Downloadable Complete mexican insurance Coverage Terms and Conditions
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Terms and Conditions of the Mexican Insurance Contract
The Mexican Insurance contract is outlined below. The company uses 5 Risks, each highlighted in large Header format so you can differentiate between them.
RISK 1 PHYSICAL DAMAGE (COLLISION)
A. Collision, Turnover and Plate Glass
Loss or material damage that the insured vehicle may suffer as a result of a collision, turnover, and plate glass breakage is covered by this item a) shall be paid by the Company only in excess of the deductible mentioned on the face of the policy and for which the Insured shall always be liable for the amount of the deductible. The before mentioned deductible shall be applied to each accident that is to be indemnified in accordance with the terms and conditions of this section.
Material damage to the insured vehicle caused by grounding, sinking, fire, explosion, collision, turnover or derailment of the means of transportation used when being transported by land, air or water, as well as by the insured vehicle falling into the sea during loading, unloading maneuvers or transshipment, including the contribution of the Insured to general or particular average, including the salvage charges for which the Insured may be held liable.
C. Towing Expenses
In the event of an accident that is to be indemnified under the terms of this policy, the Company shall pay the towing expenses necessary to tow the insured vehicle anywhere within the limits of the Republic of Mexico, and to the place where the Company decides the vehicle is to be repaired, as well as pay for the expenses up to a limit of $500.00 US that are necessary to put the vehicle into condition to be towed.
The coverage for Risk 1, Physical Damage, is contracted with the invariable application to each accident of an amount to be paid by the Insured known as a deductible. The amount of this deductible is determined by applying the percentage that appears on the face of the policy to the sum insured that is in force, subject to the minimum amounts specified thereon. Mexican Insurance Deductibles – Qualitas
RISK 2 TOTAL THEFT AND MATERIAL DAMAGE (COMPREHENSIVE)
A. Total Theft of the Vehicle:
Total theft of the insured vehicle, as well as the loss or damage that may occur as a result of such total loss
B. Fire, Lightning and/or Explosion:
Material damage that the vehicle may suffer as a consequence of fire, lightning and/or explosion
C. Strikes and Civil Commotion
Material damage that the vehicle may suffer by the acts of third parties involved in work stoppages, strikes, labor disturbances, political meetings, mutiny or popular uprisings; or by malicious mischief committed during the time such acts are being carried out; or material damage caused by measures of suppression taken by legally constituted Authorities in the performance of their duties
Damage resulting from vandalism is excluded from this Mexican Insurance agreement
D. Natural Phenomena
Material damage that the insured vehicle may suffer as a result of cyclone, hurricane, hail, earthquake or volcanic eruption, avalanches, flood (caused by the overflow of rivers, lakes or inlets, with the exception of salt water), land or rock slides, the fall or collapse of constructions, buildings, structures or other similar objects, including falling trees and branches.
The coverages for Risk 2, are contracted with the invariable application of an amount to be paid by the Insured known as a deductible. The amount of this deductible is determined by applying the percentage that appears on the face of the policy to the sum insured that is in force, subject to the minimum amounts specified thereon.
In connection with Sections 1 and 2, coverage is also included for the special equipment that is installed in the insured automobile by adding the cost of said special equipment to the value of the automobile and thus it forms part of the sum insured. It is hereby understood that for the effects of this contract, special equipment consists of lettering, signs, radio, clocks, fog and spot lights, outside mirrors, visors and other similar accessories.
RISK 3 THIRD PARTY LIABILITY
Coverage is in effect, for property damage and/or bodily injury, in accordance with the current legislation applicable in the Republic of Mexico on the subject of legal civil liability of the Insured or of any person that is driving the vehicle with the expressed or tacit consent and as a consequence of said use, may cause damage to property that does not belong to the Insured or to persons related to the Insured and/or bodily injury or death to third parties.
Without exceeding the sums insured that are shown on the face of the policy, the payments that the Insured makes shall be subject to the following concepts:
A. Damage to Property Belonging to Third Parties
B. Medical Expenses First Aid
Medical and/or burial expenses as the case may be to third parties that are injured by the vehicle insured incurred while administering first aid
C. Medical and/or Burial
Medical and/or expenses as the case may be to third parties that are injured by the vehicle insured
D. Legal Idemnity
The legal indemnity that has to be paid for death, total or partial disability, be it permanent or temporary
E. Court Costs
The expenses and court expenses that the Insured or the driver es sentenced to pay arising out of a suit fo civil liability brought against the Insured
F. Occupant Bodily Injury
In any case liability for Bodily injuries to the occupants of the vehicle is not covered
Punitive damages are specifically excluded.
RISK 4 MEDICAL EXPENSES FOR OCCUPANTS
The mexican insurance claim payment of medical expenses that are incurred within the Republic of Mexico for the concept of hospitalization, medical attention, nurses, ambulance service and funeral expenses as a result of bodily injury suffered by the Insured or by any of the occupants of the vehicle insured in a traffic accident or by fire, explosion, or meteorological phenomena while traveling in a compartment, cover or cabin designed for the purpose of transporting passengers.
