23 The insurance is furthermore covered by the Legislation on Insurance Agreements
The terms and exceptions stated in the following apply to this insurance in its entirety – points 1-22.
24 Conditions for insurance cover
a) If you have attained 70 years of age at the point in time of departure, you must purchase the insurance as a Senior (+70). It is a precondition for coverage that you have submitted and received an advance commitment before every trip. Hence you must fill in a health declaration that must be sent to Gouda. This does not apply for travel to Norway, Sweden, Finland and Iceland.
b) During the entire insurance period, you must be entitled to benefits with respect to the Danish Health Act as well as the blue EU health insurance card.
c) The insurance must have been purchased and paid for before your departure from Denmark.
If you have purchased a supplement for Cancellation, your insurance including the supplement for Cancellation must have been purchased and paid for at the latest upon payment of a deposit for the first trip that the insurance will be covering. In addition, it is a precondition that the insurance has enter into effect simultaneously with the ordering of the trip.
25 Scope of cover
a) The insurance covers only the geographical area stated in the policy.
b) Compensation will be paid for events that arise during the insurance period. If your arrival home is delayed without responsibility on your part, the insurance period is extended without payment of additional premium for up to 14 days.
c) The insurance covers from the start date specified on the policy, if the premium has been paid before this date. The insurance is subscribed to for a 1-year period and may be renewed by paying the premium for the next insurance year at the latest one week before the main due date, which is the same day as the start date the subsequent year.
26 Insurance period
The duration of the insurance appears on the policy. During the duration of the insurance, purely holiday trips of up to one month in duration will be covered. The insurance coverage will enter into effect at the point in time when you leave your residence or place you are staying in Denmark and commence your trip abroad, and ceases upon your return home to your residence.
If you have purchased a supplement for Cancellation, the following insurance period applies for this coverage: The insurance covers from the payment of the policy until departure from Denmark. It is a precondition that these points in time lie within the duration of the insurance.
27 General expections
The insurance does not cover
a) claims arising in consequence of skiing, unless you have purchased a supplement for Skiing. This exception does not apply for the Cancellation coverage,
b) claims caused by you though deliberate or gross negligence or under the influence of narcotics, medicine or other euphoriants,
c) claims caused by you under self-inflicted intoxication. This however does not apply for cover 1 Illness, 2 Repatriation, 3 Help at the destination – 24-hour medical help, 4 Dental treatment and physiotherapy, etc., 6 Erroneous medical treatment, 7 Personal liability, 8 Legal aid abroad and 10 Sending for & accompanying,
d) claims arisen in connection with your participation in scientific expeditions, under the conduct of or training for professional sport,
e) indirect loss,
f) pilots and co-pilots during flights,
g) claims arising as a direct or indirect consequence of: strike, lockout, arrest, seizure or other types of intervention by a public authority. See however points 8.1 d and 9.1 b,
h) any expense after returning to Denmark. See however point 5.3,
i) damage caused directly or indirectly by war or warlike acts, riot or civil unrest. The travel insurance will, however, cover such claims until the first opportunity of evacuation, unless evacuation had already at the time when the insured entered the area in question been recommended or carried out because of the current unrest,
j) active participation in war, riots, etc,
k) claims caused directly or indirectly as a consequence of release of nuclear energy or radioactive forces or radiation from radioactive fuel or waste.
28 Insurance amount
Unless otherwise specifically stated, the insurance sums indicated for the individual cover and partial cover form the maximum limits to Gouda’s liability to pay compensation per trip per insured.
For Cancellation, Accident and Personal Property covers, the stated insurance amounts are however maximum limits for Gouda's liability to pay compensation per insurance year per insured.
29 Incorrect information
It is important that information, including health information, provided to Gouda is precise and correct. If information is withheld or wrong answers are given which may be important for Gouda’s assessment, the compensation may be reduced or lapse entirely.
30 Double insurance
The insurance does not include claims for compensation covered by another insurance policy, the blue EU health insurance certificate, another public arrangement or a liable tortfeasor.
