Mar Estrella — Recreational Craft Multi-Risk Policy Conditions (English Translation)

Preliminary clause — applicable rules, definitions and object of the insurance ↑ top

Applicable rules

This insurance contract is governed by what is agreed in the Policy — comprising these General Conditions, the Particular Conditions and the Special Conditions, where applicable. It is subject to Spanish law and, specifically, to the Insurance Contract Act (Law 50/1980 of 8 October) and to Royal Decree 607/1999 of 16 April approving the Regulation of the compulsory third-party liability insurance for recreational or sports craft.

Definitions

In this contract:

• Insurer: La Estrella, S.A. de Seguros y Reaseguros.
• Policyholder: the natural or legal person who enters into this contract with La Estrella.
• Insured: the natural or legal person who holds the interest insured.
• Beneficiary: the natural or legal person entitled to the indemnity.
• Third party: any natural or legal person other than: a) the policyholder and the insured; b) the owner of the recreational craft identified in the policy, and anyone who by any title (hire, loan, etc.) has the use of it with the owner's authorisation; c) the skipper of the craft and those assisting in its handling; d) persons professionally engaged in the maintenance, repair or upkeep of the craft, its crew when acting for reward, and, in general, anyone providing the owner or user a professional service related to assisting navigation; e) persons water-skiing, paragliding or practising any other sport while towed by the recreational craft identified in the policy.
• Recreational craft: a floating object intended for recreational or sports navigation. The elements, instruments and devices offered as standard by the manufacturer or shipyard (or equivalents replacing them), or whose incorporation is indispensable or legally required for navigation, form an integral part of it.
• Accessories: elements, instruments and devices added to the craft for its fitting-out or to assist navigation, provided they are not among those offered as standard and their incorporation is not indispensable or legally required.
• Personal effects: objects owned by the insured, other than the accessories above, which, without being incorporated into the craft, are on board. Money, cheques, documents and securities are not considered personal effects for this policy.
• Policy: the set of documents recording the conditions of the contract — the General, Particular and (where applicable) Special Conditions.
• Premium: the price of the insurance; the receipt also contains the legally applicable surcharges, taxes and charges.
• Sum insured: the amount, in the currency agreed in the Particular Conditions, fixed for each guarantee contracted, being the maximum limit of indemnity per loss for each guarantee.
• New replacement value: the cost of replacing a damaged item with an equal or similar one in new condition, with no deduction for age or state of conservation.
• Market or real value: the sale price an item would reach on the market, in the condition of use and conservation immediately before the loss.
• Agreed value (Valor Convenido): the value assigned by the Policyholder to the insured interest, expressly accepted in the policy by the Insurer, to be used to determine the indemnity in a damage claim. The insurer may challenge the agreed value only where its acceptance was given through violence, intimidation or fraud, or where by error the estimate is notably higher than the real value at the time of the loss, as fixed by experts.
• Accident: any violent, sudden, external event, beyond the intent of the Policyholder/Insured, from which bodily and/or material damage results.
• Personal injury: personal injury or death suffered by natural persons.
• Material damage: loss, deterioration or destruction of things or animals.
• Loss (consequential): the economic loss that is a direct consequence of personal or material damage.
• Total loss: the total and definitive destruction or disappearance of the insured craft.
• Constructive total loss: damage to the craft and its accessories where the cost of its repair or replacement exceeds 75% of the capital insured in the policy if the loss occurs during the first year of cover, or 75% of the real value of the craft if it occurs later.
• Loss event (siniestro): any event whose damaging consequences are covered by a contracted guarantee. All damage and/or loss deriving from one and the same cause is treated as a single loss event.
• Excess (Franquicia): the figure, in money or percentage, to be deducted in the event of a loss from the valuation of the covered damage and/or loss, to determine the amount indemnifiable.

