EFTA01807380.pdf

From: Allan Wilson Sent: Monday, January 9, 2017 11:48 AM To: Myla Trestiza; philip baker; Admin Cc: Dave Johnson Subject: FW: STURGE Medical form x 4 - Myla Trestiza - 16/237 Hi Myla =/p> Please see below email s=ring regarding you medical claim, The outstanding clinic balance of PHP 7,=45.00 for the breast screening as stated is not part of the claim and is for your account. =/p> Also at this stage can y=u confirm that we can now close the claim and that you have not ijncurred =ny additional expenses. =/p> =/p> Best Regards Allan Wilson Wilson Yacht Management &nbs=; &=bsp; &nbs=; &nb=p; =nbsp; &nb=p; UK Office Tel: Fax: E Fax Gsm: USA Office = &n=sp; Tel: 1 EFTA_R1_00155618 EFTA01807380 E fax USA Cell Email: Web: www.wilsonyachtmanagement.com <http://www.wilsonyachtmanagement.com/> UK Office I Hessle I East Yorksh=re I HU13 0AH USA Office I I Fort Lauderdale I Florida 3331=o:p> <https://twitter.com/wymnews> <=mg border="0" width="32" height="32" style="width:.3333in;height:.=333in" id="_x0000j1033" src="cid:[email protected]" alt=3D"http://www.wilsonyachtmanagement.com/signatures/assets/facebook.png"></=pan> <https://www.fa=ebook.com/wilson.yachtmanagement> <https://www.linkedin.com/pub/allan-wilson=39/67/794> </=pan> Copyright © Wilson Yacht Management=/span> CONFIDENTIALITY NOTICE: This email (includi=g all attachments) is for the intended recipient only and may contain conf=dential information, some of which my be privileged. Please be advised that any disclosure, copying, distribution or use of any=part of the information contained is prohibited. If you received this emai= in error, please destroy the original email and its attachment and notify=me immediately. Thank you =/p> From: =lementine Kingstone Sent: 09 January 2017 11:39 To: Allan Wilson Cc: Admin Subject: RE: STURGE Medical form x 4 - Myla Trestiza - 16/237</=:p> Dear Allan Following on from my ema=l of 21st December 2016 below, I have been informed by CEGA tha= Myla has advised them that the costs for the breast clinic were for a routine mammogram. I understand that this test wa= not linked to the subject matter of this claim. =/p> With this in mind, as th= costs are for a routine screening, regrettably, these costs will not be =ecoverable under the terms of the policy. Exclusion 3 of Section 2 (medical Expenses) specifically excludes 'Examinat=ons for check-up 2 EFTA_R1_00155619 EFTA01807381 purposes not incidental to, or necessary to diagnose Illn=ss or Accidental Bodily Injury; general health examinations.' Th= outstanding clinic balance of PHP 7,245.00 for the breast screening will therefore be for Myla / the yacht's ow= account. =/p> In order that we can pro=eed towards finalising this claim, I would enquire if there Insured have a=y further medical expenses that they would like to submit as part of the claim, less the medical expenses excess of USD 20=.00? if no further costs are to be submitted, I can arrange for a debit no=e to be issued for the outstanding USD 200.00 medical expenses excess for =ettlement by the Insured. =/P> I trust that you find th=s to be in order and now await your advices. =/p> Kind regardsaspan> Clem -/p> qp> Clementine Kingstone<=span> ACII Claims Handler</=:p> Sturge Taylor & A=sociates Ltd Notebeme House, Southampton, 5O14 2NT, United Kingdom<=b> Tel Fax <=p> IMPORTANT NOTICE &#=211; THE (UK) INSURANCE ACT 2015 On the 12th Au=ust 2016 the new (UK) Insurance Act came into force and we need to inform =ou of the following changes that we are highlighting to all of our clients. 3 EFTA_R1_00155620 EFTA01807382 The Insurance Act (The Act) will apply to all new insurances, renewals =nd any changes to insurance requirements effective on or after the 12th August 2016. The Act requires that a=fair presentation of the risk is made as failure to do so could result in =voidance of the policy and retention of the premium (if failure to make a =air presentation is deliberate or reckless), or of different terms being adopted to consider how the risk would have be=n underwritten had fair presentation been made, which could result in only=partial payment of any relevant claim. As your Broker we have a key =ole in ensuring that you are aware of and comply with the updated requirements. Insurance Law for contrac=s subject to the laws of England & Wales has changed since your last r=newal and, in order that you may comply with your obligations please be advised of the undernoted requirements, which differ=to those previously in place: Duty of Disclosure You have a duty to make a=fair presentation of the risk to the insurer, via Sturge Taylor & Asso=, of every material circumstance which you ( or a member of your organisation, employee, Captain, Crew, manageme=t team etc ► know or ought to know in relation to the risk placed and this=duty is applicable before the cover is placed, when it is renewed and at a=y time throughout the contract if the risk changes. A circumstance is material if it would influence the judgem=nt of an Insurer / Reinsurer in determining whether to take the risk and, =f so, on what terms. If you are in any doubt whether a circumstance =s material we recommend that it should be disclosed. Disclosure will be consid=red fair if it