Groupama osiguranje d.d. / Groupama osiguranje d.d. - Croatia Branch
Groupama
Groupama is a travel insurance for the Croatia market with online purchase and 24/7 assistance.
Direct payment
If the insured follows the SOS centre's instructions, they generally do not need to pay medical costs abroad themselves. Where costs up to EUR 1,000 were paid by the insured personally, the claim together with supporting medical documentation must be submitted to Groupama upon return to Croatia; if prior approval from the emergency service was not obtained and circumstances cannot later be clarified, care costs are reimbursed only up to a maximum of EUR 1,000.
Geographic scope
Worldwide cover is available, or a narrower Europe (geographic) and Mediterranean countries zone, as selected on the policy.
Cover applies for all countries listed on the policy, except the country where the insured has permanent residence or entitlement to public healthcare, and the country of the insured's own citizenship. Worldwide medical cover excludes Belarus, Crimea, Donetsk and Luhansk, the Kherson and Zaporizhzhia regions, Iran, North Korea, Russia, Venezuela, Myanmar, Afghanistan and Syria; private liability cover additionally excludes the USA, Canada, Australia and New Zealand. Basic medical cover does not apply to domestic (Croatia) trips; for foreign visitors, cover is arranged for the territory of Croatia, including excursions abroad that are part of a booked package tour.
Unique selling points
- A single package policy combines travel medical, accident, personal liability, baggage and trip-cancellation cover in one contract.
- Families travelling with at least one child under 18 receive a 25% discount on the premium.
- An annual policy option covers an unlimited number of trips abroad during the year, as long as no single trip exceeds 30 days.
- A 24/7 SOS assistance line answered in Croatian coordinates emergency care through regional coordinators wherever the insured travels.
- Search-and-rescue costs, including helicopter or aircraft rescue at inaccessible locations, are covered up to EUR 10,000.
Coverage limits
Medical expenses
Covered
No limit stated
The overall sum insured for necessary emergency medical treatment abroad (doctor visits, prescribed medicines, tests, hospitalization, surgery) is freely chosen by the policyholder depending on destination and needs; the T&Cs do not state a default/fixed amount.
Emergency medical treatment
Covered
No limit stated
An emergency exists when the insured's life or physical integrity is endangered, or irreparable harm could occur, including sudden illness (loss of consciousness, bleeding, acute illness) or accident requiring urgent medical assistance. The insurer always guarantees assistance in any situation of immediate danger to life, regardless of other exclusions.
Hospitalization
Covered
No limit stated
Covers inpatient treatment costs and choice of the medical facility best suited to the insured's condition. If hospitalization extends beyond the planned end of the trip by more than 7 days and an insured family member accompanies the patient, the insurer pays hotel room costs for the accompanying person up to EUR 100 per night, for a maximum of 7 nights.
Outpatient treatment
Covered
No limit stated
Covers ambulatory medical visits at the place where the insured falls ill, X-ray/scanner/laboratory diagnostics, prescribed medicines and necessary walking/medical aids that are part of treating fractures and injuries.
Emergency dental treatment
€250
Dental service solely to relieve acute toothache, excluding dentures, implants and similar replacements, for a maximum of 2 teeth, up to EUR 250 per tooth (i.e. up to EUR 500 total).
Medical transport
Covered
No limit stated
Covers transport costs by an officially approved emergency service to the nearest hospital or nearest available doctor, exceptionally including taxi transport, and transfer to a specialist clinic if medically indicated and prescribed by a doctor.
Medical evacuation / repatriation
50% of insured sum
If the insured's condition requires repatriation, the insurer organizes transport from the place of stay to the insured's home or to a hospital in the home country, chosen by the insurer's medical staff, with a medical escort if necessary. Total costs of this benefit are capped at 50% of the medical sum insured shown on the policy. If the insurer's doctors deem repatriation possible and the insured refuses, the insurer's services are suspended.
Repatriation of remains
50% of insured sum
In the event of the insured's death, the insurer organizes and covers transport of the body to the deceased's home, or covers funeral costs at the place of death, up to a limit of 50% of the medical sum insured on the policy (including coffin costs chosen with the heirs' consent).
Search and rescue costs
€10,000
Covers necessary and proven rescue costs (e.g. helicopter or aircraft rescue) incurred to save the insured's life at inaccessible locations or to provide necessary and urgent medical assistance, up to a limit of EUR 10,000.
COVID-19 treatment
Excluded
Costs caused by epidemics or pandemics, pollution, or natural disasters that were already known before departure are excluded from cover.
Pre-existing / chronic conditions
€2,500
Damages arising from chronic illnesses known or that should have been known at the time of concluding the insurance are generally excluded. However, if the insured has a chronic illness during the period of cover and needs urgent help due to an acute state or unexpected worsening, the insurer covers costs up to a maximum of EUR 2,500, provided the insured follows the prescribed medical instructions for that condition.
