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8. Personal accident cover for passengers
2. Accidental permanent disability
If the insured is the victim of an accident covered by the policy and occurring during the period of insurance, and if, as a consequence, s/he suffers total permanent disability, the insurer will indemnify him / her with 100% of the sum insured, less any payments it may have made as indemnities for partial permanent disability.
If the insured is the victim of an accident covered by the policy and is rendered permanently partially disabled as a result, the insurer will pay him / her the indemnities specified below, expressed as percentages of the sum insured for this cover in the policy schedule.
Partial permanent disability will be assessed according to the following scale...:
Complete loss of mobility and function of the vertebral column
Total loss of a single arm or single hand
Total loss of all fingers on a hand or of the thumb and index finger, jointly
Total loss of just the index finger
Total loss of three fingers, including the thumb
Total loss of three fingers, including the index finger
Total loss of one finger that is not the thumb or index finger
Total loss of movement of one shoulder
Total loss of movement in the elbow or wrist
Total loss of a leg above the knee
Total loss of a leg at or below the knee
Total loss of one of the other toes
Total loss of movement in one hip or one knee
Total loss of an eye or a fifty percent reduction in binocular vision
Shortening of a leg by at least 5 cm
Non-union fracture of one leg or foot
Non-union fracture of the kneecap
Complete deafness in both ears
Complete deafness in just one ear
If the insured is left-handed, the percentages indicated above for upper right-side limbs will be applicable to the left-side ones and vice versa.
The loss of a phalanx or a thumb or big toe will be indemnified with half of the indicated percentage: the loss of a phalanx of any other finger or toe will be indemnified with one third of the percentage established for the total loss of the digit in question.
The absolute and permanent loss of the use of a limb shall be considered as equivalent to the total loss thereof.
Should the insured suffer, in a single accident, more than one of the injuries listed above, the insurer will indemnify him / her for each injured limb or organ at the established rate of the sum insured; however, in no case may the total indemnity exceed 100% of the sum insured for disability.
Should the insured suffer various partial sequelae in a single limb, the total indemnity may never exceed the percentage established for the total loss of the limb in question.
Those cases of permanent disability not expressly listed in the scale shall be indemnified by analogy with those that are. At all times, the degree of disability will be established irrespective of the insured's occupation.
Should the insured present impairments or sequelae upon contracting the policy or during its period of cover, if their origin cannot be traced to an accident in which he/she is involved as a passenger of the insured vehicle, the indemnity for disability will be calculated based on the injuries truly sustained, and those organs or limbs that were already impaired prior to the accident will not be considered as affected.
For residual injuries that can be corrected with prostheses, the insurer will pay for the cost of the first orthopaedic prosthesis given to the insured for up to a maximum of 10% of the sum insured for permanent disability indicated in the schedule. Other prosthetic or orthopaedic elements, such as crutches, canes, cervical collars, knee braces, bandages and / or wheelchairs, are covered up to a limit of 1,000 euros per insured.
3. Health care expenses arising from accidents
9. Personal accident cover for driver: Fixed sum plus annuity
THE FOLLOWING IS NOT COVERED:
For sections 1, 2, and 3 above:
a. Accidents unrelated to the condition of the passenger of the insured vehicle.
b. Accidents covered by the Insurance Compensation Consortium.
c. Accidents resulting from sport competitions, wagers, challenges or exploratory expeditions.
d. Aesthetic sequelae.
e. Health-care expenses that are covered by mandatory automobile insurance or occupational hazard insurance.
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