let:discover Korea Travel Insurance Ⅲ General Terms and Conditions
Section 1. Purpose and Definition of Terms
Article 1 (Purpose)
The purpose of this insurance contract (hereinafter referred to as the "contract") is to cover the risk of injury of the insured between the policyholder (hereinafter referred to as the "holder") and the insurance company (hereinafter referred to as "the Company").
Section 2. Payment for Coverage
Article 2 (Definition of Terms)
Unless otherwise defined, the terms used in this contract are as follows:
1. Terms related to contractual relations
- Policyholder: A person who purchases a contract from the Company and is obligated to pay insurance premiums.
- Insurance beneficiary: A person who can claim and receive money for a claim from the Company when a reason for payment occurs.
- insurance policy: A certificate provided by the Company to the holder to prove the contract and contents concluded.
- Diagnosis contract: A contract in which the insured needs a medical examination to conclude a contract.
- The Insured: A person subject to being covered from an insurance accident.
2.Terms of Coverage
- Injury: Injury to the body caused by a sudden accident from outside during the insurance period (Except for body aids such as prosthetic hands, prosthetic legs, prosthetic eyes, and prosthetic teeth. But may include cases where they are transplanted into the body, such as artificial organs or partial dentures, to replace their functions.)
- Disability: 【Attachment 1】 Disability status based on the criteria specified in the disability classification table
- Important matters: Matters regarding the obligation to notify before the contract. Matters that can affect the Company’s decision of making a conditional agreement such as refusing the contract, limiting the insurance coverage, excluding some coverages, reducing insurance premiums, and increasing the cost of insurance.
3. Terms related to interest rates
- Annual compound interest: It refers to an interest calculation method when the Company pays interest on money to be paid. The interest is added to the principal on the last day of each year and it becomes the principal for the next year.
< Example of annual compound calculation > When a principal is KRW 100 and the Interest rate is 10% per a year ⇒ 1 year later: KRW 100 + (KRW 100 × 10%) = KRW 110 ⇒ 2 years later: KRW 110 + (KRW 110 × 10%) = KRW 121 |
- The Company shall pay the agreed claim to the beneficiary (the recipient of the claim) if any of the following causes occurs during the insurance period specified in the certificate (hereinafter referred to as "travel").
- Death caused by a direct result of injury during travel (excluding death due to disease): claim for death
- When becoming a disability state caused by an injury during the travel and corresponds to each disability payment rate prescribed in the disability classification table(See 【Attachment 1】. Same as below): Disability claim (Amount calculated by multiplying the payment rate specified in the disability classification table by the subscription amount)
- ‘Travel’ in Korea mentioned in paragraph 1 includes the following cases.
- Until a domestic resident returns to his or her residence after departing from his or her residence for traveling.
- Until immediately before an expatriate boards an aircraft or ship at a domestic airport or dock to departure after the traveling
Article 3 (Coverages), the beneficiary and the Company may appoint a third party together and follow the third party's opinion. A third party is determined from among specialists belonging to a general hospital prescribed in Article 3 (medical institution) of the Medical Service Act, and the Company pays the full medical expenses for determining the reason for insurance payment.
Article 4 (Detailed Regulations for Insurance Payment)
- "Death" in Article 3 (Coverages) (1) 1 includes cases in which any of the following reasons occur during the insurance period.
- If the insured person is declared missing: The insured will be believed to have died at the end of the disappearance period recognized by the court.
- Where a government office investigates a flood, fire, or other disaster and notifies death of the insured: The date of death follows the date of death listed in the Family Relations Register.
- If the insured dies due to the decision to discontinue life-sustaining treatment under the 「Hospice, Palliative Care, and the Patient's Life-sustaining Treatment Determination Act」, the decision to discontinue life-sustaining treatment does not affect the cause of death and the payment of insurance for death from Article 3 Coverages (1).
- In Article 3 Coverages (2), If the disability payment rate is not determined within 180 days of the occurrence of the injury, the condition that is considered to be fixed is determined based on the doctor's diagnosis on the 180th day from the date of the injury. However, if the disability classification table (see attached 【Table 1】) determines the timing of judgment separately, the timing of the disability judgment shall be in accordance with the table.
- After the disability payment rate is determined in accordance with paragraph (3), but the disability status deteriorates further during the period covered (within one year from the date of injury in case the contract is no longer effective), the disability payment rate shall be determined based on the deteriorated disability status.
- When disability from injuries is not specified under the disability classification table, the amount of payment is determined according to a similar classification of the disability classification table, regardless of the insured's occupation, age, status, or gender. However, disability from injuries that does not reach the minimum payment rate for each disability classification in the disability classification table is not paid for the claim.
- If the beneficiary of insurance and the Company cannot agree on the reason for payment of the claim under
- If more than one disability from injuries occurs due to the same injury, the payment rate for disability will be added. However, if the criteria for determining each body part of the disability classification table are separately determined, the criteria shall be followed.
- If there are more than two disabilities due to other injuries, the corresponding disability payment rate is determined each time. However, if the disability from injuries is added to the same area where the disability has already been paid, the amount of the disability claim already paid will be deducted from the disability claim corresponding to the final disability state. However, if the criteria for determining each body part of the disability classification table are separately determined, the criteria shall be followed.
- If the insured, who has not already been covered with the reason for payment of the disability insurance (Including disability caused by or before the inception of coverage) or has not been paid, has disability again in the same part of the body according to paragraph 8, the amount of disability insurance shall be deducted from the final amount of disability insurance.
- The amount of disability coverage from one injury that the Company has to pay cannot exceed the insurance amount.
