnify is the replacement value or current value of the property.

If the sum insured is agreed when the property is insured, the maximum indemnity payable is the sum insured recorded in the policy.

If the maximum indemnity is agreed when the property is insured, the maximum indemnity payable is the maximum indemnity recorded in the policy.

3 INDEMNIFICATION ALTERNATIVESPrimarily, damaged property is indemnified by having the damaged object repaired. If the repair costs exceed the value of the property determined in accordance with these indemnification regulations, the indemnity will not exceed the value of the property. The expenses for restoring the damaged property to the condition preceding the loss are indemnified as repair costs.

Expenses for renovation or other improvements made in connection with the repair are not indemnified.

The insurance company is entitled to acquire equivalent property or repair the damaged property instead of paying the indemnity in cash. The insurance company also has the right to decide which builder or repairer is to be used for rebuilding or repairing the damaged property, or to decide from which source of supply similar property is to be acquired. If, however, the indemnity is paid in cash, the maximum amount of indemnity is determined on the basis of the amount which the company would have paid the seller for the object or the repairer for the repair costs. When assessing the amount

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of indemnity, all cash, wholesale, special and other discounts to which the company would have been entitled if it had acquired similar property or had the property repaired are taken into account.

The company is entitled to redeem the damaged property or part of it at a value determined using the same criteria as before the insurance event.

If part of the lost property is recovered after payment of the indemnity, the policyholder shall immediately surrender that part to the insurance company or return the indemnity given in respect of it.

4 DEDUCTIBLEIn all insurance events, the insured is responsible for a certain amount of the loss, i.e. the deductible, which is specified in the insurance policy.

The deductible is not subtracted – in loss due to fire, if a smoke detector has

restricted the extent of the loss by switching off the electricity, or if a separate fuse for a stove has restricted the extent of the loss by switching off the electricity from the stove

– in loss due to fire if the automatic fire alarm system restricted the extent of the loss

– in loss due to theft if the dwelling or building has been broken into through a door locked with a safety lock

– in loss due to theft if an burglar alarm system has operated as it should or

– in loss due to leakage if the leakage alarm equipment at the place of insurance has, through its operation, restricted the extent of the loss

– from the acquisition costs of a new excess-voltage preventer, if the excess-voltage preventer protecting the electrical equipment was broken due to a lightning strike or other excess voltage.

5 COSTS INDEMNIFIED IN ADDITION TO MATERIAL DAMAGE

5.1 Costs arising from limiting the loss and from orders and regulations issued by the authorities

Regardless of the amount of the sum insured, the insurance indemnifies for the following, in addition to direct material damage:– reasonable costs incurred by the insured in taking

action to limit or prevent loss that has occurred or is imminent and that is coverable under this insurance

– reasonable additional costs due to mandatory orders and regulations issued by the authorities concerning the building, up to a maximum of 10% of the amount of damage to the building.

5.2 Additional housing costs arising from a coverable loss

Regardless of the amount of the sum insured and in addition to direct material damage, the insurance indemnifies for the reasonable additional costs approved in advance by the insurance company and incurred by the insured because the permanent dwelling or a part of it could not be used due to an insurance event covered by this insurance policy. The indemnity is paid from the insurance for moveable property covering the damaged dwelling.

Restrictions:The maximum amount of indemnity for additional housing costs is 10% per month of the maximum indemnity or the sum insured indicated in the insurance policy. Additional housing costs are indemnified for a maximum of six months. Meal expenses are not covered as additional costs.

6 INDEMNITY FOR LOSS OF OR DAMAGE TO MOVEABLE PROPERTY

6.1 Replacement, current and residual values

In the event of loss of or damage to moveable property, the amount of indemnity is based on the replacement value, which refers to the cost of acquiring new identical or equivalent property. However, any cash compensation will be adjusted as referred to under clause 3. If the value of the property has depreciated by more than 50% of

its replacement value as a result of age, use, decrease in usability or similar cause, the amount of the indemnity is based on the current value of the property. Current value refers to the market value of the property before the loss occurred. The value of the property subject to age reduction is, however, determined on the basis of the age of property items as indicated in section 6.2.

Indemnity based on replacement value requires that either the damaged property be repaired or that it be replaced by new property of the same type or property intended for the same purpose within two years of the insurance event.

Indemnity based on replacement value is paid in two instalments. The indemnity based on current value is paid first. An additional indemnity, which is the difference between the indemnities based on replacement value and current value, is paid when the company has received a report on the acquisition of a new object.

Should the property still have some value after the loss, this is taken into account as a deduction in calculating the indemnity. The residual value is determined using the same criteria as for the pre-loss value.

6.2 Age reduction for indemnity for loss of or damage to moveable property

The following annual reductions are made from the replacement value, beginning with the second year of use:

Property items Age reductioper year, %

household appliances 10digital cameras 20other electronic appliances and optical instruments

10

bicycles, motor tools andmachinery and outboard motors

10

IT equipment (computers), mobile phones with accessories and other data terminalequipment

25

spectacles, clothes, accessories, footwear, sports equipment and sports gear

25

The reduction is computed by multiplying the percentage figure by the number of full calendar years following the year the equipment was first used. The age reduction is, however, no more than 70%. In addition to the reductions, the deductible specified in the insurance policy will also be subtracted.

The age reduction is not applied to the costs stated in the repair bill for the object. The indemnity for repair costs shall, however, not exceed the value of the property as specified in this section. Age reductions also apply when indemnifying for moveable property covered by the insurance for a building.

7 INDEMNITY FOR A DAMAGE TO A BUILDING AND PARTS OF A RENTED OR OWNER-OCCUPIED FLAT

Below, a building also refers to property insured as a part of rented or owner-occupied flat.

7.1 Replacement, current and residual values

In the event of damage to buildings, the amount of indemnity is based on the replacement value of the property, which refers to the cost of acquiring new identical or equivalent property. If the value of the property has declined by more than 50% of the replacement value as a result of age, use, decrease in utility or similar cause, the indemnity is determined in accordance with the current value. Assessment of the value of the loss includes consideration of the residual value of the building, which refers to the value of the property immediately after the insurance event, assessed using the same criteria as immediately before the insurance event. The value of the machinery, equipment and pipes of a building

subject to age reduction is, however, except in the case of fire damage, determined on the basis of the age of the property items as indicated in section 7.5.

7.2 Payment of replacement value indemnityIndemnity based on replacement value requires that within two years of the insurance event the damaged property be either repaired or that a new, similar building intended for the same purpose be built on the same site. If the construction is delayed due to the action of an authority, the delay period is added to the time mentioned above.

Indemnity based on replacement value is paid in two instalments. The indemnity based on current value is paid first. An additional indemnity, which is the difference between the indemnities based on replacement value and current value, is paid when the company has received a report on the replacement measures mentioned above.

7.3 Payment of current value indemnityIn payment of indemnity based on current value, the amount of indemnity is calculated according to the current value of the property concerned. If the property is repaired, the repair costs are indemnified up to a maximum of the current value of the building. If the property is not repaired, the amount of indemnity must not exceed the portion of current value corresponding to the degree of damage.

7.4 Reduction of the residual valueIf the parts of the building remaining after the loss cannot, on the basis of provisions in the Building Act or Road Act or because of a current building ban or restriction, be used in restoring the building to its former condition, the resulting reduction in the residual value is added to the indemnity.

The reduction in value is calculated by subtracting from the residual value the price obtainable from the remaining parts of the building when they are sold to be taken away. The policyholder must demonstrate that there is a ban or restriction on the building and, if the company so requests, apply for a special permit to restore the building to its former condition and, if such a permit is not granted, appeal the decision. If the insurance company so requests, the policyholder shall authorise the company to represent him/her in acquiring the special permit.

7.5 Age reduction in case of loss or damage to machinery, equipment and pipes of a building

The following annual age reductions are made, beginning with the second year of use, on the replacement and repair costs of the machinery, equipment and pipes of the building, excluding fire loss:

Machinery, equipment and pipes of a building

Age reduction,%

tanks, waste water, rainwater, service and heating pipes of the building, other than those located in the ground slab

3

copper and plastic pipes in the ground slab and underground

3

other pipes in the ground slab and underground

6

swimming pool equipment, burglar alarm equipment, frameworks and operation mechanisms of external awnings

10

stoves, range hoods, refrigerators, dishwashers and sauna stoves

10

central-heating equipment, heat exchangers and conveyors, boilers with tanks, tanks underground or in the ground slab, adjustment and control equipment, heating cables, electric radiators, air-conditioning and refrigeration equipment, and electric motors and other equip-ment

6

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The above mentioned age reductions are also made on the costs of opening and closing the structures of the building and the costs of excavating and filling.

The age reduction is computed by multiplying the percentage by the number of full calendar years following the year the equipment was first brought into use. The deductible specified in the insurance policy is not subtracted following this reduction. The reduction is, however, at least equal to the deductible in amount. Stoves, range hoods, refrigerators, dishwashers and sauna stoves are, however, covered under clause 6.2 in the insurance terms and conditions.

No reduction for age is made on costs arising from locating the fault or on electric cables.

Reductions also apply when indemnifying for equipment and pipes covered by a contents insurance.

7.6 Leakage reduction for damage caused by pipeline leakage under MyHome Insurance

In case the loss is indemnified for under the pipeline leakage cover and is caused by leakage from a service water pipework or heating pipe network, a reduction is made on the loss caused by the leakage on the basis of the age of the leaked service water pipework or heating pipe network, as follows:

Age of pipes Leakage reduction from loss amount, %

35 – 49 years 3050 years or more 60

The leakage reduction is calculated on the basis of the amount of loss caused to a building which is coverable under the insurance.

The pipe age is the number of full calendar years following the year the pipework was installed. The deductible specified in the insurance policy is not subtracted following this reduction. However, the reduction is at least equal to the deductible amount.

Leakage reductions do not apply to leakage loss caused by drain pipes or operating devices (such as boilers or water fittings).

No leakage reduction is made on parts of rented or owner- occupied flat.

However, age reductions on repair and replacement costs for a building’s machinery, equipment and pipes are always made as specified in section 7.5.

8 UNDER- AND OVER-INSURANCE AND FALSE INFORMATION

8.1 Effect of false informationIf the policyholder has submitted false information about the object to be insured and too small a premium has, therefore, been collected, the indemnity is paid only for that part of the loss amount, reduced by the deductible, which corresponds to the ratio of the premium collected for the object of insurance to the premium determined on the basis of correct data.

8.2 Sum insured and under-insuranceIn insurance based on the sum insured, the sum for which moveable property is insured shall correspond to its replacement value or, upon separate agreement, its current value.

In insurance based on the sum insured, the sum for which a building or building under construction or renovation is insured shall correspond to the replacement value of a completed building or, upon separate agreement, the current value. The sum insured shall be deemed to also include the costs arising from demolition, protection and clearance.

If the sum insured is considerably below the replacement value, the property is underinsured. In the case of an insurance event concerning the under-insured property, the insurance company indemnifies only for that part of the loss amount, calculated according to the replacement value and reduced by the deductible, which corresponds to the ratio of the sum insured to the replacement value.

If it has been agreed separately that the property is insured at the current value and the sum insured is considerably lower than the current value, the property is underinsured. In the case of an insurance event concerning the under-insured property, the insurance company indemnifies only for that part of the loss amount, calculated according to the current value and reduced by the deductible, which corresponds to the ratio of the sum insured to the current value.

If, however, the sum insured is essentially based on an estimate given by the insurance company or its representative, the amount of the indemnity is the same as the amount of loss, reduced by the deductible, but not, however, exceeding the sum insured. The amount of loss is calculated according to the current value if the property has been insured for its current value.

8.3 Sum insured and over-insuranceThe property is over-insured if the sum insured is considerably higher than the replacement value of the insured property or the separately agreed current value.

In the case of an insurance event concerning the over-insured property, the insurance company does not indemnify for more than the amount necessary to cover the loss, reduced by the deductible. The amount of loss is calculated according to the current value if the property has been insured for its current value.

If, however, the sum insured is essentially based on an estimate given by the insurance company or its representative and the insured object is completely destroyed, the indemnity is paid from the over-insurance according to the sum insured, unless the appraisal has been affected by false or insufficient information deliberately submitted by the policyholder.

9 INDEMNITY FOR DAMAGE TO SOIL AND GARDEN

Damage to soil and garden is indemnified on the basis of restoration costs.

A garden also includes the trees and bushes of a tended garden. Trees and bushes in a wild garden are not included in what is defined as a garden.

The indemnity for garden trees amounts to their forestry value. The value of garden trees is indemnified at three times their forestry value. The indemnity for shrubbery and trees with no forestry value is three times the price of the smallest new seedlings available from commercial nurseries. The indemnity for seedlings no taller than 130 cm is the same as the price of a new seedling of equal size. Reasonable costs of transporting and planting the seedlings are also indemnified.

Should the destroyed varieties not normally be available at commercial nurseries in Finland, the loss is indemnified in accordance with the value of the most comparable seedling available.

10 INDEMNITY FOR AN ANIMALThe indemnity for loss due to the accidental death of an animal is the current value of the animal, but not exceeding, however, the amount specified for pets in the ‘Home contents’ section of the common provisions of non-life insurance. Expenses for attending to an animal are not indemnified.

11 DEPRECIATION AND SENTIMENTAL VALUE

Depreciation is not indemnified. Depreciation means that the current value of the damaged property has declined, even though the property has been restored after the loss to the condition preceding the loss. Differences in the shade of colour are not taken into account when the amount of indemnity is assessed, nor are sentimental or other such values.

12 REDUCTION OF THE SUM INSURED AS A RESULT OF INDEMNITY

As a result of loss or damage, the sum insured may be reduced by the amount of indemnity paid if the indemnity is at least 10% of the sum for which the property is insured.

13 INDEMNITY FOR MORTGAGED PROPERTY

If indemnity is paid on property for which a real estate mortgage has been secured, the owner of the property is entitled to receive the indemnity (Land Act, chapter 17, section 8) provided that:– he/she has repaired the damage within a

reasonable time– he/she has provided assurance that the

indemnity will be used to renovate or repair the damaged property

– the amount of indemnity is small compared to the value of the property, or

– it is evident that drawing the indemnity does not weaken the creditor’s chance of being paid back the debt.

14 VALUE ADDED TAXLegal provisions on value added tax will be taken into account in calculations of the amount of loss.

If the recipient of the indemnity is entitled, under the Value Added Tax Act, to deduct in his/her own value added taxation the value added tax included in purchase invoices for goods or services arising from the loss or to have the tax refunded, the tax is deducted from the indemnity.

If the deduction or refund right concerning value added tax applies to the acquisition invoice of the property or the relevant part of it, the value added tax corresponding to the amount of loss is deducted from the indemnity. In replacement value indemnities, the value added tax included in the acquisition price of similar new property or the relevant part of it is deducted.

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Family liability insurance1 THOSE INSUREDThose insured are the policyholder and the persons residing permanently in the same household as the policyholder.

Persons temporarily attending to or possessing a pet insured under the Extrasure insurance cover are also insured in this capacity.

If the policyholder is a death estate, those insured are the party to the death estate who resides permanently at the place of insurance and the persons residing permanently in the same household with him/her. Other parties to the death estate are also insured in insurance events related to the ownership, possession or use of the real estate insured under the Extrasure insurance cover.

2 VALIDITYThe insurance is valid in the Nordic countries.

3 COVERABLE INSURANCE EVENTS3.1 The insurance covers any bodily injury or material damage that the insured, as a private individual, causes to a third party and for which the insured is liable under existing law, provided that the liability derives from an act or negligence that has taken place during the insurance period.

3.2 Loss or damage caused by a child is covered even when the child is not liable to pay damages because of his/her age. As an exception to section 7 of the General Terms of Contract, the insurance also covers loss or damage deliberately caused by a child under 12 years of age.

Restriction:The insurance does not cover loss or damage caused by a child if another person is liable for the loss or damage.

3.3 Regardless of any fault of the insured, the insurance covers bodily injury resulting from the bite of a dog kept as a pet in the family of the policyholder, and any loss or damage caused by the family’s dog in a direct collision with a motor vehicle.

Restriction:This regulation does not apply to– any loss or damage for which another party

is liable– a traffic or other accident caused by avoiding

a dog.

3.4 As an exception to section 4.2, the insurance covers damage which has been caused suddenly to the structures or fixed equipment of a rented or owner-occupied dwelling used for the accommodation of the insured and his/her family and for which the insured is liable under section 3.1. Damage caused to the structures or fixed equipment of a hotel suit is also covered. Rented residential buildings are, however, not considered rented dwellings.

Restriction:The insurance does not cover damage caused to surface coverings, nor damage arising from poor maintenance or wear and tear of the dwelling. Surface coverings in this respect include wood-strip and vinyl floor coverings, wall-to-wall carpeting, wall coverings and painted surfaces of the dwelling.

3.5 As an exception to section 4.4, the insurance covers liability loss based on ownership or possession of real estate if the insured lives in a building located within that real estate or if the event is related to other residential property owned or possessed by the insured and insured under the Extrasure insurance cover.

3.6 As an exception to section 4.8, the insurance covers loss which is indemnified under section 3.1 and which is caused by a temporary incident or circumstance due to an accidental error.


4.1 loss or damage caused– to the insured– to the insured’s employee or equivalent,

insofar as the person concerned is entitled to indemnity under statutory workers’ compensation insurance or motor liability insurance

4.2 loss of or damage to property which, when the act or negligence causing the loss or damage took place, is or was in the possession of, at the personal disposal of, borrowed by, stored with or otherwise handled by or in the care of the insured or a person residing permanently in the same household as the insured

4.3 loss or damage for which the insured is liable only by virtue of an agreement, engagement, promise or guarantee

4.4 loss or damage for which the insured is liable in the capacity of owner or possessor of the real estate

4.5 loss or damage which, in connection with building or renovation, is sustained by pipes or cables, if the insured has not acquired and followed cable or pipe charts for the construction site

4.6 loss or damage caused by a traffic accident as defined in the Motor Liability Insurance Act, irrespective of where the accident occurred

4.7 loss or damage caused– by use of a vessel or boat subject to

registration or a sailing boat over 6 metres long

– by use of an aircraft when the insured is liable to pay damages in the capacity of owner, possessor or user of the aircraft or as a person carrying out duties on board the aircraft or in his/her capacity as the employer of any such persons

4.8 loss or damage caused gradually by vibration, smoke, soot, gas, moisture, water, sewage or pollution of a body of water, groundwater or soil

4.9 loss or damage caused by a change in the groundwater table

4.10 loss or damage caused by quarrying or blasting performed with outside labour or for another or by consequent subsidence or land movement

4.11 loss or damage caused by the insured in the course of professional, business or wage-earning activity, or loss or damage caused by the insured to his/her employer

4.12 loss or damage caused in connection with an assault or an affray

4.13 a fine or any similar sanction

4.14 loss or damage caused by a strike or other similar cause.

5 SPECIAL MEASURES TO BE TAKEN ON OCCURRENCE OF AN INSURANCE EVENT

5.1 In any matter covered by this insurance, the company will determine whether the insured is liable to pay damages, will negotiate with the claimant and will pay the indemnity required by the loss.

5.2 The insured must provide the company with an opportunity to assess the amount of loss or damage and to reach an amicable settlement.

Restriction:If the insured makes good the loss, agrees thereon or accepts the claim, this will not be binding on the insurance company, unless the amount and basis of the damages are manifestly correct.

5.3 If damages coverable under this insurance are demanded from the insured in legal proceedings, the insured must immediately notify the insurance company of the proceedings. The company will handle the legal proceedings at its own cost on behalf of the insured insofar as they concern the said damages.

Restriction:The costs of legal proceedings taking place outside the Nordic countries are indemnified to a maximum of EUR 8,500.

5.4 If the company has notified the insured of its readiness to settle with the injured party within the limits of the sum insured, and the insured does not consent thereto, the company is not obliged to indemnify for any extra costs incurred thereafter.

6 SAFETY REGULATIONSThe insured party must comply with the safety regulations specified in the insurance policy, insurance terms and conditions, or otherwise provided in writing. If the insured party fails to comply with the safety regulations, any compensation payable to him may be reduced or disallowed under clause 6.3 of the General Terms of Contract.

6.1 Oil tanks and related oil pipelines in the real estate shall, for the first time, be checked in the tenth year of use and subsequently, steel tanks every five years and other tanks every ten years. Heating oil must be removed from tanks which are no longer in use, the equipment must be neutralised and the feed connection must be removed before the beginning of the subsequent heating period.

6.2 While using a shower in the bathroom, the user must keep a constant watch to ensure that the water flows into the floor gully and there are no sewer blockages.

7 INDEMNIFICATION REGULATIONS7.1 The sum insured recorded in the policy is the upper limit of the company’s liability in each insurance event.

