Changes in the terms and conditions 2024

From 2024, all insured persons will have the same assistance centre, the OOM Assistance Centre. If you need help from the Assistance Centre, you can call: +31 (0)70 35 32 135.

Our Assistance Centre has extensive experience with hospitals abroad. They can help you find a good hospital in your area. If you need to be admitted into hospital, always contact our Assistance Centre beforehand. If you know you need treatment from a specialist, the Assistance Centre is also there to help you.

From 1 January, you can contact the ANWB Assistance Centre for assistance with unforeseen expenses under your travel insurance. For example, booking a flight if you unexpectedly have to return to the Netherlands due to the death of a family member. For assistance from the ANWB Assistance Centre, please call: +31 (0)70 353 21 40.

When applying for your insurance, you can specify that you need to keep your Dutch national health insurance. This will mean you receive a 15% discount on your premium with OOM. You receive this discount because we can in some cases reclaim part of your medical expenses from your health insurer (recourse). The section that applies to this has been changed in the special terms and conditions: 

Current text
We are able to verify whether you are actually insured with the basic health insurance scheme. If this is not the case, we will charge you the full premium from such time as you were no longer entitled to basic health insurance.

From 1 January 2024
If you do not have Dutch national health insurance, we will charge you the full premium from the moment you were no longer entitled to basic health insurance.

The following section has been added to the terms and conditions: 
There are national and international general rules and sanction rules that may prohibit us from selling insurance to you. We are not permitted to sell you insurance if it is apparent that it is prohibited to provide a financial service under the terms of the sanctions legislation or regulations.

If, after start of the insurance, it is apparent that you, an insured person, an insured item or another interested party is directly or indirectly involved in acts, transactions or events that violate a sanctions law. Or, if it appears that you or another interested party is included on a national or international sanctions list. If this is the case, then:

• we will not reimburse any claim, or we will temporarily or permanently suspend cover;
• the general or financial interests of a person, company, government or other entity will be excluded from the insurance.

The text on fraud has been changed in the terms and conditions. Here is an overview of the changes:

Current text
By fraud we mean someone deliberately providing incorrect or incomplete information in order to obtain an advantage to which they are not entitled. For example, insurance cover, compensation or a reimbursement. Fraud can be damaging to OOM’s interests. If we identify fraud, we will notify you by letter, except where this would be contrary to the interests of investigation and prosecution.

In this situation we may:

• refuse an application for insurance, or terminate insurance that has already been taken out;
• change the insurance;
• refuse to reimburse a claim (in full or in part) or demand repayment of amounts that have already been reimbursed;
• take civil legal action, such as a claim for liability;
• demand repayment of investigation costs;
• issue a warning;
• report the matter, for example to the police;
• register the incident on the internal and external fraud registers. In doing so, we are adhering to the ‘Financial Institutions Incident Warning System’ protocol.
  
  

From 1 January 2024
Fraud occurs when someone intentionally provides incorrect or incomplete information in order to obtain an advantage to which they not entitled. This is the case, for example, when someone tries to obtain insurance cover, compensation or payment, based on an incorrect representation of the facts. Examples of fraud include:

• you do not provide all the information when applying for insurance, in order to still get insurance or avoid additional terms and conditions under the insurance. This also puts you in breach of the obligation to disclose (see also Article 10).
• you report an amount higher than the actual damage.
• you intentionally fail to comply with the obligation to limit damage.
• you falsify an invoice.
• you stage a burglary.
  
  

In cases of fraud, we may take actions including, but not limited to, the following:

• report the matter to the police;
• refuse an application for insurance, or change or terminate a current insurance with immediate effect;
• recover any wrongfully made payments and investigation costs, or not pay the claim;
• register the incident in internal and/or external fraud registers; In doing this, we are adhering to the ‘Financial Institutions Incident Warning System’ protocol;
• issue a warning;
• report the file to the Centre for Combating Insurance Crimes (CBV) operated by the Dutch Association of Insurers. The CBV records the report and, where there are similarities between incidents, informs the insurers concerned, who are then able to contact one another. Insurers can consult the CBV register when considering job applications or making personnel appointments and when carrying out integrity assessments of business contacts. The CBV also warns insurers about general and specific types of activities. To inspect the register, you can write to the CBV at P.O. Box 93450, 2509 AL The Hague, the Netherlands. You should provide a copy of a valid identification document.

Conditions OOM Living Abroad Insurance:

• Gen. terms and conditions OOM Living Abroad Insurance (pdf)
• Spec. terms and conditions for OOM Living Abroad Insurance (pdf)
  
  

Conditions OOM Temporary Residence Abroad Insurance:

• Gen. terms and conditions OOM Temporary Residence Abroad Insurance (pdf)
• Spec. terms and conditions for OOM Temporary Residence Abroad Insurance (pdf)

From 2024, all insured persons will have the same assistance centre, the OOM Assistance Centre. If you need help from the Assistance Centre, you can call: +31 (0)70 35 32 135.