is made in a manner that is reasonably clear and accessible=and the facts represented are correct and made in good faith. Failure to disclose a material circumstance may entit=e an insurer to impose different terms on your cover or proportionately re=uce the amount of any claim payable. In the event that non-disclosur= was deliberate or reckless an insurer will be entitled to avoid the policy from inception and retain the premium paid= This would result in any claims under the policy not being paid. Conditions Precedent</=pan> You must also take partic=lar note of any conditions precedent that appear in the policy. If a=condition precedent to the validity of this policy or to the commencement of the risk is not complied with, the insurer will =ot come on risk. If a condition precedent to the Insurers liability =nder this policy is not complied with, the insurer may not be liable for t=e loss in question. A condition precedent may exist in the policy using other terminology and without reference to t=e words 'condition precedent'. It is very important that=you read the full policy carefully when it is received and, if you are uns=re of, or are unable to comply with any provisions therein, please let Sturge Taylor & Assoc know immediately.=/span> <=p> Contracting Out</=:p> Some Insurers have exerci=ed their right to opt out of the requirements of the new act. In the event=that this effects the insurances we have placed for you we will advise you accordingly. 4 EFTA_R1_00155621 EFTA01807383 We have produced a simple guide to help you through some of the changes=within the Insurance Act which, if not attached to this email it is available on request. If you would like further =nformation please contact us and we will endeavour to help. Registered Office: Sturge Taylor &=mp; Associates Ltd., Highfield Court, Tollgate, Chandlers For=, Eastleigh, Hampshire 5O14 3TY Registered in England No. 370648O</=:p> Authorised and Regulated by the Financia= Conduct Authority www.sturgeyachts.com <http://www.sturgeyachts.com/> IMPORTANT: This e-mail (including all attachments) is confidential and may =e privileged. It may be read, copied and used only by the intended recipie=ts, and must not be re-transmitted in an amended form without our consent.=lf you have received it in error, please contact us immediately by return e-mail or by telephone. Please the= delete it and do not disclose its contents to any other person. We operate anti-virus programmes but you must take full responsibility for =irus checking.</=:p> =/p> From: =lementine Kingstone Sent: 21 December 2016 14:55 To: 'Allan Wilson Cc: Admin Subject: RE: STURGE Medical form x 4 - Myla Trestiza - 16/2374=:p> Hi Allan =/p> Many thanks for your swi=t response on this and the attached claim form. =/P> I am pleased to advise t=at we have now arranged urgent settlement of the Makati clinic invoice and=payment has today been authorised. =/p> 5 EFTA_R1_00155622 EFTA01807384 As mentioned in my email-of 14th December 2016, the total outstanding costs for the Maka=i clinic were PHP 121,972.73 however, included within these costs are breast clinic costs totalling PHP 7,245.00 which do=not appear to be related to the claim at this stage. CEGA are trying to ob=ain further information directly from Myla regarding these costs in order =hat the balance of PHP 7,245.00 can be assessed further. =/p> Due to the fact th=t the breast clinic costs cannot be confirmed as claim related, the sum of=PHP 7,245.00 has been excluded by insurers from the settlement to Makati clinic. The total transferred to the clinic is =herefore the net sum of PHP 114,547.72. Myla therefore may be approached d=rectly by the clinic for the balance of PHP 7,245.00. If Myla is asked to =ettle the costs directly and would like the costs considered as part of the claim, I would be very grateful if you=could please forward the proof of payment along with clarification regardi=g the reasons for these costs, in order that this matter can be considered=further. =/p> In the meantime, I note =rom the claim form that the Insured have listed 4 separate costs which hav= been incurred. Are you able to provide receipts for the costs incurred by the Insured so that I can add this to the claim =or consideration by insurers, less the USD 200.00 medical expenses excess? I look forward to hearing from you in due course. =/O> Kind regards<=span> Clem =/p> =/p> Clementine Kingstone<=span> ACII Claims Handler</=:p> Sturge Taylor & A=sociates Ltd Notebeme House, Southampton, 5014 2NT, United Kingdom<=b> Tel Fax 6 EFTA_R1_00155623 EFTA01807385 =/p> c=p> IMPORTANT NOTICE —THE (UK) INSURANCE AC= 2015 On the 12th August 2016 the new (UK) Insu=ance Act came into force and we need to inform you of the following change= that we are highlighting to all of our clients. The Insurance Act (The =ct) will apply to all new insurances, renewals and any changes to insuranc= requirements effective on or after the 12th August 2016. The Act requires that a fair presentation of the risk i= made as failure to do so could result in avoidance of the policy and rete=tion of the premium (if failure to make a fair presentation is deliberate =r reckless), or of different terms being adopted to consider