The compensation for disability and death under cover 21 Accident is not limited by the purchase of another insurance. When making a claim, you must always state whether you have an insurance with another company, or whether you have a credit card. (The stipulation is used when the case is settled before a Danish court.)
30A Insurance in other companies (Coinsurance)
If, at the time the loss or damage insured by this certificate shall occur, there is any other insurance against such loss or damage or any part thereof, the underwriter shall be liable under this certificate for its proportionate share of loss or damage only. (The stipulation is used when the case is settled before a Danish court).
31 Assignment of claim for compensation
You cannot without Gouda's acceptance pledge or assign your rights under the travel insurance.
31a You cannot, without consent from Gouda, pledge or assign your rights according to the travel insurance. (The stipulation is used when the case is settled before a Danish court).
In case of payment under the present travel insurance, Gouda shall be completely subrogated to the rights of the insured in this respect. (The stipulation is used when the case is settled before a Danish court).
32A Rights of subrogation
The underwriter shall be fully and completely subrogated to the rights of the Insured against parties who may be liable to provide an indemnity or make a contribution with respect to any matter which is the subject of a claim under this
certificate. The underwriter may at his own expense take over the Insured’s rights against third parties to the extent of his payment made. The Insured shall cooperate with the underwriter and provide such information and documentation reasonably required by the underwriter in order to collect and enforce his rights of subrogation. The underwriter may institute any proceedings at his own expense against such third parties in the name of the Insured. (The stipulation is used when the case is settled before a Danish court).
33 Cooling-off clause
The following cooling-off clause applies to travel insurance with a term of more than one month:
a) Under section 33 of the Danish Insurance Agreements Act, you are entitled to a cooling-off period.
b) The cooling-off period is 14 days. The period starts on the day on which the insurance terms were handed over/forwarded to you - however, no earlier than at the time when you received information that the insurance agreement has been entered into. If for example you receive the insurance terms on Monday the 1st, you will have until and including Monday the 15th. If the period expires on a holiday, a Sunday, a Saturday or on the 5th of June (Danish Constitution Day), you will have until the following workday.
c) Before the end of the cooling-off period, you must inform Gouda that you have changed your mind on entering into the agreement. If this information is forwarded by post, you must send the letter before the end of the period. If you want proof that you have regretted the agreement in time, you can send the letter by registered post and keep the certificate indicating you posted it.
Information that you regret the agreement shall be forwarded to:
Gouda Rejseforsikring A/S, A.C. Meyers Vænge 9, DK-2450 Copenhagen SV.
34 Refunding of the travel insurance
a) If the travel insurance is terminated in writing before it expires, the difference between the premium which would have been payable for the shorter cover period and the premium paid will be paid out after deduction of an administration fee of DKK 100 per policy. Amounts of DKK 100 and less will not be repaid. The premium for the shorter coverage period will be computed as per the price list for Gouda's single trip insurance with Super coverage within the geographical area (EU/EEA, Extended Europe and World).
b) If the insurance has not become effective and if Gouda receives the notice of termination before the effective date, the full premium less an administrative fee of DKK 100 will be refunded.
35 Index-based adjustment of prices
The prices will be adjusted by an index each year at the main due date for the policy on the basis of Statistics Denmark's published consumer price index for the month of September (the price change in relation to September of the prior year). If the consumer price index ceases to be published, or is fundamentally changed in its calculation, then Gouda is entitled to establish new rules for future index-based adjustments.
a) You are obliged to obtain and provide the information necessary for Gouda to be able to decide whether and to what extent the claim is entitled to be covered. This will be for example original police reports, third party statements from for example travel guide, hotel staff or other relevant people. See also section II – “What to do if…”.
b) Gouda’s physician is entitled to request information about your health and treatment from your own physician and from other physicians or hospitals who have treated you, and if necessary to
discuss information given with such persons. Gouda guarantees full discretion in connection with such information.
c) Gouda is entitled to demand that you subject yourself to an examination (including collection of blood sample) by Gouda's physician or a physician designated by Gouda. In case of death, Gouda is entitled to demand an autopsy. In that case Gouda will cover all costs of the above. If, in spite of Gouda's request, no autopsy is carried out, the right to compensation may lapse.