Object of the insurance

This insurance has as its object the cover of those of the guarantees set out in the following articles whose contracting has been agreed and expressly recorded in the Particular Conditions, in relation to the risks deriving from the ownership and/or use of the recreational craft described in those Particular Conditions.

Article 1 — Damage to the vessel and its accessories ↑ top

1.1. Cover

By contracting this guarantee, the insurer takes on the damage that the craft described in the Particular Conditions, the accessories listed there and the insured's personal effects may suffer — while afloat, while transported by another vehicle, or while ashore — as a result of any of the following risks:

• Sinking of the craft.
• Collision of the craft with a fixed or floating object.
• Stranding, grounding or touching bottom.
• Fire of the craft.
• Lightning striking the craft.
• Explosion of the craft's engine.
• Heavy sea (golpe de mar).
• Hidden defect of the hull or engine, consisting of a defect of design, assembly or quality of the materials used. In this case the policy does not cover the repair of the element affected by the hidden defect, only that of its consequences.
• Accident of the vehicle transporting it.
• Theft or attempted theft of the craft or of the accessories incorporated into it, only where carried out with force on things or with violence or intimidation of persons.
• Vandalism or malicious acts of third parties.

It also covers the following expenses, provided their sum plus any damage indemnity does not exceed the capital insured for this guarantee: maritime towage or salvage costs necessarily incurred as a result of damage to the insured craft; expenses reasonably incurred to minimise the extent of a loss covered by this guarantee; and the cost of repairing or replacing a windscreen by breakage.

This guarantee is contracted on an agreed-value (Valor Convenido) basis. Where a covered loss occurs, if the insured consents, the Company may replace payment of the indemnity by the repair or replacement of the damaged object. In the case of partial damage, where repair of the damaged item is possible and economically reasonable, the indemnity is based on its repair; where repair is not possible, or its cost exceeds replacement with an equal or similar item in new condition, the indemnity is calculated on the new replacement value.

Where the cost of repairs chargeable to the insurance exceeds 75% of the capital insured for the craft and accessories, the Insurer may treat the loss as a constructive total loss, indemnifying at the agreed value less the value of the wreck. However, from the second annual period of insurance, for total loss or constructive total loss only, indemnity is at real value, provided it does not exceed the capital insured. The total amount indemnifiable under this guarantee for a single damaging event may not exceed the capital insured for the damaged item.

1.1.1. Personal effects

The insurer takes on the damage that the insured's personal effects may suffer on the occasion of a loss covered by the damage guarantee. Where repair is possible and economically reasonable, indemnity is based on the repair cost; otherwise, on the new replacement value. The limit of indemnity for this cover is 5% of the capital insured for the craft and accessories, with no proportional (under-insurance) rule applied, and up to a maximum of €6,000.

1.2. Exclusions

The following exclusions apply to this guarantee. The insurer does not respond for:

• a) damage and loss from war risks and their consequences before and after declaration, rebellion, strikes, capture and embargo by government order;
• b) damage and loss from illegal or criminal actions, or caused by wilful misconduct or gross negligence of the Policyholder or Insured, or by an accident occurring while the person operating the craft is under the influence of alcoholic drinks, toxic drugs or narcotics;
• c) damage to the insured property by an accident during participation in regattas and sports competitions, or where the craft is used for commercial or profit-making operations or any activity other than recreational navigation, except where it is requested to give maritime assistance;
• d) losses occurring while the craft is moored or anchored, with no person on board, in a roadstead or unprotected waters not requiring a mooring fee;
• e) the detachment or falling of the engines attached to the craft, and of any other element or accessory (always excluded);
• f) damage and depreciation due to use, wear or lack of maintenance;
• g) damage that is a direct or indirect consequence of ionising radiation, contamination or radioactivity from any nuclear fuel or from any nuclear fission or escape resulting from the combustion of nuclear or atomic energy.

