Insurance Policy to your Gothaer Motor Sport Insurance
Transcription
Insurance Policy to your Gothaer Motor Sport Insurance
Customer Service Special Insurances Service Area Motor Sport/Travel Gothaer Allgemeine Versicherung AG . 50598 Köln Speer Racing GmbH Wannweiler Str. 65 7277 Reutlingen Telephone Telefax E-Mail Internet +49 551 701-54278 +49 551 701-964278 [email protected] www.gothaer.de Insurance Policy to your Gothaer Motor Sport Insurance 22/03/2011 Insurance Number 38.918.836495 Begin and Expiry of the Insurance Begin of Insurance Expiry of Insurance 07.03.2011 / 00.00 hrs 31.12.2011 / 24.00 hrs Scope of the Insurance Title of Event Driver Training accordant to the special informations and conditions agreements Motor Sport Liability Insurance Insurance Number per Loss Event Flat rate for Personal Injury, Property and Economic Losses 3.000.000 Your Insurance Coverage shall extend to the legal liability of the Organizer (Insurance Holder) of the Sports Officials, of the Sporting Goods or of other Persons to be commissioned by the Organizer in the organization and implementation of the event, namely for the liability of responsibility in this capacity (the Insured) of the Driving Assistant of the Participants (the Insured: as Applicant, Driver, Passenger, Vehicle Keeper and Proprietor) Federal Government, states, communities and municipal associations shall be exempt from all claims of compensation, which could be raised on the occasion of this event in accordance with the statutory liability provisions by participants or by a third party. Dokument2 Liability claims of the participants among each other and towards the organizer are co-insured, if all participants signed an effective waiver of liability (e.g. in accordance with the recommendation of the DMSB). Company Seat Supervisory Board Board Gothaer Allgemeine Versicherung AG Gothaer Allee 1, 50969 Köln (Address) Dr. Roland Schulz (Chairman) Thomas Leicht (Chairman), Dr. Werner Görg, Dr. Helmut Hofmeier, Michael Kurtenbach Jürgen Meisch, Dr. Hartmut Nickel-Waninger, Oliver Schoeller Postal Address 50598 Köln Legal Form Register Court ISt-ID Corporation District Court Köln, HRB 21433 DE 122786654 Motor Sport Accident Insurance Type of Insurance / Type of Service Amount Insured per Person Participant Accident Insurance Disability Benefit or Disability Benefit (Accordant Special Information and Agreements) 75.000 150.000 Driving Assistant Accident Insurance Death Benefit Disability Benefit with 200% Progression Total Disability Benefit 15.500 31.000 62.000 Sports Director Accident Insurance Death Benefit Disability Benefit with 200% Progression Total Disability Benefit 15.500 31.000 62.000 Spectator Accident Insurance Death Benefit Disability Benefit Those with Premium Details 15.500 31.000 specified risks are insured. Insurance Your Premium to be paid Including the Legal Insurance Tax Liability 18.000 Total Amount The premium statement will be sent to you separately. Currency Details All premiums are in Euro. Contractual Basis The mutual rights and obligations shall be regulated in accordance with your application and possibly the related written declarations submitted, this insurance policy, the statutory provisions of the Federal Republic of Germany, as well as the following listed policy conditions and agreed clauses and/or agreements such as those of the sport authority approved / registered invitations to bid. Ancillary verbal agreements shall be invalid. Insurance Conditions Insurance Conditions Status General provisions for all contained contracts: - General insurance conditions for the Liability Insurance - Special Conditions and Clauses for the Motor Sport Liability Insurance - Gothaer Motor Sport Accident Insurance Conditions 01/2008 03/2010 03/2010 - Special conditions for the disablement benefit with 25 % integralfranchise Special Information and Agreements Insurance Number 38.918.836.495 Participant Accident Insurance accordant index of submitted index of names. The Insurance Coverage shall extend to following Events: See last page Page 2 of 22/03/2011 Right of Revocation as per §§ 8 and 9 VVG You may withdraw your declaration of intention within two weeks, without any reason and in writing (e.g. letter, fax, email). The deadline begins when you receive the insurance policy, the contract provisions, including our general insurance conditions, as well as the contract information (product information sheet and insurance information), and these instructions. The punctual dispatch of the revocation is sufficient for the adherence to the right of revocation deadline. The revocation is to be sent to Gothaer Allgemeine Versicherung AG, 50598 Köln (postal address) or Gothaer Allee 1, 50969 Cologne. In the case of an effective revocation, your insurance