Medical expenses covered under this policy are:
Room and board in the hospital, physiotherapy, expenses inherent to hospitalization, drugs and medicines in general that are prescribed by a Doctor that is legally authorized to practice medicine.
B. Medical Attention
The medical services required that are provided by professionals legally authorized to practice their profession.
The cost of the services of nurses that are legally authorized to practice their profession for a maximum period of 30 days.
D. Ambulance Service
The expense incurred for ambulance service, when this is considered indispensable.
E. Funeral Expenses
The expenses incurred for this concept are covered up to a maximum amount of 50% of the sum insured per passenger and shall be reimbursed upon the presentation of the corresponding documents.
In the event that at the time of the accident, the number of passengers injured is in excess of the number of persons insured, the limit of liability per person shall be paid in a proportional manner.
The Company shall pay the above mentioned expenses up to the time as the sum insured for each person is exhausted. The obligation of the Company shall automatically cease when the effects of the injury disappear or when the doctor releases the patient or when the medical or funeral expenses incurred have been paid.
Specific exclusions for Medical Expenses for Occupants.
This mexican insurance in no way covers:
A. Outside Mexico
The payment of expenses incurred abroad for hospitalization, medical attention, nurses and ambulance service
B. Doctor Visits and Check-ups
Expenses incurred for general physical exams for the purpose of determining the state of health known as a “CHECKUP” and that are performed after the Insured insured joins the plan
C. Abroad Services
The difference in the diagnostic services, laboratory tests and X-rays that were performed abroad
D. Hospital Upgrades
Expense for a hospital room when it is different from the standard room, as well as meals for the room companion
E. Plastic Surgery
Orthodontic treatments and plastic surgery
RISK 5 LEGAL EXPENSES
The Company agrees with the Insured that by means of the obligation to pay the corresponding premiums, it agrees to cover the:
- lega1 fees
- expenses inherent to a criminal trial
- immediate issuance of a bond through a Surety company in order to obtain the temporary freedom of the driver
- release of the vehicle involved and/or cover the amount of the bond for the same purposes when so required at the time that the Insured is requested to cover as a result of an accident in which the vehicle property of the Insured is involved in an accident covered in this policy
The coverage that is issued is subject to the following:
1. The Company agrees to cover the legal expenses that the Insured has to pay as a result of an automobile accident The Insured shall have the right to request that the Company pay the expenses that are hereinafter described up to the limits that are mentioned herein:
A. The professional services received of a judicial nature by the Insured in dealing with the penal or administrative problem that occurred.
The Company shall pay for the professional services as a maximum an amount equivalent to $2,000 US.
B. The expenses inherent to the criminal trail as a direct result of the accident. For the expenses incurred in the penal process of the accident as a whole, the Company shall pay as a maximum an amount equivalent to $750 US.
C. In the event that the Judicial Authority were to establish an amount for the provisional freedom of the driver and the release of the automotive unit, the Company agrees to submit a surety bond for a combined single limit per event up to a maximum amount of $25,000 US. In every instance, the Insured agrees to comply with the requirements that for this purpose the Company needs.
D. In the event that the Judicial Authority establishes an amount for obtaining the provisiona1 freedom of the driver and the release a the vehicle, the Company shal1 cover the amount of premium for said bond, up to a maximum amount equivalent to $6,000 US and the Estado de México to a maximum amount equivalent to $8,700 US.
2. The obligation of the Company to pay the legal fees, is circumscribed to the limits of the amounts that appear in item 1 of this coverage. Said limits of the amounts issued shall be automatically reinstated when they are reduced due to any payment made by the Company during the term of the policy
3. Once the bond has been issued, the Insured agrees to comply with each and every one of the provisions that are established in the Pena1 Code in order to avoid the cancellation of the provisions freedom of the driver that is under indictment and to avoid that the Judicial Authority may call in the bond or guarantee.
In the event that the bond or guarantee is called in for reasons that are imputable to the tria1 or to the Insured, the latter shall reimburse the Company the amount of the premium of the bond or guarantee that for this reason had been paid.
4. In the event of a loss, the Insured agrees to comply with the following requirements:
A. At the time of the accident the insured shall give immediate notice within the 24 hours following the accident be it by the insured or by a third party; this notification shall be given to the offices of the Company that are close to the scene of the accident or to the Head Office.
B. The Insured shall select amongst the lawyers that are included in the list that for this purpose the adjuster of the Company shall provide; the lawyers selected shall represent the Insured and will handle all of the legal matters that arise as a result of the traffic accidents that may occur.
C. The insured agrees to attend all proceedings of a penal, civil and administrative nature that require his presence
5. The Company shall not be obligated to make any payment under this coverage, in the following cases:
A. The Company shall not pay any expense made as a result of civil liability.
B. If in the opinion of the Judicial Authorities, the accident was caused by the Insured in an intentional manner.
C. When the traffic accident occurs’ the premium has to have been paid.
D. The Company shall not pay or reimburse under any circumstance, bribes, gratuities, expenses incurred for copies or for any other concept that is not contemplated in the terms and conditions stated herein.