d) You are obliged to forward original documentation for costs or damage for which compensation is requested, including original purchase receipts, warranty certificates, police reports, reports from the transport company, etc.
e) Arrangements regarding transport may be limited in countries at war or the like. Gouda is not responsible for the extent to which transport may be possible, but will in cases where help is necessary co-operate with the Ministry of Foreign Affairs.
f) Costs of transport not arranged by Gouda will be covered as a maximum with the costs Gouda would have incurred if arranging similar transport, however, as a maximum with an amount corresponding to the price of an airline ticket - maximum economy class. See however point 11.2 a.
g) Compensation is paid as soon as Gouda has received the information considered necessary in order to determine Gouda’s liability to pay compensation.
h) After each reported claim, the insured or Gouda shall be entitled to terminate the travel insurance with 14 days’ notice. This must be done in the period from the reporting of the claim and until 14 days after payment or rejection of the claim. Gouda does not repay the premium – wholly or in part – if the insurance is terminated by the insured according to the agreement after the effective date. If Gouda terminates the travel insurance, the premium will be repaid, cf. point 34 a.
37 Appeal board
If you - after having discussed the problem with us - continue to not agree with our claims processing or the results thereof, you may file an appeal with our person responsible for complaints:
Attn: Unit responsible for complaints
A.C. Meyers Vænge 9
DK-2450 Copenhagen SV
If you continue to not be in agreement with our decision, you have the possibility to complain to:
Board Anker Heegaardsgade 2
DK-1572 Copenhagen V
(+45) 33 15 89 00 weekdays between 10:00 and 1:00 pm 13.00
The complaint must be made on a special complaints form which can be obtained from the Insurance Appeals Board. You also have the possibility to complain online. You can read more about your possibilities at ankeforsikring.dk.
Legal actions against Gouda must be brought at Copenhagen City Court or the Eastern High Court in Copenhagen.
Here you can see what we mean by the different expressions such as “acute illness” and “accompanying traveller”. The definitions you will find here are the words in italics in the insurance terms and conditions.
A newly arisen illness, a reasonable suspicion of a newly arisen serious or an unexpected worsening of an existing or chronic illness.
Expenses that the insured solely incurs as a result of an insurance event that is covered by the policy.
This means a sudden outbreak of a large number of cases of the same, contagious illness in a country or an area.
EU/EEA The Azores (Portugal), the Balearic Islands (Majorca and Ibiza), Belgium, Bulgaria, Cyprus, the Canary Islands, Estonia, Finland, France, Gibraltar (Great Britain), Greece, Ireland, Iceland, Isle of Wight (Great Britain), Italy, Croatia, Latvia, Liechtenstein, Lithuania, Luxembourg, Madeira (Portugal), Malta, the Netherlands, Northern Ireland, Norway, Poland, Portugal, Romania, Switzerland, Slovakia, Slovenia, Spain, Great Britain, Sweden, Czech Republic, Germany, Hungary and Austria.
Andorra, the Isle of Man, the Faroes, Greenland, the Channel Islands, Monaco, San Marino and the Vatican City are also encompassed, however the blue EU health insurance card cannot be used here.
Countries or areas, which for legal purposes are part of or belong to one of the above mentioned countries, but are not located in Europe geographically, are not part of the definition EU/EEA.
The insured's spouse, cohabitant, children, step-children, grandchildren, children in-law, parents, step-parents, parents in-law, siblings, step-siblings, grandparents, sisters in-law or brothers in-law.
Itinerary which can be documented by means of description from travel agency, air, train or bus tickets purchased or hotel accommodation booked.
Means a trip back to Denmark which you can make as a healthy person in economy class.
Aid Object which may limit or remedy a physical condition or disability.