Winter sports cover
€350
Under the base T&Cs, accidents arising from amateur or professional sport (including skiing) are excluded unless clause GOPO 1/2023 (amateur sport) or GOPO 2/2023 (professional sport) has been specifically purchased and paid for, in which case medical/accident cover extends to such sport. Separately, under clause GOPO 4/2023 for recreational skiing, the insured's skis, when kept in a properly locked and closed space, are covered against fire and some other perils plus burglary/robbery up to EUR 350 — this is an equipment limit, not a medical limit.
Adventure/extreme sports cover
Excluded
Accidents arising from extreme sports, parachute jumps or similar, extreme mountaineering tours without an authorized mountain guide and those above 6,000 m altitude, expeditions and sporting activities in wild waters are fully excluded, with no clause available to buy this back.
Pregnancy complications
Conditional
Consequences of pregnancy or pregnancy complications are excluded, in particular elective termination, delivery and miscarriage. However, in the event of acute complications during pregnancy, the insurer covers the cost of the first medical intervention necessary to remove danger to the life of the mother and/or child.
Personal liability
Optional
No limit stated
Optional add-on cover within the travel package for the insured's non-contractual civil liability for death, bodily injury or damage/destruction of a third party's property, worldwide during the trip except the USA, Canada, New Zealand and Australia. The sum insured is chosen by the policyholder; a per-claim deductible of EUR 100 applies (EUR 135 for damage to glasses and portable electronic devices).
Legal assistance
No limit stated
Not mentioned as a separate benefit in the reviewed T&Cs or IPID for this product.
24/7 assistance line
Covered
A 24-hour SOS telephone line (in Croatian) must be called whenever the potential cost of an insured medical event exceeds EUR 1,000. The insured provides name, date of birth, policy number, country/city and phone number; the centre contacts a regional coordinator and arranges the necessary level of healthcare.
Key conditions
Assistance call deadline
The 24-hour SOS line must be called for any emergency medical case where the potential cost exceeds EUR 1,000. Otherwise, the insured must contact the insurer no later than 5 days after the insured event occurred, except in unforeseen circumstances or force majeure.
Unauthorized treatment
If prior approval of the emergency service was not obtained and the relevant circumstances cannot later be clarified, care costs are reimbursed only up to a maximum of EUR 1,000.
Purchase while abroad
The insurance contract can only be concluded before the trip begins; it is not possible to buy the policy after travel has already started.
Chronic conditions
Chronic illnesses and their known consequences are excluded, including conditions treated within the six months before the start of cover, except where medical help is needed to save the insured's life or relieve acute pain; acute worsening of a known chronic condition during the trip is covered up to EUR 2,500 if prescribed treatment is followed.
Pregnancy
Pregnancy-related costs (elective termination, delivery, miscarriage) are excluded; only the first medical intervention needed to eliminate danger to the life of the mother and/or child during acute pregnancy complications is covered.
Pre-existing condition exclusions
Illnesses or conditions that existed, were known, or should have been known at the time of concluding the insurance, and illnesses treated in the six months prior, are excluded from cover, except for life-saving or acute-pain-relief intervention.
Coverage duration limit
A single-trip policy can be taken out for 1 to 365 days, as stated on the policy. An annual travel policy covers an unlimited number of trips during the year, provided no individual trip exceeds 30 days.
Policy specifics
Trip cancellation coverage
Coverage for financial losses due to trip cancellation or change of plans
SourceMedical emergency assistance
24/7 emergency medical assistance and coordination of health services abroad
SourceMaximum entry age
Only individuals up to a maximum entry age of 75 years may be insured; mentally ill persons and persons fully deprived of legal capacity cannot be insured under this product.
SourceDeductibles (excess)
Per-claim deductibles apply on certain covers: EUR 100 for private liability claims (EUR 135 for glasses and portable electronic devices), and EUR 50 for damage to baggage carried by the insured.
SourceSports activities coverage distinction
Different coverage conditions for amateur sports vs. professional sports activities
SourcePre-existing condition exclusion
Coverage excludes illnesses or conditions diagnosed before the insurance contract begins
SourceSOS center claim notification requirement
Insured cases must be reported to 24-hour SOS center with specific information requirements
SourceImmediate notification requirement for trip cancellation
Travel agencies must be notified immediately about cancellation; insurance claim within 30 days
SourceSelf-paid medical expenses reimbursement limit
Medical expenses up to EUR 1,000 that the insured paid themselves can be claimed after return to Croatia
SourceNotification deadlines for trip cancellation
For trip cancellation claims, the travel agency (or accommodation/transport provider) must be notified within 3 working days of the reason for cancellation arising; the insurer must be notified in writing within 15 working days of that same reason arising; and the full claim with supporting documents must reach the insurer within 30 days of the trip's planned start date.
Source