Accident Care - Terms & Conditions
The rights of any Cardmember subscribing to the Accident Care Platinum are governed by the Group Personal Accident (“Policy”) held by Mashreqbank. The following is a summary of salient conditions from the aforementioned Policy. This is not the Policy. In the event of any doubt/conflict arising out of difference in meaning between the summary herein and the Policy held by Mashreqbank, then the meaning conveyed by the Policy shall prevail.
Definitions
“Aggregate Limit” the maximum amount an insured person will receive during the whole policy period regardless how many occurrences.
“Business” a trade, profession or occupation engaged in on a full-time, part-time or occasional basis or any other activity engaged in for money or other compensation.
“Credit Accounts” any credit arrangements from a qualified financial institution for personal use, such as credit card account, car/ home loan account.
“Identity Theft” the unauthorized and/ or illegal use of the Insured Person’s personal information such as the Insured Person’s name or personal papers to open credit accounts and/ or bank accounts that the Insured Person did not authorize.
“Money” currency, coins and bank notes in current use and having a face value.
“Payment card” The primary Classic, Gold, VIP, MM and Platinum credit cards issued by the Policyholder for personal use only
“Per Occurrence Limit” is the maximum amount an Insured Person will receive on any covered occurrence.
“Personal Papers” identification documents issued by Insured Person’s country, state or province including but not limited to driver’s license and passport of the Insured Person.
“Policy Aggregate Limits” the maximum amount the insurer will pay to all Insured Person’s under this policy during the policy period regardless of the number of occurrences.
“Relative” an Insured Person’s legally married spouse, parent, step-parent, parent in-law, grandparent, child, stepchild, legally adopted child, grandchild, brother, brother in-law, sister, sister in-law, son in-law, daughter in-law, uncle, aunt, niece, nephew, and first cousin.
“Suit” a civil proceeding seeking monetary damages as a result of identity theft, or a criminal proceeding in which the Insured Person is charged with illegal acts committed by someone else while engaged in the theft of the Insured Person’s identity.
“Company” means American Home Assurance Company.
"Hospital" means an establishment which meets all of the following requirements: (1) holds a license as a hospital, if licensing is required in the country or governmental jurisdiction; (2) operates primarily for the reception, care and treatment of sick, ailing or injured persons as in-patients; (3) provides 24-hour a day nursing service by registered or graduate nurses; (4) has a staff of one or more physicians available at all times; (5) provides organized facilities for diagnosis and major surgical procedures; (6) is not primarily a clinic, nursing, rest or convalescent home or similar establishment and is not, other than incidentally, a place for alcoholics or drug addicts; and (7) maintains X-ray equipment and operating room facilities.
"Injury" means accidental bodily injury occurring while policy is in force as to the Insured Person whose injury is the basis of claim, and resulting, directly and independently of all other causes, in loss covered by the Policy.
“Insured Person” means a Credit Cardholder of Mashreqbank (Policyholder) between the ages of 18 & 69 who has not opted out of Accident Care Platinum enrollment.
"Physician" means a person legally licensed to practice medicine and /or surgery other than the Insured Person or a member of the Insured Person’s immediate families.
“Policyholder” means Mashreqbank.
“Scheduled Airline” means any civilian aircraft operated by a civilian scheduled air carrier holding a certificate, license or similar authorization for civilian scheduled air carrier transport issued by the country of the aircraft’s registry, and which in accordance therewith flies, maintains and publishes tariffs for regular passenger service between named cities at regular and specified times, on regular or chartered flights operated by such carrier.
“Premium Charge Date” means the date on which the Policyholder charges the Premium due to the Mashreqbank Credit Card account.
“Totally and Permanently Disabled” means the Insured Person is unable to engage in any substantially gainful occupation or employment for the remainder of the Insured Person’s life.
“Terrorism” means the use or threatened use of force or violence against person or property, or commission of an act dangerous to human life or property, or commission of an act that interferes with or disrupts an electronic or communication system undertaken by any person or group, whether or not acting on behalf of or in any connection with any organization, government, power, authority or military force, when the effect is immediate, coerce or harm a government, the civilian population or segment thereof, or to disrupt any segment of the economy.
“War” means war, whether declared or not, or any warlike activities, including use of military force by any sovereign nation to achieve economic, geographic, nationalistic, political, racial, religious or other ends.
SECTION 1
Benefits
(A) Loss of Life Indemnity
If a covered injury results in death of an Insured Person within one hundred eighty (180) days after the date of the accident, the Company will pay AED 300,000 to such Insured Person’s legal heir(s) less any other amount paid or payable under Benefit (B).
