Skip to content

easyPROTECT PRO – Company accident insurance IPID EN

Résumé

Insurance Product Information Document for easyPROTECT PRO – Company accident insurance, issued under the LALUX Assurances brand. The Company guarantees payment of the benefits agreed in the Special Conditions when the insured person is the victim of an accident during the period of validity of the contract, the coverage being granted to both the company owner and employees. Three basic guarantees are described: benefits in the event of death, benefits in the event of permanent disability, and reimbursement of medical expenses. The insurance is valid throughout Europe and, by extension, worldwide for stays outside Europe of no more than three months.

Définitions

Terme Définition Page
Accident event occurring independently of the insured person’s will and which has a sudden and violent impact from the outside on the insured person’s body, and which results in either death or a medically certified bodily injury p. 1
What is considered as an accident? – Bodily injuries caused by lightning and electricity Bodily injuries caused by lightning and electricity p. 1
What is considered as an accident? – Pulled and ruptured muscles, tendons or ligaments following physical exertion Pulled and ruptured muscles, tendons or ligaments following physical exertion p. 1
What is considered as an accident? – Poisoning and asphyxiation Poisoning and asphyxiation, when they are the sudden consequence of the involuntary absorption of a product not intended for this purpose or of an accidental release of gas or steam p. 1
What is considered as an accident? – Drowning Drowning, when not caused by congestion p. 1
What is considered as an accident? – Blood infections, freezing and sunstroke Blood infections, freezing and sunstroke, but only when they are the direct consequence of a covered accident p. 1
What is considered as an accident? – Animal or insect bites or stings Animal or insect bites or stings p. 1
Medical expenses * Medical expenses: e.g. medical and prosthetic expenses, pharmaceutical and paramedical expenses incurred on medical prescription, expenses for prostheses damaged by the accident or made necessary as a result of the accident, transport expenses from the accident site to the nearest hospital p. 1

Garanties

Benefits in the event of death - p. 1

If the insured person dies as a result of a covered accident, the Company guarantees the payment of the death benefit stipulated in the Special Conditions to the designated beneficiaries immediately or within two years from the date of the accident. If no beneficiaries are designated, the capital is paid to the insured person’s legal heirs. - Optionnelle : non · Portée : The insurance is valid throughout Europe. By extension, it is valid worldwide for stays outside Europe of no more than three months. · Limite : the death benefit stipulated in the Special Conditions - Condition : immediately or within two years from the date of the accident. - Condition : If no beneficiaries are designated, the capital is paid to the insured person’s legal heirs. - Condition : For a single accident, death and permanent disability benefits cannot be combined.

Benefits in the event of permanent disability - p. 1

If the insured person suffers from a permanent disability following a covered accident, the Company guarantees the payment of an indemnity calculated by applying the rate of permanent disability to the total permanent disability capital stipulated in the Special Conditions. The rate of permanent invalidity is determined, regardless of the insured person’s occupation, according to the scale of permanent invalidity set out in the Ordinary General Conditions. - Optionnelle : non · Portée : The insurance is valid throughout Europe. By extension, it is valid worldwide for stays outside Europe of no more than three months. · Limite : an indemnity calculated by applying the rate of permanent disability to the total permanent disability capital stipulated in the Special Conditions. - Condition : The rate of permanent invalidity is determined, regardless of the insured person’s occupation, according to the scale of permanent invalidity set out in the Ordinary General Conditions. - Condition : For a single accident, death and permanent disability benefits cannot be combined.

Reimbursement of medical expenses - p. 1

The Company guarantees, within the limit of the amount insured, the reimbursement of medical expenses* incurred by the insured person during the two-year period following a covered accident. - Optionnelle : non · Portée : The insurance is valid throughout Europe. By extension, it is valid worldwide for stays outside Europe of no more than three months. · Limite : within the limit of the amount insured - Sous-limite : Transport costs from the accident site to the nearest competent hospital are reimbursed only for a maximum distance of 200 km. - Condition : during the two-year period following a covered accident.