7.2 Multiple loss or damage caused by a single event or circumstance is considered a single insurance event.

7.3 In all insurance events, the insured is responsible for a certain amount of the loss, i.e. the deductible, which is specified in the insurance policy.

7.4 Legal provisions on value added tax will be taken into account in calculations of the amount of loss.

If the recipient of the indemnity is entitled, under the Value Added Tax Act, in his/her own value added taxation to deduct the value added tax included in purchase invoices for goods or services arising from the loss or to have the tax refunded, the tax is deducted from the indemnity.

If a deduction or refund right applies to the acquisition invoice of the property or the relevant part of it, the value added tax corresponding to the amount of loss is deducted from the indemnity.

If the indemnity is to be considered income which replaces business income subject to value added tax, the indemnity is exempt from tax.

8 JOINT AND SEVERAL LIABILITYWhere several parties are jointly liable to make good a case of loss or damage, the insurance will indemnify for that part of the loss or damage which

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corresponds to the culpability attributable to the insured and to any advantage he/she may have gained through the insurance event.

9 EXTENSION TO FORESTRYIf forest insurance, included in Extrasure, or forest fire insurance has been taken out on a forest, family liability insurance will also apply to the insured forest property, as follows:

9.1 The insurance covers liability for damages resulting from forest management and harvesting work carried out by the insured party or third parties on the insured forest property.

9.2 Those insured also include such unpaid or temporary employees for whom the policyholder is liable as regards the activities specified in this section of the insurance terms and conditions.

9.3 Deviating from section 4.4 of the insurance terms and conditions, the insurance covers liability loss which is based on the ownership or possession of the property and which concerns a forest property specified in the contract and insured under forest or forest fire insurance.

9.4 Deviating from restriction section 4.11 of the insurance terms and conditions pertaining to wage-earning activity, the insurance covers liability loss

which is related to a private individual’s activities specified in this section of the terms and conditions.

9.5 The insurance does not cover loss or damage caused by the controlled burning of forest which is carried out by the insured or a third party.

9.6 The insurance does not cover loss or damage insofar as it is covered under liability insurance included in farm insurance or under some other liability insurance taken out by the policyholder.

9.7 In other respects, the insurance is subject to the family liability insurance terms and conditions.

Family legal expenses insurance

1 PURPOSE OF INSURANCEThe purpose of this insurance is to indemnify for any necessary and reasonable legal expenses incurred by the insured as a result of resorting to legal counsel in a disputed civil case, criminal case or non-contentious civil case concerning an insurance event as referred to under section 4.

The insurance applies to the insured in matters related to his/her private life.

2 THOSE INSUREDThose insured are the policyholder and the persons residing permanently in the same household as the policyholder.

If the policyholder is a death estate, those insured are the party to the death estate who resides permanently at the place of insurance and the persons residing permanently in the same household with him/her.

3 COURTS OF LAW AND TERRITORIAL SCOPE OF VALIDITY OF INSURANCE

The insured may use the insurance in insurance events arising in Finland or another Nordic country and which in Finland can immediately be brought before a district court or a corresponding Nordic court. The circumstances on which the insurance event is based must have originated in a Nordic country.

The insurance does not indemnify for expenses in cases which are handled by the administrative authorities or in special courts, e.g. a provincial State office, an administrative court, the Insurance Court or the Supreme Administrative Court. Neither does the insurance indemnify for expenses incurred from cases handled in the European Court of Human Rights or the European Union Court of Justice.

4 COVERABLE INSURANCE EVENTS

4.1 Definition of an insurance eventA coverable insurance event refers,

in a disputed or non-contentious civil case,– to a dispute. ‘Dispute’ refers to a claim with

specified grounds and amount demonstrably and specifically disputed as to its grounds or amount.

in a criminal case,– to a civil claim made by the insured, disputed as

to its grounds or amount– to a complainant’s charges against the insured

brought or pursued after the public prosecutor has decided to waive or withdraw charges for the same action. The charges are considered to have been brought when the complainant’s application for a summons has arrived at the office of a district court. The charges are considered pursued when the complainant has notified the court in writing of pursuing the charges after the public prosecutor has withdrawn the charges.

The insurance indemnifies for insurance events occurring during the validity of the insurance.

Restriction:If the insurance has been valid for less than two years at the time of the insurance event, the matters on which the claim or charge is based must also have taken place during the validity period of the insurance. The validity period means the time this insurance alone or consecutively together with other terminated legal expenses insurance policies with equivalent contents, has been continuously valid for the benefit of the insured. However, if, on the occurrence of an insurance event, the insured has several effective legal expenses insurance policies, only this insurance will be taken into account when determining the validity period of the insurance.

4.2 Single insurance eventA ‘single insurance event’ refers to an insurance event where– two or more people covered by this insurance

are on the same side in a disputed civil case, criminal case or non-contentious civil case; or

– the insured or those insured have several disputed civil cases, criminal cases or non-contentious civil cases pending which are based on the same event, circumstance, juristic act or infringement, or which are based on the same or similar claim with different grounds.

5 RESTRICTIONS RELATED TO INSURANCE EVENTS

The insurance does not cover expenses incurred by the insured in a case 1) where the claim has not been demonstrably

disputed;2) which is related to the current, earlier, future

or planned profession, self-employment, official post, occupation, business or gainful employment, partnership of a commercial enterprise or membership of the administrative bodies of such an enterprise, or other main or ancillary wage-earning activity of the insured or of another insured person living in the same household as the insured;

3) which is related to investment operations or to an individual investment which exceeded EUR 85,000 when the dispute began or the investment was made;

4) which is related to guarantee, pledging or other commitment for a loan or commitment by another person for his/her business or gainful employment;

5) which is related to a loan granted for the business or gainful employment of another person;

6) which is related to real estate or the relevant part of it, a building, a housing corporation dwelling or rented dwelling other than the insured’s permanent home or a holiday home in his/her personal use;

7) of minor importance to the insured;8) in which those insured under this insurance

represent opposing parties;9) which is related to a claim or receivable

transferred to the insured, unless, at the time the dispute arises, two years have elapsed since the transfer;

10) in which the insured has filed a petition in a criminal procedure, or is being prosecuted

by the public prosecutor, or in which the complainant has filed a civil claim against the prosecuted insured while such prosecution is pending; 11) in which the insured is required to pay damages for a civil claim on account of which he/she has been sentenced or, on the basis of the relevant special provisions, the charges or sentence against him/her have been waived;

12) in which the insured has submitted a civil claim on account of which he/she has been sentenced or, on the basis of the relevant special provisions, the charges or sentence against him/her have been waived;

13) which is related to a restraining order14) which concerns a divorce or the cancellation

of a registered partnership, or property disputes or other claims connected with a divorce or separation, the termination of marriage-like cohabitation or the cancellation or termination of a registered or an unregistered partnership;

15) which is related to the custody or habitation of a child, or maintenance liability or rights of access;

16) which concerns the appointment of a trustee, or an executor or administrator of an estate or the release of such an appointed person from his or her duties or the dissolution of joint ownership;

17) in which the insured is involved as the owner, possessor or driver of a motor vehicle or a watercraft subject to registration under the Register of Watercraft Act or in which the expenses incurred by the insured are covered under liability insurance;

18) which is related to a bankruptcy;19) which is related to a distraint, execution

dispute referred to in the Execution Act or the execution of distraint, or the execution of a decision on the custody of a child and on the rights of access to a child;

20) which concerns proceedings carried out in accordance with the provisions on company restructuring or the debt rescheduling of private individuals, or the voluntary debt rescheduling of farmers in accordance with the Rural Industries Act;

21) which demand clarification of whether the expenses incurred from the insurance event reported by the insured are fully or partly coverable under legal expenses insurance;

22) which is dealt with as a class action.

6 MEASURES TO BE TAKEN ON OCCURRENCE OF AN INSURANCE EVENT

6.1 If the insured wishes to use the insurance, he/she shall inform the insurance company thereof in advance and in writing. The insurance company will then send the insured a written claim settlement decision.

6.2 The insured shall use a solicitor or other legal counsel as his/her representative.

Restriction:If the insured does not use any representative at all or uses a representative who is not a Finnish Master of Laws or who does not have equivalent foreign qualifications, no indemnity will be paid.

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6.3 The insured shall, during court proceedings or settlement negotiations, require the opposing party to reimburse the insured’s legal expenses in full. If the insured has presented to the opposing party a legal expenses demand that is partly or fully rejected by a court order, an appeal is to be lodged against the decision in response to the insurance company’s demand.

Restriction:If the insured does not demand his/her legal expenses from the opposing party or if he/she abandons the demand or any part of it without the insurance company’s consent or refuses to appeal against the court order on legal expenses, the indemnity which would otherwise be paid out of the insurance may be reduced or denied under the Insurance Contracts Act.

6.4 The insured has no right to approve, in a manner that would be binding on the company, the amount of expenses incurred from handling his/her case.

Restriction:Any payment by the insured to his/her representative for legal fees and expenses is not binding on the insurance company in its evaluation of inevitable and reasonable litigation costs.

7 INDEMNIFICATION REGULATIONS

7.1 Sum insuredThe sum insured recorded in the policy is the upper limit of the company’s liability in each insurance event.

7.2 DeductibleThe deductible recorded in the policy is subtracted from the coverable expenses.

7.3 Coverable expensesThe insurance covers necessary and reasonable legal expenses as follows:

7.3.1 Disputed or non-contentious civil casesExpenses incurred by the insured for use of a legal counsel and presentation of evidence.

If bringing the case before a court requires a juristic act or a decision taken by a given body or in connection with any specific proceedings, the expenses are indemnified as of the date when the case can be brought before a district court.

If the matter has been handled as a conciliation case by a court of law, the insurance will also cover the insured’s portion of the fee and expenses for an assistant to the conciliator calculated per capita of the parties to the dispute.

7.3.2 Cases of arbitration or conciliationExpenses incurred by the insured for use of a legal counsel and presentation of evidence.

Restriction:Fees and costs of arbitrators and conciliators are not indemnified.

7.3.3 Criminal cases7.3.3.1 The insured as the complainantLegal expenses incurred by the insured for use of a legal counsel and presentation of evidence insofar as the court proceedings involved a civil claim made by the insured for other than legal expenses on the basis of a crime.

7.3.3.2 The insured as the defendantLegal expenses incurred by the insured for use of a legal counsel and presentation of evidence if the case involves charges raised by the complainant against the insured when the public prosecutor has waived or withdrawn charges for the same action.

7.3.4 Appealing to the Supreme CourtIf a permit is required to appeal to the Supreme Court, the costs incurred from the appeal are

indemnified under the insurance only if the permit has been granted.

Costs incurred in the use of extraordinary channels of appeal are indemnified only if the Supreme Court has approved the appeal for nullification, reversed the judgement or reinstituted a time limit forfeited.

7.3.5 Common interestIf the case involves an interest essentially other than that of the insured or the insured has an interest to safeguard in the insurance event in common with persons not covered by this insurance, the insurance indemnifies only for those costs which are attributable to the insured.

7.4 The amount and calculation of indemnityThe legal expenses indemnified under the insurance are determined in accordance with the relevant provisions of the Procedural Code and the Act on Criminal Proceedings.

If, owing to the admission by interested parties, the court of law has not mentioned legal expenses in its decision, or if the matter has been settled out of court, the coverable expenses are determined by taking into account the expenses normally paid or ordered by a court to be paid in similar cases. However, the coverable expenses come to a maximum of the amount which the court orders the insured party’s adverse party to pay, unless the court has specifically concluded, on the basis of the grounds appearing from its decision, that the insured party must personally bear his expenses, in part or in full, to his detriment.

For the use of a legal counsel, the insurance covers a reasonable fee charged by the counsel for his/her work and necessary expenses. In the determination of a reasonable sum for the fees and expenses, the value of the disputed benefit, the difficulty and extent of the case, and the quantity and quality of the work involved are taken into account. However, coverable expenses will not exceed the amount of expenses claimed by the insured party from the adverse party.

In case the monetary value of a disputed benefit is assessable, the insurance covers, in a disputed or non-contentious civil case and when the insured is a litigant in a criminal case, a maximum of a twofold amount of the disputed benefit. When assessing the amount of benefit, no claims for interest, legal or litigation expenses or expenses arising from being party to the matter are taken into account. In case a dispute concerns a periodic payment, a maximum of a tenfold amount of the disputed single periodic payment is taken into account when assessing the amount of benefit.

7.5 Expenses not covered by the insuranceThe insurance does not cover

7.5.1 expenses incurred from measures taken before an insurance event or from the preliminary investigation of a case or from the investigation or handling of such a disputed case as a result of which the insured justifiably waives his/her claims against the adverse party.

7.5.2 any legal expenses of the opposing party which the insured has been ordered, or has agreed, to pay.

The legal expenses of the opposing party which the insured has been ordered to pay are, however, indemnified on the same terms as the insured’s own legal expenses– if the insured has been assisted in the litigation

by the Consumer Ombudsman or his/her representative and the handling of the insured’s case was significant to the application of the law and in the interest of consumers, or

– if the opposing party of the insured has largely failed to observe a decision of the Consumer Disputes Board, the Insurance Complaints Board or an equivalent body, which in the central issues of the dispute was favourable to the insured.

7.5.3 expenses arising from the enforcement of a ruling or decision

7.5.4 the insured’s wasted time, own work, loss of income or earnings, travel or accommodation costs, or any additional costs arising from a change of legal counsel or from any conduct on the part of the insured which has increased costs or caused unnecessary costs

7.5.5 the costs of acquiring an expert legal opinion

7.5.6 costs incurred from reporting a criminal offence or making a request for investigation, or from pre-trial investigation of a criminal case

7.5.7 costs incurred from matters and evidence which the court of law will not take into account as they have been presented too late

7.5.8 costs caused by the insured or his/her legal counsel by not being present in court, by disregarding the orders of the court, or by entering a plea which they knew or should have known to be unfounded, or costs which they have themselves caused by prolonging the litigation wilfully or through negligence

7.5.9 costs for litigation which the insured or his/her legal counsel initiated without the opposing party giving any cause, or if they have in some other way caused litigation wilfully or through negligence

7.5.10 fees and costs of arbitrators and conciliators.

7.6 Other regulations concerning indemnity7.6.1 The insurance company indemnifies for the insured’s legal expenses after a legal ruling has been issued or a settlement has been reached.

Restriction:Final compensation is paid after the insured has, in response to the insurance company’s demand, proved that he/she has paid his/her deductible from the costs and that he/she has paid any amount exceeding the sum insured into the same bank account of the legal counsel into which any indemnity is to be paid out of the insurance.

7.6.2 The insurance company’s liability to pay indemnity will be reduced by any expenses compensation which the insured’s opposing party has been ordered by the court or has undertaken to pay to the insured, provided that it has been possible to collect this sum from the party liable for payment.

7.6.3 If the opposing party has been ordered by the court or has undertaken to pay expenses compensation to the insured and this remains unpaid at the time the indemnity is paid, the insured is obliged, before the indemnity is paid, to transfer his/her right to the said compensation to the insurance company, up to the sum indemnified.

If the insured has had to pay a proportion of the costs him/herself because they exceeded the maximum indemnity under section 7.1, the insured is obliged to transfer to the insurance company that part of the expenses compensation collected from the opposing party which is in excess of the part paid by the insured him/herself.

7.6.4 If the expenses compensation the opposing party has been ordered or has agreed to pay has been paid to the insured or it has otherwise been taken into consideration in the insured’s favour, the insured must return the expenses compensation cum interest to the insurance company up to the amount of compensation paid out of the insurance.

8 EXTENSION TO FORESTRYIf forest insurance, included in Extrasure, or forest fire insurance has been taken out on a forest, family legal expenses insurance will also apply to the following issues related to the insured forest property:

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8.1 The insurance applies to issues related to the insured party’s ownership, possession or forest management of the insured forest property.

8.2 Those insured also include such unpaid or temporary employees for whom the policyholder is liable as regards the activities specified in this section of the insurance terms and conditions.

8.3 Deviating from restriction section 5.2 of the insurance terms and conditions pertaining to wage-

earning activity, the insurance covers loss which is related to the insured party’s activities specified in this section of the terms and conditions.

8.4 Deviating from restriction section 5.6 of the insurance terms and conditions pertaining to issues related to the ownership and possession of a real estate property, the insurance covers a case related to a forest property specified in the contract and insured under forest or forest fire insurance.

Pet insurance

The insurance cover for pets includes animal, loss-of-use, medical expenses, dog litter and animal liability insurance.

COMMON PROVISIONS

1 THE INSURED ANIMALThe insured animal is the animal specified in the insurance policy.

2 VALIDITY

2.1 Territorial scope of validityThe insurance cover is valid throughout the Nordic countries.

The animal, loss-of-use, medical expenses and animal liability cover is temporarily also valid in the other EU countries and Switzerland, but only for a maximum of one year without interruption.

The territorial scope of the animal, loss-of-use and medical expenses insurance can be extended by a supplementary agreement at an additional premium.

2.2 Effect of the insured animal’s age on validity

The loss-of-use insurance ceases to be valid at the end of the insurance period during which the insured dog reaches the age of 8. The dog litter insurance ceases to be valid at the end of

the insurance period during which the insured dogs reach the age of 2. Other insurance policies cease to be valid at the end of the insurance period during which the animal reaches the age of 10.

3 COMMENCEMENT OF INSURANCE EVENT IN CASE OF ILLNESS

An illness is considered to have begun when it has begun in accordance with generally accepted veterinary practice, regardless of when the illness or its symptoms were first diagnosed.

Animal insurance

1 COVERABLE INSURANCE EVENTSCompensation is paid under the insurance when the insured animal during the validity of the insurance cover– has died because of an illness or accident– has fallen ill or been injured as a result of an

accident so severely that a vet has considered it necessary to have the animal put to sleep (euthanasia)

– has been lost or stolen .

Euthanasia is considered necessary when the animal has to be put to sleep for reasons of animal protection.

Restrictions:For compensation to be paid, the illness must have begun or the accident occurred during the validity of the insurance.

Payment of compensation for a lost or stolen animal requires that the animal has not been returned within thirty days of the disappearance or theft.

2 LOSSES EXCLUDED FROM COVERThe insurance does not cover the death or euthanasia of an animal if the reason for the death or euthanasia is– developmental disorder of the skeleton or the

joints– behavioural problem.

Similarly, compensation is not paid under the insurance insofar as the insurance event is indemnified under some other insurance, the Animal Diseases Act or otherwise from public funds.

3 COMPENSATIONThe compensation amount is the sum insured entered in the insurance policy.

4 REDUCTION OF THE SUM INSUREDThe sum insured of animal insurance is reduced when a right to compensation arises under loss-of-use insurance. The reduced sum insured is the difference between the former sum insured and the compensation paid out of the loss-of-use insurance.

Loss-off-use insurance

1 COVERABLE INSURANCE EVENTSCompensation is paid under the insurance if, as a result of an accident which occurred or an illness which began during the validity of the insurance, the insured dog, during the validity of the insurance, becomes permanently incapable of fulfilling the purpose for which it was insured.

Permanent incapability means that– a competition dog which has been used for

competitive shows and has successfully completed an official competition becomes permanently unable to compete

– a trained hunting dog which has successfully completed the required breed-specific working trials becomes permanently unable to hunt

– a stud dog with at least one registered litter becomes permanently unable to father offspring

– a specially trained dog used for the purpose of its training becomes permanently incapable of this use.

2 LOSSES EXCLUDED FROM COVERThe insurance does not cover loss of use caused by– a developmental disorder of the skeleton or

the joints– a behavioural problem.

Similarly, compensation is not paid under the insurance if the stud dog can no longer be used for breeding for genetic or other reasons.

3 COMPENSATIONThe compensation amount is the sum insured entered in the insurance policy.

4 EFFECT OF THE INSURANCE EVENT ON VALIDITY

The insurance ends when a right to compensation under this insurance has arisen.

8.5 The insurance does not cover a case where costs incurred by the insured are covered under legal expenses insurance included in farm insurance or under some other legal expenses insurance taken out by the policyholder.

8.6 In other respects, the insurance is subject to the family legal expenses insurance terms and conditions.

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Medical expenses insurance1 COVERABLE INSURANCE EVENTSCompensation is paid under the insurance for expenses incurred from the treatment of the insured animal caused by an illness or an accident, if the illness begins or the accident occurs during the validity of the insurance cover.

Restriction:Medical expenses are covered only if they are incurred during the validity of the insurance cover.

2 COMPENSATION

2.1 Coverable treatment expensesTreatment expenses are covered provided that the examination or treatment of the illness or injury is performed or prescribed by a vet. In addition, the examination or treatment procedures must be in accordance with generally accepted veterinary practice and necessary for treatment of the illness or injury in question.

Coverable treatment expenses include– fees for examination and treatment by a vet

– cost of bandaging and medical products sold at the chemist’s under a Finnish National Agency for Medicines licence

– fees for x-ray and laboratory examinations.