Article 5 (Exclusions)
- The Company shall not pay a claim when any of the following reasons arise:
- In the case where the insured intentionally harms himself/herself. However, if the insured damages himself or herself without free decision-making due to unsoundness of mind, the claim will be paid.
- In the case where the beneficiary intentionally harms the insured. However, if the beneficiary is a partial beneficiary of the claim, the claim is paid to the other beneficiary.
- If the policyholder intentionally harms the insured
- Pregnancy, childbirth (including cesarean section), and postpartum of the insured. However, if there is a reason for the insurance payment covered by the Company, the insurance payment will be paid.
- War, acts of foreign enemies, revolution, civil war, riots, or any of such events
- The Company shall not pay the claim if the insured has a reason for payment under Article 3 (Coverages) due to the activities listed below for occupation, as part of his/her job, or club activities, unless there is any other agreement.
- Professional climbing (meaning climbing up and down a rock or ice wall using professional climbing equipment or requiring special skills, experience, and pre-training), glider control, skydiving, scuba diving, hang gliding, water boat, paragliding
- Motorboat, competition/demonstration/performance (including practice) of a car or motorcycle and test driving for those (provided that insurance payments are covered when a reason for payment occurs during a test drive on a public road)
- While the insured is on board a ship due to his/her duties
Article 6 (Notification of Coverages)
When the policyholder, the insured, or the beneficiary of the insurance is aware of the occurrence of the reason for payment of the claim prescribed in Article 3 (Coverages), he/she shall notify the Company without delay.
Article 7 (Claim)
- The beneficiary must submit the following documents and claim the claim.
- A Letter of Request (Company Form)
- Accident certificate (medical expense statement, death certificate, disability certificate, inpatient treatment confirmation, doctor's prescription (prescription fee), etc.)
- ID card (ID card issued by a government agency with a photo, such as a resident registration card or a driver's license, and if the person who claims the money is not the beneficiary, the beneficiary's stamp certificate or signature confirmation certificate is required.)
- Other documents submitted by the beneficiary of insurance as necessary for the receipt of a claim
- The accident certificate under paragraph 1 (2) must be issued by a domestic hospital or clinic prescribed in Article 3 (medical institution) of the Medical Act, or by a medical institution prescribed in foreign medical-related laws.
Article 8 (Procedure for Payment of Insurance Claims)
- When the Company receives the documents prescribed in Article 7 (Claim for claim), the Company gives a receipt and sends them by text message or e-mail, and pays the claim within three business days from the date of receipt.
- If it is clearly expected that the period necessary for the Company to investigate and confirm the reasons for payment exceeds the payment date under paragraph (1), the specific reasons, the scheduled payment date, and the insurance pre-payment system (payment within 50% of the estimated insurance amount) shall be immediately notified to the insured or beneficiary. However, the scheduled payment date shall be determined within 30 business days from the date of receipt of the documents prescribed in Article 7 (Claim for claim), except in any of the following cases:
- Filing a lawsuit
- An application for dispute settlement
- Investigation by the investigative agency
- Investigation into an insurance accident that occurred overseas
- If the investigation and confirmation of the grounds for payment of a claim is delayed due to the responsibility of the policyholder, the insured, or the beneficiary, such as refusal of consent to the Company's request for an investigation under paragraph 6
- Where it is decided to follow the opinion of a third party on the grounds for payment of claim pursuant to Article 4 (Detailed Regulations for Insurance Payment) paragraph 6
- In relation to the determination of the disability payment rate and the determination of the claim to be paid pursuant to paragraph 2, if the insurance payment is delayed due to a dispute over the amount exceeding the fixed disability payment rate, the claim which is already confirmed shall be paid first at the request of the beneficiary.
- In the event of an additional investigation pursuant to paragraph 2, the Company shall pay 50% of the coverage estimated by the Company as provisional coverage at the request of the beneficiary.
- If the Company fails to pay the claim within the payment date prescribed in paragraph 1 (including the case of
notifying the scheduled payment date prescribed in paragraph 2), it shall pay the amount calculated as annual compound interest rate according to the ‘<Attachment> Interest rate when paying claim’ for the period from the next day to the payment date. However, if the payment is delayed due to the responsibility of the policyholder, the insured, or the beneficiary of the insurance, interest on the period shall not be paid. However, the Company does not refuse to pay interest just because the policyholder, etc. applied for dispute settlement.
The policyholder, insured, or beneficiary shall agree to the Company's written request for an investigation of medical institutions, the National Health Insurance Service, police stations, etc. in relation to the investigation of the reasons for payment of insurance under Article 15 (Effect of Violation of Obligation to Notify) and paragraph 2 Investigation of Coverages. However, if the parties do not agree to this without a justifiable reason, the Company will not pay interest on the delay in insurance payment until the fact-checking is completed.
When the Company requests consent to the written investigation under paragraph 6, it specifies and explains the purpose and use of the investigation.
< Provisional Coverage > Provisional Coverage is a system in which the company pays part of the expected claim first, if it is determined that the claim will not be paid within the payment deadline. It is a temporary grant paid first by the company to compensate for the expenses required by the insured. |
Article 9 (Change in the method of receiving claim)
- The policyholder (Who shall be the beneficiary of the insurance after the reason for payment of the claim occurs) may change how he/she will receive all or part of the claim to be paid separately or at once, as prescribed in the Company's business methodology.
- If the Company pays the money several times by dividing the total amount according to paragraph 1, the amount to be paid later is added to the amount calculated by calculating the "average monthly regular deposit rate disclosed by the Korea Insurance Development Institute" as an annual compound interest rate. If the amount to be paid in installments is paid at a time, the amount obtained by discounting the "average monthly regular deposit rate disclosed by the Korea Insurance Development Institute" as an annual compound interest rate will be paid.
