ESIS, Inc. (“we”, “us”, “our”), a subsidiary of Chubb Limited, with its registered office at 436 Walnut Street, Philadelphia, PA 19106, United States of America, administers the AVAT No Fault Compensation Scheme (the “Program”), in accordance with the terms of the Protocol for AVAT No Fault Compensation Scheme (the “Protocol”).
Who Does This Policy Apply To?
- Where the Patient is a child, we will be relying on consent given by the Patient’s duly authorized representative, as per Sections 10 and 11 of the Application Form.
If you have any questions, please do not hesitate to contact us by email at [email protected], or by regular mail to one of the Program’s Regional Centers. We will be happy to answer them.
You can also contact us by calling the Program’s Global Telephone Hotline or any of the direct telephone numbers for the Program’s Regional Centers, available under the “Contact Us” page of the Program’s website at avatclaims.com.
Why Do We Collect and Use Your Personal Data?
- The information collected through the submission of your Application enables us to administer and manage the Program, which includes the following activities:
- Reception and registration of Applications for compensation under the Program.
- Verification of your identity, including conducting sanctions checks.
- Distribution and acknowledgement of receipt and registration of Application Forms, including the Supporting Evidence Form.
- Review of Applications, including the Application Form and the Supporting Evidence Form.
- Assessment of Receivable Claims.
- Approval or denial, as the case may be, of payment for compensation.
- Processing of appeals or other proceedings arising from or in connection with the Application for compensation under the Program.
- Response to questions and provision of information.
- For any purpose required by applicable laws.
- Except as set out in Section 4.3, our processing of Personal Data for the purposes of administration of the Program is based on the consent you or your authorized representative provide when making the Application. You can withdraw your consent at any time but please note that such withdrawal:
- Does not call into question the lawfulness of any processing carried out prior to such withdrawal and based on your consent.
- May result in you no longer being able to benefit from the Program.
- To the extent permitted or required by applicable law, we may need to base our processing of Personal Data on alternative grounds to consent in the event that consent is not the appropriate legal basis, such as establishing or defending legal claims, enforcing the terms of the Protocol, or complying with legal requirements.
How Do We Obtain Your Personal Data?
- In most cases, we will collect your Personal Data when you (or your authorized representative) submit an Application for compensation. The Supporting Evidence Form will be completed by one or more Registered Healthcare Professionals, and we may need to seek additional information from such Registered Healthcare Professionals. Unless expressly indicated, the provision of all Personal Data in connection with the Application or appeals under the Program is necessary in order to consider your Application under the Program.
- We may also use third party databases to obtain additional Personal Data about you where this is relevant to assessing your claim. In particular, we carry out sanction screening by using a third party database to check your identity against published sanctions lists. We may also run checks designed to identify potentially fraudulent claims by using third party fraud databases.
What Types of Personal Data Do We Collect?
- We collect various categories of Personal Data about the Patient, as listed on the Application Form. This includes basic identity and contact information, as well as national identifiers. It also includes detailed information about the Patient’s history with the Vaccine and the injury which they are claiming to have suffered.
- As set out on the Application Form, we also need contact and identity information about any representative authorized to represent a Patient (if applicable), as well as the identity of and professional information about any Registered Healthcare Professionals submitting information in or with a Supporting Evidence Form.
- As part of verifying your identity, we will conduct appropriate checks, including sanction screening against lists published by government, regional or other bodies. Those checks may reveal additional data if you are included on a relevant list. After receiving the Application Form, we may need to request supplementary medical information from you or from Registered Healthcare Professionals that have completed the Supporting Evidence Form and/or have treated you, in order to fully analyze your Application. Finally, if we decide to make a payment for compensation under the Program, we may need to request further information (such as bank account information) in order to process that payment.
Who Do We Disclose Your Personal Data To?
These service providers include (but may not be limited to):
- Crawford & Company International Inc., who will facilitate:
- on-the-ground assistance in administrating the Program;
- assessment of Receivable Claims;
- payment of claims if awarded and securing release of the funds;
- issuance of compensation denial letters; and
- further claims adjusting activities for the Program.
- NAVEX Global, who help us to provide a global telephone hotline
- Soteria, who help to host the website avatclaims.com and Soteria’s sub-processors who will provide translation services of the Applications into English of an Applicant’s answers to the Application Form, but only where (a) the Applicant completes and submits the Application directly on the Program’s website, and (b) the Applicant’s answers to the online Application Form are provided in French or Portuguese.
- We may also share your Personal Data with third parties other than our service providers, such as:
- AVAT, who instruct us to administer the Program.
- The members of the Review Panel, the members of the Appeals Panel and/or any other persons representing and/or advising any of them.
- Members of the Chubb group of companies, of which ESIS forms part, strictly to the extent necessary for the purposes listed in Section 4.1.
- If applicable, any companies reinsuring risk under the Program.
- Any local health services, government agencies and intergovernmental organizations as may be required from time to time for the purposes of the risk profiling of vaccines or public health measures or interventions or any other reasonably proportionate activity which may from time to time be required in connection with the Application or any appeals or other proceedings arising from or relating thereto, or by applicable law.