Exclusions

Exclusion Description S'applique à Page
Animal bites Accidents caused by dog bites by dogs of the Staffordshire terrier and American Staffordshire terrier (pit bull, in particular), tosa and mastiff breeds, owned, kept or guarded by insured persons, are not covered. all p. 1
Uninsurable persons Persons with paralysis, epilepsy, epilepsy, insanity, stroke or delirium tremens are not insurable under the company accident insurance. If any of these illnesses or conditions already existed at the time the policy was taken out, all premiums collected since its effective date shall be refunded, at the request of the most diligent party. all p. 1
Specific restrictions: illnesses of any kind and surgical operations Illnesses, illnesses of any kind and their direct or indirect consequences, including allergies, as well as surgical operations and their consequences, unless these illnesses and operations are the direct consequence of a covered accident all p. 1
Specific restrictions: varicose veins, calluses, eczemas and dermatoses Varicose veins and their consequences, calluses, eczemas and dermatoses, even when produced by external agents all p. 1
Specific restrictions: lumbago, sciatica and hernias of all kinds Lumbago, sciatica and hernias of all kinds all p. 1
Specific restrictions: injuries caused by radiation devices and radioactive substances Injuries caused by radiation devices and radioactive substances used in diagnoses and radiotherapy, unless they result from a malfunction or misuse for the person treated, or are the result of treatment which the insured person undergoes as a result of a covered loss. all p. 1

Obligations de l'assuré

  • Provide as complete and accurate a description as possible of the risk to be insured, without misrepresentation or omission (When subscribing · If the policyholder and/or the insured person or their beneficiaries do not fulfil one of the obligations provided for in the General Terms and Conditions and this results in damage to the Company, the Company is entitled to claim a reduction in its benefit up to the amount of the damage it has suffered. The Company may decline its coverage if the insured person or their beneficiaries have not fulfilled one of these obligations due to fraudulent intent.) p. 2
  • Submit a certificate from the former insurance company specifying the degree of bonus-malus and any claims (When subscribing) p. 2
  • Report to the company any new circumstances that may increase the risk or create new ones (During the contractual period · If the policyholder and/or the insured person or their beneficiaries do not fulfil one of the obligations provided for in the General Terms and Conditions and this results in damage to the Company, the Company is entitled to claim a reduction in its benefit up to the amount of the damage it has suffered. The Company may decline its coverage if the insured person or their beneficiaries have not fulfilled one of these obligations due to fraudulent intent.) p. 2
  • Notify the company of any change in the data included in the contract, in particular in the event of a change of address or a change of bank account (During the contractual period) p. 2
  • Pay your insurance premiums within the time limits stipulated in your contract. (During the contractual period · In case of non-payment, the company can suspend the warranties or cancel the contract.) p. 2
  • Declare all claims within eight days of their occurrence and obtain the company’s consent before any action involving its intervention (In the event of a claim · If the policyholder and/or the insured person or their beneficiaries do not fulfil one of the obligations provided for in the General Terms and Conditions and this results in damage to the Company, the Company is entitled to claim a reduction in its benefit up to the amount of the damage it has suffered. The Company may decline its coverage if the insured person or their beneficiaries have not fulfilled one of these obligations due to fraudulent intent.) p. 2
  • Send in all the items required by the company to settle the claim. Transcripts, accident reports and other official documents must be sent as soon as possible. (In the event of a claim · If the policyholder and/or the insured person or their beneficiaries do not fulfil one of the obligations provided for in the General Terms and Conditions and this results in damage to the Company, the Company is entitled to claim a reduction in its benefit up to the amount of the damage it has suffered. The Company may decline its coverage if the insured person or their beneficiaries have not fulfilled one of these obligations due to fraudulent intent.) p. 2

Procédure de sinistre

  1. Declare all claims within eight days of their occurrence (délai : within eight days of their occurrence) p. 2
  2. obtain the company’s consent before any action involving its intervention (délai : before any action involving its intervention) p. 2
  3. Send in all the items required by the company to settle the claim. Transcripts, accident reports and other official documents must be sent as soon as possible. (délai : as soon as possible) p. 2