2.2 Expenses which are not coveredMedical expenses are not covered if they are caused by– a developmental disorder of the skeleton or

the joints– infertility or sterility– a behavioural problem– castration, sterilisation, treatment of

parasites or extraction of teeth, unless these are necessary to treat an illness or injury covered by the insurance

– the purchase of vitamins, minerals, food supplements, special diets or organically grown produce

– a caesarean section on a dog which has already had a caesarean section. The operation is never covered in the case of French or English bulldogs, Boston bull terriers or Chihuahuas

– preventive care

– false pregnancy– complications arising from an illness or

a medical procedure not covered by the insurance.

2.3 Deductible and maximum coverThe deductible entered in the policy is subtracted from the treatment expenses incurred during the qualifying period. The qualifying period begins when the animal is first taken to the vet or from the first visit after the expiry of the previous qualifying period. Each qualifying period is 180 days.

The maximum amount of medical expenses paid for one qualifying period is the sum insured for the animal concerned.

2.4 Value added tax (VAT)No VAT is paid from the insurance if the recipient of the compensation is liable to pay VAT.

Dog litter insurance

1 COVERABLE INSURANCE EVENTSThe insurance compensates for the death of an insured dog caused by a latent disorder during the validity of the insurance cover or for euthanasia which was necessary because of a latent disorder and was performed on the orders of a vet during the validity of the insurance cover.

The insurance also covers medical expenses for treatment of a latent disorder during the validity of the insurance cover.

A latent disorder is a congenital or heritable latent disease or a latent disorder which was impossible to diagnose in the vet’s examination required by the insurance company before the inception of the insurance but which, in accordance with veterinary experience, must have been in existence at the time of the examination.

Euthanasia is considered necessary when the dog must be put to sleep for reasons of animal protection.

Restriction:Compensation for the death or euthanasia of the dog is only paid if a written deed of sale had been made on the dog and the dog had been handed over to the buyer before the latent disorder was diagnosed. In addition, the seller must be liable to the buyer for a latent disorder under the consumer protection legislation. Even if the seller is not a trader as referred to in the said legislation, the liability is assessed accordingly.

2 LOSSES EXCLUDED FROM COVERThe insurance does not cover the dog’s death, euthanasia or medical expenses caused by– hip or elbow joint dysplasia– osteochondrosis– a behavioural problem– a disorder that does not affect the dog’s

health or life as a pet.

Similarly, no compensation is paid for– a latent disorder recurring in the second or

some later litter of a bitch whose puppy from a previous litter has had the same disorder, which the breeder has been or should have been aware of at the time the bitch was serviced

– death, euthanasia or medical expenses covered either fully or partly under Extrasure animal insurance or medical expenses insurance, regardless of whether the animal is covered by these insurance schemes

– medical expenses caused by the identification of a latent disorder if no such disorder is diagnosed

– medical expenses caused by the purchase of vitamins, minerals, food supplements, special diets or organically grown produce.

3 COMPENSATION

3.1 DeathWhen the dog dies, the sum insured entered in the insurance policy and the vet’s fee for putting the dog

to sleep are paid.

3.2 Medical expenses3.2.1 Coverable treatment expensesA precondition for the compensation of medical expenses is that the examination or treatment of a latent disorder is performed or prescribed by a vet. In addition, the examinations and treatments must be in accordance with generally accepted veterinary practice and necessary for treatment of the latent disorder in question.

The following costs of treatment are covered:– fees for examination and treatment by a vet– cost of bandaging and medical products sold at

the chemist’s under a Finnish National Agency for Medicines licence

– x-ray and laboratory fees.

3.2.2 Maximum compensation and deductibleThe maximum compensation paid for medical expenses during the validity of the insurance is the sum insured for the dog.

The deductible mentioned in the policy is subtracted per any one insurance event.

3.3 Value added tax (VAT)No VAT is paid from the insurance if the recipient of the indemnity is liable to pay VAT.

Safety regulations in pet insurance1 SIGNIFICANCE OF SAFETY

REGULATIONSThe safety regulations laid down in the insurance policy, insurance terms and conditions, or other instructions in writing shall be complied with. In the case of failure to comply with the safety regulations, any compensation payable may be reduced or denied under section 6 of the General Terms of Contract.

2 CARE OF THE ANIMALProper care of the animal includes necessary vaccinations. The dog shall at all times have a valid vaccination against the Parvo virus and distemper. The cats shall have a valid cat vaccination.

If the insured animal is injured, falls ill or goes limp, or suffers weight loss, the policyholder or the carer of the animal shall without delay report this to a vet and, if necessary, call a vet to see the animal or take the animal to a vet for treatment.

The treatment of a sick or injured animal must continue uninterrupted until it has recovered. Instructions given by the vet must be followed.

3 OTHER REGULATIONSThe provisions of the Animal Diseases Act and Prevention of Cruelty to Animals Act, and other regulations issued by the authorities shall be complied with.

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How to claim compensation under pet insurance

1 NOTIFICATION OF INSURANCE EVENTThe claimant must immediately notify the insurance company of the insurance event. This can be done by filling in the insurance company’s notification form.

2 ANIMAL INSURANCEA vet’s statement about the cause of death or need for euthanasia must be appended to the notification form.

The police must be informed without delay of the disappearance or theft of an animal. A copy of the notification made to the police must be appended to the notification form. If the strayed or stolen animal is returned to the owner, he or she must return the compensation to the insurance company without delay.

3 LOSS-OF-USE INSURANCEThe following documents must be appended to the notification form:

– copies of documents verifying the specific use for which the dog was insured

– a statement by a vet on permanent loss of use and the reason thereof.

4 MEDICAL EXPENSES INSURANCEThe following documents must be appended to the notification form– a vet’s bill of costs giving details of the treated

animal, the illness or injury, and the procedures performed

– original receipts for treatment expenses paid.

A claim for medical expenses indemnity must be submitted within one year of the date on which the expenses incurred.

5 DOG LITTER INSURANCE

5.1 Death benefitThe following documents must be appended to the notification form completed by the policyholder:

– a copy of a vet’s statement on an examination carried out before the inception of the insurance

– a copy of the deed of sale on the dog– evidence that the dog has been handed over– a vet’s statement on the cause of death or the

need for euthanasia.

5.2 Compensation for treatment expensesThe following documents must be appended to the notification form completed by the policyholder:– a copy of a vet’s statement on an examination

carried out before the inception of the insurance– a vet’s bill of costs giving details of the treated

animal, the latent disorder and the procedures performed

– original receipts for treatment expenses paid.

6 DOCUMENT COSTSClaimant must supply the documents listed in items 1-5 at their own cost. The insurance company will indemnify the cost of any other certificates, statements and records it asks for.

Animal liability insurance

1 THOSE INSUREDThose insured are the owner, carer and keeper, each in this capacity, of the animal specified in the insurance policy and covered by animal insurance.

2 COVERABLE INSURANCE EVENTS2.1 The animal liability insurance covers any bodily injury and material damage caused, within the territorial scope of validity of the insurance, to a third party by an animal which is insured under animal insurance and which is the legal responsibility of the insured person, provided that the liability has arisen from an act or negligence which has taken place during the validity of the insurance.

2.2 Loss or damage caused by a child is covered even if the child is not liable to pay damages because of his/her age. Contrary to section 7 of the General Terms of Contract, the insurance also covers wilful loss or damage caused by a child under the age of 12.

Restriction:Loss or damage caused by a child is not covered if a third party is liable for it.

2.3 Regardless of any fault of the insured, the insurance covers bodily injury resulting from the bite of a dog insured under animal insurance, and any loss or damage caused by the insured dog in a direct collision with a motor vehicle.

Restriction:This extension does not cover – loss or damage which is the liability of a third

party– a traffic or other accident caused by the driver

avoiding the dog.


3.1 loss or damage caused to– the insured or a person residing permanently

with the insured in the same household– the insured’s employee or the equivalent

insofar as the person concerned is entitled to compensation under statutory workers’ compensation or motor liability insurance.

3.2 loss or damage to property which, when the act or negligence causing the loss or damage took place, is or was in the possession of, at the personal disposal of, borrowed by, stored with or otherwise handled by or in the care of the insured or a person residing permanently in the same household as the insured

3.3 loss or damage for which the insured is liable only by virtue of an agreement, engagement, promise or guarantee

3.4 loss or damage caused by a strike or other similar cause.

4 SPECIAL MEASURES TO BE TAKEN ON OCCURRENCE OF AN INSURANCE EVENT

4.1 In any matter covered by this insurance, the company will determine whether the insured is liable to pay damages, will negotiate with the claimant and will pay the indemnity required by the loss.

4.2 The insured shall provide the company with an opportunity to assess the amount of loss or damage and to reach an amicable settlement.

Restriction:If the insured pays damages or agrees to pay damages for the loss or damage or approves the claim, this does not bind the company unless the amount and basis for the damages are manifestly correct.

4.3 If damages coverable under this insurance are demanded from the insured in legal proceedings, the insured must immediately notify the insurance company of the proceedings. The company will handle the legal proceedings at its own cost on behalf of the insured insofar as they concern the said damages.

Restriction:The costs of legal proceedings taking place outside the Nordic countries are indemnified to a maximum of EUR 8,500.

4.4 If the company has notified the insured of its readiness to settle with the injured party within the limits of the sum insured, and the insured does not consent thereto, the company is not obliged to indemnify for any extra costs incurred thereafter.

5 INDEMNIFICATION REGULATIONS5.1 The sum insured recorded in the policy is the upper limit of the company’s liability in each insurance event.

5.2 Multiple loss or damage caused by a single event or circumstance is considered a single insurance event.

5.3 In all insurance events, the insured is responsible for a certain amount of the loss, i.e. the deductible, which is specified in the insurance policy.

5.4 Legal provisions on value added tax (VAT) will be taken into account in calculations of the amount of loss.

If the recipient of the indemnity is entitled under the Value Added Tax Act, in his/her own value added taxation, to deduct the VAT included in purchase invoices for goods or services arising from the loss or to have the tax refunded, the tax is deducted from the indemnity.

If a deduction or refund right applies to the VAT included in the purchase invoice on the property or the relevant part of it, VAT corresponding to the loss amount is deducted from the indemnity.

If the indemnity is to be considered income which replaces business income subject to VAT, the indemnity is exempt from tax.

6 JOINT AND SEVERAL LIABILITYWhere several parties are jointly liable to make good a case of loss or damage, the insurance will indemnify for that part of the loss or damage which corresponds to the culpability attributable to the insured and to any advantage he/she may have gained through the insurance event.

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Forest insurance and forest fire insurance

The types of insurance covering forests are forest insurance and forest fire insurance.

By excluding risks, a type of forest insurance can be selected which only covers– losses caused by storm, snow, fire and lightning– losses caused by storm, fire and lightning– losses caused by storm and snow, or– losses caused by storm.

The form and type of the selected cover is recorded in an insurance policy.

If the policyholder has family liability and legal expenses insurance included in Extrasure,- family liability insurance also covers the insured

person’s liability for damages regarding forest management in a forest property, and

- family legal expenses insurance covers issues related to the insured party’s ownership, possession or forest management of the insured forest property.

Property insured The object of insurance is the forest of the farm specified in the insurance policy. ‘Forest’ refers to tree and sapling stands with silvicultural value.

A tree stand is forest in which the dominant height of the trees is over seven metres. A sapling stand is forest in which the dominant height of the trees is no more than seven metres and the diameter of the trees does not meet the requirements for pulpwood.

The object of insurance is also – any timber owned by the policyholder, felled on

the insured farm and stored at a felling site or roadside landing or in a forest depot

– seedlings intended for the forestation of the insured forest, when the seedlings are in a storage space, or before plantation temporarily in a motor vehicle or forest

– wood-felling residues, owned by the policyholder and collected or intended to be collected for bioenergy use, for which an agreement has been concluded with an outside buyer for processing forest chips.

Restriction:Sawn, planed or otherwise processed wood does not, however, constitute objects of insurance

Forest insurance

1 COVERABLE INSURANCE EVENTS1.1 The insurance covers direct material damage caused by storm to a tree stand, sapling stand, timber or seedlings to be planted.

1.2 The insurance covers direct material damage caused by snow to a tree stand, sapling stand, timber or seedlings to be planted.

1.3 The insurance covers direct material damage caused by fire, fire extinguishing measures or lightning to a tree stand, sapling stand, timber or seedlings to be planted or wood-felling residues.

1.4 The insurance covers direct material damage caused by insects, flood, theft or malicious damage to a tree stand, sapling stand, timber or seedlings to be planted. Loss or damage caused to wood-felling residues are only covered on condition that the loss or damage has been caused by theft or malicious damage.

1.5 The insurance covers direct material damage caused by rodents, hares, deer, birds or fungi to a sapling stand or seedlings to be planted.

Indemnities are paid on the condition that the damage has occurred during the validity of the insurance cover.

Restriction alternatives of the scope of cover

If recorded in an insurance policy, the insurance only covers

losses caused by storm, snow, fire and lightning as per sections 1.1, 1.2 and 1.3

losses caused by storm, fire and lightning as per sections 1.1 and 1.3

losses caused by storm and snow as per sections 1.1 and 1.2

losses caused by storm as per section 1.1

to a tree stand, sapling stand, timber or seedlings to be planted.

2 PRECONDITIONS FOR COMPENSATION OF INSURANCE EVENTS

2.1 Damage to a tree stand or timber is covered provided that the volume of damaged trees and timber totals at least 15 solid cubic metres per insurance event.

2.2 Damage to a sapling stand is covered provided that the continuous damaged area totals at least 0.5 ha and artificial reforestation is required to compensate for underproduction. The underproduction of the area is assessed in accordance with instructions from the Forestry Development Centre Tapio.

2.3 The preconditions laid down in sections 2.1 and 2.2 do not apply to loss caused by theft or malicious damage.

2.4 Damage to seedlings to be planted is covered provided that the amount of damaged seedlings equals at least an amount needed for planting a forest area of 0.5 ha.

2.5 Loss or damage caused to wood-felling residues is covered only if the amount of felling residues that has been destroyed or stolen equals at least the

amount collected or intended to be collected from a forest area of 0.5 ha.

3 REMOVAL OF THE PRECONDITIONS FOR COMPENSATION

3.1 If so recorded in the insurance policy, damage is covered even if the amount is smaller than is required under sections 2.1 and 2.2. In the case of damage to a sapling stand, however, underproduction as referred to under section 2.2 is a precondition for compensation.

3.2 If so recorded in the insurance policy, damage is covered even without existence of the preconditions for compensation as referred to under sections 2.1 and 2.2.


4.1 loss if the loss event began before the insurance took effect

4.2 loss insofar as it has been covered or it can be covered from public funds, or insofar as it is coverable under perpetual forest insurance or perpetual forest fire insurance

4.3 extinguishing costs or clearance costs

4.4 loss caused by pollution of the air, soil or water

4.5 reforestation due to damage to a tree stand. In case of damage caused by storm and fire to a seed-tree stand, however, the insurance covers forest cultivation costs in situations specified in section 4.2 of the indemnification regulations.

Forest fire insurance1 COVERABLE INSURANCE EVENTSThe insurance covers direct material damage caused by– fire and measures taken to extinguish it– lightningto a tree stand, sapling stand, timber, seedlings to be planted or felling residues during the validity of the insurance.

2 PRECONDITIONS FOR COMPENSATION OF INSURANCE EVENTS

2.1 Damage to a tree stand or timber is covered provided that the volume of damaged trees and timber totals at least 15 solid cubic metres per insurance event.

2.2 Damage to a sapling stand is covered provided that the continuous damaged area totals at least 0.5 ha and artificial reforestation

is required to compensate for underproduction. The underproduction of the area is assessed in accordance with instructions from the Forestry Development Centre Tapio.

2.3 Damage to seedlings to be planted is covered provided that the amount of damaged seedlings equals at least an amount needed for planting a forest area of 0.5 ha.

2.4 Loss or damage caused to wood-felling residues is only covered provided that the amount of felling residues that has been destroyed equals at least the amount obtained or intended to be obtained from a forest area of 0.5 ha.


3.1 loss if the loss event began before the insurance took effect

3.2 loss insofar as it has been covered or it can be covered from public funds, or insofar as it is coverable under perpetual forest insurance or perpetual forest fire insurance

3.3 extinguishing costs or clearance costs

3.4 loss caused by pollution of the air, soil or water

3.5 reforestation due to damage to a tree stand. In case of damage caused by fire to a seed-tree stand, however, the insurance covers forest cultivation costs in situations specified in section 4.2 of the indemnification regulations.

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Safety regulations for forest insurance and forest fire insurance

1 SIGNIFICANCE OF SAFETY REGULATIONS

The insured shall comply with the safety regulations given in the insurance policy, insurance terms and conditions or other instructions in writing. If the insured fails to comply with the safety regulations, the compensation payable to him/her may be reduced or denied under section 6 of the General Terms of Contract.

2 OPEN FIRENo open fire may be built without the necessary permits. No camp fire or any other open fire may

be built if, owing to a drought or some other reason, the conditions are such that there is an obvious risk of forest fire.

Open fires must be watched over continuously and extinguished with extreme care. Proper extinguishing equipment must be at hand when an open fire is burning.

3 INSECT AND FUNGUS DAMAGEIn order to prevent damage by insects and fungi, unbarked softwood must be taken from the logging site or interim storage site in accordance with the Forest Insect and Fungi Damage Prevention Act

(263/1991), unless the logs are debarked one month before the planned transport date or protected against insect and fungal damage.

Softwood damaged by storm, snow, forest fire or other reason must be removed from the forest within the time prescribed in the above act.

4 THEFT AND CRIMINAL DAMAGETo prevent theft and criminal damage, insured seedlings may not be stored alongside a public road or in an otherwise visible place without supervision.

Indemnification regulations for forest insurance and forest fire insurance

1 HOW TO CLAIM INDEMNITY

1.1 Notification of insurance eventThe claimant shall immediately notify the insurance company of an insurance event. This can be done by filling in the insurance company’s notification form.

The claimant shall provide the insurance company with the documents and information necessary for the assessment of the insurance company’s liability. These include documents and information which confirm the occurrence of loss, the extent of the loss and the recipient of indemnity. Examples of such documents are a police investigation report or notice of a crime, abstract of title and account of mortgage holders. A crime must be reported to the police at the location of the crime without delay.

1.2 Documents and the cost of obtaining them

The claimant must, if so requested, provide the insurance company with a police investigation report. The company will refund the costs of the police investigation report and any other official documents it has requested for the claims handling.

Any costs incurred from a specialist’s evaluation requested by the insurance company for the claims handling are refunded. To clarify the amount of loss, the insurance company may require a certificate of measurement with unit prices or a deed of conveyance.

1.3 Loss inspectionThe insurance company must be reserved the right to inspect the loss before the damaged area is cleared, damaged trees are harvested or other measures are taken which may hamper ascertainment of the loss.

The fact that the insurance company inspects or assesses the loss does not prove that the loss is coverable under the insurance.

2 UPPER LIMITS OF INDEMNITYThe insurance covers damage to a tree stand and timber caused by– their destruction– unsuitability for use or– the fall of a higher stumpage price tree stand or

timber into a lower assortment class (a change in the timber assortment).

In addition, the insurance covers loss due to a rise in the felling and harvesting costs of a tree stand.

The maximum compensation for a tree stand is its stumpage price and for timber the sales price for the felled timber. If the tree stand is destroyed completely with no residual value, increased felling and harvesting costs are indemnified even in excess of the stumpage price. The indemnity in excess of the stumpage price for increased felling and harvesting costs may not, however, be more than 20 per cent of the stumpage price.

The loss caused by the destruction of a sapling stand is compensated in accordance with the instructions of the Forestry Development Centre Tapio.

Curly birches are considered equivalent to silver birches and Christmas tree plantations equivalent to spruce stands.

Storm damage to a tree stand is only compensated up to the maximum indemnity specified in the insurance policy in euros per solid cubic metre.

3 DEDUCTIBLEIn all insurance events, the policyholder is responsible for a certain amount of the loss, i.e. the deductible, which is specified in the insurance policy. Also, when the maximum indemnity for storm damage applies, the deductible is subtracted from the maximum indemnity.

4 COSTS COVERED IN ADDITION TO MATERIAL DAMAGE

4.1 Compensation of expectation value lossIn addition to material damage, the insurance covers the expectation value loss incurred from premature cutting following a coverable loss. The insurance also covers expectation value loss where the maximum indemnity limit for storm damage applies. The expectation value of a tree stand refers to its current value calculated on the basis of the income from felling obtainable in the future.

To qualify for compensation for expectation value loss, the tree stand must, as a result of a loss, have been underproductive as defined by the Forestry Development Centre Tapio.