coverage will end and we will reimburse the part of your premium, which is not applicable for the period after receipt of the revocation. We may retain the part of your premium, which is not applicable for the period until receipt of the revocation, if you agreed that the insurance coverage would begin before expiry of the period of revocation. If you have not issued such an agreement or the insurance coverage begins after expiry of the revocation period, we will reimburse you the entire amount. We immediately reimburse premiums to you, at the latest 30 days after receipt of the revocation. Your right of revocation is excluded, if the contract was completely fulfilled, at your express request, by both sides, before you exercised your right of revocation. Should you revoke a replacement contract, the original insurance contract shall continue. The right of revocation shall not apply to contracts with a duration period of less than one month. Right of Objection as per § 5 VVG At the places marked red and/or specified with #, the insurance policy/supplement differs from the application. For the variations with related legal consequences, please refer to the explanatory numbers specified below. #1 The insurance coverage begins at a different time than applied for. #2 The insurance coverage ends a different time than applied for. #3 Consequently, another premium is to be paid. #4 Consequently, the insurance coverage is limited. The variations shall be deemed approved, if you do not revoke the insurance policy/supplement in writing within one month after receipt (e.g. per email). Gothaer Allgemeine Versicherung AG Dr. Werner Görg Insurance Number 38.918.836.495 Thomas Leicht Page 3 of 22/03/2011 Art Tes tevent (Racer only) Renntraining Renntraining Montagstraining Montagstraining Renntraining Sportfahrer- und Instruktorentraining Renntraining Sportfahrer- und Instruktorentraining Sportfahrer- und Instruktorentraining Montagstraining Sportfahrer- und Instruktorentraining Sportfahrertraining Sportfahrer- und Instruktorentraining Fahrs icherheits training Autotraining Sportfahrer- und Instruktorentraining Montagstraining Montagstraining Sportfahrer- und Instruktorentraining Sportfahrertraining Renntraining Montagstraining Sportfahrer- und Instruktorentraining CupEvent Sportfahrer- und Instruktorentraining Montagstraining Renntraining (300 Meilen-Rennen) Renntraining Fahrs icherheits training Montagstraining Sportfahrer- und Instruktorentraining Sportfahrer- und Instruktorentraining Sportfahrer- und Instruktorentraining CupEvent Sportfahrer- und Instruktorentraining Sportfahrer- und Instruktorentraining Sportfahrer- und Instruktorentraining Sportfahrertraining Sportfahrer- und Instruktorentraining Sportfahrer- und Instruktorentraining Montagstraining Sportfahrer- und Instruktorentraining Montagstraining Renntraining Sportfahrer- und Instruktorentraining Renntraining Renntraining Insurance Number 38.918.836.495 Ort Valencia Hockenheim Aragon Hockenheim Hockenheim Barcelona Anneau du Rhin Mugello Mos t (Toni-Mang-Training) Anneau du Rhin Hockenheim Hockenheim Spa-Francorcham ps Hockenheim Neuhausen ob Eck Hockenheim Hockenheim Hockenheim Hockenheim Salzburgring Nürburgring Os chers leben Hockenheim Salzburgring Magny Cours Hockenheim Hockenheim Hockenheim Brünn Hockenheim Hockenheim Anneau du Rhin Hockenheim Pannoniaring (Toni-Mang-Training) Mugello Salzburgring Hockenheim Hockenheim (Toni-Mang-Training) Sachs enring Hockenheim Brünn (Toni-Mang-Training) Hockenheim Anneau du Rhin Hockenheim Mugello Anneau du Rhin Mugello Barcelona von 07.03.11 26.03.11 04.04.11 11.04.11 18.04.11 21.04.11 22.04.11 22.04.11 29.04.11 01.05.11 02.05.11 06.05.11 11.05.11 13.05.11 15.05.11 21.05.11 22.05.11 23.05.11 30.05.11 02.06.11 08.06.11 10.06.11 20.06.11 23.06.11 24.06.11 24.06.11 04.07.11 11.07.11 15.07.11 17.07.11 25.07.11 29.07.11 01.08.11 05.08.11 12.08.11 21.08.11 22.08.11 29.08.11 05.09.11 05.09.11 16.09.11 19.09.11 23.09.11 26.09.11 07.10.11 08.10.11 14.10.11 21.10.11 bis 09.03.11 27.03.11 06.04.11 11.04.11 18.04.11 26.04.11 24.04.11 24.04.11 01.05.11 01.05.11 02.05.11 07.05.11 12.05.11 15.05.11 15.05.11 21.05.11 22.05.11 23.05.11 30.05.11 03.06.11 08.06.11 13.06.11 20.06.11 23.06.11 26.06.11 26.06.11 04.07.11 11.07.11 23.07.11 18.07.11 25.07.11 30.07.11 01.08.11 07.08.11 14.08.11 21.08.11 22.08.11 30.08.11 06.09.11 06.09.11 18.09.11 19.09.11 24.09.11 26.09.11 09.10.11 09.10.11 16.10.11 23.10.11 ges Tage Rennen 3 nein 2 nein 3 ja 1 nein 1 nein 6 ja 3 nein 3 ja 3 nein 1 nein 1 nein 2 nein 2 nein 3 ja 1 nein 1 nein 1 nein 1 nein 1 nein 2 nein 1 nein 4 ja 1 nein 1 nein 3 ja 3 nein 1 nein 1 ja 9 ja 2 nein 1 nein 2 nein 1 nein 3 nein 3 ja 1 nein 1 nein 2 nein 2 nein 2 nein 3 nein 1 nein 2 nein 1 nein 3 ja 2 nein 3 ja 3 ja Page 4 of 22/03/2011