Durée & résiliation

  • Durée : The start (effective date) and expiry of the contract are indicated in the Special Conditions
  • Reconduction tacite : oui
  • Préavis : 30 days before the annual expiry date of the contract (customer) ; 60 days before the annual expiry date of the contract (company)
  • Modalité : Cancellation must be requested by registered letter
  • Droit spécial : Cancellation must be requested by registered letter 30 days before the annual expiry date of the contract, within one month following the cancellation of a guarantee or other contract by the company after a claim or within 60 days after a rate increase notified by the company.
  • Droit spécial : The company may cancel the contract after a claim has been submitted, in the event of fraud, non-payment, or following notification 60 days before the annual expiry date of the contract.
  • Droit spécial : In the event of cancellation, the company shall provide the customer with a bonus-malus certificate stating the degree and the claims for the current period.
  • Droit spécial : The contract is extended from year to year unless terminated by the customer or the company (tacit renewal)

Prime

  • The amount indicated on the annual due date notice is payable on the first day of the month of the due date
  • Monthly payments may be made by direct debit, without additional costs
  • Pay your insurance premiums within the time limits stipulated in your contract. In case of non-payment, the company can suspend the warranties or cancel the contract.

Conditions particulières

  • The words « Non-exhaustive list » are printed at the foot of the « What is not insured? » box and at the foot of the « Are there any restrictions on cover? » box: both enumerations are, on the document's own statement, incomplete. p. 1
  • This document is not tailored to your specific needs and the information and obligations set out herein are not exhaustive. For full information on the rights and obligations of the insurance company and policyholders, please consult the general and/or special conditions relating to the insurance product chosen. p. 1
  • If any of these illnesses or conditions already existed at the time the policy was taken out, all premiums collected since its effective date shall be refunded, at the request of the most diligent party. p. 1