4.2 Forest cultivation costs in case of damage caused by storm or fire to seed-tree stand

The insurance covers forest cultivation costs if storm makes seed trees fall or fire destroys a seed-tree stand to the extent that artificial reforestation is required to compensate for underproduction. Artificial reforestation is replaced if natural reforestation has been recorded in the valid forestation plan as the most recommendable forestation method in the said forest area and if the forestation has been undertaken in accordance with guidelines issued by a forest professional. It is required, among other things, that enough seed trees are available and that they have been grouped in an accurate manner and that the forest area intended for reforestation has been cultivated or that cultivation measures are recorded to be taken in a forest use declaration.

Losses are covered on the basis of costs incurred from forest seeding. Compensation is paid on the condition that the forest area has been insured under insurance corresponding to storm or fire insurance and that compensation is paid even if the volume of the damaged tree stand did not total 15 solid cubic metres as required by the preconditions for compensation.

Artificial reforestation, instead of forest seeding where seedlings are planted, is only covered if that is specifically justified in the damaged forest area according to the guidelines issued by a forest professional.

Expenses are not covered if storm makes seed trees fall or if fire damages the seed-tree stand after five full calendar years have elapsed from the year of seed-tree cutting.

4.3 Indemnity for fire-watch and other measures taken to prevent loss or damage

In addition to material damage, the insurance covers – any necessary and reasonable fire-watch costs

from the moment when the rescue operations leader has transferred the responsibility for the fire-watch to the forest owner

– any reasonable costs incurred due to measures taken by the policyholder to prevent and limit forest fire

5 COMPENSATION FOR LOSS

5.1 Bases for the amount of compensationThe basis for the amount of compensation is the felling value of the tree stand, the price of timber or the cost value of the sapling stand.

If the property still has value after the loss, it is taken into account when the compensation is calculated. The residual value is defined on the same bases as the value before the loss.

The felling value of a tree stand refers to the stumpage price obtainable for the stand if it had been sold as current timber assortments at the price level current in the place of loss at the date of loss.

The price of timber refers to the sales price obtainable for felled timber at the price level current in the place of loss at the date of loss.

The cost value of a sapling stand refers to the cost of establishing and growing such a stand.

Loss or damage caused to wood-felling residues intended for bioenergy use is covered based on the current value loss. The amount of loss is determined by calculating the current value of the felling residues immediately before and after the damage occurred.

5.2 Bases of compensation in conservation areas

If the economic use of a forest land which is the object of insurance has been significantly restricted by some law, statute or agreement, the compensation payable may be reduced to correspond to the actual felling possibilities in the forest area at the time of loss.

5.3 Effect of false or insufficient informationIf the policyholder has submitted false or insufficient information for the calculation of the premium and too small a premium has, therefore, been collected, the

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indemnity is paid only for that part of the loss amount, reduced by the deductible, which corresponds to the ratio of the premium collected for the object of insurance to the premium determined on the basis of correct data.

5.4 Ornamental value coefficientIf an ornamental value coefficient has been specified in the insurance policy, the amount of loss for a tree stand is its felling value and for saplings the cost value multiplied by the ornamental value coefficient.

6 INDEMNITY FOR MORTGAGED PROPERTY

If indemnity is paid on property for which a real estate mortgage has been secured, the owner of the property is entitled to receive the indemnity (Land Act, chapter 17, section 8) provided that:– he/she has repaired the damage within

reasonable time– he/she has provided assurance that the

indemnity will be used to renovate or repair the damaged property

– the amount of indemnity is small compared to the value of the property, or

– it is evident that drawing the indemnity does not weaken the creditor’s chance of being paid back the debt.

7 VALUE ADDED TAXLegal provisions on value added tax will be taken into account in calculations of the amount of loss.

If the insurance indemnity is considered income which replaces income from business operations subject to value added tax, the indemnity is paid tax free.

TRAVEL INSURANCEYou can select the following travel insurance policies under Extrasure:- Eurooppalainen Traveller’s Insurance- Luggage insurance

- travel liability insurance - legal expenses travel Insurance.


COMMON PROVISIONS TO ALL TRAVEL POLICIES

These provisions apply to all travel policies, that is, Eurooppalainen’s Traveller’s Insurance, luggage insurance, and legal expenses travel insurance and travel liability insurance.

1 TERRITORIAL LIMITSEurooppalainen’s Traveller’s Insurance coverage is valid on trips abroad throughout the world. If it has been separately agreed and the appropriate entry has been made in the policy with regard to a specific cover, this cover may also be valid on domestic trips.

Luggage, travel liability insurance and legal expenses. Travel Insurance policies are valid throughout the world for travels abroad and in Finland.

A travel abroad refers to a journey outside Finland. It begins when the insured person leaves his home, workplace, study place or holiday home in Finland and ends when he returns to any of the aforementioned places. The insurance cover is not, however, valid in the above-mentioned places, nor on journeys between them. A travel in Finland connected with a travel abroad forms part of the travel abroad in case the travel continues without interruption from the aforementioned places abroad or from abroad back.

A travel in Finland refers to journeys made to places which are more than a straight-line distance of 50 kilometres from the insured person’s home, place of work or study, or holiday home. It begins when the insured person leaves his home, workplace, study place or holiday home in Finland and ends when he returns to any of the aforementioned places. The insurance cover is not, however, valid in the above-mentioned places, nor on journeys between them.

2 VALIDITYThe maximum number of days that coverage is provided from the beginning of a journey is entered in Eurooppalainen Traveller’s Insurance policy.

Insurance coverage ends concerning a journey that has begun after a period that has been entered in the policy, even if the journey should be longer than that.

A travel abroad that has begun is not considered to end, i.e. a journey or stay abroad is not considered to have been interrupted, through a visit to Finland of less than 30 days, if the journey from which the insured person has returned has continued uninterruptedly for more than three months and the insured person intends to return to the same destination. Illnesses diagnosed or bodily injuries sustained during the visit in Finland are not coverable as travel illnesses or injuries abroad.

The length of time for a journey does not affect the validity of luggage, travel liability and legal expenses travel insurance.

3 EFFECT OF RESIDENCE ON INSURANCE VALIDITY

An insured person must have a factual and permanent home municipality and residence in Finland, under the Municipality of Residence Act and the Population Information System, at the time of the occurrence of the insured event in order to be entitled to compensation under the insurance he has taken out. If, however, an extension to the validity period has been separately agreed upon regarding certain cover under Eurooppalainen Traveller’s Insurance and the appropriate entry has been made in the insurance policy, the above requirement is not applied during the extension. If the same insured person has luggage, travel liability and legal expenses travel insurance, the above requirement is not applied to these policies either during the validity period extension of Eurooppalainen’s Traveller’s Insurance.

4 HIGH-RISK AREAS, NUCLEAR ACCIDENT AND AVIATION ACCIDENT

Eurooppalainen’s Traveller’s Insurance is not valid in a country or area to which the Ministry for Foreign Affairs of Finland recommends avoiding travelling or which the Ministry for Foreign Affairs of Finland recommends leaving. However, this exclusion will not apply - during ten days from the date of such

recommendation if the insured person has arrived in the country or a part of the country described above before the Ministry for Foreign Affairs’s recommendation, unless a major war is concerned or the insured person has participated in the war or an armed conflict or the insured

person has participated in peace-keeping operations organised by the United Nations, the European Union or another community or organisation, or some other military operation

- if the insured person’s travel illness or injury is not due to the reason why the Ministry for Foreign Affairs issued its recommendation.

If it has been separately agreed upon concerning certain coverage under Eurooppalainen Traveller’s Insurance and the appropriate entry has been made in the insurance policy to provide cover in high-risk areas, this cover will also be valid in a country or a part of the country to which the Ministry for Foreign Affairs of Finland recommends avoiding travelling or which the Ministry for Foreign Affairs of Finland recommends leaving even if the insured person’s travel illness or injury is due to the reason why the Ministry issued its recommendation. Extending the cover to include a high-risk area does not, however, extend the cover for a major war or situations in which the insured person participated in the war or an armed conflict. Despite the extension, the cover is not valid either if the insured person has participated in peace-keeping operations organised by the United Nations, the European Union or another community or organisation, or some other military operation.

The insurance does not cover damage or loss caused by a nuclear accident as described in the Nuclear Liability Act, or by damage caused by material, equipment or weapons based on nuclear reaction or ionising radiation, regardless of where the nuclear accident occurred.

In the event of illness, injury or death occurring in connection with an aviation accident, Eurooppalainen Traveller’s Insurance does not, neither in hobby nor in professional aviation, cover pilots or any other persons who are members of the flight crew or persons carrying out other duties related to the flight.

5 APPLICABILITY OF GENERAL TERMS AND CONDITIONS

The general terms and conditions are applied in all insurance policies.

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Eurooppalainen Traveller’s Incurance

1 INSURANCE COVER The following types of insurance cover are available:- Traveller’s Medical Treatment Cover - Traveller’s Disability Cover- Traveller’s Death Cover - Traveller’s Daily Allowance Cover- Traveller’s Crisis Cover - Travel Cancellation Cover- Travel Interruption Cover - Delayed Departure Cover- Missed Departure Cover.


2 COMMON PROVISIONS TO ALL COVERAGE UNDER EUROOPPALAINEN TRAVELLER’S INSURANCE

2.1 Those insuredThose insured are the persons named in the insurance policy.

2.2 BeneficiaryThe policyholder may name a beneficiary to whom any compensation is paid. Such a beneficiary clause and relevant alterations to or cancellations of it must be submitted to the insurance company in writing.

Compensation with the exception of Death Cover is paid to the insured person unless the policyholder has determined another beneficiary. When the insured person is an unborn child, the beneficiary is the mother until the child’s birth.

2.3 Validity during sports 2.3.1 Definition of competitive sportsBy competitive sports we mean sports games or matches arranged by a sports association or sports club and training arranged according to a training programme or other training typical of the sport, regardless of the level of competitiveness or the age of the insured person.

By training arranged according to a training programme we mean training carried out following either a written or verbal training plan (the coach does not have to be present).

Other training typical of the sport refers to training that supplements the main sport when done as part of preparation to games or sports.

2.3.2 Competitive sports Traveller’s Medical Treatment Cover, Traveller’s Daily Allowance Cover, Traveller’s Crisis Cover, Travel Cancellation Cover, Travel Interruption Cover, Delayed Departure Cover and Missed Departure Cover are not valid in competitive sports.

If it has been separately agreed and the appropriate entry has been made in Traveller’s Medical Treatment Cover or Travel Interruption Cover (comprehensive cover), this cover is nevertheless valid in the sports entered in the policy. They are nevertheless never valid for high-risk sport competitions referred to in clause 2.3.4.

However, Traveller’s Disability Cover and Traveller’s Death Cover are valid in competitive sports.

2.3.3 Special sports Traveller’s Medical Treatment Cover, Traveller’s Daily Allowance Cover, Traveller’s Crisis Cover, Travel Cancellation Cover, Travel Interruption Cover, Delayed Departure Cover and Missed Departure Cover are not valid in any of the sports listed below, referred to in these terms and conditions as special sports. The above applies regardless of whether the insured person is competing in any of the sports or not.

If it has been separately agreed and the appropriate entry has been made with reference to Traveller’s Medical Treatment Cover or Travel Interruption Cover (comprehensive cover), this cover is nevertheless valid in all the special sports listed below. However, the insurance is not valid in competitions of such special sports. Competitive sports have been specified in clause 2.3.1.

However, Traveller’s Disability Cover and Traveller’s Death Cover are valid in special sports.

Special sports are:- Motor sports- Combat and contact sports- The following team sports: Australian football,

rugby and lacrosse- The following winter sports: Bobsleigh, luge,

freestyle skiing and speed and downhill skiing- The following air sports: hot air ballooning, gas

ballooning, motor aviation, hang gliding and paragliding, ultralight aviation, parachuting, flying a homebuilt aircraft, gliding and motor gliding

- The following strength sports: Powerlifting, weightlifting and body building

- Scuba diving- Other special sports: BMX biking, water skiing,

bungee jumping, parasailing, skimbat and kite surfing, kite boarding, parkour, abseiling, acrobatics and free running.

2.3.4 High-risk sports Traveller’s Medical Treatment Cover, Traveller’s Daily Allowance Cover, Traveller’s Crisis Cover, Travel Cancellation Cover, Travel Interruption Cover, Delayed Departure Cover and Missed Departure Cover are not valid in the sports listed below, referred to in these terms and conditions as high-risk sports. The above applies regardless of whether the insured person is competing in any of the sports or not.

If it has been separately agreed and the appropriate entry has been made in Traveller’s Medical Treatment Cover or Travel Interruption Cover (comprehensive cover), this cover is nevertheless valid in the sports listed below as high-risk sports. This also means that coverage extends to competitive events in such sports. Competitive sports have been specified in clause 2.3.1.

However, Traveller’s Disability Cover and Traveller’s Death Cover are valid in high-risk sports.

High-risk sports are:- American football- Mixed Martial Arts- Wrestling- Off piste skiing - Ice and rock climbing- Ice and mountain climbing- Strength athletics- Downhill biking- Downhill skating- Ocean sailing- BASE jumping- Hiking in uninhabited areas- Wildwater canoeing- Freediving- Other sports where the risks are at similar level.

2.4 Effect of the insured’s age on validityTraveller’s Daily Allowance Cover expires at the end of the insurance period during which the insured reaches 70 years of age. Other insurance coverage expires at the end of the insurance period when the insured person turns 100.

2.5 Travel illness2.5.1 Travel illnessTravel illness is defined as an illness requiring medical treatment and which started, or its first symptoms appeared (with the insurance still being valid), during the journey and for which medical treatment was given during the journey or within 14 days of the end of the journey.

2.5.2 Travel illness does not include Travel illness does not include - Mountain sickness - Illness caused by abuse of medicine or use

of alcohol or other intoxicant- Illness that started before the journey or the

symptoms of which appeared before the journey. An illness as described above is not considered a travel sickness even if it suddenly gets worse during the journey or its status changes. Neither is it considered a travel illness when the worsening or change in the state of the illness was likely or expected on the basis of general medical experience. Even in cases of travel illness, any illness that began or showed its first symptoms before the journey is compensated as specified in clause 3.2.3 of Traveller’s Medical Treatment Cover

- Illness that started in connection with a medical examination or treatment, unless this was carried out for the treatment of a travel accident or illness compensated from the same insurance

- Illnesses, pain or other symptoms of teeth, periodontium or masticatory system. Even in cases that are not considered travel illnesses or accidents, sudden dental pain, dental pain treatment and injury to tooth caused by chewing are nevertheless compensated as specified in clause 3.2.2 of Traveller’s Medical Treatment Cover A dental injury caused by a travel accident is handled according to the terms and conditions in Traveller’s Medical Treatment Cover

- Termination of pregnancy or infertility or related illnesses or complications

- Pregnancy or childbirth or related illnesses or complications.

Extension for pregnancy when the insured person is an unborn child: When the insured is still unborn, the above

restriction related to pregnancy and childbirth is nevertheless not applied in a child’s Traveller’s Medical Treatment Cover in cases of sudden change in the pregnancy requiring immediate care and if the change according to general medical experience was not likely or predictable. In cases like this Traveller’s Medical Treatment Cover provides cover up to the birth as specified in the terms and conditions for the treatment of both child and mother to the extent that is necessary for the health of the child.

2.6 Travel accident and restrictions2.6.1 Travel accidentA travel accident is a sudden, external occurrence which is beyond the control of the insured, which takes place during the journey when the insurance cover is valid, and which causes bodily injury.

The following are also considered to be travel accidents which take place when the insurance cover is valid: unintentional drowning, heatstroke, sunstroke, hypothermia, injury caused by considerable variation in atmospheric pressure, gas poisoning sustained by the insured, and poisoning caused by a substance taken inadvertently.

2.6.2 Excluded from coverage as travel accidentsThe concept ‘travel accident’ does not include injury caused by- an event arising from an illness, defect or

injury of the insured- operation, treatment or other medical

procedure, unless the procedure is undertaken from the same policy in order to treat an injury or travel illness caused by a coverable travel accident

- by poisoning due to medicine, alcohol or other intoxicant used by the insured or due to a substance taken as food

- biting on a tooth or dentures, even though an external factor has contributed to the

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damage. However, damage to a tooth caused by biting is compensated as specified in clause 3.2.2

- suicide or attempted suicide.

Injuries which are not covered as travel accidents- hernia of the intervertebral disk, abdominal

or inguinal hernia, a rupture of an Achilles tendon, long head of biceps tendon or rotator cuff, or recurrent dislocation unless the injury was caused by an accident that would also cause injury to healthy tissues.

- infectious diseases caused by a bite or sting- the psychic consequences of an accident.

2.6.3 Effect of illness, defect, injury or degeneration not related to travel accidentThe insurance does not cover illness, defect, injury, or degeneration of the musculoskeletal system, which are not related to a travel accident, even if they had been symptomless before the accident. If these factors not related to the travel accident have materially contributed to the emergence of the injury sustained during the journey or its delayed recovery, compensation from Traveller’s Medical Treatment, Daily Allowance and Disability Cover will only be paid to the extent that the expenses, disability or permanent handicap are deemed to have been caused by the travel accident.

2.7 Reasonableness of expenses If it becomes apparent that the claimed expenses substantially exceed the generally accepted and applied reasonable level of prices and costs at the destination, the insurance company has the right to lower the amount of compensation but not, however, below the reasonable level.

2.8 The insurance company’s right to decide hospital/clinic

The insurance company has the right to decide the hospital/clinic where the insured person’s medical examinations and treatment procedures are undertaken, unless this is unreasonably inconvenient for the insured.

3 TRAVELLER’S MEDICAL TREATMENT COVER

3.1 Key contents of insurance cover The insurance compensates, as specified in these terms and conditions, for expenses caused by travel illnesses that began or travel accidents that occurred during the insurance’s validity.

The insurance also covers, to the extent specified herein, sudden tooth ache; injury to tooth caused by biting; sudden deterioration of illness before a journey; and expenses caused by a journey being interrupted or extended. Compensation can only be paid if the symptoms appear and injury took place during the policy’s validity period. The insurance also covers repatriation costs if the insured person dies during a journey and the policy is valid.

Compensation will be paid only if the expenses have incurred during the validity of the insurance.

Indemnifiable events must occur within a period, specified in the insurance policy, from the beginning of the journey.

A deductible specified in the insurance policy is subtracted from coverable expenses per each illness, accident or other coverable event. The size of the deductible in accidents depends on when the accident occurred, and in illnesses on when the illness examinations or treatment began.

Expenses are coverable as far as they do not grant or would not have granted entitlement to compensation under the Health Insurance Act, Motor Liability Insurance Act, Employment Accidents Act, Patient Injury Act or under equivalent foreign law or other legislation.

3.2 Coverable expenses 3.2.1 Travel illnesses and accidentsExpenses are covered provided that the examination or treatment of illness or injury is prescribed by a physician. In addition, the examination or treatment procedures must be in accordance with generally accepted medical practice and necessary for the treatment of the illness or injury in question.

Of these expenses, the following are coverable:- reasonable fees for examination and treatment

procedures carried out by physicians or healthcare professionals


- daily hospital charges- reasonable travel expenses to a local physician

or a hospital/clinic. Costs incurred by the insured person using his/her own car or hired car are covered to the maximum amount of motor vehicle travel costs specified under the decree issued by the Ministry of Social Affairs and Health on the basis of the Health Insurance Act

- costs of the first orthopaedic brace or bandage if no more than two weeks have elapsed from a coverable operation or accident as a result of which such a brace of bandage is required. These expenses are only covered up to EUR 500 per operation or accident.

- rental costs of forearm or underarm crutches- expenses for necessary physiotherapy prescribed

by a doctor following a fracture or an operation. The insurance compensates a maximum of 10 sessions per insurance event. However, treatment is never compensated for longer than the period specified in the insurance policy from the date of the first treatment or examination of the illness or the date of the accident.

The following are also compensated when related to travel illness or travel accident - necessary telephone charges incurred during

the journey up to EUR 200- necessary expenses for purchase of essential

commodities related to the medical treatment up to EUR 200, provided that such commodities are not, according to local practice, included in the hospital treatment.

The insurance company may demand that the insured be transported, at the insurance company’s expense, back to Finland for treatment if local treatment would otherwise cause substantially higher expenses as compared to similar treatment in Finland. If the insured does not accept the suggested arrangement, the insurance company undertakes to indemnify for expenses incurred from treatment given abroad up to an amount corresponding to expenses incurred from repatriation of the insured to Finland and treatment given in Finland.

Expenses caused by travel illness are compensated for no longer than the period specified in the insurance policy from the date of the first treatment or examination of the illness. Expenses incurred due to a travel accident are covered for a maximum of three years after the accident.

3.2.2 Sudden toothache and dental injury caused by bitingMedical treatment expenses incurred from necessary treatment of sudden toothache that started on a journey abroad, including reasonable local travel expenses, are covered up to a maximum total of EUR 300, provided that the ache began and treatment was given during the journey abroad and that the insurance was still valid.