Article 2 — Third-party liability: compulsory insurance ↑ top

2.1. Cover

By contracting this guarantee, the insurer covers the extracontractual civil liability that may be incurred by the owner of the recreational craft named in the Particular Conditions, and/or persons duly authorised by the owner who have the use of it, and/or those who skipper it or assist in its handling, and/or the water-skiers the craft may tow — for the material and personal damage and consequent losses that, through fault or negligence, they cause to third parties, ports or maritime installations, as a result of collision, contact and, in general, the other events arising from the use of craft in maritime or fluvial waters, and by the skiers and objects they tow at sea. All of this on the terms and within the limits fixed in the Regulation of the compulsory third-party liability insurance for recreational or sports craft (approved by RD 607/1999 of 16 April).

The cover of this liability guarantee also comprises the provision of judicial bonds (never the payment of fines or penalties) that may be imposed on any of the above persons as a result of a covered loss, and the defence of those persons by the lawyers and court agents appointed by LA ESTRELLA in the civil and criminal proceedings brought against them for a covered loss. The insurer is obliged to meet payments or provide bonds for this only up to a limit of 50% of the capital insured for this guarantee. Where the claimant is also insured with the same insurer, or there is some other conflict of interest, the insurer will immediately inform the insured, who may choose between keeping the insurer's legal direction or entrusting his own defence to another person; in that case the insurer is obliged to pay the cost of that legal direction up to the limit of 50% of the capital insured for this guarantee.

2.2. Exclusions

The exclusions set out in the Regulation of the compulsory liability insurance apply; the cover does not comprise:

• a) damage to the policyholder, operator or owner of the craft identified in the policy, or to the insured user;
• b) death or injury of persons carried who pay for the cruise or voyage;
• c) death or injury of persons professionally engaged in the maintenance, upkeep and repair of the insured craft;
• d) death or injury of the skipper or pilot of the craft;
• e) damage to the insured craft;
• f) damage caused by the craft during its repair, while ashore, or when towed or transported by land;
• g) damage to property which for any reason (ownership, deposit, use, transport, handling, etc.) is in the keeping of the insured, his dependants or the craft's occupants;
• h) personal or material damage to persons voluntarily occupying the craft while operated by someone without the proper licence, if the insurer proves they were aware of this;
• i) damage to craft and objects under tow for the purpose of saving them, and their occupants;
• j) personal and material damage caused by the insured craft where it had been robbed or stolen;
• k) the payment of penalties and fines and the consequences of their non-payment;
• l) damage from participation in regattas, trials, competitions of all kinds and their training, including bets and challenges.

Article 3 — Third-party liability: voluntary insurance ↑ top

3.1. Cover

By contracting this guarantee, the insurer covers — in excess of the capitals covered by the compulsory liability guarantee (Article 2) and up to the capital agreed in the Particular Conditions — the extracontractual civil liability that may be incurred by the owner of the craft named in the Particular Conditions, and/or persons duly authorised by the owner who have the use of it, and/or those who skipper it or assist in its handling, and/or the water-skiers the craft may tow, for the material and personal damage and consequent losses that, through fault or negligence, they cause to third parties, ports or maritime installations, as a result of collision, contact and the other events arising from the use of craft in maritime or fluvial waters, and by the skiers and objects they tow at sea.

3.2. Exclusions

The exclusions set out in the Regulation of the compulsory liability insurance apply (the same list as in Article 2.2); the cover does not comprise:

• a) damage to the policyholder, operator or owner of the craft identified in the policy, or to the insured user;
• b) death or injury of persons carried who pay for the cruise or voyage;
• c) death or injury of persons professionally engaged in the maintenance, upkeep and repair of the insured craft;
• d) death or injury of the skipper or pilot of the craft;
• e) damage to the insured craft;
• f) damage caused by the craft during its repair, while ashore, or when towed or transported by land;
• g) damage to property which for any reason (ownership, deposit, use, transport, handling, etc.) is in the keeping of the insured, his dependants or the craft's occupants;
• h) personal or material damage to persons voluntarily occupying the craft while operated by someone without the proper licence, if the insurer proves they were aware of this;
• i) damage to craft and objects under tow for the purpose of saving them, and their occupants;
• j) personal and material damage caused by the insured craft where it had been robbed or stolen;
• k) the payment of penalties and fines and the consequences of their non-payment;
• l) damage from participation in regattas, trials, competitions of all kinds and their training, including bets and challenges.

