Policy number:  00000132321902

Policyholder: Universidad del País Vasco / Euskal Herriko Unibertsitatea

Insurer: Zurich Insurance plc

Group insured: Anyone currently enrolled at the EHU on any of the courses taught at the university (undergraduate degrees, official Master's degrees, own degrees, complementary courses, etc.), as well as students studying at any of the institutions affiliated with the EHU (Elías Querejeta Film School, University School of the Bilbao Chamber of Commerce, Vitoria-Gasteiz University School of Nursing, IMH University School of Dual Engineering and Goimailako Online Institutua).

Policy name: MANDATORY ACCIDENT INSURANCE

Mandatory requirements for medical care:

• The student’s EHU University ID card
• Submission of the completed and signed Medical Care Report

What should I do in the event of an accident if I require medical assistance?

-  You should go to any of the Authorised Medical Centres affiliated with the Insurance Company, which are listed below:

-  Once at the Authorised Medical Centre, you must identify yourself by providing your EHU university card and National ID card.

-  In the event of urgent medical assistance being required and the Authorised Medical Centres being located at a distance from where the accident occurred, you may receive medical care at the nearest Medical Centre.

- In both cases, in order to receive medical care, you must present your EHU university card and, where applicable, the Accident Report, which must be duly signed and stamped by the Dean or Director of the School or Faculty to which you belong, or where applicable, by the Deputy Director of the corresponding Campus.

If you are unable to provide the Accident Report at the time, you must provide it within a maximum period of 72 hours.

How can I obtain an Accident Report?

Accident Report

In the event of an EMERGENCY, how should I proceed if I go to a non Authorised Medical Centre?

You may receive emergency medical assistance at the nearest Medical Centre upon presentation of your EHU university card. After 24 hours, or once any emergency treatment or care has been provided, you must be transferred to one of the Authorised Medical Centres to continue your treatment. It is your responsibility to notify the insurance company your stay at a non Authorised Medical Centre within 24 hours of admission, and to submit the duly signed and stamped Medical Care Report.

If you remain at a Medical Centre not authorised by the insurer without said insurer’s express authorisation, the insurer will not cover any medical bills derived from the services received.

What should I do if I need further tests or other services?

Access to the procedures and services outlined below require prior authorisation from the Insurance Company:

• Diagnostic tests (CT scan, MRI, ultrasound, arthroscopy, gamma scan, etc.).
• Surgical procedures..
• Rehabilitation sessions.
• Transfers (ambulances, taxis, etc.)

To request these authorisations, contact:

Email: aperturas@zurich.com

Telephone num.:  91 458 9070 - ext. 334 and 337 (08:00 to 13:30 and 15:00 to 17:00)        

24-hour helpline: 93 267 10 55

How do I process any other claim besides medical care?

To process any other claim covered by the policy (death or permanent disability resulting from an accident, inability to attend class or enrol on a course, family misfortune, etc.), the contact person is::

• Contact person: Maitane Petreñas Arbizu
• Email: maitane.petrenas.arbizu@aoncss.es
• Telephone num.: 93 390 07 64

1. Aim and scope

The aim of this Protocol is to provide a swift and effective tool for managing claims covered by insurance policy number 99481517, held by the University of the Basque Country (EHU), and thereby offer an efficient service to beneficiaries in the processing of claims arising from the guarantees included in the policy.

This Protocol will only be applicable during the term of the insurance policy to which it is linked..

Furthermore, its content may not, under any circumstances, serve as a reference for interpreting the general, specific and particular conditions of the established insurance contract.

2. Medical care

2.1 Care provided at Medical Centres Authorised by Zurich Insurance plc

Insured persons may receive emergency or scheduled medical care at any of the medical centres authorised by Zurich.