We compensate necessary medical treatment expenses and local travel expenses incurred abroad from treatment of injury caused by biting on a tooth or dentures for up to a maximum total of EUR 300, provided that the injury occurred and treatment was given during the journey abroad and that the insurance was still valid.

Only those expenses are compensated that were incurred from the first day of the journey for a period entered as the insurance’s validity in the policy.

3.2.3 Sudden deterioration of illness before a journey Compensation for expenses caused by illness that began or whose symptoms appeared before the journey will be paid when it is a case of sudden deterioration or change of illness during the journey if the policy is valid and provided the deterioration or change were not foreseeable on the basis of general medical experience. Only acute, emergency-type medical treatment given at the destination is covered as expenses. Expenses will be covered for no more than 7 days from the first day of treatment, unless otherwise specified in the insurance policy.

3.2.4 Repatriation of a deceasedIf the insured dies during the journey – and the policy is valid at the time - the insurance will cover the insured person’s reasonable expenses for repatriation to Finland or reasonable funeral expenses abroad. These expenses will be paid regardless of the cause of death.

3.2.5 Travel interruption or delayed return The following items, 1-4, owing to travel interruption or delayed return will only be compensated if caused by travel illness or accident. Another condition for compensation is that the travel illness or travel accident is of the kind that the patient’s condition judged on medical grounds makes it necessary to return to Finland or to remain in the travel destination contrary to the original itinerary. The compelling nature of the reason is assessed purely on medical grounds. In situations like this, compensation is paid in cases of interruption of journey or delayed return for1. necessary and reasonable extra travel and

accommodation costs caused to the insured person during the journey when the journey must be interrupted or the return delayed owing to the insured person’s travel illness or accident

2. necessary and reasonable travel and accommodation costs caused to the insured person because a travelling companion’s journey is interrupted or return delayed owing to the latter’s travel illness, travel accident or death. The condition for compensation to be paid is that the travelling companion’s condition is serious. Such expenses are only compensated to one person per another person who fell ill or was injured

If approval has been received from the insurance company in advance, the following may also be compensated in cases of travel interruption or delayed return 3. costs for medically necessary repatriation of the

insured and of the travel expenses of a person who must accompany the insured out of medical necessity

4. reasonable travel and accommodation costs of one next of kin from Finland to the insured person and back to the next of kin’s home in Finland, provided the insured person’s life is by medical assessment at risk owing to a travel illness or accident.

If the journey is delayed or interrupted because the insured or person travelling with the insured refuses treatment, no extra travel or accommodation costs are compensated.

If the insured person’s journey is interrupted because his or his travelling companion’s close relative in Finland falls seriously ill unexpectedly and suddenly or has a serious accident or dies, the insured person’s necessary and reasonable extra accommodation and travel expenses back to Finland are compensated.

Expenses will be compensated only if the condition of the close relative in Finland is life-threatening.

By close relative we refer to the insured person’s next of kin, the insured person’s spouse or the insured

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person’s spouse’s next of kin. Any cousins or more distant relatives are not considered next of kin. By spouse we refer to a person who the insured person is married to or in a civil partnership or cohabits with.

By travelling companion we refer to up to two persons in addition to the insured person or a family with which the insured person has jointly made the travel reservations and gone for a trip together.

By extra travel and accommodation costs we refer to costs caused to the insured in addition to those paid in advance.

Expenses are only compensated during the period specified in the insurance policy from the date of the accident, or first examination or beginning of treatment of an illness.


physiotherapist, chiropractor, osteopath, naprapathy practitioners, masseur or equivalent health care professional. However, this restriction does not apply to necessary physiotherapy prescribed by a doctor following a fracture or an operation. Even then, a maximum of 10 treatments per insurance event are compensated and for no longer than the period specified in the insurance policy from the date of the first treatment or examination of the illness or the date of the accident

- purchase of micronutrient, mineral or vitamin preparations





- orthopaedic brace or bandage, unless it was the first of either that was acquired within two weeks of a coverable operation or accident. In cases like this, too, these expenses are only covered up to EUR 500 per operation or accident.



Indirect expenses, such as having a car, other means of transport or luggage delivered home, lost income, meal, parking or other similar costs are not compensated.


Expenses are not compensated if the same expense has already been compensated or if compensation has been sought from another voluntary cover or insurance policy.

3.4 Filing a claim 3.4.1 Notification of journey and illness or accidentThe claimant shall submit to the insurance company a written clarification of the journey, illnesses and accidents or death. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information necessary for claim settlement.

3.4.2 ReceiptsThe claimant must pay the treatment expenses him/herself and claim reimbursement of the expenses

under the Health Insurance Act. Claims under the Health Insurance Act must be submitted to the Social Insurance Institution within six months of paying the medical treatment expenses. The claimant must upon request provide the insurance company with the original receipt for the reimbursement paid by the Social Insurance Institution, plus copies of original receipts submitted to the Social Insurance Institution. Originals of the receipts for expenses which have not been reimbursed under the Health Insurance Act or some other law must also be submitted upon request to the insurance company.

Claimant must also pay for any other expenses and subsequently claim compensation they are entitled to by law from those responsible for them. If expenses have not been compensated by virtue of law, original receipts or equivalent documentation of them must be sent upon request to the insurance company.

3.4.3 Loss inquiry costsFees charged by doctors for medical statements are not compensated as loss inquiry costs. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.

3.5 Other applicable terms and conditionsThe common provisions of all travel insurance policies and Eurooppalainen Traveller’s Insurance are applied to this cover.

4 TRAVELLER’S DISABILITY COVER

4.1 Key contents of insurance coverThe right to compensation arises if the insured suffers permanent handicap caused by a travel accident which occurred during the validity of the cover and the permanent handicap has continued for three months, with the cover being valid throughout that time. Permanent handicap refers to a medically assessed general handicap which the insured has incurred through an injury and which, according to medical prognosis, is unlikely to be healed. In determining the handicap, only the nature of the injury is taken into account. The individual circumstances of the injured person, such as his/her profession or leisure-time pursuits, do not affect the determination of the handicap.

The degree of handicap is determined in accordance with the handicap classification decree by the Ministry of Social Affairs and Health on the basis of the Empoyment Accidents Act valid when the travel accident occurred. Injuries are divided into handicap classes 1-20, with class 20 corresponding to full handicap and class 1 to the smallest coverable handicap.

The benefit for full, permanent handicap as per class 20 is paid as a lump sum equal to the sum entered in the insurance policy valid at the time the travel accident occurred. For partial, permanent handicap, the benefit is paid as a lump sum equal to as many twentieths of the sum as indicated by the handicap class.

A handicap is considered permanent once it has been medically diagnosed as such, and this can be done no sooner than three months and no later than three years after the accident. The cover must be valid at this time.

If the degree of handicap changes by at least two handicap classes before three years have elapsed since the accident, the amount of benefit must be revised correspondingly provided the Disability Cover is still valid. However, no benefit already paid will be recovered.

The benefit will be paid under the insurance terms and conditions valid at the time of the travel accident.

4.2 ExclusionsNo benefit is paid for the psychic consequences of a travel accident.

4.3 Filing a claim The claimant must notify the insurance company of the journey and travel accident in writing by filling in the insurance company’s loss report accompanied by any other relevant documentation.

In order for the handicap benefit to be processed, the claimant must send upon request an E Doctor’s statement to the insurance company, describing the handicap. The fee for a doctor’s statement is compensated only if the insurance company has specifically requested for one.


5 TRAVELLER’S DEATH COVER

5.1 Key contents of insurance coverThe right to compensation arises if the insured dies as a result of a travel accident which occurred during the validity of the cover.

The compensation is the sum entered in the insurance policy valid at the time of the travel accident.


5.2 ExclusionsThe benefit is not paid if the insured dies after three years have elapsed since the accident occurred. Moreover, no benefit is paid for the psychic consequences of a travel accident.

5.3 Filing a claim The claimant must notify the insurance company of the journey and travel accident in writing.

For the processing of death benefit, the claimant must provide the insurance company with a death certificate for the insured and official extracts from the population register, or equivalent, on beneficiaries. The insurance company must also be sent, upon request, further documentation by the authorities on the cause of death.



6 TRAVELLER’S DAILY ALLOWANCE COVER

6.1 Key contents of insurance coverThe right to compensation arises if the insured who is in an employment relationship becomes unable to work as a result of a travel accident which occurred during the validity of the cover.

A daily compensation to the amount that was entered in the insurance policy on the date of the travel accident will be paid for days when the insured is fully unable to do the work he has been employed to do, and when work disability is only partial, the amount corresponding to the amount of work disability will be paid. Compensation will only be paid for the pays when the cover is valid.

An insured will be considered fully unable to work if owing to a travel accident that occurred while the cover was valid, he is – judged on medical grounds – unable to perform any of his usual work duties. An insured will be considered partly unable to work if owing to a travel accident that occurred while the cover was valid, he is – judged on medical grounds – unable to perform some of his usual work duties.

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The benefit is paid for as many days as the disability continues in excess of the qualifying period mentioned in the policy. The deductible will be subtracted once per each accident. The qualifying period begins on the first day of the disability as stated by a physician.

Benefit for any single travel accident is paid up to the maximum period stated in the policy.


The cover expires at the end of the insurance period during which the insured reaches 70 years of age.

6.2 ExclusionsCompensation will not be paid - for psychic consequences of a travel

accident- if the insured is not in an employment

relationship when the travel accident occurs.

6.3 Filing a claim The claimant must notify the insurance company of the journey and travel accident in writing and any current work relationships by filling in the insurance company’s loss report accompanied by any other relevant documentation.

For the purposes of having the daily benefit application processed, the claimant must submit to us documentation showing the disability period and the reason for the disability. A tax card must also be sent to us for the payment of the benefit.



7 TRAVELLER’S CRISIS COVER

7.1 Key contents of insurance coverThis cover compensates evacuation and psychotherapy expenses that were caused for reasons specified in the insurance terms and conditions.

Compensation will be paid only if the expenses have incurred during the validity of the insurance. The event on the basis of which compensation is sought must have occurred while the cover was still valid.

Indemnifiable events must also occur within a period, specified in the insurance policy, from the beginning of the journey.

Expenses are only covered insofar as they are not or would not have been coverable under the Health Insurance Act, Motor Liability Insurance Act, Empoyment Accidents Act or other act, or to the extent that the insured is not or would not have been entitled to compensation from the tour operator, travel agent, hotel, transport company or equivalent.

Expenses are not compensated from this cover if the right by law to compensation has been lost owing to a neglect of some insurance responsibility.

Evacuation and psychotherapy costs are compensated for up to the maximum amount per insurance event that is entered in the policy. Expenses are compensated up to the maximum amount that was valid when the event on the basis of which compensation is sought took place.

We will subtract the deductible per insurance event that was entered in the insurance policy and valid when the event on the basis of which compensation is sought took place.

7.2 Coverable events and restrictions to them

Evacuation and psychotherapy expenses are compensated when they were caused at the travel destination by - a sudden natural catastrophe- a sudden epidemic constituting a public hazard

or- a sudden armed conflict or act of terrorthat could not have been foreseen.

By natural catastrophe we refer to earthquakes, volcanic eruptions, landslides, large waves and floods or other major equivalent natural disasters.

By epidemic we mean a sudden and unforeseeable outbreak of infection that affects large groups of people or a large geographic area.

Expenses are compensated only if the Finnish Ministry for Foreign Affairs, a Finnish embassy or equivalent authority has noted the event that led to the evacuation and recommends people to leave the travel destination.

Another requirement is that the insured person follows the instructions provided by the Finnish Ministry for Foreign Affairs, a Finnish embassy or equivalent authority.

Moreover, psychotherapy expenses will be compensated if they incurred while the policy was valid during the journey and - the insured person and his/her travelling

companion were the target of a violent crime or its attempt

- there was a road, waterborne or air accident in which the insured person or his/her travelling companion was involved

- a significant fire broke out in the building where the insured was accommodated

By travelling companion we refer to a person with whom the insured person has jointly made the travel reservations and gone for a trip together.

The crime or attempted crime must be notified to the police.

Compensation will not be paid if- if a violent crime or its attempt was committed

or a fire caused by the spouse or common-law spouse, child, sibling or parent of the insured, or a person residing in the same household as the insured

- the travel destination is in an area to which the Ministry for Foreign Affairs of Finland or other Finnish authority has banned travel or recommended that you do not travel before that journey began

- if the insured has taken part in an armed conflict, a peacekeeping operation organised by the United Nations, the European Union or other organisation, or in some other military operation.

7.3 Coverable expenses7.3.1 Evacuation expenses Coverable expenses include the insured person’s reasonable and necessary travel and accommodation expenses which- are necessary in order for the insured to continue

according to the original itinerary or- were caused by the return trip to Finland from

the incident location.

The incident location we mean the place where a natural catastrophe, armed conflict, terrorist act or epidemic defined in these terms and conditions occurred.


Extra travel expenses cover ticket prices only up to tourist class.

The insured must personally arrange the travel and accommodation services for which he seeks compensation.

7.3.2 Psychotherapy costs We cover costs for psychotherapy given by a psychotherapist approved by the Finnish National Supervisory Authority for Welfare and Health (Valvira).

The prerequisite for compensation payment is that treatment has been sought within three months of the event for which compensation has been applied. Expenses are compensated for a maximum of six months from the coverable insurance event. Expenses are only compensated for psychotherapy provided in Finland and only for up to ten sessions per insurance event.

If psychotherapy comes in the form of couple, family or group therapy, only the insured person’s part of the therapy is compensated.

7.4 Expenses which are not coveredCoverable expenses do not include- loss of income or indirect costs, such as

those incurred for meals, parking or similar- expenses that have a l ready been

compensated or for which compensation has been sought from another voluntary cover or insurance policy.

7.5 Filing a claim 7.5.1 Documentation on the itinerary and coverable insurance eventThe claimant must submit to the insurance company a written itinerary and documentation on the event on the basis of which compensation is sought. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information necessary for claim settlement.


Claimant must also pay for any other expenses and subsequently claim compensation they are entitled to by law from those responsible for them. If expenses have not been compensated by virtue of law, original receipts or equivalent documentation of them must be sent upon request to the insurance company.



8 TRAVEL CANCELLATION COVER

8.1 Key contents of insurance coverThe cover compensates, during its validity, for travel cancellation when the insured person missed the departure for a compelling reason specified in the terms and conditions.

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Compensation will be paid only if the reason for the cancellation appeared and the journey was cancelled while Travel Cancellation Cover was valid.

Only those expenses are compensated that were incurred from the first day of the cancelled journey for a period entered as the insurance’s validity in the policy.

Expenses are only covered insofar as they are not or would not have been coverable under some Act or by a tour operator, travel agent, hotel, transport company or equivalent.

Costs are compensated for up to the maximum amount that is entered in the policy per cancelled journey. Costs are compensated according to the maximum amount of compensation that was valid when the reason for the cancellation became known.

A deductible referred to in the insurance policy that was valid when the reason for the cancellation became known is subtracted from each cancelled journey.

If the insured cannot begin the journey owing to an illness or injury included in the risk area exclusion, Travel Cancellation Cover will be valid only if its coverage has been extended.

8.2 Coverable cancellations and restrictions to them

8.2.1 Coverable events entitling to compensation under basic coverageAs cancellation, we compensate a journey that could not be started owing to a compelling reason attributed to any of the following:- sudden illness, accident or death suffered by the

insured- substantial loss of or material damage to the

insured’s property in Finland- serious, unexpected and sudden illness, serious

accident or death of a next of kin or spouse’s next of kin

- serious, unexpected and sudden illness, serious accident or death of travelling companion

- serious, unexpected and sudden illness, serious accident or death of travelling companion’s next of kin or travelling companion’s spouse’s next of kin.

By sudden illness we also mean a sudden deterioration of an illness which the insured person had had for a long time, provided such deterioration was not medically likely or predictable when the journey was booked.

The compelling nature of the reason related to either illness of accident is assessed purely on medical grounds.

With reference to property damage, a reason is considered compelling if the insured person’s presence is required at the site of the loss.

By close relative we refer to the insured person’s next of kin, the insured person’s spouse or the insured person’s spouse’s next of kin. Any cousins or more distant relatives are not considered next of kin. By spouse we refer to a person who the insured person is married to or in a civil partnership or cohabits with.

By travelling companion we refer to up to two persons in addition to the insured person or a single family with which the insured person has jointly made the travel reservations and to go for a trip together.

8.2.2 Coverable events entitling to compensation under comprehensive coverageAs cancellation, we compensate a journey that could not be started owing to a compelling reason attributed to any of the following:- sudden illness, accident or death suffered by the

insured- substantial loss of or material damage to the

insured’s property in Finland

- serious, unexpected and sudden illness, serious accident or death of a next of kin or spouse’s next of kin

- serious, unexpected and sudden illness, serious accident or death of travelling companion

- serious, unexpected and sudden illness, serious accident or death of travelling companion’s next of kin or travelling companion’s spouse’s next of kin.

By sudden illness we also mean a sudden deterioration of an illness which the insured person had had for a long time, provided such a deterioration was not medically likely or predictable when the journey was booked.

The compelling nature of the reason related to either illness or accident is assessed purely on medical grounds.


By travelling companion we refer to up to two persons in addition to the insured person or a single family with which the insured person has jointly made the travel reservations and to go for a trip together.

The insured is also entitled to compensation if he cannot go on the journey because- he becomes unemployed or is laid off- he has been invited to a wedding, christening

or confirmation taking place during a scheduled paid-for journey

- he attends a funeral that takes place during a scheduled paid-for journey

- he is in the process of getting a divorce- he has been summoned as a witness in court

during a scheduled paid-for journey- any of the above reasons has prevented his

spouse, insured underage child or underage insured person’s parent from joining them on a journey as planned

- if any of the reasons above has prevented his travelling companion’s travel.


8.2.3 Events not compensated from Travel Cancellation CoverTravel Cancellation Cover does not apply, neither under basic or comprehensive coverage if- the reason for the cancellation became

apparent before Travel Cancellation Cover became valid

- the reason for the cancellation became apparent before the reservation or payment of the journey

- coverage began later than three days prior to the beginning of the journey

- the reason for the cancellation is the insured’s fear of flying or contagious disease or other phobia

- a sudden illness or deterioration of pre-existing condition causing the cancellation was the result of medicine abuse or use of alcohol or other intoxicating substance.

8.3 Coverable expensesWe compensate expenses paid in advance for which the insured is responsible according to the tour operator’s or other service provider’s terms and conditions and which the tour operator or other service provider is not obliged to return by law, general terms and conditions of package tours or other conditions.

The tour operator or other service provider must be contacted to cancel a journey or other service as soon as it is clear that cancellation is necessary. If the journey is not cancelled, we only compensate from Travel Cancellation Cover the part of the insured person’s expenses which according to the

law or the terms and conditions of the tour organiser or other service provider would have been the insured person’s responsibility if the journey had been cancelled.

8.4 Expenses which are not coveredCoverable expenses do not include- loss of bonus points, RCI points or equivalent- indirect costs, such as those arising from

claiming for compensation- expenses that have a l ready been


8.5 Filing a claim 8.5.1 Documentation for cancellation of a journeyThe claimant must submit to the insurance company written documentation on the itinerary, cancellation of journey, the reason for the cancellation, the losses and any remuneration provided by the tour operator or other service provider. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information necessary for claim settlement.

8.5.2 ReceiptsClaimant must first pay for the expenses for which they are responsible by law and under the terms and conditions or the tour operator or other service provider and subsequently claim compensation from those liable for them. If expenses have not been compensated by virtue of law or according to the tour operator or other service provider, the claimant must, upon request, submit to the insurance company original receipts or equivalent documentation of them, as well as information on any remuneration received.

8.5.3 Loss inquiry costsDoctor’s fees, other medical treatment expenses or fees charged by doctors for medical statements are not compensated as loss inquiry costs. Claimant must acquire said documentation and information and submit them to the insurance company at their own expense.


9 TRAVEL INTERRUPTION COVER

9.1 Key contents of insurance coverCompensation is paid in accordance with these terms and conditions when the insured person’s journey is interrupted for a reason referred to in the terms and conditions.

Compensation will only be paid if the reason for the interruption became apparent or the loss took place during the validity of the insurance.

Indemnifiable events must also occur within a period, specified in the insurance policy, from the beginning of the journey. Only those expenses are compensated that were incurred from the first day of the interrupted journey for a period entered as the insurance’s validity in the policy. However, the expenses of a new one-way journey necessary for work or study will be compensated even if this took place after this period.


Expenses are usually compensated up to a maximum total of a sum entered in the insurance policy per incident that caused the interruption. Costs are compensated according to the maximum amount of compensation that was valid when the reason for the interruption became known.