- Any law enforcement or governmental organizations as may be required from time to time for the purposes of detecting, preventing or prosecuting criminal activity.
- Courts, other governmental organizations, legal advisers or other parties to a dispute where necessary to enforce the Protocol or to otherwise establish, exercise or defend our legal rights.
- Any third party insurance company to whom administration of the Program is transferred.
Where Will Your Personal Data Be Processed?
- The service providers listed in Section 7 above are based in the United States of America and the United Kingdom. Our contracts with these service providers impose obligations on them to protect your Personal Data to the same standard regardless of where it is processed, and also impose any specific safeguards required by data protection laws (such as the EU Commission’s or the UK data protection authority’s standard contractual clauses or equivalent). You should be aware that, although we impose contractual obligations that require your Personal Data to be protected to the same standard wherever it is processed, data protection laws in countries where your Personal Data may be processed may not be equivalent to those in your home jurisdiction. The transfer of your Personal Data to these countries is necessary in order for us to assess your Application under the Program.
- Where required by applicable laws, we will put in place additional safeguards to protect your Personal Data as it is transferred internationally. You may have the right to see a copy of these safeguards by contacting us using the information set out in Section 3 above.
How Do We Secure Your Personal Data?
- We attach great importance to the security of your Personal Data and we undertake to use commercially reasonable means to prevent any exposure or disclosure of your Personal Data. In particular, we implement and maintain appropriate measures (including administrative, physical, technical and organizational measures) to deal with unauthorized disclosure or exposure of your Personal Data.
Your Rights With Regards to Your Personal Data
- You may have certain rights in respect of your Personal Data such as access to your Personal Data, as set out in Section 10.2 below, depending on applicable law. You can exercise these rights by submitting a request as explained in Section 3 above. If you contact us, we will handle your request in accordance with any applicable laws. In any case where we do not have a legal requirement to address your request, we will still endeavor to honor your request but this will be on a reasonable and voluntary basis.
- You may have in particular the following rights in respect of your Personal Data, depending on applicable law:
- Right to access, update and delete your Personal Data.
- Right of rectification if your Persona Data is inaccurate or incomplete.
- Right to object to the processing of your Personal Data.
- Right to limit the processing of your Personal Data.
- Right to portability of your Personal Data, i.e. the right obtain a copy of your Personal Data in a structured, commonly used and machine-readable format.
- Right to withdraw your consent at any time when the processing of your Personal Data is based on consent.
- Right to complain to any competent data protection authority about the collection and use of your Personal Data, it being specified that we ask that you attempt to address any complaints with us in the first instance.
- We may ask you to prove your identity before responding to a request based on the above rights or otherwise related to your Personal Data. We may also rely on certain exemptions from the above rights, but will explain to you where we have done so. If your request is manifestly unfounded or excessive, we may refuse to comply with it, or we may charge you a reasonable fee for complying with it.
Retention of Your Personal Data
- We will retain your personal data for as long as is reasonably necessary for the purposes listed in Section 4 of this Policy. In some circumstances we may retain your Personal Data for longer periods of time, for instance where we are required to do so in accordance with legal, regulator, tax or accounting requirements.
- In specific circumstances we may also retain your Personal Data for longer periods of time so that we have an accurate record of your dealings with us in the event of any complaints or challenges, or if we reasonably believe there is a prospect of litigation relating to your Personal Data or dealings.
- We maintain a data retention policy which we apply to records in our care. Where your personal data is no longer required we will ensure it is either securely deleted or stored in a way which means it will no longer be used by the business.
- We reserve the right to store data in an anonymized form after deletion of your Personal Data.
Role of AVAT
AVAT NFCS Trust (“AVAT”), with its offices at 7th Floor, Happy World House, 37 Sir William Newton Street, Port-Louis 11328, Mauritius, is responsible for certain obligations in connection with the AVAT No Fault Compensation Scheme (the “Program”) (for example the payment of claims under the Program). AVAT also instructs ESIS, Inc. (“ESIS”), a claims administration company, to administer the Program.
Role of ESIS
ESIS (ESIS, Inc.) administers the Program. Under the Program, ESIS needs to collect certain personal data about the patient, their authorized representative (if applicable), and any healthcare professional providing supporting evidence. The personal data ESIS collects is set out in the Application Form and Supporting Evidence Form, and may also be supplemented by additional information collected from healthcare professionals who have treated the patient, as well as third party sanctions and anti-fraud databases.
ESIS uses the personal data it collects in order to consider whether a claim is eligible for payment under the Program, to communicate with the patient or their representative, and to process any payment made on a claim (if eligible). Where necessary, the personal data may be shared with third parties including ESIS’s service providers, reinsurers, and government health and law enforcement agencies.
Version: September 2021
A pan-African and pan-Caribbean no fault compensation program established by the AVAT NFCS Trust and administered by the Administrator with the aim of providing compensation to Patients who suffer an Injury (the most likely cause of such Injury (based on the balance of probabilities) being the result of a Vaccine or its administration, without the need for the Patient to demonstrate a defect in the relevant Vaccine or any fault by any person.