Article 4 — Damage-claim recovery ↑ top

4.1. Cover

By contracting this guarantee, the Insurer covers, within the limits set in the policy, the expenses necessary to claim — amicably or judicially — from the responsible third party the damage and loss directly caused by that third party on the occasion of an accident of the insured craft. The cover comprises: the extrajudicial steps to obtain the indemnity amicably; and the legal assistance and defence in any proceedings to claim the damage where amicable recovery is not achieved.

4.2. Rights and obligations in the event of a loss

The Insured has the right to free choice of lawyer and court agent where a conflict of interest arises between the parties to the contract. The lawyer and court agent must be qualified to practise before the jurisdiction where the proceedings are heard, and their names communicated to the Insurer before appointment; once appointed, they are not subject to the Insurer's instructions. Where a lawyer or court agent must act urgently before the loss is notified, the Insurer will likewise pay the fees of those actions within the policy limits. The Insured (or Policyholder) must notify the loss within a maximum of SEVEN DAYS of becoming aware of it, provide all information on its circumstances and consequences, and forward promptly all extrajudicial letters, claims, summons and notifications, and any judgments and judicial resolutions received.

4.3. Limit of cover

The Insurer assumes the lawyer's and court agent's fees up to a limit of €3,000 per loss, scaled to any agreements between the Insurer and the lawyers/court agents or their professional colleges and, failing that, to the minimums of the relevant professional college's guideline rules and the legal tariffs in force; any difference is borne by the Insured (this limit does not apply where the lawyer/court agent is appointed by the Insurer). The Insurer does not pay the costs of the judicial procedure where the case is won with costs awarded against the other party (in which case the professional must claim them in enforcement or amicably, directly from the other party) — though the Insurer will pay them if the convicted party's insolvency is judicially established.

4.3.1. If the Insurer considers a suit or appeal to be without merit, it informs the interested party, who is then free to bring it at his own expense; if he obtains a more favourable result, the Insurer reimburses the necessary defence expenses, including professional fees, within the limits above. 4.3.2. Where a possible conflict of interest arises, the Insurer immediately informs the Insured of it and of his rights under paragraph 4.2. The Insured may submit to arbitration any difference arising between him and the Insurer over this guarantee; arbitrators may not be designated before the disputed question arises.

Article 5 — Personal accident ↑ top

5.1. Insureds

For this guarantee, the insureds are the passengers of the craft and the persons water-skiing or practising another sport while towed by the insured craft — except where they are under 14 years old or legally incapacitated (in which case they are insured only for the Permanent Disability, Medical Expenses and Funeral Expenses covers), or over 65 years old (in which case they are insured only for the Funeral Expenses cover). If at the time of the loss the number of insured persons exceeds the maximum declared in the Particular Conditions, the capital insured per person for each cover is reduced in the same proportion by which the declared number was exceeded.

5.2. Death cover

In the event of death of an insured (per 5.1) due to an accident on the occasion of the use of the insured craft, the Insurer pays the capital per person contracted in the Particular Conditions, to the beneficiaries designated by the deceased or, failing express designation, to his legal heirs.