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We will subtract the deductible per insurance event that was entered in the insurance policy and valid when the reason for the interruption became apparent.


9.2.1 Coverable insurance eventsJourney interruption expenses are compensated if a journey is interrupted because the insured person is hospitalised at the destination or has to return to Finland prematurely for a reason specified in the insurance terms and conditions.

Journey interruption is compensated provided there was a compelling reason for the interruption:- travel illness, travel accident or death of the

insured during the journey - travel illness, travell accident or death of travelling

companion - substantial loss of or material damage to the

insured’s property in Finland.

With regard to returning to Finland early, the condition for compensation is that the travel illness or travel accident is of the kind that the patient’s condition judged on medical grounds makes it necessary to return to Finland.

The compelling nature of the reason related to either illness of accident is assessed purely on medical grounds.


Travel interruption expenses are also compensated if the insured has to return from the travel destination to Finland prematurely because- the insured person’s next of kin in Finland

unexpectedly and suddenly falls ill, has a serious accident or dies

- the insured person’s travelling companion’s next of kin in Finland unexpectedly and suddenly falls ill, has a serious accident or dies.

Expenses will be compensated only if the condition of the close relative in Finland is life-threatening.


By travelling companion we refer to up to two persons in addition to the insured person or a family with which the insured person has jointly made the travel reservations and gone for a trip together.

9.2.2 Events not covered from Travel Interruption Cover Travel interruption is not compensated if the reason for any interruption has been known before the journey began.

9.3 Coverable expenses9.3.1 Expenses coverable from basic coverageIf a journey is interrupted, we will compensate expenses you have paid before the reason for the interruption became apparent.

We cover the following expenses due to travel interruption:- separately paid services that were not at all used,

and trips at the destination - separately paid trips you never went to

and travel tickets outside the destination where the interruption occurred or from there onwards and the insured person’s part of such unused accommodation or other services. If these expenses are already included in the compensation for the entire journey described in the next item, they will not be compensated on the basis of this item

- the price of the entire journey if the insured person loses at least 70% of his travel days owing to hospitalisation or coming back home prematurely. Indemnity for days lost on account of hospital treatment is only paid to the insured who is hospitalised. If the insured who is hospitalised is under 15 years of age and the treatment of the travel illness or injury requires, on the order of a physician, the guardian’s assistance, the guardian is correspondingly indemnified for travel days lost

- necessary and reasonable extra travel and accommodation expenses to the insured during the journey when the insured is compelled to interrupt his journey owing to major loss to his property in Finland. By extra travel and accommodation costs we refer to costs caused to the insured owing to journey interruption in addition to those paid in advance

- reasonable expenses approved by the insurance company for a new journey to the same destination if such a journey takes place during the validity of the insurance and is necessary because of work or continuing studies in an educational institution.

Any unused services or accommodation or trips and journeys you will not get to must be cancelled with the tour organiser or service provider as soon as the reason for the interruption becomes apparent. If they are not cancelled, Travel Interruption Cover only compensates the part of the insured person’s expenses which according to the law or the terms and conditions of the tour organiser or other service provider would have been the insured person’s responsibility if cancellation had been done.

By services we mean separately paid rented transportation, courses, events and equivalent related to the interrupted journey. By local trips we mean short trips in the travel destination or its immediate vicinity.

The price of the journey is considered to be previously bought travel tickets and the insured person’s part of previously paid-for accommodation expenses or the price of a package tour or special package tour. Separately paid services and local trips are not included in the calculation of the journey price. A package tour is defined here as a journey which is subject to the general terms and conditions of package tours and the Package Travel Act. By special package tour we mean a journey to which also the tour organiser’s special conditions are applied.

Journey days are calculated as full 24-hour periods from the time the insured arrived at the first travel destination to the scheduled departure time of the means of transport to which the insured had already at the time of the interruption bought a ticket.

Lost journey days are calculated as full 24-hour periods from the time hospitalisation began or from the journey interruption to the time when hospitalisation ended, or in the case of travel interruption, to the scheduled departure time of the means of transport to which the insured had already at the time of the interruption bought a ticket. If the last period is over 12 hours but less than 24 hours, this period is also factored in when calculating lost journey days.

If the insured has not already bought a ticket to leave the destination when the reason for the interruption becomes apparent, the price of the entire journey will not be compensated on the basis of lost travel journeys.

9.3.2 Expenses coverable from comprehensive coverageIf a journey is interrupted, we will compensate expenses you have paid before the reason for the interruption became apparent.We cover the following expenses due to travel interruption:- separately paid services that were not at all used,

and trips at the destination

- separately paid trips you never went to and travel tickets outside the destination where the interruption occurred or from there onwards and the insured person’s part of such unused accommodation or other services. If these expenses are already included in the compensation for the entire journey described in the next item, they will not be compensated on the basis of this item

- the price of the entire journey if the insured person loses at least 40% of his travel days owing to hospitalisation or coming back home prematurely. Indemnity for days lost on account of hospital treatment is only paid to the insured who is hospitalised. If the insured who is hospitalised is under 15 years of age and the treatment of the travel illness or injury requires, on the order of a physician, the guardian’s assistance, the guardian is correspondingly indemnified for travel days lost

- necessary and reasonable extra travel and accommodation expenses to the insured during the journey when the insured is compelled to interrupt his journey owing to major loss to his property in Finland. By extra travel and accommodation costs we refer to costs caused to the insured owing to journey interruption in addition to those paid in advance

- reasonable expenses approved by the insurance company for a new journey to the same destination if such a journey takes place during the validity of the insurance and is necessary because of work or continuing studies in an educational institution.

Any unused services or accommodation or trips and journeys you will not get to must be cancelled with the tour organiser or service provider as soon as the reason for the interruption becomes apparent. If they are not cancelled, Travel Interruption Cover only compensates the part of the insured person’s expenses which according to the law or the terms and conditions of the tour organiser or other service provider would have been the insured person’s responsibility if cancellation had been done.

By services we mean separately paid rented transportation, courses, events and equivalent related to the interrupted journey. By local trips we mean short trips in the travel destination or its immediate vicinity.

The price of the journey is considered to be previously bought travel tickets and the insured person’s part of previously paid-for accommodation expenses or the price of a package tour or special package tour. Separately paid services and local trips are not included in the calculation of the journey price. A package tour is defined here as a journey which is subject to the general terms and conditions of package tours and the Package Travel Act. By special package tour we mean a journey to which also the tour organiser’s special conditions are applied.

Journey days are calculated as full 24-hour periods from the time the insured arrived at the first travel destination to the scheduled departure time of the means of transport to which the insured had already at the time of the interruption bought a ticket.

Lost journey days are calculated as full 24-hour periods from the time hospitalisation began or from the journey interruption to the time when hospitalisation ended, or in the case of travel interruption, to the scheduled departure time of the means of transport to which the insured had already at the time of the interruption bought a ticket. If the last period is over 12 hours but less than 24 hours, this period is also factored in when calculating lost journey days.

If the insured has not already bought a ticket to leave the destination when the reason for the interruption becomes apparent, the price of the entire journey will not be compensated on the basis of lost travel journeys.

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9.4 Expenses which are not coveredCoverable expenses do not include- extra travel and accommodation costs,

unless the reason for the travel interruption is major damage to the insured person’s property in Finland. By extra travel and accommodation costs we refer to costs caused to the insured owing to journey interruption in addition to those paid in advance

- the costs of transporting a car, other means of transport or luggage back to Finland

- loss of bonus points, RCI points or equivalent- loss of income or indirect costs, such as



9.5 Filing a claim 9.5.1 Itinerary and documentation on event causing interruptionClaimant must submit to the insurance company written documentation on the itinerary, illness, accident or death that caused the interruption, or major damage to property in Finland, and any expenses and losses that were incurred. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information necessary for claim settlement.

9.5.2 ReceiptsClaimant must first pay for the expenses and subsequently claim compensation from those responsible for them under the law or tour organiser’s or other service provider’s terms and conditions. If expenses have not been compensated by virtue of law or according to the tour operator or other service provider, the claimant must submit upon request original receipts or equivalent documentation of them to the insurance company.



10 DELAYED DEPARTURE COVER

10.1 Key contents of insurance coverThe insurance provides cover for alternative routes, when the insured must wait for public transportation for a reason referred to in the insurance terms and conditions.

Compensation is only paid if the reason for waiting has become apparent and the expense for the alternative route occurred while the insurance was valid.

Indemnifiable events must also occur within a period, specified in the insurance policy, from the beginning of the journey. Only those expenses are compensated that were incurred from the first day of the journey for a period entered as the insurance’s validity in the policy.


Costs are compensated for up to the maximum amount that is entered in the policy per one journey. Costs are compensated according to the maximum amount of compensation that was valid when the journey began.

We will subtract the deductible per insurance event that was entered in the insurance policy and valid when the reason for waiting became apparent.


Expenses are covered if the vehicle with which the insured person should be using and for which he had already bought a ticket does not depart in at least four hours or at all from Finland to abroad or from the location where the journey back to Finland should start. Expenses are covered if the delay occurs because a means of public transport cannot be used owing to poor weather, natural disaster, technical fault, criminal act or action taken by the authorities.

It may also have been separately agreed upon and so entered in the insurance policy that coverage is extended to domestic travel.

The condition for any compensation to be paid is that the insured submits to the insurance company the reasons for the delay provided by the airline, transport company, tour organiser or authority.

Expenses are not compensated if the reason for waiting or delay was a strike or bankruptcy.

10.3 Coverable expensesCoverable expenses include the insured person’s reasonable extra travel costs that are necessary to continue the journey to the destination or back to Finland according to the original itinerary.

By extra travel costs we refer to costs caused to the insured in addition to those paid in advance.

10.4 Expenses which are not coveredCoverable expenses do not include- bonus or other points used to cover extra

travel expenses- loss of income or indirect casts, such as



10.5 Filing a claim 10.5.1 Documentation concerning journey and waiting Claimant must submit to the insurance company written documentation on the itinerary, delayed vehicle, the reason for its delay and the extra costs. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information necessary for claim settlement.

10.5.2 ReceiptsClaimant must first pay for the expenses and subsequently claim compensation from those responsible for them under the law or tour organiser’s or other service provider’s terms and conditions. If expenses have not been compensated by virtue of law or according to the tour operator or other service provider, the claimant must submit upon request original receipts or equivalent documentation of them to the insurance company.

10.5.3 Loss inquiry costsClaimant must acquire said documentation and information and submit them to the insurance company at their own expense.


11 MISSED DEPARTURE COVER

11.1 Key contents of insurance coverCoverage is provided against missed departure for a journey abroad in the cases referred to in the terms and conditions.

Compensation is only paid if the reason for the delay has become apparent and the expense caused by it occurred while the insurance was valid.

Indemnifiable events must also occur within a period, specified in the insurance policy, from the beginning of the journey. Only those expenses are compensated that were incurred from the first day of the journey for a period entered as the insurance’s validity in the policy.


The compensation is up to the maximum amount that is entered in the policy per insurance event caused by missed departure. Costs are compensated according to the maximum amount of compensation that was valid when the reason for the missed departure became apparent.

We will subtract the deductible per insurance event that was entered in the insurance policy and valid when the reason for the missed departure became apparent.


Missed departure is compensated if the insured fails to arrive at the departure point for a flight or a boat, train or bus journey to a foreign destination or the departure point for a connecting flight or a boat, train or bus journey to a foreign destination because- a public conveyance on which the insured

intended to travel or on which he/she was travelling to the above departure point is delayed due to weather, natural catastrophe, technical malfunction, criminal act, traffic accident or action by an authority, or

- a motor vehicle which the insured intended to use or which he was actually using to get to the above departure point is delayed due to weather, natural catastrophe, technical malfunction, criminal act against the vehicle, traffic accident or action by an authority.

Compensation is payable provided that - the insured has already bought a ticket for the

vehicle he misses - the insured submits to the insurance company

written documentation provided by the airline, transport company, tour organiser, authority or vehicle repair shop on the reason for the delay.

Expenses are not compensated if the reason for the missed departure was a strike or bankruptcy.

11.3 Coverable expensesThe following are compensated from Missed Departure Cover:- insured person’s reasonable extra travel and

accommodation costs that are necessary to continue the journey to the destination or back to Finland according to the original itinerary

- travel services at the destination bought separately in advance that were not used because the insured person missed his departure

- the share of lost travel days of the journey price owing to missed departure, or the entire price of the journey if, owing to the missed departure, it is no longer possible to take the journey.


By travel services we mean vehicle rents, fees for local trips and courses and event entrance fees related to the journey in question which the insured has paid in advance.

The price of the journey is considered to be previously bought travel tickets and the insured person’s part of previously paid-for accommodation expenses or the price of a package tour or special package tour. Separately paid travel services are not included in

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the calculation of the journey price. A package tour is defined here as a journey which is subject to the general terms and conditions of package tours and the Package Travel Act. By special package tour we mean a journey to which also the tour organiser’s special conditions are applied.

Journey days are calculated as full 24-hour periods from the time the insured should have arrived at the travel destination according to the original itinerary to the scheduled departure time of the latest means of transport to which the insured had already bought a ticket. Lost travel days are calculated as full 24-hour periods from the time when the insured should have arrived at the destination according to the original itinerary to the time when he actually arrived there.

If the insured has not already bought a ticket to leave the destination when the reason for the missed departure becomes apparent, the share of lost travel days of the journey price will not be compensated.

11.4 Expenses which are not coveredCoverable expenses do not include- bonus or other points used to cover extra

travel expenses

- loss of income or indirect costs, such as those incurred for meals, parking or similar

- lost travel days if the insured receives compensation for the price of the entire journey from Travel Interruption Cover

- expenses that have a l ready been compensated or for which compensation has been sought from another voluntary cover or insurance policy.

11.5 Filing a claim 11.5.1 Documentation on the itinerary and missed departureThe claimant must submit to the insurance company written documentation on the itinerary, missed departure, reason for missed departure and any expenses and losses that resulted. This must be done by filling in the insurance company’s loss report. If requested, you must also provide additional information in order to settle the claim.

11.5.2 ReceiptsClaimant must first pay for the expenses and subsequently claim compensation from those

Luggage insurance1 CONTENT OF INSURANCEThe insurance covers the insured luggage against material damage during the validity of the insurance.

2 THOSE INSUREDThose insured are the policyholder and persons residing permanently in the same household as the policyholder, unless otherwise stipulated in the policy.

3 PROPERTY INSUREDLuggage means property of the insured taken along on or acquired during a journey. The insurance covers luggage up to the maximum total of the sum insured stated in the policy.

Instruments of payment and securities are considered luggage up to a total of EUR 85 when carried by the insured, and up to a total of EUR 500 if kept in a locked safe deposit box.

Restrictions:The following are not considered to be luggage:– motorised vehicles, caravans or other

trailers, watercraft or aircraft, or any parts or accessories thereof, with the exception of keys to motorised vehicles

– sailboards or sails thereof– merchandise, samples of goods, advertising

material, commercial or educational films or tapes, photographs, drawings, or program diskettes

– professional equipment, te le- and photocopiers, or files and software included in IT storage devices

– manuscripts, collections and their parts– removal goods or separate consignments– animals or plants.

4 COVERABLE INSURANCE EVENTS4.1 The insurance indemnifies for any direct material damage caused by some sudden and unforeseeable occurrence during the validity of the insurance.

4.2 Irrespective of the sum insured, the insurance covers– any reasonable expenses incurred in searching

for lost luggage, provided the luggage had been entrusted to a hotel, haulage or transport company, tour operator or similar

– any reasonable costs incurred by the insured in taking action to limit or prevent loss that has occurred or is imminent and that is coverable under this insurance

– expenses caused by acquiring necessities when luggage handed in for transportation is delayed at least two hours after the insured has reached the destination of his/her outward journey. These expenses will be indemnified up to a maximum of EUR 85 per day or part thereof and to a maximum total of EUR 340 per person insured.

– travel, accommodation and telephone costs incurred from the theft of travel tickets, visa or passport during a journey to a maximum of EUR 170.

5 LOSSES EXCLUDED FROM COVERThe insurance does not cover– any loss arising from the loss of payment

instruments and securities or from leaving them behind

– any loss arising from the ordinary use of goods, or damage to goods caused by insufficient covering, wear and tear, chafing, scratching, corrosion or other comparable gradual phenomenon

– any loss arising from an action taken by the authorities

– any loss which is covered under some special legislation, guarantee or other insurance

– sports equipment or sports gear occurring while being used for its intended purpose, except where the loss or damage is caused by negligence of a third party

– theft of valuables kept in a motor vehicle, trailer, boat, outside boot of a motor vehicle or trailer, pannier of a vehicle or a tent

– theft of optical instruments, electronic equipment and electric tools kept in a trailer, outside boot of a motor vehicle or trailer, pannier of a vehicle or a tent. However, this exclusion does not apply to theft of optical instruments, electronic equipment and electric tools from caravans

– any loss arising from luggage disappearing or being left behind.

Valuables include jewellery, precious metal objects, furs, valuable collections and works of art.

The insurance does, however, cover loss up to EUR 120 arising from luggage, other than payment instruments and securities, disappearing or being left behind, provided that the time, place and circumstances of the loss can be defined, that the loss was noticed during the journey at the place where it occurred and that an outsider was demonstrably and immediately informed of the loss. If luggage left in the custody of the tour operator or corresponding party is lost, the loss is covered to its full amount, though not beyond the maximum of the sum insured.


If a loss or damage is coverable under the insurance terms and conditions, sections 1, 3 and 6 of the safety regulations for none-life insurance apply to this insurance.

The indemnification regulations concerning under-insurance do not apply to luggage insurance. Otherwise the indemnity is calculated according to the indemnification regulations for non-life insurance.

Travel liability insuranceThe common provisions on travel insurance and, where these are not applicable, the terms and conditions of family liability insurance apply to travel liability insurance, with the following exceptions.

1 THOSE INSUREDThose insured are the policyholder and the persons residing permanently in the same household as

the policyholder, unless otherwise stipulated in the policy.

2 COVERABLE INSURANCE EVENTSAs an exception to section 4.2 of the terms and conditions for family liability insurance, the insurance covers any loss sustained by the insured because of damage suddenly caused by him/her to a bicycle,

moped, scooter or a corresponding watercraft rented temporarily by him/her. On the same conditions, the insurance also covers damage caused to skis, ski poles or snowboards rented for a maximum of 14 days abroad.

Restriction:In the cases referred to above, loss is covered up to a maximum of EUR 340.

responsible for them under the law or tour organiser’s or other service provider’s terms and conditions. If expenses have not been compensated by virtue of law or according to the tour operator or other service provider, the claimant must submit upon request original receipts or equivalent documentation of them to the insurance company.

11.5.3 Loss inquiry costsClaimant must acquire said documentation and information and submit them to the insurance company at their own expense.


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Legal expenses travel insuranceThe common provisions on travel insurance and, where these are not applicable, the terms and conditions of family legal expenses insurance apply to legal expenses travel insurance, with the following exceptions.

1 PURPOSE OF INSURANCEThe insurance applies to the insured in his/her capacity of traveller in matters related to his/her private life in insurance events set out in the family

legal expenses insurance and occurring within the territorial scope and during the validity of the insurance in question.

2 THOSE INSUREDThose insured are the policyholder and the persons residing permanently in the same household as the policyholder, unless otherwise stipulated in the policy.

3 COURTS OF LAWThe insured may refer to the insurance in matters which in Finland can be brought directly before a district court or before a corresponding foreign court.

This means that the insurance does not cover expenses in cases which are handled by the administrative authorities or by other special courts, e.g. a provincial State office, an administrative court, the Insurance Court or the Supreme Administrative Court.

GENERAL TERMS OF CONTRACTThe general terms of contract apply to all the types of insurance included in the insurance contract. They apply to both insurance of the person and non-life insurance, unless the heading or text of an individual section indicates that it applies only to insurance of the person or non-life insurance.

These General Terms of Contract contain the relevant provisions of the Insurance Contracts Act (543/94). The symbol § in brackets refers to the relevant sections of the Insurance Contracts Act in which the matters in question are dealt with. The insurance contract is also subject to certain provisions of the Insurance Contracts Act not appearing from these General Terms of Contract.

1 KEY CONCEPTS (§§2 6, 16, 17 AND 31)Insurance of the person, or personal insurance, is insurance by which a natural person is covered. Such insurance includes Pohjola Health Incurance, Pohjola Living Allowance Insurance, Life Incurance, Disability Incurance and Eurooppalainen Traveller’s Insurance.

Non-life insurance is a policy taken out to cover a loss incurred due to material damage, an obligation to pay damages, or other financial loss. Non-life insurance comprises MyHome insurance, luggage insurance, valuables insurance, small boat insurance, pet insurance, forest insurance, forest fire insurance, liability insurance and legal expenses insurance.

