Non-Disclosure Warning
Please note that you are under duty to disclose all facts likely to influence the acceptance of your proposal.
Please ensure that you and any Other person/s whom You propose to insure (hereinafter ‘Others’):
- are Maltese Residents;
- are traveling for holiday or business purposes;
- are taking a round trip starting and ending in Malta ;
- are not taking out this travel insurance for more than 6 months in any one year;
- have not reached the age of 81 by the end of the travel period;
- have never been arrested, have pending prosecutions or have been convicted of any offence;
- have not received advice, medication or treatment for any medical condition in the last 12 months;
- are not aware of any reason why a planned trip will be cancelled or cut short e.g. illness of a close relative, close business associate or someone else upon whose health your trip depends;
- have not started or are already on the trip to be insured;
- have not had any previous travel claims.
If you or any Insured Person are unable to conform to the criteria above, or wish to amend the policy, or are in doubt please contact Atlas Insurance PCC Limited (hereinafter ‘Atlas’) on 23 43 53 81. Failure to do so may prejudice the settlement of any claim or invalidate your policy.
Declaration
I hereby warrant that I have presented this Declaration and the leaflet ‘Information for Policyholders’ to ‘Others’ and have obtained their necessary explicit verbal consent.
I confirm that I have read or have had read to me the contents of the completed on-line form and agree that the above statements are, to the best of my knowledge and belief, correct and complete and will form the basis of the contract between me and Atlas.
Data Protection Statement
Atlas is the controller of personal data held about me and Others, under the terms of the Data Protection Act (hereinafter the “Act”). I consent (on my behalf and on behalf of any other person/s specified in this form (Others) to:
a) the processing of any information by Atlas and/or by any other subsidiary companies of Atlas or Atlas Holdings Limited (hereinafter the “Group”) which constitutes personal data in terms of the Act, insofar as such processing relates to (but not limited to) underwriting and administration of the insurance proposal and policy, handling and settling of claims, detecting and prevention of fraud and the keeping of statistics;
b) the disclosure by the Group of personal data held by them to other insurers or to persons acting on their behalf and/or instructions, including (but not limited to) the Malta Insurance Association, insurance intermediaries, credit reference agencies, the Malta Insurance Fraud Platform and other appointed experts, together with the Commissioner of Police and any public or private hospital or clinic, other healthcare provider of any kind or any person, body or authority authorised by law to receive personal data;
c) the abovementioned third parties, and other third parties legally entitled to communicate such data, disclosing relevant personal data to the Group and processing such data as described in paragraph (a) above;
d) the Group informing me and Others of their products and services by any means. me understand and have explained to others that me or Others may inform Us in writing if me or Others do not wish to receive such information;
e) the recording of telephone calls for training, security and quality control purposes.
I also confirm that I understand (and have explained to Others) that I have the right to submit a written and signed request for access to or rectification of data held by the Group and that I and Others are aware that the full details of Atlas’ Data Protection Policy, updated from time to time, may be found on
https://www.atlas.com.mt/Legal/Data_Protection.aspx