Gouda Gouda Rejseforsikring is a part of the Gjensidige Group and the Danish branch of Gjensidige Forsikring ASA, Norway ORG. No. 995 568 217. As of November 1st 2013 the activities of Gouda Travel Insurance in Denmark have been bought by Gjensidige Forsikring ASA, Norway and continue as a part of the Danish branch of Gjensidige.
Casualty/collision damage Damage arising due to theft, fire, accident or vandalism. Damage that is solely due to the mechanical, electrical and/or electronics parts are not considered to be casualty/collision damage, unless the damage has occurred by fire, explosion, lightening strike, theft or vandalism.
This means a qualified physician authorised by the authorities in the country of destination who is not the insured, a relative of the insured or travelling together with the insured.
Means calendar months, which may involve different numbers of days. For example 4 February to 3 March (28 days) and 26 May to 25 June (31 days).
This means costs that cannot reasonably be avoided. In cases where both local treatment and repatriation for further treatment in the home country are possible, the travel insurance will cover the solution which leads to the lowest costs for Gouda..
Costs of accommodation
This means the total costs of hotel, meals and public transport and the like.
This means children who are not the biological children of the insured, where the insured is married to or co-habiting with one of the child’s biological parents, with whom the insured has been living in a family-like relation for a minimum of one year.
Means people who are not the biological parents of the insured, but who are married to or co-habiting with one of the biological parents and with whom the insured has been living in a family-like relationship for at least one year, or who has been living with one of the insured’s biological parents for at least two years.
Means persons who are not the biological siblings of the insured, but with whom the insured is or has been living in a sibling-like relationship for a period of at least one year until the 21st year of the insured’s life.
A foster child always has its registered address with you and you have been approved by the local authorities as the provider for the child.
Foster parents People who are not your biological parents or step-parents, but who have been approved by the local authorities as your providers.
This means the conduct of sport with contractual obligations towards club, sponsor, etc., where payment is received or prizes made available. You are considered a professional sportsman/sportswoman if you have during one of the last five years before the insurance period had an annual income of at least DKK 100,000.00 received as remuneration, sponsorship or prize money.
Prostheses Artificial joints and limbs and artificial dentures and teeth.
This is one or more people who has/have bought the same journey as the insured and who is/are covered by Gouda travel insurance.
Trip's price per day
This means the travel services ordered in advance for which payments or non-refundable fees may be required to be paid for transport, accommodation and other tourist-related services, divided by the trip's duration (both the day of departure and the day of arrival back home are counted as a day). For travel in one's own vehicle, the expenses for transport are calculated based upon the state's low rate for tax-free driving compensation (currently DKK 2.13) per vehicle per kilometre driven from the residence in Denmark to the final destination abroad as well as the return trip to the residence divided by the duration of the trip (both the day of departure and the day of arrival back home are counted as a day). The distance from there residence in Denmark to the final destination abroad and back is the shortest possible distance between the residence and the final destination.
This means a person with whom the insured is living in a marriage-like relationship and who had the same national register address as the insured when the insurance was taken out.
A claim is an expression for a situation in which you want to make a claim to Gouda.
This means an organised act of violence or the threat of such act which by creating fear in the population tries to put pressure on the authorities to obtain religious or political goals.
This means a concrete and current conflict which may reasonably form the basis of a civil legal action.
Chewing damage Dental damage, including damage to prostheses, which occurs through eating or chewing.
Departure from Denmark - by water, when the ferry or boat sails from the harbour - by land, when the border is crossed - by air, when the airplane is in the air.
Means the countries in the EU/EEA (see definition above) as well as the following countries: Albania, Algeria, Bosnia-Herzegovina, Egypt, Gaza, Belarus, Israel, Jordan, Kosovo, Lebanon, Libya, Macedonia, Morocco, Moldavia, Montenegro, Palestine, Russia up to the Ural Mountains, Serbia, Syria, Tunisia, Turkey, Ukraine and the West Bank.
This means bodily harm affecting the insured though a sudden, external event. In the event of injury to the arms and legs of the insured, the reason for the injury need only be sudden and cause bodily harm that can be documented.
This means expeditions to areas where the local public authorities require separate permission to stay and where the insured receives payment for the expedition.