Article 10 (Notification of Change of Address)
- The policyholder (including the beneficiary if the beneficiary is different from the policyholder) shall notify the Company of the change without delay if the address or contact number is changed.
- If the policyholder or beneficiary fails to notify the change as prescribed in paragraph 1, the Company's notice, such as registered mail, shall generally be deemed to have reached the policyholder or beneficiary after the period required time for delivery.
Article 11 (Designation of Insurance Beneficiary)
If the beneficiary of insurance is not designated, the beneficiary of insurance shall be the legal heir of the insured if it falls under Article 3 (Coverages) para. 1. If it falls under para. 2 of the same Article, the beneficiary of insurance will become the insured.
Article 12 (Designation of Representative)
- If there are more than two policyholders or insurance beneficiaries, each representative must be designated. In this case, the representative shall represent different policyholders or insurance beneficiaries.
- If the location of the designated policyholder or beneficiary is not clear, the Company's actions against the policyholder or one beneficiary in this contract shall also be effective for other policyholders or beneficiaries.
- If there are more than two policyholders, the responsibility shall be united.
< If there are more than two policyholders > If there are more than two policyholders, the policyholders' obligations under the insurance contract, such as the obligation to notify before the contract and the obligation to pay insurance premiums, shall be joint responsibility. < Joint Responsibility > Since two or more people are responsible together, each person is responsible for fulfilling all of their debts (different from dividing them into shares), but the other person can be exempted from responsibility by the performance of one person. |
Section 3. Policy holder’s obligation to notify before the contract
Article 13. Obligation to notify before the contract
The policyholder(s) or the insured must inform the facts they know about the questions (In the case of diagnosis contract, it refers to medical examination) in the application form (hereinafter referred to as the "obligation to notify before the contract" and the "obligation to notify" under the Commercial Act). However, in the case of a diagnosis contract, a health examination can be replaced by data that can determine the health status, such as a copy of a health certificate conducted by a workplace or an individual at a general hospital and a hospital under Article 3 (medical institution) of the Medical Act.
< Obligation to notify before the contract > Obligations prescribed in Article 651 of the Commercial Act. The policyholder or insured person must inform the truth about important matters asked by the insurance company in writing at the time of purchasing the insurance, and in case of violation, they may be disadvantaged such as termination of the insurance contract or non-payment of claim. |
Article 14 (Obligation to Notify After the Contract of Injury Insurance)
The policyholder or the insured shall notify the Company without delay by mail, phone call, visit, etc. if any of the following changes occur to the insured during the insurance period.
- Changes in occupation or duties listed in insurance policies, etc.
- If the insured’s current job or duty has changed
- If the insured is employed after being without a job
- If the insured has quit his/her current job
< Job >
< Duty > A task given with responsibility for a job or occupation |
- Where the purpose of operation of the insured listed in the insurance policy, etc. is changed;
e.g.) Change from private car to business, change from business car to private car, etc.
- Where the insured's operation status listed in the insurance policy, etc. is changed;
e.g.) Change from non-driver to driver, change from driver to non-driver, etc.
- Where a motorcycle or motorized bicycle is continuously used (limited to cases where it is mainly used for occupation, duties, club activities, commuting, etc.) ;(Includes electrically operated personal mobility devices such as electric scooters and electric wheels, excluding electric wheelchairs, medical scooters, etc., which are walking assistance cars used by the disabled or the vulnerable.)
- In the event of a change in risk due to the notification under paragraph 1, the Company may change the contents of the contract in accordance with Article 21 (Change of details in the contract, etc.)
- If the risk is reduced when changing the contract according to paragraph 2, the Company will reduce the insurance premium and refund the settlement amount (hereinafter referred to as the "settlement amount") caused by differences in liability reserves, which are financial resources for guaranteeing the period. On the other hand, if the risk increases, the insurance premium may be increased and the settlement amount may be requested to be paid additionally, and the policyholder must pay it.
- If the policyholder fails to pay the additional fee (Including settlement amount) claimed by the Company due to the increase in risk in accordance with the notice in paragraph 1, the Company shall deduct the amount from the claim according to the rate to be applied after the risk increases (hereinafter referred to as "Changed Rate") after comparing the previous risk (hereinafter referred to as "Rate before Change"). However, when the reason for the insurance payment is irrelevant to the increased risk, the money will be paid as it was.
- If the policyholder or insured fails to notify the Company of the change in each subparagraph of paragraph 1 by intention or gross negligence, if the changed rate is higher than the rate before the change, the Company notifies the policyholder or the insured within one month of the change and pays the insurance accordingly.
Article 15 (Effect of Violation of Obligation to Notify)
- In the event of the following, the Company may terminate this contract within one month from the date of knowing the occurrence of the reason for payment of the claim.