(B) Total and Permanent Disability
If, as the result of a covered injury, and commencing within one hundred eighty (180) days after the date of the Injury, an Insured Person becomes Totally Disabled and such disability has continued for a period of twelve (12) consecutive months and if the Insured Person is Totally and Permanently Disabled at the end of this period, the Company will pay AED 300,000 to such Insured Person.
(C) Accidental Medical Expense (Reimbursement)
If, as the result of a covered injury and commencing within thirty (30) days after the date of the injury and Insured Person shall require treatment by a Physician, use of Hospital facilities or the employment of a licensed or graduate nurse while at the Hospital, the Company will pay the reasonable, customary and necessary medical expenses incurred within fifty two (52) weeks from the date of the accident for such Physician treatment, Hospital charges and nurses fees which are in excess of the Deductible of AED 100 stated in the Schedule of Benefits but not to exceed the Amount payable to such Insured Person (AED 2,500) in accordance with the classification of Insured Persons and Schedule of Benefits as the result of anyone accident.
Exceptions
This policy does not cover any loss or expense caused by a resulting from:
- Intentionally self-inflicted injury, suicide or any attempt thereat while sane or insane; nor
- War, civil war, invasion, insurrection, revolution, use of military power or usurpation of government or military power; nor
- Any period an Insured Person is serving in the Armed Forces of any country or international authority, whether in peace or war, and in such an event the Company, upon written notification by the Policyholder, shall return the pro rata premium for any such period of service; nor
- Loss sustained or contracted in consequence of an Insured Person being intoxicated or under the influence of any narcotic or drug unless administered on the advice of a physician; nor
- Any loss of which a contributing cause was the Insured Person's attempted commission of, or wilful participation in, an illegal act or any violation or attempted violation of the law or resistance to arrest by the Insured Person; nor
- Any loss sustained while flying in any aircraft or device for aerial navigation except as specifically provided herein; nor
- Congenital anomalies and conditions arising out of or resulting there from, hernia or dental treatment except to sound natural teeth as occasioned by injury; nor
- Bacterial infections except pyogenic infections which are caused by an accidental wound; nor
- Flying in any aircraft owned, leased or operated by or on behalf of: (a) the Policyholder or any subsidiary or affiliate of the Policyholder; (b) an Insured Person or any member of an Insured Person's household; nor
- Driving or riding as a passenger in or on (a) any vehicle engaged in any race, speed test or endurance test or (b) any vehicle being used for acrobatic or stunt driving; nor
- Any claim caused by opportunistic infection or malignant neoplasm, or any other sickness condition, if, at the time of the claim, the Insured Person had been diagnosed as having AIDS (Acquired Immune Deficiency Syndrome), ARC (AIDS Related Complex) or having an antibody positive blood test to HIV (Human Immune Virus).
- Terrorism, including any action taken in hindering or defending against an actual or expected incident of Terrorism; nor
- The use, release or escape of nuclear materials that directly or indirectly results in nuclear reaction or radiation or radioactive contamination; nor
- The dispersal or application of pathogenic or poisonous biological or chemical materials; nor
- The release of pathogenic or poisonous biological or chemical materials.
- Any loss sustained while the Insured person is participating in any professional sports, or in sky diving, parachuting, hand gliding, bungee jumping, scuba diving, mountain climbing, pot-holding, nor
SECTION 2
Benefits
(D) Identity Theft
The applicable limits of liability are stated in the Limits of Liability Table below:
| Aggregate Policy Limit | Per Occurrence Limit | Lost Wages | Deductible |
| AED 15,000 | AED 7,500 | AED 2,500 | AED 75 |
The following expenses are covered:
- Legal Expenses –
We will reimburse you for attorney and court fees incurred by you for:
a. defending any suit brought against you by a creditor or collection agency or someone acting on your behalf as a result of the identity theft;
b. removing any civil or criminal judgment wrongfully entered against you as a result of the identity theft;
c. challenging the accuracy or completeness of any information in a consumer credit report provided this information is inaccurate and falsely provided to the credit agency or financial institution as a result of identity theft. - Lost Wages - We will reimburse you for time taken from work solely as a result of your efforts to correct financial records that have been altered due to identity theft up to the applicable lost wages sub-limit in the Limits of Liability Table above. Payment of lost wages includes compensation for whole or partial unpaid workdays. You must take these unpaid days within 12 months of making a claim.
- Obligation to pay - If any credit accounts and or bank accounts were opened in your name without your authorization, We will pay for the actual loss from the unauthorized account. We will pay for your legal obligation to pay a creditor when the account was created as part of the identity theft.
- Miscellaneous Expenses – We will reimburse the following expenses:
a. the cost of re-filing applications for credit accounts or banking accounts that are rejected solely because the lender received incorrect information as a result of your identity theft;
b. the cost of notarizing documents related to your identity theft, long distance telephone calls, and certified mail reasonably incurred as a result of efforts to report an identity theft or to correct financial and credit records that have been altered as a result of your identity theft;
c. the cost of contesting the accuracy or completeness of any information contained in credit history as a result of your identity theft; and
d. the cost of a maximum of three (3) credit reports from an entities approved by us The credit reports shall be requested at time of claim.