5.3. Permanent disability cover

In the event of irreversible anatomical or functional loss suffered by an insured (per 5.1) due to an accident during use of the craft, the Insurer indemnifies up to the capital per person contracted, according to the degree of permanent disability the loss represents, determined by medical valuation against the following scale (baremo):

Rules: A.2) if the insured is left-handed, the percentages for the right upper limb apply to the left and vice versa. A.3) the degree is determined without regard to the injured person's usual work or occupation. A.4) for sequelae not expressly listed, the degree is determined by the model of the World Health Organisation's International Classification of Impairments, Disabilities and Handicaps (Annex 1 of Royal Decree 1971/1999 of 23 December). A.5) the degree may never exceed 100%, even from several sequelae of one accident. A.6) if an organ or limb already had a defect, the degree considered is the difference between the result after the accident and the pre-existing state. B.1) the percentage is applied to the capital insured per victim. C.1) the indemnity per victim may never exceed the capital contracted per insured. C.2) for the same loss and insured, amounts paid under this cover are deductible from any death indemnity (if death results from the same accident).

5.4. Medical expenses cover

The Insurer indemnifies, up to the capital per victim contracted, the reasonable and appropriate medical, pharmaceutical and hospital expenses incurred in Spain for the treatment of bodily injuries suffered by an insured (per 5.1) in an accident during use of the craft. After the loss, this cover stays in force until the earliest of: the injuries heal or become permanent; the indemnity paid reaches the capital insured per victim; or three years elapse from the accident.

5.5. Funeral expenses cover

In the event of death of an insured (per 5.1) due to an accident during use of the craft, the Insurer reimburses the funeral expenses incurred in Spain, up to the capital per victim contracted, to the heirs or relatives who documentarily prove they bore those expenses.

5.6. Exclusions

The insurer does not respond for accidents:

• a) occurring while the craft is ashore;
• b) caused by war risks and their consequences before and after declaration, rebellion, strikes, riot, civil disorder or sedition;
• c) resulting from illegal or criminal actions of the sufferer, or caused by his wilful misconduct or gross negligence, or while the injured person is under the influence of alcoholic drinks, toxic drugs or narcotics;
• d) during participation in regattas and sports competitions, or where the craft is used for commercial or profit-making operations or any activity other than recreational navigation, except where requested to give maritime assistance;
• e) while the craft is skippered by a person without the legally required licence for its handling;
• f) illnesses of any kind, poisonings, intoxications, infections, congestions, sunstroke and hypothermia are excluded, except where they are a consequence of an accident covered by this guarantee.

Article 6 — Travel assistance ↑ top

By contracting this guarantee, LA ESTRELLA undertakes the provision, by the company stated in the Particular Conditions or its replacement (“the Assistance Service”), of the assistance services specified below.

6.1. Steps in the event of a loss

On an event that may give rise to a covered service, it is an indispensable requirement to obtain the Assistance Service's authorisation by immediately notifying the loss, by phone or in writing to the number or address in the Particular Conditions (or, in case of force majeure, as soon as the impediment ceases). The Insured states the craft's data, its location, a contact phone, the circumstances and the type of assistance requested. If the Insured acts contrary to the Assistance Service's instructions, the resulting expenses are at his charge.

6.2. Guaranteed limits

The amounts shown as limits for each service are maximum amounts accumulable during the contractual period.

6.3. Covers

A) Medical and technical services ashore.