- Where the policyholder, the insured, or their agent violates Article 13 (the obligation to notify before the contract) intentionally or by gross negligence, and the obligation falls under an important matter
- When the policyholder, the insured, or their agent fails to perform the obligation to notify after the contract prescribed in Article 14 (Obligation to notify after a contract of injury insurance) related to a clear increase in risk due to intention or gross negligence
- Notwithstanding the case of paragraph 1 (1), the Company may not terminate the contract in any of the following cases:
- When the Company knew the fact at the time of the contract was purchased or was not aware of it due to negligence;
- When more than one month has passed since the date the Company knew the fact, or two years have passed (one year for disease in the case of diagnosis contracts) and the reason for payment have not occurred since the first insurance premium was received
- When three years have passed since the date of signing the contract
- In the case where the Company agrees according to the basic data (a copy of the health certificate, etc.) that can determine the health status of the insured when subscribing to this contract, and the reason for payment of the claim occurs as specified in the copy of the health certificate (The contract may be terminated if the policyholder or the insured intentionally writes important matters differently from the facts in the basic data submitted to the Company)
- When an insurance planner, etc. did not give the policyholder or the insured an opportunity to notify important matters, prevented the policyholder or the insured from notifying the facts, or recommended poor notification. However, even when there are such acts of an insurance planner, etc., the contract may be terminated if the policyholder or the insured does not notify the truth or is deemed to have made a poor notification.
- In accordance with paragraph 1, if the contract is terminated before the reason for payment of the claim occurs and there is an insurance premium to be refunded by the Company, the insurance premium under Article 33 (Refund of insurance premiums) shall be paid to the policyholder.
- If the contract is terminated under paragraph 1 (1) after the reason for payment of the claim occurs, the Company does not pay the claim. In addition to the violation of the obligation to notify before the contract (specifically stating the violation that causes the termination of the contract) and the reason why the obligation to notify before the contract is important will be written and sent to the policyholder with a phrase saying "If there is evidence against it, you may file an objection." In addition, in this case, if there is an insurance premium to be refunded by the Company due to the termination of the contract, the insurance premium under Article 33 (Refund of insurance premiums) shall be paid to the policyholder.
- If the contract is terminated under paragraph 1 (2) after the occurrence of the reason for the payment of the claim, the claim shall be paid in accordance with para.4 or para.5 of Article 14 (Obligation to notify after a contract of injury insurance).
- Notwithstanding paragraph 1, if the Company fails to prove that the violation of the obligation to notify affected the occurrence of the reason for payment of the claim, the agreed claim shall be paid regardless of paragraphs 4 and 5.
- The Company does not terminate the contract or refuse to pay a claim for violating the obligation to notify before the contract of other insurance coverage.
Article 16 (Contract by fraud)
If the policyholder or insured passes the diagnostic procedure by fake diagnosis or drug use, or if the Company proves that the contract has been concluded by fraud, such as hiding and signing up after receiving a diagnosis of cancer or HIV infection before the date of purchase, the contract can be canceled within 5 years from the purchased date (within 1 month from the date of fraud).
Section 4 Establishment and Maintenance of Insurance Contracts
Article 17 (Establishment of Insurance Contracts)
- The contract consists of the policyholder's subscription and the Company's consent.
- If the insured is not suitable for the contract, the Company may refuse to accept it or accept it under separate conditions (limited insured amount, excluding some coverages, reduction of claim, surcharge, etc.).
- Contracts that do not receive medical checkups must be accepted or rejected within 30 days from the date of subscription, and contracts that required diagnosis must be accepted or rejected within 30 days from the date of diagnosis (Final date of diagnosis in the case of re-diagnosis), and insurance certificates will be given when approved. However, if there is no notice of acceptance or rejection within 30 days, it is considered to have been accepted.
- If the Company refuses to accept the first insurance premium, the amount received with the refusal notice will be returned to the policyholder, and the "average monthly regular deposit rate announced by the Korea Insurance Development Institute + 1%" will be added to the annual compounded amount. However, if the policyholder refuses to accept the contract that paid the first insurance premium by credit card, the Company cancels the sales of the credit card and does not pay interest.
Article 18 (Withdrawal of Subscription)
- The policyholder may withdraw the subscription within 15 days from the date of receipt of the policy. However, a contract that supports a health condition diagnosis by the Company, a contract with an insurance period of fewer than 90 days, or a contract signed by a professional financial consumer cannot be withdrawn.
< A professional financial consumer > It refers to a person who has the ability to take risks under an insurance contract in light of his/her expertise in insurance contracts, the size of assets, etc. It is a professional financial consumer prescribed in Article 2 (Definition) 9 of the Financial Consumer Protection Act, including the state, and local governments, the Bank of Korea, financial companies, and sovereign listed corporations. < A general financial consumer > It refers to a policyholder who is not a professional financial consumer. |
- Notwithstanding paragraph 1, a contract exceeding 30 days from the date of subscription cannot be withdrawn.
- The withdrawal of the subscription shall take effect when the policyholder calls by phone, sends a written, e-mail, mobile phone text message, or an electronic expression of intention (hereinafter referred to as "written document, etc.") to indicate the withdrawal intention. The policyholder shall notify the Company about sending the notification without delay when he/she sent in a form of written documents, etc.
- If the policyholder withdraws the subscription, the Company will return the fee paid within 3 business days from the date of receipt of the withdrawal of the subscription, and the insurance contract loan rate for the delayed return period will be added to the amount calculated as annual compounded. However, if the policyholder withdraws the contract for paying the first fee by credit card, the Company must not let the credit card company charge the fee within three business days from the date of receipt of the withdrawal of the subscription, and in this case, the Company is deemed to have refunded the premium.
- If the reason for insurance payment has already occurred when the subscription is withdrawn, but the policyholder is not aware of the reason for insurance payment, the withdrawal of the subscription will not take effect.
- In the event of a dispute over the date of receiving the insurance policy in paragraph 1, the Company must prove it.
Article 19 (Issuance of Terms and Conditions and Obligation of Explanation, etc.)
- The Company shall explain the important details of the terms and conditions to the policyholder when the policyholder subscribes, and after the subscription, the policyholder will check the following methods and the Company will provide the terms and conditions and applications without delay. If the Company provides it by e-mail or electronic means, and the policyholder or his/her agent receives the terms and conditions and applications, the document shall be deemed to have been given.