The AVAT No Fault Compensation Scheme, as detailed in the Protocol and its Schedules.
Any data that contains one or more identifiers from which the identity of the person can be determined or accessed directly or indirectly such as (but not limited to) their full name, national identification number, social insurance or social security number, passport number, driver’s license, or other government-issued identification number, credit card, debit card or financial account information, date of birth, mother’s maiden name, medical information or health insurance information, biometric records, digital signature files, account login information (such as a combination of user ID or email address when combined with password or other information that would give access to an account), and any other data that is protected by Privacy Laws.
A written claim for compensation completed by an Applicant on the application form approved by and provided by the Administrator, as set forth in Schedule 2 to the Program's Protocol, which must be accompanied by all Supporting Evidence, using the prescribed form in Schedule 3 to the Program’s Protocol.
A resident, a citizen or person within the population of a Participating Member State who claims or in respect of whom it is claimed that he or she has suffered or sustained a Serious Adverse Event which is associated with a Vaccine or its administration, and which, in turn, has resulted in an Injury.
Any healthcare professional, including physicians, surgeons, nurses, midwives, nurse practitioners, physicians’ assistants, psychiatrists, psychiatrists, physical therapists, occupational therapists, dentists, and pharmacists, who is duly licensed or legally authorized to practice the profession in the Participating Member State in which the Patient resides and received the Vaccine, or in the case of birth defects, where the Patient’s mother resides and received the Vaccine.
The supporting evidence, using the form in Schedule 3 to the Program's Protocol, required to evaluate an Application and that shall include:
- detailed medical documentation from a Registered Health Professional describing the Injury and medical treatment required as a result of the Injury, together with details of any Hospitalization or prolonged Hospitalization, including but not limited to admission and discharge records;
- a description of the nature, extent, functional impact and prognosis of the Injury, as assessed by the Registered Health Professional.
- a statement from the Registered Health Professional that the Injury was, in the Registered Health Professional’s opinion, the result of the Vaccine or its administration;
- certification from a Registered Health Professional of when, where and which Vaccine was administered;
- in the case of death, a death certificate and any other documentation available from a Registered Health Professional of the cause and manner of death; and
- any further evidence that the Administrator may deem necessary to adjudicate the Application, and/or Receivable Claim, as applicable, guided, as appropriate, by the Scientific Advisory Committee, the Review Panel, and/or the Appeals Panel.
Either (as the context requires):
- The Patient who directly submits an Application for compensation under the Program for himself; or
- In the event the Patient has died, is a child, or is disabled or otherwise lacks the legal capacity to submit an Application for himself, then the Applicant must be a person who is a duly authorized legal heir (in the case of death), parent, legal guardian, or other legal representative of the Patient.
Any duly completed Application for compensation (i) that is accompanied by all Supporting Evidence, (ii) that is filed/submitted by an Applicant prior to the end of the Reporting Period with the Administrator, and (iii) that is found by the Administrator, and/or by the Administrator’s Vice President of Risk Consulting to be receivable as provided in Section 4 or Section 7 of the Program's Protocol.
A COVID-19 vaccine received in any Participating Member State through the AVAT Framework that:
- either (A) has licensure or authorization from a stringent (“functional”) regulatory authority or (B) has received WHO prequalification, following licensure or authorization from a stringent (“functional”) regulatory authority, or (C) has been issued authorization for emergency use based on licensure or authorization by a stringent (“functional”) regulatory authority; and
- is included in Schedule 1 to the Program's Protocol, as updated from time to time; and
- has received all required approvals and authorizations for importation, distribution, and use in the relevant Participating Member State; and
- has not reached its Scope of Coverage Endpoint.
The African Vaccine Acquisition Trust of 7th Floor, Happy World House, 37 Sir William Newton Street, Port-Louis 11328, Mauritius, a centralised negotiating, purchasing, and payment agent incorporated on behalf of the AU Member States and CARICOM Member States for the purchase of COVID-19 vaccines pursuant to the AVAT Framework.
A panel appointed by the Administrator comprised of 5 duly licensed nurses, selected from a roster of 11 such nurses, who will review all Receivable Claims submitted by Claimants and determine – in accordance with the terms of the Program’s Protocol – whether Payment for compensation should be approved or denied.
A three-member panel that:
- Is comprised of 2 duly licensed physicians and 1 duly licensed nurse, who shall be appointed by the Administrator from a roster of 6 such physicians and nurses and
- Will review all Notices of Appeal of Denied Receivable Claims filed by Claimants and determine – in accordance with the terms of the Program's Protocol — whether the Review Panel’s denial of the relevant Receivable Claim should be upheld or reversed.
The AVAT No Fault Compensation Scheme Trust of 7th Floor, Happy World House, 37 Sir William Newton Street, Port-Louis 11328, Mauritius, incorporated on behalf of the AU Member States and CARICOM Member States for the purposes of establishing and maintaining in place the AVAT No Fault Compensation Scheme.