• 6.3.1. Hotel accommodation: if the craft is immobilised by breakdown or accident for less than four days, the Assistance Service covers the extended stay at the hotel nearest the port, up to 3 nights at €60 per person per day, and up to €720 for all insureds together.
• 6.3.2. Custody of the craft: custody expenses on immobilisation are covered up to €300.
• 6.3.3. Medical expenses abroad: on illness or accident of the insured during a trip, up to €750 per person and €4,500 for all insureds aboard — medical fees, prescribed medicines, hospitalisation, and ambulance from the port to the nearest medical centre. The first €30 is borne by the insured; original invoices with a full medical report are required where the Service did not act directly.
• 6.3.4. Medical transfer of the sick and injured: where the Service's medical team authorises transfer to a better-equipped or specialist hospital near the insured's home in Spain, by special air ambulance (used only within Europe and the Mediterranean-rim countries), medical helicopter, scheduled flight, first-class train or ambulance — only medical requirements decide the means and the hospital. If the insured refuses the transfer determined by the medical team, all resulting guarantees and expenses are automatically suspended.
• 6.3.5. Transport of mortal remains: on death of the insured (the remains having first been moved to the nearest port), transport to the place of burial in Spain, plus embalming, the minimum compulsory coffin and administrative formalities. This cover does not extend to funeral-parlour and burial costs.
• 6.3.6. Sending medicines: where the insured needs a medicine unavailable locally, the Service locates and sends it by the fastest means (subject to local law) to the designated port, for packages up to 10 kg; the insured reimburses the price of the medicine on presentation of the invoice. Cases of discontinued manufacture or unavailability through the usual distribution channels in Spain are excluded.
• 6.3.7. Search and sending of spare parts for the craft or the towing vehicle/trailer that cannot be found locally; the Service bears the sending cost, the parts being at the insured's charge.
• B) Specific services.
• 6.3.8. Sending nautical charts: the Service searches for and sends nautical charts; it bears only the sending cost, the charts being at the insured's charge.
• 6.3.9. Information service: information on Spanish ports/yacht clubs, the calendar of nautical events, weather/sea state in Spain, specific administrative information (federations, harbourmasters, licences, etc.), nautical shops and specialist bookshops and gestorías, refuelling points, berths and port technical characteristics, and nautical dealers and suppliers in Spain.
• 6.3.10. Covered services: translation/linguistic support abroad; connection with emergency services (SASEMAR, Guardia Civil, etc.).
• 6.3.11. Medical advice: on illness or injury of an insured, advice to decide, with the attending doctor, the best treatment and the most suitable means of transfer if needed.
• 6.3.12. Accompaniment of minors: where insureds travelling with children under 14 cannot care for them through illness or accident, the Service organises and pays the return travel of a person resident in Spain designated by the insured or family, or of a Service hostess, to accompany the children home in Spain.
• 6.3.13. Transmission of urgent messages (deriving from the covered guarantees), via a 24-hour service, where the insured has no other means.

6.4. Exclusions

These guarantees cease when the insured returns to his usual home or residence in Spain, or when he has been repatriated by the Service. Services not previously notified to, or authorised by, the Assistance Service are excluded generally. Also excluded are damage, situations, expenses and consequences deriving from: 1) pre-existing or chronic illnesses, injuries or conditions suffered before the start of the contract or its renewal, and those manifesting during it but before the trip begins; 2) glasses and contact lenses, and the acquisition, fitting, replacement, removal and/or repair of prostheses and anatomical/orthopaedic pieces of any kind; 3) medical, surgical and pharmaceutical expenses of less than €30; 4) labour accidents of persons in their own risk-rated activity, and occupational illnesses; 5) the insured's participation in bets, challenges or brawls; 6) suicide, attempted suicide or self-harm; 7) illnesses or accidents from consumption of alcohol, narcotics, drugs or medicines (unless medically prescribed); 8) wilful acts of the Policyholder, insured or their successors; 9) rescue on the high seas; 10) wars, demonstrations, insurrections, riots, terrorism, sabotage and strikes, whether or not officially declared; 11) nuclear transmutation and radiation from artificial particle acceleration; 12) earthquakes, floods, volcanic eruptions and, in general, events from the unleashing of natural forces; 13) any other catastrophic event classified as a catastrophe or calamity. Also particularly excluded: medical transfer for conditions treatable “in situ”; mental illness, preventive check-ups, spa cures, cosmetic surgery, AIDS and trips whose object is to receive treatment or surgery, and pregnancy diagnosis/follow-up/voluntary interruption and childbirth (save urgent care before the sixth month).