- A written delivery
- Mail or e-mail
- Mobile phone text messages or other electronic means
<Important contents of the terms and conditions> It refers to the following in Article 42-2 of the Enforcement Decree of the Insurance Business Act (Important matters of explanation, etc.) and Article 4-35-2 of the Insurance Business Supervision Regulations (Obligation to explain important matters of insurance contracts).
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- In the case of the network sales contract in connection with paragraph 1, the Company will give you terms and conditions that include only the special contract signed by the policyholder, and with the consent of the policyholder, you can explain the important contents of the terms and conditions in one of the following ways.
- The Company may have the Policyholder read or download the Terms and Conditions and their Descriptions (documents describing important information in the Terms and Conditions) from the Internet homepage In this case, when the policyholder confirms that he/she has read or downloaded it, it is deemed that the relevant terms and conditions are given and the important information is explained.
- The Company can use the telephone to ask or explain the details of the subscription, insurance premium payment, insurance period, obligation to notify before the contract and important details of the terms and conditions. In this case, it is considered that the important contents of the terms and conditions are explained by voice recording the answers and confirmations of the policyholder.
< Network Sales Contract > It refers to a contract signed using communication means such as phone, mail, and the Internet. |
- Policyholder may cancel the contract within three months from the date of signing the contract if the Company fails to deliver the terms and conditions to the Policyholder or fails to explain the important details of the Terms and Conditions to be provided under paragraph (1) or if the Policyholder fails to sign the contract (or stamp, it includes electronic signatures under Article 2, (2) of the Electronic Signature Act).
- Notwithstanding paragraph 3, if a contract is concluded by phone, a handwritten signature may be omitted when any of the following is satisfied, and it is deemed that the policyholder's application for storage is delivered by providing a documented confirmation of the voice recording under paragraph (2).
- In the case of a contract where the policyholder, the insured, and the beneficiary are the same,
- If the policyholder and the insured are the same and the beneficiary of the insurance is the policyholder's legal heir
- If the contract is canceled pursuant to paragraph 3, the Company will return the insurance premium already paid to the policyholder, adding the amount calculated by the "insurance contract loan rate disclosed by the Korea Insurance Development Institute" as an annual compound interest rate.
Article 20 (Nullity of Contract)
If any of the following occurs, the contract will become null and the insurance premium already paid will be refunded. However, if the contract becomes invalidated due to the Company's intention or negligence and the insurance premium is not returned even though the Company knew or could have known that it was invalid before consent, the Company will return the money by using "the insurance contract loan rate disclosed by the Insurance Development Institute" as annual compound interest.
- In a case where the written consent of the insured is not obtained until the contract is concluded in a contract in
which the death of another person is the reason for insurance payment. (In cases where there is an electronic signature under subparagraph 2 of Article 2 of the Electronic Signature Act, including electronic documents with reliability for identification and prevention of forgery and alteration, as prescribed in Article 44-2 of the Enforcement Decree of the Commercial Act) However, this does not apply when a group enters into a contract in which all or part of its members are insured in accordance with the policy. At this time, when designating an insurance beneficiary of group insurance as an insured or a person who is not an heir thereof, it applies unless explicitly stipulated in the group's regulations.
- When an insurance contract designates the death of a person under 15 years of age, a mentally unsound person, or a mentally deficient person as a peril insured. However, if a mentally deficient person enters into a contract or becomes an insured person of group insurance in accordance with the rules of the affiliated organization, the contract is valid when they have the capability of decision-making.
- When a contract is concluded, the age of the insured prescribed in the contract is not met or exceeded. However, when the Company finds an age error, if the contract age has already been reached, it is considered a valid contract, but the exception to paragraph 2 for those under the age of 15 is not accepted.
<Mentally unsound person or mentally deficient person > The term "Mentally unsound person" or “mentally deficient person” refers to a person who has no or insufficient ability to distinguish objects or make decisions due to mental or physical disabilities such as mental illness, mental weakness, or severe consciousness disorder. |
Article 21 (Change of contract details, etc.)
- With the consent of the Company, the Policyholder may make the following changes: In this case, the consent will be notified in writing or written on the back of the insurance policy.
- Insurance category
- A period of insurance
- The payment cycle, payment method, and payment period of the insurance premium
- Policyholder, some of the insured
- Contents of contracts such as insured amount, insurance premium, etc.
- The policyholder may change the beneficiary of the insurance, in which case the Company's consent is not required. However, if the policyholder does not notify the Company of the change in the beneficiary, and there is a protest regarding the payment of a claim, such as paying a claim to the beneficiary before the change, the Company may refuse the payment of the claim to the changed beneficiary.
- When the policyholder requests a change in the insurance item of a valid contract more than one year after the first payment of the fee, the Company will change it according to the method prescribed in the Company's business rules.
- When the policyholder intends to reduce the insurance premium pursuant to paragraph 1 (5), the reduced portion is deemed to have been terminated, and if there is an insurance premium to be refunded by the Company, the insurance premium under Article 33 (refund of insurance premiums) shall be paid to the policyholder.
- If the policyholder intends to change the beneficiary of the insurance in accordance with paragraph 2, the insured must agree in writing before the reason for payment of the claim occurs.
- If the policyholder is changed pursuant to paragraph 1, the Company will issue an insurance policy and terms and conditions to the changed policyholder, and if requested by the changed policyholder, the important details of the terms and conditions will be explained.
Article 22 (Insurance Age, etc.)