Exceptions
This policy will not pay for any expenses or loss as a result of:
- monetary losses other than the out-of-pocket expenses related to the resolution of an your identity theft outlined in the policy;
- any physical injury, sickness, disease, disability, shock, mental anguish and mental injury including required care, loss of services or death;
- requesting credit reports before the discovery of an identity theft; taking time from self-employment or workdays that will be paid by your employer in order to correct financial records that have been altered due to identity theft.
- losses that do not occur within the policy period stated herein;
- losses that result from or related to business pursuits including the Insured Person’s work or profession;
- losses intentionally caused;
- losses that result from the direct actions of a relative, or actions that a relative knew of or planned;.
- losses due to war, invasion, act of foreign enemy, hostilities or warlike operations (whether war has been declared or not), civil war, rebellion, revolution, insurrection, civil commotion, uprising, military or usurped power, martial law, terrorism, riot or the act of any lawfully constituted authority; or
- losses due to the order of any government, public authority, or customers’ officials.
General Conditions
- Premiums: All premiums and applicable taxes are payable by the Insured Person to the Policyholder by the payment due date in the credit card statement and thereon to the Company.
- The maximum limit of benefit per Insured Person under Section 1 is AED 300,000, irrespective of the number of Mashreqbank credit cards that Insure Person may have.
- Flying Coverage: Coverage as respects flying is limited to injury sustained during the trip while the insured person is riding as a passenger (but not as a pilot, operator or a member of the crew) in or on, boarding or alighting for a Scheduled Airline.
- Commencement of Insurance: The coverage in respect of the Insured Person commences on each Premium Charged Date. “Premium Charged Date” is the date on which the Policyholder charges the premium due, to the Mashreqbank Credit Card account.
- Period of Cover: Maximum of Thirty One (31) days in the event the immediately following “Premium Charged Date” falls within 30 days from commencement of Insurance.
- Termination of individual Insurance: The coverage in respect of the Insured Person terminates are the earliest of:
(1) the date of the Policy is terminated by the Policyholder;
(2) the last of the month in which the Insured Person reaches the age of Sixty Nine;
(3) the date of the Insured Person ceases to be a Cardholder of the Policyholder.
(4) the “Premium Charged Date” immediately following the cancellation of this Policy by the Insured Person or by the Policyholder with respect to the Insured Person.
(5) the premium due date, if the required premium is not paid.
(6) the claims being settled in respect to the Insured Person.
Any such termination shall be without prejudice at any valid claim originating prior to the date of termination. - Reinstatement of an individual Insurance: When the individual Insurance is terminated by either of sub-conditions (3), (4) or (5) as in General Condition (6) above, then any subsequent acceptance of the premium and reinstatement of the individual Insurance by the Company shall cover loss resulting from Injury sustained after the date of such reinstatement.
- Any payment of any claim whatsoever to be paid to an Insured Person has to be released by the Company. A dispute of non-payment of claim shall be solely between Company and Insured Person. Policy-holder has no responsibility to any claims or losses whatsoever nature except as provided herein.
- Cancellation: The Company or the Policyholder may cancel the Policy at any time.
- Notice of Claim: Written notice of claim must be given to the Company by or on behalf of the Insured Person within thirty (30) days occurrence of the incident-giving rise to the claim.
- Time for filing of claim forms: Completed Claim forms and written proof of loss must be given to the Company within one hundred eight (180) days from the date of such loss.
- Time of payment claim: Benefits payable under the Policy for covered losses will be paid immediately upon receipt of due written proof of loss.
- Claim forms: The Company, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually required by the Company for filing proofs of such loss.
- To whom benefits are paid: Any payment for Accidental Death becoming due hereunder shall be payable to the legal heirs of the Insured Person, upon providing authenticated proof.
- Medical Examination: The Company at its own expense, shall have the right and opportunity to examine an Insured Person when and as often as the Company may reasonably require during the pendency of a claim hereunder, and also the right and opportunity to make an autopsy incase of death.
- Legal action: No action at law or an equity shall be brought to the recover on the Policy prior to the expiration in sixty (60) days after written proof of loss has been furnished in accordance with the requirements of the Policy. No such action shall be brought after the expiration of three (3) years after the time written proof of loss is required to be furnished.
- Change in premium notes: The Company and the Policyholder may anytime without prior notice to the Insured Person, change the premium notes for this Policy.
- Compliance with policy provisions: Failure to comply with any of the provisions contained in this policy shall invalidate all.