Case File
efta-01807380DOJ Data Set 10OtherEFTA01807380
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01807380
Pages
10
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
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
=
Tel:
&n=sp;
1
EFTA_R1_00155618
EFTA01807380
E fax
USA Cell
Email:
Web: www.wilsonyachtmanagement.com <http://www.wilsonyachtmanagement.com/>
UK Office I
Lauderdale I Florida 3331=o:p>
Hessle I East Yorksh=re I HU13 0AH USA Office I
I Fort
<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
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>
Fort
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
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EFTA01807389
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View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
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http://www.sturgeyachts.comURL
http://www.wilsonyachtmanagement.comURL
http://www.wilsonyachtmanagement.com/signatures/assets/facebook.pngURL
https://twitter.com/wymnewsURL
https://www.fa=ebook.com/wilson.yachtmanagementURL
https://www.linkedin.com/pub/allan-w=lson/39/67/794URL
https://www.linkedin.com/pub/allan-wilson=39/67/794URL
https://www=facebook.com/wilson.yachtmanagementWire Ref
referenceRelated Documents (6)
DOJ Data Set 10CorrespondenceUnknown
EFTA Document EFTA01784062
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DOJ Data Set 10CorrespondenceUnknown
EFTA Document EFTA01808973
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DOJ Data Set 9OtherUnknown
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DOJ Data Set 10OtherUnknown
EFTA01808750
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DOJ Data Set 10CorrespondenceUnknown
EFTA Document EFTA01758189
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EFTA Document EFTA01785893
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