- The insured's age in these terms and conditions is based on the insurance age. However, in the case of Article 20 (Nullity of Contract) (2), the American age is applied.
- The insurance age under paragraph 1 shall be calculated based on the American age of the insured as of the contract date, and the number of fewer than 6 months will be discarded while the number of more than 6 months shall be calculated as one year, and the age shall increase every year on the contract date.
< Example of calculating insurance age if the contract date does not exist> Initial contract date: 29 February 2020, Insurance age 40 * February 28, 2021 Insurance age 41 * February 29, 2024, Insurance age 44 |
- If the insured's age or gender is different from the ID card (resident registration card, driver's license, or government-issued ID card with a photo), the correct age or gender according to the ID card, and change the money for the claim and insurance premiums according to the age and gender. When changing the claim and insurance premiums corresponding to the corrected age or gender. The difference between insurance premiums is settled in accordance with the "Method of Calculating Insurance Fee and Liability Reserve."
<Example of calculating insurance age> Date of birth: 2 October 1988, Current (Contract Date): 13 April 2014 * 2014.04.13 - 1988.10.02 = 25 years 6 months 11 days = 26 years old |
Article 23 (Extinction of Contract)
If the reason for payment of the claim prescribed in these terms and conditions can no longer occur due to the death of the insured, this contract will not be effective from the moment.
Section 5 Payment of Insurance Fee
Article 24 (First Insurance Fee and Inception of Coverage)
- From the time the Company accepts the contract and receives the first insurance premium, the Company covers the risks as prescribed by these terms and conditions. In addition, even when the Company accepts the contract after receiving the first fee along with the subscription, the inception of coverage will begin when the first fee is received. In the case of automatic transfer or credit card payment, the time when the information necessary for automatic transfer application or credit card sales approval is provided is when the first fee is received, and if automatic transfer or sales approval is not possible due to the policyholder's responsibility, it is considered that the fee is not paid.
- When a reason for payment of claim occurs before the Company accepts the subscription after receiving the first insurance premium along with the subscription, the inception of coverage begins as prescribed by the terms and conditions from the inception date of coverage.
<Start Date of Coverage> It refers to the date when the contract is established and the first fee is received, but if the company receives the first fee with the subscription even before accepting it, it refers to the date when the first premium is received. In addition, the start date of the coverage is considered as the date of the contract. |
- Notwithstanding paragraph 2, the Company does not guarantee in any of the following cases:
- Where the Company proves that the contents notified to the Company by the policyholder or the insured pursuant to Article 13 (Obligation to notify before the contract) or the contents of the medical examination have affected the occurrence of the reason for payment of the claim
- Where the Company may not guarantee by applying Article 15 (Effect of Violation of Obligation to Notify)
- In the case where the diagnosis contract is not diagnosed until the reason for payment of the claim occurs. However, even if the insured is not diagnosed in the diagnosis contract, the Company will guarantee if there is a reason for insurance payment due to injury.
- If the contract is renewed, the guarantee under paragraphs 1 or 3 shall be applied from the end of the coverage under the existing contract.
- Notwithstanding the provisions of paragraph 1, the Company does not compensate for accidents that occur before the insured leaves the residence and after the insured arrives at the residence.
- If the insured is in an aircraft that is illegally controlled by a third party or is bound by public authority, the term of the Company's guarantee will be extended to the extent necessary for the insured to return to normal travel conditions or the time deemed reasonable by the Company.
Article 25 (Payment of insurance premiums from the second payment)
The policyholder must pay the fee from the second time by the due date, and the Company will issue a receipt if the policyholder pays the fee. However, if insurance premiums are paid through a financial company (including a post office), the documentary evidence issued by the financial company is replaced by a receipt.
< Payment date> This refers to the date on which the policyholder decides to pay the fee from the second time. |
Article 26 (Declaration of Payment and Termination of Contract in the event of late payment of insurance premiums)
- If the fee is overdue because the policyholder has not paid the premium from the second payment date, the Company will set a maximum period of 14 days (7 days if the insurance period is less than 1 year) as the maximum period and notify the policyholder in writing (registered mail, etc.), by phone (voice recording) or electronic document. If the last day of the payment period is not a business day, the final date will become the next day. However, the Company will compensate for the reasons for the insurance payment that occurred before the termination.
- The content that the overdue insurance premium must be paid by the policyholder (including the insurance beneficiary if the policy beneficiary and the policyholder are different) within the maximum payment period
- The content that if the fee is not paid by the end of the payment request period, the contract will be terminated the day after the end of the payment request period
- If the Company intends to guide the payment notice (request) by electronic means, the Company should obtain agreement from the policyholder by written method or electronic signature under Article 2, para. 2 of the Electronic Signature Act on the condition of having confirmation of receipt from the policyholder. It should be regarded that the electronic document shall not be transmitted until the policyholder confirms the receipt of the electronic document. If the Company confirms that the electronic document has not been received, it will notify again in writing (registered mail, etc.) or by phone (voice recording).
- When the contract is terminated pursuant to paragraph 1 and there is an insurance premium to be refunded by the Company, the insurance premium shall be paid to the policyholder according to Article 33 (Refund of insurance premiums)
Article 27 (Resurrection of a contract terminated due to overdue payment of insurance premiums (restoration of effect))
- If the contract is terminated under Article 26 (Declaration of Payment and Termination of Contract in the event of late payment of insurance premium) but the money was not refunded under Article 33 (Refund of insurance premiums), the policyholder may request the reinstatement of the contract within three years from the date of termination. When the Company agrees to revive the contract, the policyholder shall pay the overdue fee up to the date of the resumption plus the amount calculated at the rate set by the Company for each product within the range of "the average monthly fixed deposit rate disclosed by the Korea Insurance Development Institute + 1%.