Article 7 — Provisions common to all guarantees ↑ top

7.1. Duration of the insurance and payment of premiums

7.1.1. Duration. This insurance is taken out for a period of one year from its effective date, unless the Particular Conditions set a different term. However, the policy is automatically suspended while any of the following situations applies:

• 1. the craft is operated by a person not holding the licence legally required for the type of craft;
• 2. the craft is navigating outside the navigation area declared in the Particular Conditions, or (though within it) outside the area legally permitted for the skipper's licence or the craft's classification;
• 3. one month has elapsed since the due date of a premium (after the first) without it being paid;
• 4. the craft has not passed the Technical Inspection of Recreational Craft, or its Seaworthiness Certificate is not in force (this does not apply while the craft is ashore).

This suspension does not prejudice the Insurer's right to collect the premiums accruing in the period, nor postpone the contractual due date.

7.1.2. Automatic renewal and cancellation. Unless expressly cancelled by the Policyholder or Insurer, communicated in an authentic form to the other party at least two months before the due date, the insurance is tacitly renewed for one year from that date.

7.1.3. Payment of premiums. The premium for each new period is adjusted to the premium tariffs on file with the Directorate-General for Insurance. The Policyholder must pay the premium on the conditions stipulated; if no place of payment is fixed, it is made at the Policyholder's address. If through the Policyholder's fault the first or single premium is not paid, the Insurer may terminate the contract or demand payment by enforcement on the basis of the Policy; save agreement to the contrary, if the premium is unpaid before a loss occurs, the Insurer is released from its obligation. On non-payment of a subsequent premium, cover is suspended one month after its due date; if the Insurer does not claim payment within the following six months, the contract is deemed extinguished. While suspended, the Insurer may demand only the current period's premium. If the contract has not been terminated or extinguished, cover resumes at 24:00 on the day the Policyholder pays the premium.

7.2. Action in the event of a loss

The Policyholder and, where applicable, the Insured must notify the loss to the Insurance Company and, in urgent cases, directly request an Average Commissioner or expert (perito) via the phones in the Particular Conditions. They must take the measures needed to lessen the loss's damaging consequences and provide the Insurer and the Commissioner/expert all relevant information for handling and settling the loss. Neither the Policyholder nor the Insured nor anyone on their behalf may negotiate, admit or reject any claim without the Insurer's authorisation; breach allows the Insurer to reduce its payment (involving the insured in the loss to the extent his conduct aggravated the economic consequences) or to claim damages.

7.3. Payment of the indemnity

7.3.1. The indemnity is calculated by the rules in the Policy for the affected guarantee, on the capital insured and after deducting the agreed excess. 7.3.2. The insurer must pay at the end of the investigations and expert valuations needed to establish the loss and the amount of damage; in any case, within forty days of receiving the loss declaration, it must pay the minimum it may owe according to the circumstances known (Art. 18 Insurance Contract Act). 7.3.3. Resolution of disputes: Estrella Seguros has a Complaints and Claims Department to which the client may turn. Where a loss dispute over the merits and amount is not resolved within the period above, the pre-litigation procedure of Articles 38 and 39 of the Insurance Contract Act applies: each party appoints an expert (a party failing to appoint within eight days of being required is deemed to accept the other's expert); if the experts agree, a joint report is made; if not, a third expert is appointed by agreement or, failing that, by the Court of First Instance; the experts' opinion is binding unless judicially challenged within thirty days (insurer) or one hundred and eighty days (insured), after which it is unchallengeable. Each party pays its own expert; the third expert and other valuation costs are shared equally, unless one party forced the valuation by a manifestly disproportionate estimate, in which case it alone bears them.

7.4. Prescription (limitation)

Actions arising from this contract are time-barred after two years for the Damage or Liability guarantees, and five years for the Accident guarantee.

7.5. Consorcio de Compensación de Seguros — indemnity for losses from extraordinary events ↑ top

In accordance with the legal Statute of the Consorcio de Compensación de Seguros (CCS), the policyholder of a contract that must incorporate a surcharge in favour of the CCS may agree the cover of extraordinary risks with any authorised insurer. Indemnities from losses caused by extraordinary events in Spain (and abroad where the policyholder is habitually resident in Spain) are paid by the CCS where the insured paid the corresponding surcharges and: a) the extraordinary risk is not covered by the policy contracted with the insurer; or b) even if covered, the insurer's obligations cannot be met because it is judicially declared insolvent or is in a CCS-assumed liquidation.