Our Assistance Centre has extensive experience with hospitals abroad. They can help you find a good hospital in your area. If you need to be admitted into hospital, always contact our Assistance Centre beforehand. If you know you need treatment from a specialist, the Assistance Centre is also there to help you.

From 1 January, you can contact the ANWB Assistance Centre for assistance with unforeseen expenses under your travel insurance. For example, booking a flight if you unexpectedly have to return to the Netherlands due to the death of a family member. For assistance from the ANWB Assistance Centre, please call: +31 (0)70 353 21 40.

The following has been added to Article 5 of the general terms and conditions:

Sanction rules

There are national and international general rules and sanction rules that may prohibit us from selling insurance to you. We are not permitted to sell you insurance if it is apparent that it is prohibited to provide a financial service under the terms of the sanctions legislation or regulations.

If, after start of the insurance, it is apparent that you, an insured person, an insured item or another interested party is directly or indirectly involved in acts, transactions or events that violate a sanctions law. Or, if it appears that you or another interested party is included on a national or international sanctions list. If this is the case, then:

• we will not reimburse any claim, or we will temporarily or permanently suspend cover;
• the general or financial interests of a person, company, government or other entity will be excluded from the insurance.

The text on fraud has been changed in the terms and conditions. Here is an overview of the changes:

Current text

What action do we take if we discover misleading information or fraud?

We define fraud as when ‘deliberate deception under false pretence is used to attain (or attempt to attain) an achievement, payment or insurance cover for which there is no right’. The misleading information harms OOM's interests. When taking out insurance or claiming a loss, there are different types of insurance fraud and misleading information that can occur.
For example:

• You do not provide all the information when applying for insurance in order to still get insurance or avoid additional terms and conditions on the insurance. This also puts you in breach of the obligation to disclose (see also Article 7).
• You are not telling the truth by telling a different story.
• You report an amount higher than the actual damage.
• You intentionally fail to comply with the obligation to limit damage.
• You falsify an invoice.
• You stage a burglary.

This is why we accurately record every claim. If we think that something is not right, we will investigate it. Avoiding any misunderstandings.

Measures

If we detect fraud, there are a number of actions we may take. Including:

• Not or only partially reimbursing your claim. If this was intentionally done to deceive us, your will not be entitled to reimbursement of the costs.
• Recover claims we have reimbursed.
• Invoice any additional expenses incurred.
• Rejecting the application and/or terminate the current policy. We will then terminate the insurance contract without period of notice on a date of our choosing. In the case of fraud, the current premium will not be reduced.
• All running insurance policies with all OOM companies will be terminated.
• The person committing fraud will be registered on internal or external warning lists of insurance companies in the Netherlands. You can read more about this in Article 8.
• The matter will be reported to the police.
  
  

Fraud control at OOM

Fraud and misleading information damage the trust relationship. You – as a trusted customer – are also paying into the fraudulent behaviour of others. This is why we want to prevent and control the negative effects of fraud and misleading information as much as possible. To find out more about how we deal with fraud, you can request our brochure on your rights and obligations by phoning + 31 (0)70 353 21 00 or by sending an email to: info@oomverzekeringen.nl. You can also download this brochure from our website www.oominsurance.com.

From 1 January 2024

What action do we take if we discover fraud?

Fraud occurs when someone intentionally provides incorrect or incomplete information in order to obtain an advantage to which they not entitled. This is the case, for example, when someone tries to obtain insurance cover, compensation or payment, based on an incorrect representation of the facts. Examples of fraud include:

• you do not provide all the information when applying for insurance, in order to still get insurance or avoid additional terms and conditions under the insurance. This also puts you in breach of the obligation to disclose (see also Article 10).
• you report an amount higher than the actual damage.
• you intentionally fail to comply with the obligation to limit damage.
• you falsify an invoice.
• you stage a burglary.

In cases of fraud, we may take actions including, but not limited to, the following:

• report the matter to the police;
• refuse an application for insurance, or change or terminate a current insurance with immediate effect;
• recover any wrongfully made payments and investigation costs, or not pay the claim;
• register the incident in internal and/or external fraud registers; In doing this, we are adhering to the ‘Financial Institutions Incident Warning System’ protocol;
• issue a warning;
• report the file to the Centre for Combating Insurance Crimes (CBV) operated by the Dutch Association of Insurers. The CBV records the report and, where there are similarities between incidents, informs the insurers concerned, who are then able to contact one another. Insurers can consult the CBV register when considering job applications or making personnel appointments and when carrying out integrity assessments of business contacts. The CBV also warns insurers about general and specific types of activities. To inspect the register, you can write to the CBV at P.O. Box 93450, 2509 AL The Hague, the Netherlands. You should provide a copy of a valid identification document.