- When a termination contract is revived (restoration of effect) it will follow Article 13. Obligation to notify before the contract, Article 15 (Effect of Violation of Obligation to Notify), Article 16 (Contract by fraud), Article 17 (Establishment of Insurance Contracts), and Article 24 (First Insurance Fee and Inception of Coverage)
- Article 15 (Effect of Violation of Obligation to Notify) applies if the policyholder or the insured violates Article 13 (Obligation to notify before the contract) at the time of the initial contract subscription, even if the contract is revived.
Article 28 (Special revival of contracts terminated in accordance with procedures such as compulsory execution
(restoration of effect))
- In the case of a contract for another person, if the contract is terminated due to taxes and debts (such as forced execution, execution of security rights, the procedure for overdue national and local taxes) on the policyholder's right to claim a refund under Article 33 (refund of insurance premiums), the Company notifies the beneficiary of the following: The beneficiary should be notified that the beneficiary can pay for the amount paid by the Company to the creditor, which is agreed by the policyholder, request change the name of the policyholder to the beneficiary him or herself according to Article 21 (Change of contract details, etc.) para. 1 to request revival of the contract.
- The Company accepts the application for the change of the policyholder's name and the contract's special revival (restoration of validity) subscription, and the contract will be specially revived (restoration of validity) from the time of subscription.
- The Company shall notify the designated beneficiary of paragraph 1. However, if the legal heir is designated as an insurance beneficiary, the Company may notify the policyholder under paragraph 1.
- The Company shall give notice under paragraph 1 within seven days from the date of termination of the contract. However, if the Company's notification arrives seven days later and the beneficiary subsequently applies for a change of contract name and a special revival (resumption of validity) of the contract under paragraph 1, the special revival (resumption of effect) will be made on the 7th day of the contract termination.
- The beneficiary may carry out the procedure under paragraph 1 within 15 days from the date on which the notice is received (if notified to the policyholder pursuant to paragraph 3, it means the date received by the policyholder).
- If the Company terminates the contract pursuant to paragraph 1, the Company notifies the policyholder to that effect, and if there is an insurance premium to be refunded by the Company upon termination, the insurance premium shall be paid to the policyholder under Article 33 (refund of insurance premiums).
< Forced execution > Forced execution refers to the performance of the obligation by the country with compulsory power to a person who fails to fulfill his/her judicial or administrative obligations. <Execution of security rights> It refers to the execution of the security right against the debtor who fails to fulfill the obligation by the creditor who establishes the security right. < Procedure for overdue national and local taxes > This refers to the collection of surcharges, issuance of reminders, and seizure of property for taxes in arrears under the National Taxes and the Local Tax Act. The court may seize the debtor's termination refund by forced execution and execution of security rights at the request of the creditor, and then company pays the cancellation refund to the creditor according to the court's collection order or all orders. In addition, the debtor's termination refund may be seized by the National Tax Service and local governments in case of arrears, and the company will pay the cancellation refund to the creditor in accordance with the procedure for disposition of arrears. |
Section 6 Termination of Contracts and Refund of Insurance fee, etc.
Article 29 (Discretionary termination of the policyholder and withdrawal of the insured's written consent)
- The policyholder may terminate the contract at any time before the contract expires, and in this case, if there is an insurance premium to be refunded by the Company, the insurance premium shall be paid to the policyholder under Article 33 (Refund of insurance premiums).
- In accordance with Article 20 (Nullity of Contract), the insured who agrees in writing to a contract that uses death as a reason for insurance payment may withdraw the written consent for the future at any time during the period when the contract is maintained. If the contract is terminated due to the withdrawal of written consent and there is an insurance premium to be refunded by the Company, the insurance premium shall be paid to the policyholder under Article 33 (Refund of insurance premiums).
- If the insured amount has not been reduced even when the Company pays the insurance due to the occurrence of the insurance payment reason, the policyholder may terminate the contract even after the insurance payment reason occurs.
Article 30 (Cancellation due to Critical Reasons)
- The Company may terminate the contract within one month from the date of knowing the facts below.
- If the policyholder, the insured, or the beneficiary intentionally incurred the reason for payment of a claim to receive the claim;
- In the case where the policyholder, the insured, or the beneficiary intentionally stated something different from the facts in the document on the insurance claim or forged or falsified the document or evidence. However, if the reason for the payment for the claim has already occurred, the claim will be paid.
Article 31 (Declaration of Bankruptcy of the Company and Termination)
- If the Company is declared bankrupt, the policyholder may terminate the contract.
- A contract that has not been terminated pursuant to the provisions of paragraph 1 shall cease to be effective three months after the declaration of bankruptcy.
- If the contract is terminated pursuant to the provisions of paragraph 1 or the contract becomes invalid pursuant to the provisions of paragraph 2, the Company pays the insurance premium under Article 33 (Refund of insurance premiums).
Article 32 (Cancellation of Illegal Contracts)
- According to Article 47 of the Financial Consumer Protection Act and related regulations, if there is a violation of the Company's law on the contract, the policyholder may request the termination of the illegal contract within one year from the date of signing the contract (It should not exceed 5 years from the purchased date).
- The Company shall notify the policyholder of its acceptance within 10 days from the date of receipt of the request for termination, and if it refuses, it shall also notify the reason for rejection.
- The Policyholder may terminate the contract if the Company fails to comply with the requirements of paragraph 1 without justifiable grounds.