Extraordinary events covered

The following are extraordinary events: a) natural phenomena — earthquakes and tidal waves, extraordinary floods (including sea surges), volcanic eruptions, atypical cyclonic storm (including extraordinary winds with gusts over 135 km/h, and tornadoes) and falls of celestial bodies and meteorites; b) those caused violently by terrorism, rebellion, sedition, riot and civil commotion; c) acts of the Armed Forces or Security Forces in peacetime.

Risks excluded by the CCS

Not indemnifiable by the CCS, among others: losses not giving rise to indemnity under the Insurance Contract Act; losses on persons insured under a contract for which the CCS surcharge is not compulsory; those from armed conflicts (even without declared war); those from nuclear energy (without prejudice to Law 25/1964); natural phenomena other than those in Article 1 of the extraordinary-risks Regulation (e.g. rising water table, slope movement, landslip, rockfall — unless clearly caused by rainwater that itself produced an extraordinary flood); tumultuary actions in lawful meetings/demonstrations and during lawful strikes (unless classifiable as extraordinary events); those caused by the insured's bad faith; losses before the first premium is paid or while the CCS cover is suspended or the insurance extinguished for non-payment; and losses classified by the Government as a “national catastrophe or calamity”.

Extent of the cover

The CCS indemnifies, with no waiting period or excess, on a compensation basis, the damage from extraordinary events occurring in Spain and affecting risks situated in it. Personal injury from extraordinary events occurring abroad is also indemnifiable by the CCS where the policyholder is habitually resident in Spain. The cover of extraordinary risks reaches the same persons and sums insured established in the policy for the cover of ordinary risks. The CCS acts in accordance with its legal Statute, the Insurance Contract Act (Law 50/1980), Royal Decree 300/2004 approving the extraordinary-risks Regulation, and complementary provisions.

Procedure in the event of a loss indemnifiable by the CCS

In the event of a loss, the insured, policyholder, beneficiary or their legal representatives must notify the loss, within a maximum of seven days of becoming aware of it, to the relevant CCS regional delegation (according to where the loss occurred) — either directly or through the insurer or the mediator who arranged the ordinary insurance. The notification is made on the form for the purpose, available on the CCS website (www.consorseguros.es) or at its or the insurer's offices, to which the following documentation is attached:

• Injuries causing partial, total or absolute permanent disability: photocopy of the injured person's DNI/NIF (and the payee's, if different); the bank-account details where the indemnity is to be paid (entity, branch, control digit and account number — the 20-digit Client Account Code — and the bank's address); photocopy of the general and particular conditions of the policy (individual or collective) and all appendices/supplements; photocopy of the premium receipt in force at the date of the loss, clearly specifying the commercial premium and the surcharge paid to the CCS; and any documentation the injured person may hold evidencing the cause of the loss and the injuries.
• Death: death certificate; photocopy of the possible beneficiary's DNI/NIF; photocopy of the general and particular conditions and all appendices/supplements; photocopy of the premium receipt in force at the date of the loss (specifying the commercial premium and the CCS surcharge); the bank-account details for payment; any documentation on the cause of the loss; and, where no beneficiary was designated in the policy, the family book and will (or, failing it, a declaration of heirs or notarial deed of notoriety) and the Inheritance Tax settlement.

For any query on the procedure, the CCS provides the following policyholder assistance line: 902 222 665 (www.consorseguros.es).

Insurer of record: LA ESTRELLA S.A. de Seguros y Reaseguros (Generali group). Registered office: Orense 2, Madrid. C.I.F. A-28007268. Madrid Commercial Registry. The original Spanish conditions (Mod. 60494/06) are the binding text.