To find out more about how we deal with fraud, please read our brochure on your rights and obligations, which is available on our website https://www.oominsurance.com/fraud-policy/.

Conditions OOM Studying Abroad Insurance:

• Policy terms and conditions OOM Studying Abroad Insurance (pdf)

Conditions OOM Studying in the Netherlands Insurance:

• Policy terms and conditions OOM Studying in the Netherlands Insurance (pdf)

From 2024, all insured persons will have the same assistance centre, the OOM Assistance Centre. If you need help from the Assistance Centre, you can call: +31 (0)70 35 32 135.

Our Assistance Centre has extensive experience with hospitals abroad. They can help you find a good hospital in your area. If you need to be admitted into hospital, always contact our Assistance Centre beforehand. If you know you need treatment from a specialist, the Assistance Centre is also there to help you.

From 1 January, you can contact the ANWB Assistance Centre for assistance with unforeseen expenses under your travel insurance. For example, booking a flight if you unexpectedly have to return to the Netherlands due to the death of a family member. For assistance from the ANWB Assistance Centre, please call: +31 (0)70 353 21 40.

When applying for your insurance, you can specify that you need to keep your Dutch national health insurance. This will mean you receive a 15% discount on your premium with OOM. You receive this discount because we can in some cases reclaim part of your medical expenses from your health insurer (recourse). The section that applies to this has been changed in the special terms and conditions: 

Current text
We are able to verify whether you are actually insured with the basic health insurance scheme. If this is not the case, we will charge you the full premium from such time as you were no longer entitled to basic health insurance.

From 1 January 2024
If you do not have Dutch national health insurance, we will charge you the full premium from the moment you were no longer entitled to basic health insurance.

The following section has been added to the terms and conditions: 
There are national and international general rules and sanction rules that may prohibit us from selling insurance to you. We are not permitted to sell you insurance if it is apparent that it is prohibited to provide a financial service under the terms of the sanctions legislation or regulations.

If, after start of the insurance, it is apparent that you, an insured person, an insured item or another interested party is directly or indirectly involved in acts, transactions or events that violate a sanctions law. Or, if it appears that you or another interested party is included on a national or international sanctions list. If this is the case, then:

• we will not reimburse any claim, or we will temporarily or permanently suspend cover;
• the general or financial interests of a person, company, government or other entity will be excluded from the insurance.

The text on fraud has been changed in the terms and conditions. Here is an overview of the changes:

Current text
By fraud we mean someone deliberately providing incorrect or incomplete information in order to obtain an advantage to which they are not entitled. For example, insurance cover, compensation or a reimbursement. Fraud can be damaging to OOM’s interests. If we identify fraud, we will notify you by letter, except where this would be contrary to the interests of investigation and prosecution.

In this situation we may:

• refuse an application for insurance, or terminate insurance that has already been taken out;
• change the insurance;
• refuse to reimburse a claim (in full or in part) or demand repayment of amounts that have already been reimbursed;
• take civil legal action, such as a claim for liability;
• demand repayment of investigation costs;
• issue a warning;
• report the matter, for example to the police;
• register the incident on the internal and external fraud registers. In doing so, we are adhering to the ‘Financial Institutions Incident Warning System’ protocol.
  
  

From 1 January 2024
Fraud occurs when someone intentionally provides incorrect or incomplete information in order to obtain an advantage to which they not entitled. This is the case, for example, when someone tries to obtain insurance cover, compensation or payment, based on an incorrect representation of the facts. Examples of fraud include:

• you do not provide all the information when applying for insurance, in order to still get insurance or avoid additional terms and conditions under the insurance. This also puts you in breach of the obligation to disclose (see also Article 10).
• you report an amount higher than the actual damage.
• you intentionally fail to comply with the obligation to limit damage.
• you falsify an invoice.
• you stage a burglary.
  
  

In cases of fraud, we may take actions including, but not limited to, the following:

• report the matter to the police;
• refuse an application for insurance, or change or terminate a current insurance with immediate effect;
• recover any wrongfully made payments and investigation costs, or not pay the claim;
• register the incident in internal and/or external fraud registers; In doing this, we are adhering to the ‘Financial Institutions Incident Warning System’ protocol;
• issue a warning;
• report the file to the Centre for Combating Insurance Crimes (CBV) operated by the Dutch Association of Insurers. The CBV records the report and, where there are similarities between incidents, informs the insurers concerned, who are then able to contact one another. Insurers can consult the CBV register when considering job applications or making personnel appointments and when carrying out integrity assessments of business contacts. The CBV also warns insurers about general and specific types of activities. To inspect the register, you can write to the CBV at P.O. Box 93450, 2509 AL The Hague, the Netherlands. You should provide a copy of a valid identification document.

Conditions OOM International insurance:

• Policy terms and conditions OOM International insurance (pdf)