The essential content of an insurance contract is defined in the insurance policy and the insurance terms and conditions.

Policyholder is a party who has concluded an insurance contract with the insurer.

The insurer for Life Insurance and Disability Insurance is OP Life Assurance Company Limited and for travel insurance (Eurooppalainen Travel Insurance, luggage, travel liability and legal expenses travel insurance) the insurer is Eurooppalainen Insurance Company Ltd. For any other insurance, the insurer is Pohjola Insurance Ltd.

In these terms and conditions, the insurers are referred to as the insurance company. The insurers under the contract are stated in the insurance policy.

Insured is a party who is covered by personal insurance or for whose benefit non-life insurance is valid.

Insurance period is the agreed period recorded in the insurance policy during which the insurance is valid. The insurance contract continues for one agreed insurance period at a time, unless either contracting party gives notice of termination.

Premium period is the period for which a premium is paid at regular intervals as agreed.

Insurance event is an event for which compensation is paid under the insurance.

Safety regulation is the obligation to observe regulations on a device, procedure or other

arrangement recorded in the non-life insurance policy or insurance terms and conditions, or otherwise in written form, aimed at preventing or restricting the occurrence of a loss.

2 DISCLOSURE OF INFORMATION PRIOR TO CONCLUDING AN INSURANCE CONTRACT

2.1 Insurance company’s obligation to disclose information (§§5 and 9)

Prior to concluding an insurance contract, the insurance company will provide the insurance applicant with relevant information on such matters as the insurance company’s own types of insurance, premiums and insurance terms and conditions, so that the applicant can evaluate his/her insurance needs and choose the most suitable insurance cover. The insurance company will also bring the most relevant insurance exclusions to the applicant’s attention.

In distance selling of insurance products, the insurance company must also provide consumers with the advance information referred to in chapter 6 a of the Consumer Protection Act. Distance selling refers to selling insurance policies for example over the telephone or on the internet.

If the insurance company or its representative has failed to provide the policyholder with any necessary information when marketing its insurance or has provided him/her with incorrect or misleading information, the insurance contract will be considered valid in the form that the policyholder has had reason to understand it in the light of the information he/she received.

2.2 Policyholder’s and insured party’s obligation to disclose information (§§22, 23 and 24)

Prior to the insurance being granted, the policyholder and the insured party must provide full and correct answers to all questions presented by the insurance company that may be relevant to the assessment of the insurance company’s liability. During the validity of the insurance period, the policyholder and the insured party must also correct without undue delay any information provided to the insurance company by him/her which he/she has found to be incorrect or insufficient.

If the policyholder or the insured person has acted fraudulently with regard to the above-mentioned obligation, the insurance contract is not binding on the insurance company. The insurance company has the right to withhold all premiums paid, even if the insurance is annulled.

2.3 Failure to disclose information2.3.1 Insurance of the person (§24)If the policyholder or the insured person has wilfully or through negligence which cannot be deemed minor failed in his/her obligation to disclose information under personal insurance, and the insurance company would have refused to grant the insurance altogether had the full and correct information been provided, the insurance company is released from liability. If the insurance company had

granted the insurance only against a higher premium or otherwise on terms other than those agreed, the insurance company’s liability is restricted to what corresponds to the agreed premium or the terms on which the insurance would have been granted.

If the above-mentioned consequences of failure to disclose information lead to a result that is clearly unreasonable from the point of view of the policyholder or another party entitled to compensation, they may be adjusted.

2.3.2 Non-life insurance (§§23 and 34)If the policyholder or the insured person has wilfully or through negligence which cannot be deemed minor failed in his/her obligation to disclose information under non-life insurance, the compensation payable under the insurance can be reduced or disallowed. When considering whether compensation must be reduced or disallowed, the insurance company takes account of the effect of the incorrect or insufficient information given by the policyholder or the insured person on bringing about the loss or damage. In addition, it takes account of the policyholder’s and the insured person’s intent or the type of negligence and other circumstances.

If, due to incorrect or insufficient information provided by the policyholder or the insured person, the agreed premium is smaller than it would have been had the insurance company been given the correct and full information, the insurance company, when reducing the amount of compensation, takes account of the ratio of the agreed premium to the premium that would have been charged had the information provided been correct and full. If, however, the information provided differs only slightly from the correct and full information, the insurance company is not entitled to reducing compensation.

3 COMMENCEMENT OF THE INSURANCE COMPANY’S LIABILITY AND VALIDITY OF THE INSURANCE CONTRACT

3.1 Commencement of the insurance company’s liability (§11)

If the insurance company has not agreed on any other date individually with the policyholder, the insurance company’s liability will commence from the time when the insurance company or the policyholder has submitted or sent an affirmative reply to the offer/bid of the other contracting party.

Payment of the premium for the insurance period is a precondition for commencement of the insurance company’s liability- always in the case of a fixed-period travel

insurance;- if the insurance company has set the payment

of the premium for the first insurance period as a precondition before continuous travel insurance can enter into force; or

- if there are special reasons, for instance, because of the policyholder’s earlier default of payment.

The insurance bill contains a mention to this effect.

In the case of medical treatment expenses insurance reserved to take effect at childbirth, the insurance

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company’s liability will not commence until the reservation premium has been paid in full by the due date indicated in the bill. The mention of this precondition appears from the cover letter of the bill.

If the policyholder has submitted or sent a written insurance application to the insurance company and if it is apparent that the insurance company would have approved the application, the insurance company will also assume liability for an insurance event occurring after the application was submitted or sent.

An insurance application or an affirmative reply which the policyholder has submitted or sent to the insurance company’s representative is considered to have been submitted or sent to the insurance company. If there is no indication of the time of the day when the reply or application was submitted or sent, it is considered to have taken place at 12.00 midnight.

3.2 Grounds for granting insuranceThe insurance premium and other contract terms are determined in accordance with the policy anniversary. If new insurance is added to the contract, the premium and other terms of contract for this insurance are determined in accordance with the date of inception of the added insurance.

For insurance of the person, the insured person’s state of health is assessed and his/her age calculated on the basis of his/her state of health and age at the time he/she gave or submitted the insurance application. The insurance premium and other contract terms are determined on the basis of the insured person’s state of health at the time he/she gave or submitted the insurance application.The insurance company will not reject an application for personal insurance on the grounds that an insurance event has occurred or that the state of health of the person for whom the application is made deteriorated after the application documents were submitted or sent to the insurance company.

3.3 Validity of the insurance contract3.3.1 Insurance of the person (§17)After the first premium period, the insurance contract is valid for one agreed premium period at a time, unless the policyholder or the insurance company terminates the contract. However, the insurance company has no right to terminate the contract in the case of Life Insurance.

The insurance contract may also terminate for other reasons referred to in clauses 4.2 and 14 below.

3.3.2 Non-life insurance (§16)After the first insurance period, the insurance contract is valid for one agreed insurance period at a time, unless the policyholder or the insurance company terminates the contract.

The insurance contract may also terminate for other reasons referred to in clauses 4.2 and 14 below.

3.3.3 Fixed-period insuranceA fixed-period insurance contract is valid for the agreed insurance period. However, the insurance may terminate during the insurance period on grounds specified in clauses 4.2, 14.1 and 14.2 below.

Under fixed-period travel insurance, if the journey back to the insured person’s country of residence is delayed for reasons beyond his/her control, the validity period of the insurance will be extended by 48 hours.

4 INSURANCE PREMIUM

4.1 Premium payment (§38)The insurance premium must be paid within one month of the date on which the bill for the premium was sent by the insurance company to the policyholder. However, the initial premium need not be paid before the commencement of the insurance

company’s liability, nor the subsequent premiums before the beginning of the agreed premium period or insurance period, except in circumstances described in clause 3.1 above, whereby the insurance company’s liability will not commence until the premium has been paid. If some of the insurance company’s liability commences at a later date, the related premium will not need to be paid before said liability commences.

The premiums of individual insurance policies included in the same insurance contract are combined into a single premium to be invoiced in one or several instalments as agreed. If a premium resulting from an alteration made to the insurance contract has not been combined with the instalments agreed previously, this premium will be invoiced separately. The insurance premium paid for this insurance contract is divided among all individual policies in proportion to the ratio of the premium paid to the billed amount in such a way that all continuous insurance policies are valid until the same date.

If payment by the policyholder is not sufficient to cover all Pohjola’s insurance premium receivables, the policyholder has the right to decide for which of the outstanding premiums he/she wishes to use the money. However, the policyholder’s payment will primarily apply to the insurance contract in accordance with the reference data based on the paid bill unless the policyholder has specifically determined otherwise in writing in connection with the payment.

4.2 Delayed premium (§39)If the policyholder has neglected to pay the premium in part or in full by the due date as referred to in clause 4.1 above, the insurance company has the right to terminate the insurance contract in 14 days’ time after sending a notice of termination. Such termination may also be carried out by one insurance company on behalf of another.

However, if the policyholder pays the outstanding premium in full before the end of the notice period, the insurance will not cease to be effective at the end of the notice period. The insurance company will state this option in its notice of termination.

If the delay in payment is caused by the policyholder’s financial difficulties resulting from illness, unemployment or other special reason primarily beyond the policyholder’s control, then, despite the notice given, the insurance will not expire until 14 days after the obstacle in question has ceased to exist. However, the insurance will expire three months from the end of the notice period, at the latest. The notice of termination states this option to continue the insurance for a fixed period. The policyholder must notify the insurance company in writing of the financial difficulties referred hereto during the notice period at the latest. If the premium is not paid by the due date referred to in clause 4.1 above, penalty interest shall be paid for the period of delay in accordance with the Interest Act.

The insurance company is entitled to compensation for costs incurred due to collection of insurance premiums under the Act on the Collection of Debts. If the insurance company has to collect an unpaid insurance premium through legal action, it is also entitled to being recompensed for the statutory fees and charges incurred due to legal proceedings.

The insurance company may transfer outstanding amounts for collection by a third party.

4.3 Reinstatement of terminated insurance of the person (§43)

If a contract of insurance of the person has terminated as a result of non-payment of other than the initial premium, the insurance regains its validity if the policyholder pays the outstanding premium within six months of termination of the insurance. The insurance company will state this option in its notice of termination.

If the insurance regains its validity, the insurance company’s liability will commence on the day following payment.

4.4 Payment of a delayed non-life insurance premium (§42)

If the policyholder pays a non-life insurance premium in full after the insurance has terminated, the insurance company’s liability will commence on the day following payment. In such a case, the insurance is valid from the date of its reinstatement until the end of the insurance period originally agreed.

However, if the insurance company does not wish to reinstate the insurance, the insurance company will, within 14 days of payment of the premium, notify the policyholder that it will not accept the payment.

4.5 Returning of premium at the termination of a contract (§45)

If the insurance terminates before the date agreed, the insurance company is entitled only to the premium for the period during which it was liable. The rest of the premium paid will be returned to the policyholder.

When determining the amount of the returnable premium, the validity is calculated in days according to the insurance period to which the premium pertains.

However, the premium is not returnable in cases stated below in this clause or if the policyholder or the insured person has acted fraudulently in the circumstances referred to in clause 2.2 above. However, the premium will not be returned separately if the returnable euro amount is smaller than that mentioned in the Insurance Contracts Act.

The insurance company charges a non-returnable minimum premium for travel insurance, valuables insurance, animal insurance and treatment expenses insurance covering animals, as specified in the respective policies.

4.6 Setoff against premiums to be returnedAny one of the insurance companies may, on behalf of all of the insurance companies that may be acting as insurers in the Extrasure insurance cover, deduct any outstanding premiums overdue and other outstanding amounts from the premium to be returned.

5 DISCLOSURE OF INFORMATION DURING VALIDITY OF CONTRACT

5.1 The insurance company’s obligation to disclose information (§§6, 7 and 9)

Upon entering into an insurance contract, the insurance company issues the policyholder with an insurance policy and the insurance terms and conditions, if these terms and conditions have not already been given to the policyholder. In distance selling of insurance products to consumers, however, the provisions of chapter 6 a, section 11 of the Consumer Protection Act shall apply.

During the validity of the insurance, the insurance company will annually notify the policyholder of the sum insured and any other insurance-related matters that are of obvious relevance to the policyholder (annual bulletin).

If, during the validity period of the insurance, the insurance company or its representative has provided insufficient, incorrect or misleading information on the insurance, the insurance contract will be considered valid in the form that the policyholder has had reason to understand it in the light of the information he/she was given, provided that such insufficient, incorrect or misleading information can be regarded as having influenced the policyholder’s conduct. However, this does not apply to information provided by the insurance company or its representative on future compensation payable after an insurance event has occurred.

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5.2 Policyholder’s obligation to disclose information about any increase in risk

5.2.1 Insurance of the person (§27)The policyholder must notify the insurance company of any changes in factors increasing risk that were reported when the insurance contract was concluded and that are relevant in terms of assessment of the insurance company’s liability, such as changes in profession/occupation, leisure time activities or place of residence, or the termination of any other insurance cover. The policyholder must notify the insurance company of any such changes no later than one month of receipt of the annual bulletin following such a change. Notifying of changes in the state of health is not required. The insurance company reminds policyholders in the annual bulletin of their disclosure obligation.

If, in the case of insurance of the person, the policyholder has wilfully or through negligence which cannot be deemed minor failed to notify the insurance company of increased risk as mentioned above, and the insurance company would not have kept the insurance in force as a result of the changed circumstances, the insurance company is released from liability. If, however, the insurance company had extended the validity of the insurance but only for a higher premium or on other terms, the insurance company’s liability is limited to what corresponds to the insurance premium or the terms on which the insurance would have been extended.

If the above-mentioned consequences of failure to disclose information lead to a result that is clearly unreasonable from the point of view of the policyholder or another party entitled to compensation, they may be adjusted.

5.2.2 Non-life insurance (§§26 and 34)In the case of non-life insurance, the policyholder must notify the insurance company of any essential change, during the insurance period, in the circumstances stated at the time of concluding the insurance contract or in the state of affairs recorded in the insurance policy which has increased the risk of loss or damage, and which the insurer cannot be deemed to have taken into account when concluding the contract. The policyholder must notify the insurance company of any such changes no later than one month of receipt of the annual bulletin following such a change. The insurance company will remind the policyholder of this obligation in the annual bulletin.

Changes resulting in increased risk may include repairs, alterations or extensions of the insured object, its altered use, surrender to the use of others than those insured for a continuous period exceeding three months, or transfer to other than homelike premises.

If the holder of a non-life insurance policy has wilfully or through negligence which cannot be deemed minor failed to notify the insurance company of the increased risk, the insurance company may reduce or disallow the compensation payable under the insurance. The effect of the changed, risk-increasing circumstance on the occurrence of the loss or damage is taken into account when considering whether to reduce or disallow the compensation. The policyholder’s intent or the type of negligence and any other circumstances will also be taken into account.

If, due to incorrect or insufficient information provided by the policyholder or the insured person, the agreed premium is smaller than it would have been had the insurance company been given the correct and full information, the ratio of the agreed premium to the premium that would have been charged had the information provided been correct and full is taken into account. If, however, the information provided differs only slightly from the correct and full information, the insurance company is not entitled to reducing the compensation.

5.3 Decrease in risk of lossIf the risk of loss has decreased to such an extent that it has a bearing on the insurance contract, the

company is responsible, having been informed thereof by the policyholder, for adjusting the premium and the insurance terms and conditions to correspond to the changed circumstances as of the date of the change, and at the earliest as of the beginning of the current insurance period.

6 OBLIGATION TO PREVENT AND MITIGATE LOSS OR DAMAGE UNDER NON-LIFE INSURANCE

6.1 Obligation to observe safety regulations (§§31 and 34)

The insured person must observe the safety regulations recorded in the insurance policy, or in the insurance terms and conditions or otherwise provided in writing. If the insured person has wilfully or through negligence which cannot be deemed minor failed to observe the safety regulations, the insurance company may reduce or disallow any compensation payable to him/her. The effect of the failure to observe the safety regulations on the occurrence of a loss or damage is taken into account when considering whether to reduce or disallow the compensation. The insured person’s intent or type of negligence and any other circumstances will also be taken into account.

6.2 Obligation to prevent and mitigate loss or damage (duty of salvage) (§§32, 34 and 61)

In the case of an insurance event or the immediate threat of one, the insured person must, to the best of his ability, take the necessary action to prevent or mitigate the loss or damage. If the loss or damage is caused by a third party, the insured person must take the necessary action to uphold the insurance company’s right vis-à-vis the liable party. The insured person must, for instance, attempt to establish the identity of the liable party. If the loss or damage resulted from a punishable act, the insured person shall, without delay, report it to the police and sue the offenders if the insurance company’s interest so requires. The insured person must, in other respects too, observe all instructions given by the insurance company aimed at preventing and mitigating loss or damage.

The insurance company will indemnify for reasonable expenses incurred due to fulfilling the above duty of salvage even if the sum insured were thus be exceeded.

If the insured person has wilfully or through negligence which cannot be deemed minor failed to observe the duty of salvage referred to above, the insurance company may reduce or disallow the compensation payable to him/her. The effect of the insured person’s failure to observe the duty on the occurrence of the loss or damage is taken into account in considering whether to reduce or disallow compensation. The insured person’s intent or type of negligence and any other circumstances will also be taken into account.

6.3 Failure to observe the safety regulations and the duty of salvage under liability insurance (§§31 and 32)

Under liability insurance, negligence on the part of the insured person will not lead to compensation being reduced or disallowed.

However, if the insured person has wilfully or through gross negligence failed to observe the safety regulations or the duty of salvage, or if the insured person’s use of alcohol or other intoxicant has contributed to the negligence, compensation may be reduced or disallowed.

If the insured person has through gross negligence failed to observe the safety regulations or the duty of salvage or if his/her use of alcohol or other intoxicant has contributed to the negligence, the insurance company will nevertheless pay under the liability insurance that portion of the compensation which the natural person who has suffered the loss or damage has been unable to collect because of the insured

person’s state of insolvency as authenticated by distraint or bankruptcy.

7 CAUSING AN INSURANCE EVENT

7.1 Insurance of the person7.1.1 Occurrence of the insurance event (§28)The insurance company is released from liability to any insured who has wilfully caused a loss event.

If the insured person has caused the insurance event through gross negligence, the insurance company’s liability may be reduced, depending on what is deemed reasonable in the circumstances.

7.1.2 Insurance event caused by a person entitled to compensation or benefit (§29)If a person entitled to compensation or benefit other than the insured person has wilfully caused the insurance event, the insurance company is released from liability to such party. If a person has caused the occurrence of an insurance event through gross negligence or if he/she was at such an age or in such a state of mind the he/she could not have been sentenced to punishment for a crime, the person may be entitled to full or partial compensation or benefit only if considered reasonable in view of the circumstances in which the occurrence of the insurance event was caused.

If the insured person has died, other parties entitled to compensation or benefits are paid that part of the compensation or benefits not paid to the person or persons who caused the insurance event.

7.2 Non-life insurance (§§30 and 34)The insurance company is released from liability to the insured person if he/she has wilfully caused an insurance event.

If the insured person has caused an insurance event through gross negligence or if the insured person’s use of alcohol or some other intoxicant has contributed to the insurance event, the compensation payable to him/her may be reduced or disallowed.

The effect of the insured person’s action on the occurrence of the loss or damage is also taken into account in considering whether the compensation is to be reduced or disallowed in the above-mentioned cases. The insured person’s intent or the type of negligence and other circumstances will also be taken into account.

7.3 Causing an insurance event under liability insurance (§§30 and 34)

If the insured person has caused an insurance event through gross negligence or if his/her use of alcohol or other intoxicant has contributed to the insurance event, the insurance company will nevertheless pay under the liability insurance that part of the compensation which the natural person who has suffered the loss or damage has been unable to collect because of the insured person’s state of insolvency as authenticated by distraint or bankruptcy.

8 IDENTIFICATION WITH ANOTHER PERSON UNDER NON-LIFE INSURANCE (§33)

The provisions set out above concerning the insured person with regard to causing an insurance event, observing the safety regulations or the duty of salvage also apply to a person:1) who, with the consent of the insured person, is

responsible for a motor-driven or towed vehicle, vessel or aircraft covered by the insurance;

2) who, jointly with the insured person, owns the insured property and uses it jointly with him/her; or

3) who co-habits with the insured person and uses the insured property jointly with him/her.

The provisions set out above concerning the insured person with regard to observing the safety regulations also apply to a person who, on the

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basis of his/her employment or service with the policyholder, is responsible for supervising the observance of such safety regulations.

When a company which is not comparable to a consumer under section 3 of the Insurance Contracts Act is recorded as the policyholder, the following will be comparable to the policyholder:1) a partner in a general partnership2) a general partner (active partner) in a limited

partnership3) a shareholder in a limited liability company who

holds over half of the company shares4) the policyholder’s employee who has the insured

property in his/her use.