Lacunes d'extraction

  • Assureur indéterminable au sens juridique. Le document imprime « LALUX Assurances - Product : easyPROTECT PRO – Accident insurance » et, dans le corps, « the Company » / « the insurance company » — une marque et des désignations génériques, sans forme sociale ni numéro RCS. L'entité juridique porteuse n'est pas déterminable à partir de ce seul document ; insurer_name reste le nom de marque fourni par la tâche.
  • Deux noms de produit différents sont imprimés sur la même page : le titre du haut de page est « easyPROTECT PRO – Company accident insurance » et la ligne d'identification imprime « LALUX Assurances - Product : easyPROTECT PRO – Accident insurance », sans « Company ». Les deux formulations sont conservées verbatim dans key_quotes ; product_name reprend le titre imprimé et variant retient « Company accident insurance ». Aucune des deux n'a été corrigée d'après l'autre.
  • Deux coquilles par redoublement de mot, imprimées et conservées telles quelles : « Persons with paralysis, epilepsy, epilepsy, insanity, stroke or delirium tremens » (« epilepsy » imprimé deux fois) et « Illnesses, illnesses of any kind and their direct or indirect consequences » (« illnesses » imprimé deux fois). Ni l'une ni l'autre n'a été réparée ; les deux passages sont cités verbatim.
  • Le document déclare lui-même ses listes incomplètes : la mention « Non-exhaustive list » est imprimée au pied de la boîte « What is not insured? » et au pied de la boîte « Are there any restrictions on cover? ». Les 6 exclusions et les 2 restrictions enregistrées sont celles qu'imprime le document, et non l'ensemble des exclusions du produit ; rien n'a été ajouté pour les compléter.
  • Incohérence de fond, conservée sans correction : le document est une assurance accidents d'entreprise, mais deux passages renvoient à un mécanisme de bonus-malus, propre à l'assurance automobile — « Submit a certificate from the former insurance company specifying the degree of bonus-malus and any claims » (obligations à la souscription) et « In the event of cancellation, the company shall provide the customer with a bonus-malus certificate stating the degree and the claims for the current period » (résiliation). Le document ne définit ni n'explique de bonus-malus par ailleurs. Les deux phrases sont enregistrées et citées telles quelles.
  • Intitulé contredit par son emplacement : la sous-rubrique « Specific restrictions: », qui introduit quatre points, est imprimée à l'intérieur de la boîte « What is not insured? » et non dans la boîte « Are there any restrictions on cover? » qui la suit. Les quatre points sont des exclusions rédigées comme telles (« unless … », « of all kinds ») et ont été rangés en exclusions ; l'intitulé n'a pas été réparé et est cité verbatim.
  • Contenu de la boîte « Are there any restrictions on cover? » rangé selon sa nature et non selon son intitulé : la non-cumulabilité (« For a single accident, death and permanent disability benefits cannot be combined. ») figure dans les conditions des deux garanties concernées, et le plafond kilométrique (« … reimbursed only for a maximum distance of 200 km. ») figure dans les sub_limits de la garantie Reimbursement of medical expenses. Aucun des deux n'a été transformé en exclusion.
  • Espace fine insécable U+2009 avant les « ? » et les « : » de sept intitulés et de la ligne « Product : » (8 occurrences), mais pas partout : « What is not insured? », « Are there any restrictions on cover? » et « What is considered as an accident? » sont imprimés sans cette espace. La typographie du document est donc inconsistante d'une boîte à l'autre. Toutes les citations ont été découpées programmatiquement dans le texte source et conservent le caractère réellement présent ; aucune n'a été retapée.
  • Autres défauts de composition conservés : double espace après un point dans « … within two years from the date of the accident. If no beneficiaries … » et dans « Disclaimer: This document … ».
  • L'ordre de lecture de la couche texte ne suit pas l'ordre visuel de la page 1 : la rubrique « What type of insurance is it ? » et le Disclaimer, imprimés en haut de page, sortent après les trois boîtes de garanties, d'exclusions et de restrictions. Chaque bloc a été rattaché à sa rubrique par son intitulé, jamais par sa position dans le flux.
  • Le document ne chiffre aucun capital : les prestations décès et invalidité permanente renvoient aux Special Conditions (« the death benefit stipulated in the Special Conditions », « the total permanent disability capital stipulated in the Special Conditions ») et le remboursement des frais médicaux à « the limit of the amount insured ». Le seul chiffre imprimé de tout le document est la distance maximale de 200 km pour le transport. Aucun montant n'a été déduit.
  • Le barème d'invalidité permanente n'est pas reproduit : le document renvoie aux « Ordinary General Conditions » (« according to the scale of permanent invalidity set out in the Ordinary General Conditions »). Le barème lui-même reste donc hors de cette extraction.
  • target_audience mis à « entreprises » sur la base de deux énoncés du document lui-même — le titre imprimé « Company accident insurance » et la phrase « This coverage is granted to both the company owner and employees. », reportée verbatim dans target_audience_note. Le document ne nomme aucune catégorie plus fine (ni taille d'entreprise, ni secteur, ni statut d'indépendant) et ne fixe aucune condition d'âge ni d'effectif.
  • Sections absentes ou muettes, laissées vides ou nulles sans substitution : aucune franchise (deductibles null), aucun délai de carence (waiting_periods vide), aucun délai de prescription (prescription_period null). Aucune date d'édition, aucune référence interne et aucun code de branche ne sont imprimés : edition_date, reference et branch_code restent null ; rien n'a été promu depuis le nom de fichier ni depuis les métadonnées du PDF.
  • notice_period consigne les deux délais imprimés dans la même rubrique « How do I cancel the contract ? » : 30 jours avant l'échéance annuelle pour le client, 60 jours avant l'échéance annuelle pour la compagnie. Le document énonce en outre deux délais spéciaux (un mois après la résiliation par la compagnie d'une garantie ou d'un autre contrat à la suite d'un sinistre ; 60 jours après une majoration tarifaire notifiée par la compagnie), portés dans special_rights.
  • Ce document est la version anglaise. Aucune rubrique, aucun montant et aucune formulation n'ont été repris d'une version française ou allemande parallèle du même produit.

Documents liés

Source & fidélité