Information on Your Insurance Contract LBS0015 (Germany)

1  Information on the insurer

  1.1   The insurer of the offered insurance contract will be

Lloyd’s Insurance Company S.A., Bastion Tower, Marsveldplein 5, 1050 Brussels, Belgium

Legal form: Belgian limited liability company

Seat: Brussels, Belgium

  1.2   You are concluding the insurance contract via an insurance intermediary or directly via a Lloyd's Broker as intermediary. You may obtain the name and address of your insurance intermediary from your correspondence with the insurance intermediary.

  1.3   You may notify Lloyd’s Insurance Company S.A. of a claim by contacting the following:

Intana Global, Sussex House, Perrymount Road, Haywards Heath, West Sussex RH16 1DN, UK

Tel: +44 (0)1444 442 260   email: columbusclaims@intana-global.com   Fax: UK +44 (0) 1992 450 717

  1.4   Lloyd's Insurance Company S.A. transacts non-life insurance and non-life reinsurance business.

  1.5   Lloyd's Insurance Company S.A. is subject to the supervision of:

National Bank of Belgium, Boulevard de Berlaimont 3, 1000 Brussels, Belgium

2   Information on the offered performance

2.1   Per the attached you are made an offer for an insurance contract including the general insurance terms and conditions.

The insurance contract is subject to German law unless the validity of another law has effectively been agreed upon between you and the insurer.

Type, scope, due dates and performance by the insurer are included in the schedule and the insurance terms and conditions.

2.2   The total price of the insurance including all taxes and other price elements are specified in the schedule.

2.3   Other costs incurred, if any, are specified in the schedule and the insurance terms and conditions. For taxes, which are not settled by the insurer, please refer to your tax advisor.

2.4   Details in respect of payment and the fulfilment of your payment obligations, in particular with view to the mode of the premium payments will be advised to you by your insurance intermediary.

2.5   Our offer for the conclusion of an insurance contract is time limited. The time limit will be advised to you by your insurance intermediary.

2.6   For contracts on professional disability insurance and accident insurance with premium return please refer to the following information (insofar as monetary amounts are concerned, in Euro) contained in the terms and conditions of insurance: information on the amount of the costs calculated into the premium amount (acquisition costs as a lump-sum amount and the remaining costs already calculated as part of the annual premium stating the respective period of contract), on any other costs, the principles and criteria of calculation applied to the surplus determination and participation, cash surrender values, the minimum amount insured for a conversion into a premium-free or premium-reduced insurance, benefits arising from a premium-free or premium-reduced insurance, the extent, to which the cash surrender value and the premium-free or premium-reduced insurance is guaranteed, as well as any general information on the tax regulations applicable to this type of insurance.

3   Information on the contract

3.1   The insurance contract becomes effective following your proposal upon receipt of the policy from the insurer.

3.2   For the time of inception of the insurance cover please refer to the schedule and the insurance terms and conditions.

3.3   The period of the offered contract is specified in the schedule.

3.4   Prior to the lapse of the agreed period of contract you may cancel the insurance contract only on the grounds of legally stipulated reasons and, where applicable, on the grounds of the reasons stipulated in the insurance terms and conditions.

3.5   The entry of relations between you and the insurer for the purpose of concluding the insurance contract shall be subject to German law or the foreign law effectively agreed between you and the insurer even with regard to the period prior to the conclusion of the insurance contract.

3.6   The law applicable to the contract and the competent court are specified in the insurance terms and conditions.

3.7   The terms and conditions of contract and this advance information will be made available to you in German language. Correspondence between you and the insurer during the period of the contract will also be in German language or with your agreement in English language.