- If the contract is terminated pursuant to paragraphs 1 and 3, the Company shall pay the refund under Article 33 (Refund of Insurance Premium) to the policyholder.
- Notwithstanding the exclusion period under paragraph 1, the policyholder may exercise legal rights as prescribed by relevant laws and regulations such as Civil Act.
Article 33 (Refund of insurance premiums)
- If this contract becomes null, ineffective, terminated, or extinguished, the insurance premium will be refunded as follows. However, if an insurance accident occurs during the insurance period and the insurance premium is paid, and when the insured amount is reduced, the insurance premium for the same insurance year will not be refunded in any case. [The first year means one year from the first day of the insurance period, and after the second year it means one year from the corresponding day of the insurance period.]
- In the case of non-responsibility reasons by the policyholder, the insured, or the beneficiary: In the case of nullity, the total insured amount premiums paid to the Company, in the case of loss of effect, termination, or extinction, the insurance premium calculated by a day
- In the case of liability reasons for the policyholder, the insured, or the beneficiary: the balance excluding insurance premiums is calculated at the short-term rate (rate applied to a period less than one year) for the period already elapsed. However, if it becomes null due to intentional or gross negligence of the policyholder, the insured, or the beneficiary of the insurance, the insurance premium will not be refunded.
- If a contract with an insurance period exceeding one year becomes null, ineffective, or extinguished, the insurance premium for the insurance year on which the invalid, ineffective, or extinguished date belongs shall be applied under paragraph 1, and the full amount of the insurance premium for the subsequent insurance year shall be refunded.
- If there is an insurance premium to be refunded due to nullity, loss of effect, termination, or extinction of the contract, the policyholder shall claim the refund, and the Company shall pay the "Insurance Contract Loan Interest Rate disclosed by the Insurance Development Institute" as an annual compound interest rate.
Section 7 Mediation of Disputes, etc.
Article 34 (Mediation of Disputes)
- In the event of a dispute over a contract, the disputing party or other interested parties and the Company may apply to the Director of the Financial Supervisory Service for mediation, and during the dispute settlement process, the policyholder may request access to the data recorded and maintained by the Company (including providing copies or listening).
- When the Company initiates mediation procedures for a dispute case in which the value of rights or profits claimed by a policyholder, who is a general financial consumer, is within a certain amount prescribed in Article 42 of the Financial Consumer Protection Act, the Company does not file a lawsuit except as provided by relevant laws and regulations.
Article 35 (Court with Jurisdiction)
Litigation and civil mediation regarding this contract shall be made by the court having jurisdiction over the policyholder's address. However, the Company and the policyholder may agree to set a different court.
Article 36 (Extinction of Prescription)
If the right to claim or request of refund of a claim is not exercised for three years, the extinction of a prescription will be completed.
< Extinction of Prescription > It means the period during which a given right is lost when it is not exercised. If you don’t exercise your right to claim the money for three years after the reason for the insurance payment occurs, you may not receive the insurance payment. |
Article 37 (Interpretation of Terms and Conditions)
- The Company must interpret the terms and conditions fairly according to the principle of good faith and not interpret them differently depending on the policyholder.
- If the terms and conditions are unclear, the Company interprets them in favor of the policyholder.
- The Company does not expand the interpretation of contents that are disadvantageous or burdensome to the policyholder or the insured, such as reasons for not paying a claim.
Article 38 (Effect of Provisioning Insurance Manual and Guidance Materials, etc.)
- The Company should explain important matters about insurance products to the policyholder so that the policyholder can understand if the subscription is recommended to the general financial consumer or if the general financial consumer requests an explanation about insurance. In addition, the policyholder must be confirmed by signing (including electronic signatures under Article 2, paragraph 2 of the Electronic Signature Act) or recording, and a manual should be provided to the policyholder.
- If there is a dispute between the policyholder and the Company regarding the provision of the documentation, terms and conditions, subscription paper for the policyholder's storage, and insurance policy, the Company shall prove it.
- If the contents of the insurance guide used by the insurance planner, etc. in the contract process are different from the contents of the terms and conditions, the contract is deemed to have been established in favor of the policyholder.
Article 39 (Company's liability for damages)
- The Company shall be liable for damages incurred to the policyholder, the insured, and the beneficiary for the responsibility of the employees, insurance planners, and agents in connection with the contract in accordance with relevant laws and regulations.
- The Company is responsible for compensation for damages to the policyholder, the insured, or the beneficiary by filing a lawsuit even though it knew or could have known that there was no reason for refusal or delayed payment.
- Even if the Company inflicts damage to the beneficiary of the insurance due to an agreement that has significantly lost fairness in whether or not the insurance payment is paid and the amount paid, the Company is responsible for compensating for the damage pursuant to paragraph 2.
< An agreement that has significantly lost fairness > It's a social norm that fairness has significantly been lost and the average person wouldn’t agree with it. |
Article 40 (Protection of Personal Information)
- The Company shall not collect, use, inquire, or provide personal information related to this Agreement without the consent of the policyholder, the insured, or the beneficiary of the Insurance, except as provided by relevant laws and regulations.
- The Company should safely manage personal information related to the contract.
Article 41 (Applicable Act)
This contract is governed by and interpreted in accordance with the laws of the Republic of Korea, and matters not prescribed in the terms and conditions shall be governed by relevant laws such as the Financial Consumer Protection Act, the Commercial Act, and the Civil Act.
Article 42 (Guarantee of Payment by Deposit Insurance)
If the Company is unable to pay a claim due to bankruptcy, etc., the payment is covered as prescribed by the Depositor Protection Act.