To this end, upon arrival at the Medical Centre, they must identify themselves by providing:

1. Their EHU University ID card
2. The corresponding Accident Report

The injured person must submit the completed Accident Report within 72 hours of receiving medical attention. The report must be completed in as much detail as possible, paying particular attention to the date and the manner in which the incident occurred, the injured person's personal information and the description of their injuries. The report must be signed and stamped by the Dean or Director of the student's Faculty or School, or, if applicable, by the Deputy Director of the corresponding Campus.

In cases in which medical care is provided, by necessity, in a non Authorised Medical Centre, the procedure outlined below must be followed.

2.2 Medical Care provided in Medical Centres not authorised by the Insurance Company

The insured person may receive emergency medical care at the nearest medical centre. In such cases, Zurich Insurance plc will cover the bills for any emergency medical care provided within the first 24 hours following the accident. After this emergency medical care has been provided, the insured person must be transferred to an Authorised Medical Centre to continue their treatment. It is the responsibility of the insured person to notify Zurich Insurance plc within 24 hours of their stay at a non Authorised Medical Centre. The decision whether or not to proceed with the transfer rests with the physician appointed by the insurance company, in consultation with the physician currently treating the insured person.

If the insured person remains at a Medical Centre not authorised by Zurich without express authorisation, Zurich will not cover any medical bills derived from the services received, except in the event of it proving impossible to transfer the patient for a duly justified and documented reason.

2.3 Specific authorisations for carrying out tests and receiving services

3. Communicating and processing other claims  

To process any other claim covered by the policy (death or permanent disability resulting from an accident, inability to attend class or enrol on a course, family misfortune, etc.), the contact person is:

• Contact person: Maitane Petreñas Aribizu
• Email: maitane.petrenas.arbizu@aoncss.es
• Telephone num.: 93 390 07 64

The Company (through the brokerage firm AON) will request, in each case and in writing, the documents required to process claims in accordance with their specific type.

4. Accurate documentation in the event of an accident

As a general rule and depending on the guarantees outlined in the corresponding policy, the documents required to process claims are outlined in the provisions of the relevant section. Nevertheless, depending on the specific case, further specific documents may also be required to ensure the correct processing of the claim.

Medical care:

• Accident Report (signed and stamped by the EHU)
• Medical Report (provided by the medical centre).

For claims relating to simple medical care, the accident report completed by the Policyholder and the medical information provided by the Medical Centre will be deemed sufficient justification for correct processing.

Death as a result of an accident: 

• Accident Report.
• Medical certificate issued by the physician who attended the deceased, indicating the cause of death, or, if applicable, a copy of the complete Judicial Proceedings and the autopsy report.
• Death certificate.
• Copy of the National ID card of both the deceased and their beneficiaries.
• Copy of the Last Will and Testament registry.
• Copy of the deceased's Will, or, failing that, a Declaration of Heirs Certificate.

In the event of death, in order to avoid unintentional management errors, the Company recommends you not complete any tax settlements or issue a declaration of heirs until the Company's OK has been obtained.

Permanent disability resulting from an accident:

• Accident Report.
• Copy of the Medical Assessment Report - Proposed Opinion.
• INSS (Social Security) Resolution (where appropriate).

5. Contact information

In order to manage any issue that may arise in relation to this Protocol as smoothly as possible, the following telephone numbers are available to all insured persons:

Medical Care (ZURICH):

•  91 458 9070 - ext. 334 and 337 (08:00 to 13:30 and 15:00 to 17:00)

• 24-hour helpline: 93 267 1055

Other accidents (AON):

• Office opening hours (from 8:00 to 19:00): 94 425 15 00

6. Medical follow-up by the Company  

In cases in which the Company deems it necessary, a medical examination will be carried out by a designated physician to assess the insured person's injuries. In such cases, the physician may directly authorise the services indicated in section 2.3.

7. Cancellation of the protocol

Zurich reserves the right to cancel this Protocol in the event of non-compliance by the Policyholder or the person insured through it or through the insurance contract from which it arises.