how the risk would have been underwritten had fair pre=entation been made, which could result in only partial payment of any rele=ant claim. As your Broker we have a key role in ensuring that you ar= aware of and comply with the updated requirements. Insurance Law for contracts subject to the laws of E=gland & Wales has changed since your last renewal and, in order that y=u may comply with your obligations please be advised of the undernoted requirements, which differ to those previously in place:=o:p> Duty of Disclosure</=> You have a duty to make a fair presentation of the r=sk to the insurer, via Sturge Taylor & Assoc, of every material circum=tance which you ( or a member of your organisation, employee, Captain, Crew, management team etc ) know or ought to know=in relation to the risk placed and this duty is applicable before the cove= is placed, when it is renewed and at any time throughout the contract if =he risk changes. A circumstance is material if it would influence the judgement of an Insurer / Reinsurer in =etermining whether to take the risk and, if so, on what terms. If yo= are in any doubt whether a circumstance is material we recommend that it =hould be disclosed. Disclosure will be considered fair if it is made in = manner that is reasonably clear and accessible and the facts represented =re correct and made in good faith. Failure to disclose a material circumstance may entitle an insurer to impose differen= terms on your cover or proportionately reduce the amount of any claim pay=ble. In the event that non-disclosure was deliberate or reckless an =nsurer will be entitled to avoid the policy from inception and retain the premium paid. This would result in an= claims under the policy not being paid. Conditions Precedent=/p> You must also take particular note of any conditions=precedent that appear in the policy. If a condition precedent to the=validity of this policy or to the commencement of the risk is not complied with, the insurer will not come on risk. If=a condition precedent to the Insurers liability under this policy is not c=mplied with, the insurer may not be liable for 7 EFTA_R1_00155624 EFTA01807386 the loss in question. =A condition precedent may exist in the policy using other terminology and without reference to the words 'conditio= precedent'. It is very important that you read the full policy c=refully when it is received and, if you are unsure of, or are unable to co=ply with any provisions therein, please let Sturge Taylor & Assoc know immediately. Contracting Out Some Insurers have exercised their right to opt out =f the requirements of the new act. In the event that this effects the insu=ances we have placed for you we will advise you accordingly. We have produced a simp=e guide to help you through some of the changes within the Insurance Act w=ich, if not attached to this email it is available on request. If you would like further information please contact us =nd we will endeavour to help. Registered Office: Sturge Taylor &=mp; Associates Ltd., Highfield Court, Tollgate, Chandlers For=, Eastleigh, Hampshire 5O14 3TY Registered in England No. 37064804=:p> Authorised and Regulated by the Financia= Conduct Authority www.sturgeyachts.com <http://www.sturgeyachts.com/> IMPORTANT: This e-mail (including all attachments) is confidential and may =e privileged. It may be read, copied and used only by the intended recipie=ts, and must not be re-transmitted in an amended form without our consent.=If you have received it in error, please contact us immediately by return e-mail or by telephone. Please the= delete it and do not disclose its contents to any other person. We operate anti-virus programmes but you must take full responsibility for =irus checking.</=:p> =/p> From: =Ilan Wilson Sent: 20 December 2016 15:23 To: Clementine Kin stone Cc: Admin Subject: FW: STURGE Medical form x 4 8 EFTA_R1_00155625 EFTA01807387 Hi Clem =/p> Finally received the att=ched form is this what you are looking for qp> Best Regards Allan Wilson Wilson Yacht Management &nbs=; &=bsp; &nbs=; &nb=p; =nbsp; &nb=p; UK Office Tel: Fax: E Fax Gsm: USA Office = &n=sp; Tel: E fax USA Cell Email: Web: www.wilsonyachtmanagement=com <http://www.wilsonyachtmanagement.com/> UK Office Hessle I East Yorksh=re I HU13 OAH USA Office Fort Lauderdale I Florida 3331=o:p> <https://twitter.com/wymnews> <https://www=facebook.com/wilson.yachtmanagement> <https://www.linkedin.com/pub/allan-w=lson/39/67/794> <=o:p> 9 EFTA_R1_00155626 EFTA01807388 Copyright © Wilson Yacht Management=/span> CONFIDENTIALITY NOTICE: This email (includi=g all attachments) is for the intended recipient only and may contain conf=dential information, some of which my be privileged. Please be advised that any disclosure, copying, distribution or use of any=part of the information contained is prohibited. If you received this emai= in error, please destroy the original email and its attachment and notify=me immediately. Thank you qp> From: =ave Johnson Sent: 20 Decem • To: Allan Wilson Cc: Myla Baker US Subject: STURGE Medical form x 4 Hi Allan, Please find attached the completed STURGE Claim form= (total 4 pages) as signed by Myla & Capt. James 4th September 2016 10 EFTA_R1_00155627 EFTA01807389