9 CLAIMS SETTLEMENT PROCEDURE

9.1 Duties of claimant (§§69 and 72)The claimant shall observe the regulations on making a claim entered in the terms and conditions of insurance of the person or non-life insurance and submit the documents mentioned therein to the insurance company. The claimant shall obtain and submit to the insurance company said documentation and information at his/her own expense, unless otherwise stipulated in the terms and conditions or agreed otherwise.

The claimant is required to obtain the documentation which he/she is reasonably able to obtain, though taking into account that the insurance company may also acquire such documentation.

All crimes must be reported to the local police without delay.

The insurance company is not obliged to pay compensation before it has received the above documentation.

If the claimant has, after the insurance event, fraudulently provided the insurance company with incorrect or insufficient information relevant to the assessment of the insurance company’s liability, his/her compensation may be reduced or disallowed, depending on what is reasonable in the circumstances.

Insurance companies share a non-life insurance information system which can be used in processing claims to check claims submitted to different companies.

9.2 Time limitation on claims (§73)A claim for compensation must be presented to the insurance company within 12 months of the date when the claimant became aware of the insurance and was informed of the insurance event and the damaging consequences of that event. A claim for compensation must in any case be presented within 10 years of the date when the insurance event occurred or, in the case of insurance taken out against bodily injury or liability for damages, the damaging consequences were caused. Making a notification of an insurance event is comparable to presenting a claim. If the claim is not presented within said period, the claimant loses his/her entitlement to compensation.

9.3 The insurance company’s obligations (§§7, 8, 9, 67, 68 and 70)

After the occurrence of an insurance event, the insurance company is under an obligation to provide the claimant (eg the insured person, the beneficiary and, in circumstances listed in clause 15.4 in liability insurance, the person who has suffered injury, loss or damage) with information on the contents of the insurance and the claim procedure. Any advance information that may have been given to the claimant on the compensation, its amount or method of payment will not affect the payment obligation stated in the insurance contract.

The insurance company will pay the compensation resulting from the insurance event in accordance with the insurance contract or notify the claimant of

non-payment of compensation without delay and, at the latest, in one month’s time of the date on which it received the documentation and information necessary for the assessment of its liability. If the amount of compensation is disputed, the insurance company will nonetheless pay any undisputed part of the compensation within the abovementioned period.

In the case of a claim settlement decision under liability insurance, the insurance company will also inform the person who has suffered the injury, loss or damage.

If the total amount of compensation payable to a legally incompetent person for losses other than expenses or loss of property exceeds 1,000 euros, the insurance company will notify the guardianship authority in the locality of the legally incompetent person of such compensation.

The insurance company will pay penalty interest on any delayed payment of compensation in accordance with the Interest Act.

9.4 Setoff against compensationAny one of the insurance companies may, on behalf of all of the insurance companies that may be acting as insurers under the Extrasure insurance cover, deduct any outstanding premiums overdue and other outstanding overdue amounts from compensation.

10 OVERINSURANCE AND UNDERINSURANCE UNDER NON-LIFE INSURANCE

Provisions governing overinsurance (§57) and underinsurance (§58) can be found in the indemnification regulations.

11 LODGING AN APPEAL AGAINST A DECISION TAKEN BY THE INSURANCE COMPANY (§§ 8, 68 AND 74)

The policyholder or claimant has several ways of appealing against a decision taken by the insurance company. If his/her matter remains unsettled after he/she has contacted the insurance company, he/she can ask for advice and counselling from the Finnish Financial Ombudsman Bureau or request a recommendation for the decision from the relevant board. A policyholder or claimant who is dissatisfied with the insurance company’s decision may also bring action against the insurance company.

11.1 Right to correctIf a policyholder or claimant suspects that the insurance company has made a mistake in its claim settlement decision, he/she has the right to obtain more information about matters which have led to the decision. The insurance company will revise the decision if the new investigations give cause to do so.

11.2 Finnish Financial Ombudsman Bureau and boards issuing recommendations

If the policyholder or claimant is dissatisfied with the insurance company’s decision, he/she may ask the Finnish Financial Ombudsman Bureau for advice and counselling. The Bureau is an impartial body tasked with advising consumers in insurance and claims matters. The insurance company’s decision can be submitted to the Finnish Insurance Complaints Board within the Bureau. The Board is tasked with issuing recommendations for decisions in disputes which concern interpretation and application of the law and insurance terms and conditions in an insurance relationship.

The insurance company’s decision can also be submitted to the Consumer Disputes Board, which provides recommendations for decisions on the basis of consumer protection legislation.

These boards will not handle a case while it is pending or when a ruling has been given in court. These counselling services and board statements are free of charge.

11.3 District courtIf the policyholder or claimant is dissatisfied with the insurance company’s decision, he/she may bring

action against the insurance company in the district court of his/her domicile in Finland, of the insurance company’s domicile or of the place of loss in Finland, unless otherwise provided by Finland’s international agreements.

Action against the insurance company’s decision must be brought within three years of the policyholder or claimant being informed in writing of the insurance company’s decision and the time limit. The right to bring action ceases once the time limit has expired.

Handling of a case by any of the above-mentioned boards will interrupt the limitation period for the right to bring action.

12 INSURANCE COMPANY’S RIGHT OF RECOVERY (§75)

12.1 Insurance company’s right of recovery vis-à-vis a third party

The insured person’s right to claim damages from a third party which is held liable transfers to the insurance company up to the amount of compensation paid by the insurance company.

If the loss or damage was caused by a third party as a private person or as an employee, a civil servant or any other person comparable to these as referred to in Chapter 3, Section 1 of the Tort Liability Act, the right of recovery will be transferred to the insurance company only if the person in question caused the insurance event wilfully or through gross negligence or is held liable regardless of the nature of his/her negligence.

In the case of compensation paid under insurance of the person, the insurance company has the right of recovery vis-à-vis a third party only in the case of compensation paid for loss of property or costs incurred due to illness or accident.

12.2 Other cases of right of recovery under non-life insurance

The insurance company’s right of recovery vis-à-vis the policyholder, the insured party or a party identifiable with the insured one is defined according to section 75, paragraph 4 of the Insurance Contracts Act.

13 ALTERING AN INSURANCE CONTRACT

13.1 Altering the terms of contract during the insurance period

13.1.1 Insurance of the person (§20)The insurance company has the right to alter the insurance premiums or other terms of contract during the insurance period to correspond to the current or changed circumstances if 1) the policyholder or the insured person has

wilfully or through negligence which cannot be deemed minor failed to observe his/her obligation to disclose information as referred to in clause 2.2 above, and if the insurance company, had it been given the correct and full information, had granted the insurance only against a higher premium or otherwise on terms other than those agreed; or

2) the policyholder or the insured person has acted fraudulently in observing his/her obligation to disclose information as referred to in clause 2.2 above and, regardless of this, the insurance is binding on the insurance company on the basis of this clause due to the adjustment of the consequences of the failure to disclose information; or

3) during the insurance period, a change as referred to in clause 5.2 above has occurred in the circumstances reported by the policyholder or the insured person to the insurance company at the time of concluding the contract, and the insurance company would have granted the insurance only against a higher premium or on otherwise other terms in the event that the circumstance related to the insured person would already have corresponded to the change when the insurance company granted the insurance.

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After being informed of said change, the insurance company will notify the policyholder, in writing and without undue delay, of any change in the premium or other terms. This notification will state that the policyholder has the right to terminate the insurance.

13.1.2 Non-life insurance (§18)The insurance company has the right to alter the insurance premiums or other terms of contract during the insurance period to correspond to the changed circumstances if1) the policyholder or the insured person has

neglected his/her obligation to disclose information as referred to in clause 2.2 above; or

2) during the insurance period, a change as referred to in clause 5.2 has occurred in the circumstances recorded in the insurance policy or reported by the policyholder or the insured person to the insurance company at the time the contract was concluded.

After being informed of said change, the insurance company will notify the policyholder, in writing and without undue delay, of how and from what date the premium or other terms of contract will be altered. This notification will state that the policyholder has the right to terminate the insurance.

13.2 Altering the terms of contract of a continuous policy at the end of an insurance period (§§19 and 20a )

Notification procedure

The insurance company has the right to alter the insurance terms and premiums and other terms of contract at the end of the insurance period on the basis of- new or amended legislation or a regulation

issued by the authorities- an unforeseeable change in circumstances (eg

an international crisis, exceptional natural event and catastrophe)

- a change in the claims expenditure.

Under Life Insurance, the insurance company has the right to alter the insurance terms and conditions, premiums and other terms of contract at the end of the premium period for the following special reasons:- general development in claims expenditure- change in interest rates provided that the content

of the insurance contract does not change substantially compared with the original contract.

The insurance company also has the right to make minor changes to the insurance terms and conditions and other terms of contract provided that the changes do not affect the primary content of the insurance contract.

If the insurance company alters the insurance contract as outlined above, it will, when sending an insurance bill, notify the policyholder of the changes in the insurance premium and other terms of contract. This notification will state that the policyholder has the right to terminate the insurance.

In the case of insurance of the person, the change will take effect from the beginning of the next premium period or, if no premium period has been agreed, from the beginning of the next calendar year following one month from the date the notification was sent. In the case of non-life insurance, the change will take effect from the beginning of the next insurance period following one month from the date the notification was sent.

The insurance contract may also change in accordance with clause 13.3 below concerning index regulations.

Changes requiring termination of insurance

If the insurance company alters the insurance terms and conditions, premiums or other terms of contract in cases other than those listed above or discontinues an actively marketed benefit included in the insurance, it must give written notice of termination of the insurance as of the end of the insurance period. The notice of termination will be

sent one month before the end of the insurance period at the latest. However, changes to the terms and conditions requiring termination of insurance are not possible in the case of Life Insurance.

13.3 Effect of the indexThe maximum compensation and the sums insured under Pohjola Health Insurance, Pohjola Living Allowance Insurance, Eurooppalainen Traveller’s Insurance, Life Insurance and Disability Insurance are linked to the latest series of the consumer price index. If, however, the sum insured decreases with age, the insurance premium is linked to the consumer price index.

In the case of non-life insurance, the sums insured recorded in the policies for valuables luggage, small boat, liability and legal expenses insurance are linked to the consumer price index. The deductible specified in the insurance policy is also linked to the consumer price index.

In the case of MyHome Insurance, the premiums, maximum compensation and deductibles are all linked to the construction cost index. The premiums, maximum indemnities and deductibles for the insurance for home contents and parts of flats in blocks of flats and terraced houses as well as for the insurance for stored home contents are, however, linked to the Finnish consumer price index.

In the case of forest insurance and forest fire insurance, the premium is linked to the forest insurance premium index and the deductible to the consumer price index.

Non-life insurance which has no reference to any index in the insurance policy is not index-linked.

13.3.1 Index clause for the sum insuredThe adjustment index used is the calendar month index four months before the first day of the insurance period. The sum insured recorded in the insurance policy is adjusted at the beginning of every insurance period by the same percentage as the adjustment index deviates from the adjustment index most recently used.

As of the beginning of the insurance period, the insurance premium is altered to match the adjusted sum insured.

The sum insured is rounded off to the nearest full euro.

In the case of non-life insurance, the ratio of the sum insured at the moment of loss or damage to the sum insured recorded in the insurance policy will be identical to the ratio of the calendar month index four months before the loss date to the adjustment index most recently used. In such a case, however, the sum insured at the moment of loss will be a maximum of 15% above the sum insured recorded in the insurance policy or the sum insured adjusted at the beginning of the previous insurance period.

13.3.2 Index clause for the insurance premiumThe adjustment index used is the index for September of the calendar year preceding the first day of the insurance period. The insurance premium for each insurance period is changed by the same percentage as the adjustment index deviates from the adjustment index most recently used. In insurance policies based on sums insured, the sum insured for the insurance period changes to match the adjusted insurance premium.

13.3.3 Index linking of maximum compensation and sums insured under Pohjola Health Insurance, Pohjola Living Allowance Insurance, Eurooppalainen Traveller’s Insurance, Life Insurance and Disability Insurance.

The adjustment index used is the index for September of the calendar year preceding the first day of the insurance period. The maximum compensation amounts and the sums insured recorded in the insurance policy are adjusted at the

beginning of every insurance period by the same percentage as the adjustment index deviates from the adjustment index previously used.

The maximum compensation and the sums insured are rounded off to the nearest full euro.

13.3.4 Index clause for the deductibleThe adjustment index used is the index for September of the calendar year preceding the first day of the insurance period. The deductible recorded in the insurance policy is adjusted at the beginning of every insurance period by the same percentage as the adjustment index deviates from the adjustment index most recently used.

The deductible is rounded off to the nearest full euro.

14 TERMINATION OF INSURANCE CONTRACT

14.1 Policyholder’s right to terminate the insurance (§12)

The policyholder has the right to terminate the insurance contract anytime during the insurance period. Notice of termination must be given in writing. Notice of termination given in any other manner shall be null and void. If the policyholder has not specified a later termination date for the insurance, the insurance will terminate on the date the notice was submitted or sent to the insurance company.

Notice given to one of the insurance companies is also valid for the other insurers.

14.2 The insurance company’s right to terminate the insurance during the insurance period

14.2.1 Insurance of the person (§17)The insurance company has the right to terminate the insurance during the insurance period if1) the policyholder or the insured person has wilfully

or through negligence which cannot be deemed minor neglected his/her obligation to disclose information as referred to in clause 2.2 above, and the insurance company, had it been given correct and complete information, had refused to grant the insurance altogether;

2) the policyholder or the insured person has acted fraudulently in observing his/her obligation to disclose information as referred to in clause 2.2 above and, regardless of this, the insurance contract is binding on the insurance company on the basis of that clause;

3) during the insurance period, a change as referred to in clause 5.2. above has occurred in the circumstances reported by the policyholder or the insured person to the insurance company at the time of concluding the contract, and the insurance company would not have granted the insurance in the event that the circumstance related to the insured person would already have corresponded to the change when the insurance company granted the insurance;

4) the insured person has wilfully caused the insurance event

5) the insured person has, after the insurance event, fraudulently provided the insurance company with incorrect or insufficient information relevant to the assessment of the insurance company’s liability.

14.2.2 Non-life insurance (§15)The insurance company has the right to terminate the insurance during the insurance period if1) the policyholder or the insured person has, before

the insurance was granted, provided incorrect or insufficient information and the insurance company, had it known the circumstances, would have refused to grant the insurance;

2) during the insurance period, a change which has substantially increased the risk of loss or damage has occurred in the circumstances recorded in the insurance policy or reported by the policyholder or the insured person to the insurance company at the time of concluding the contract, and which the insurance company cannot be deemed to have taken into account when concluding the contract;

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3) the insured person has wilfully or through gross negligence failed to observe the safety regulations;

4) the insured person has wilfully or through gross negligence caused the insurance event; or

5) the insured person has, after the insurance event, fraudulently provided the insurance company with incorrect or insufficient information relevant to the assessment of the insurance company’s liability.

14.2.3 ProcedureAfter having been informed of the grounds for permitting termination, the insurance company will give written notice of termination without undue delay. The notice of termination has a mention of the grounds for termination. The insurance contract will terminate in one month’s time from the date the notice was sent.

The insurance company’s right to give notice of termination of insurance owing to an outstanding insurance premium is defined in clause 4.2 above.

14.3 The insurance company’s right to terminate the insurance at the end of the insurance period

14.3.1 Insurance of the person (§17a) The insurance company has the right to terminate a contract of insurance of the person effective as of the end of the premium period.

If the premium period is less than one year or its length has not been agreed, the insurance company has the right to terminate the insurance effective as of the end of the calendar year. The notice of termination will be sent one month before the end of the premium period at the latest or, if the premium period has not been agreed, one month before the end of the calendar year at the latest. Notice of termination has a mention of the grounds for termination.

However, notice of termination of the insurance may not be given if the grounds are that the state of health of the insured person has deteriorated since the time the policy was taken out, or that an insurance event has occurred.

However, the insurance company has no right to terminate the contract in the case of Life Insurance.

14.3.2 Non-life insurance (§16)The insurance company has the right to terminate a non-life insurance contract effective as of the end of the insurance period. Notice of termination has a mention of the grounds for termination. The notice of termination will be sent one month before the end of the insurance period at the latest.

14.4 Notice of termination of life insurance (§21)

If the life insurance has been valid for more than a year, the insurance company will send the policyholder a reminder one month before the termination of the validity period at the latest, and three months at the earliest.

If the nsurance company fails to send this reminder, the Life Insurance remains valid. However, the period of validity terminates in one month’s time from the date on which the delayed reminder was sent to the policyholder and at the latest in six month’s time from the end of the validity period of the insurance.

14.5 Change of owner under non-life insurance (§63)

If the insured property is transferred to a new owner other than the policyholder him/herself or his/her estate, the insurance on this property will terminate. If an insurance event takes place within 14 days of the transfer of ownership, the new owner will, however, be entitled to compensation unless he/she has taken out insurance on the property.

15 RIGHTS OF A THIRD PARTY UNDER NON-LIFE INSURANCE

15.1 Other insured parties who benefit from property insurance (§62)

In addition to what is otherwise stipulated herein concerning the insured person, a property insurance contract is valid for the benefit of the owner, the person who has purchased the property under a provision regarding reservation of title, the holder of a right of lien and a right of retention, or some other party who bears the risk pertaining to the property.

15.2 Position of the insured person after the occurrence of an insurance event (§65)

Against the insured person as referred to in clause above, the insurance company will, for reduction or disallowance of compensation, refer to failure of the policyholder or other insured person to disclose information (clause 2.2) or to notify of an increase in risk (clause 5.2) only if the insured person as referred to in clause 15.1 knew or should have known, prior to the insurance event, of the conduct of the policyholder or the other insured person.

Every insured person is entitled to compensation on the occurrence of an insurance event. However, the policyholder may negotiate with the insurance company in a manner binding on the insured person, and collect compensation, unless the name of the insured person has been recorded in the contract or he/she has declared that he/she will assert his/her rights, or it is the question of a mortgage holder’s right to be paid from the compensation.

15.3 Priority to payment from compensation (§66)

If property insurance is valid in favour of a person who has right of lien on the property in security for a receivable, he/she is entitled, even if the receivable is not overdue, to payment from the compensation before the owner, provided that the owner has not rectified the loss or placed collateral for its rectification. The above also applies in favour of a person who is entitled to retaining the property in security for an overdue receivable.

In receiving payment from the compensation, the owner has priority over a person who has bought the property on a provision regarding reservation of title.

The provisions governing a mortgage holder’s right to compensation will also apply to the mortgage holder’s right to payment from the compensation (see section 13 of the indemnification regulations).

15.4 Right to compensation under liability insurance of a person who has suffered injury, loss or damage (§67)

A person who has suffered injury, loss or damage has the right, under liability insurance, to claim compensation as per the insurance contract directly from the insurance company if the insured person has been declared bankrupt or is otherwise insolvent. If the insurance company is presented with a claim, it will notify the insured person thereof without undue delay and reserve him/her an opportunity to explain the insurance event. The insured person will also be notified of the subsequent processing of the matter. If the insurance company accepts the claim of the person who has suffered the injury, loss or damage, this acceptance is not binding on the insured person.

15.5 Right of appeal under liability insurance of a person who has suffered injury, loss or damage (§68)

A person who has suffered injury, loss or damage has the right to bring action against the insurance company regarding a claim settlement decision taken by the insurance company or to submit the matter to the Finnish Insurance Complaints Board or the Consumer Disputes Board as provided in clause 11 above.

16 APPLICABLE LAW AND CALCULATION BASES

Finnish law shall apply to all insurance contracts and, in the case of insurance of the person, also the calculation bases required by the Insurance Companies Act.

17 OTHER MATTERS COVERED BY THE INSURANCE CONTRACTS ACT

The Insurance Contracts Act also covers the following matters:

Scope of application (§1)Peremptory nature of the provisions (§3)Insignificance of misrepresentation or increase in underlying risk (§35)Irresponsibility and emergency (§36)Limitations on liability in certain events (§37)Payment of premium through bank or post office (§44)Limitation on insurer’s right to insurance premium (§46)Beneficiary clause (§§47–50 and 53)Execution under accident insurance and health insurance (§55)Recovery to bankrupt estate under insurance of the person (§56)Overinsurance and underinsurance (§§57 and 58)Double insurance (§§59 and 60)Payment to wrong person (§71)Insurance company’s right of recovery vis-à-vis the policyholder, the insured person or a person identifiable with the insured person (§75, paragraph 4).

Pohjola Insurance Ltd, business ID 1458359-3Eurooppalainen Insurance Company Ltd, business ID 0196741-6Lapinmäentie 1, FI-00013 Pohjola

OP Life Assurance Company Ltd, business ID 1030059-2Lapinmäentie 1, FI-00350 Helsinki, domicile HelsinkiDomicile: Helsinki, main field of operations: insurance business