Accident insurance e. Accident insurance: making the right choice. “Boxed” accident insurance policy

The main purpose of such insurance is to help overcome financial difficulties associated with partial or complete loss of ability to work. Companies engaged in this type of activity provide financial support to the client himself, as well as, if necessary, his immediate relatives.

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Types of insurance against illnesses and accidents

Insurance comes in two forms:

On personal initiative.
As part of a group expression of will.

In the first case, the Policyholder insures himself or another person on his own initiative, paying all premiums independently. And in the second, the organization pays the money and insures its employees. The contract may last a full day, or may be limited to the work schedule.

This type of relationship is resorted to by companies that are conscientiously socially responsible or organizations with an increased risk of injuries and dangers. The group nature of insurance provides powerful support to the employee in the event of an illness or accident, and allows the company to reduce the cost of payments.

It should be noted that collective rates are significantly lower than personal ones.

Insurance cases

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Receiving damage to health as a result of an accident - dislocations of joints, fractures of bones or bone apparatus, various types of wounds, burns, etc.
Poisoning with chemicals or plants (salmonellosis bacteria, dysentery and other types of toxic poisoning are not included).
Tick-borne encephalitis or polio infection.
Pregnancy outside the womb or childbirth of a pathological nature leading to loss of reproductive capacity in women.
Fatal outcome from the above listed insured events, as well as from suffocation due to the entry of a foreign body into the respiratory system, excessive cooling or due to the onset of anaphylactic shock.

From the list you can see that insurance companies have protected themselves as much as possible from fraudsters, but there are still people who moderately cause injuries or other damage to themselves in order to receive payments.

In order to bring such people to light, if necessary, the organization has every right to conduct its own investigation of the situation, after which a verdict on insurance payment is made. Those who were in any type of intoxication at the time of the insured event will not receive the amount.

For whom is this type of insurance mandatory?

There are 2 types of accident insurance:

Mandatory type.
Voluntary.

Who is subject to compulsory insurance:

military;
law enforcement and court officials;
emergency workers and many other high-risk categories;

Upon the occurrence of an insured event, payments can be one-time or monthly as a benefit due to temporary disability or to help pay for funds intended for the rehabilitation of the insured.

Funds are contributed from the Social Insurance Fund of the Russian Federation, and the tariff depends on the category of the victim, his regional location and is established by legislative acts of the Russian Federation. Payments are made in connection with the loss of ability to work, temporary or full, as well as due to the death of the victim.

Voluntary insurance implies an independent choice of an insurance company, the amount of insurance, the duration of the contract and a list of risks that the client wants to cover. The conclusion of an agreement is made on the basis of an application, and not in accordance with a legal requirement.

Insurance period and tariff schedule

Dates:

24-hour insurance.
For the period of the working day and the time spent on transfer from home to work and back.
Only for working hours.
For a specific period of time (for example, during a workout).

An insurance contract can be concluded for a period from one day to several years. For individual insurance, the most popular term is 1 year. In the Russian Federation, the practice of concluding this type of relationship for life is not yet sufficiently developed.

The period from which the insurance begins to be in force is indicated in the document; traditionally, this is the next day after payment of the premium - its amount ranges from 0.12 to 10% of the insurance amount.

The percentage depends on the list of risks. It is possible to include support in the list within 24 hours, anywhere on planet Earth, whether a person is at home, on a trip or in training.

In cases where an insured event occurs simultaneously in two categories, payments are made for each separately in full.

This is the first option for issuing a policy, but there is also a second, less expensive option - it is issued for a specific period and is most often initiated by companies seeking to reduce their financial liability to a minimum. Incidents that occur outside of the time limit or outside the insurance coverage area are not eligible for payment.

Tariff fee schedule

The amount insured is the main subject of the contract. The policyholder can determine it for himself individually, depending on his desires and means.

The tariff is set by the organization and it depends on the list of included risks - the more points, the larger the contribution. Usually it is no more than 10% of the insurance amount.

Factors influencing the amount of contribution:

Client's professional activity– the more risky the work, the higher the tariff.
Lifestyle and hobbies. For example, a person likes to travel to exotic countries or is interested in a dangerous extreme sporting activity, this also raises the ante.
Age category of citizen– the percentage is higher for the elderly and children.
Gender– in men after they reach 40 years of age, the risks increase.
Depending on the state of the client’s health. For people with serious illnesses, the percentage is higher.
History of insurance. It must be flawless. The more accurately the payment of deductions is made, the greater the likelihood of receiving a discount from the company; in addition, it looks at how much a person takes care of himself and does not get involved in risky activities.
Number of people willing to insure themselves– rates are lower for package offers.
Terms of cooperation– to its regular customers, upon expiration of the insurance period with subsequent repeated or extended conclusion of the contract. In such situations, organizations provide discounts as a percentage of the contribution amount.
List of risks specified in the document– the more, the higher the cost of the policy.
You can pay contributions using three schemes– one-time, annually, after a quarter or monthly.

Before concluding an agreement, you should carefully read the agreement, preferably in the presence of a legally competent person, and discuss all the nuances.

Registration of an insurance policy

It is best to contact a company that has been engaged in this activity for many years, which has an impressive base and a good reputation.

You can specify any amount not exceeding RUB 3,000,000. in currency - rubles, US dollars or the single European currency. Payments are made within 10 days from the date of delivery of the required package of documents in the event of an insured event.

You can draw up a contract by contacting the insurance company in person.

What to do for this:

Provide a document confirming your identity.
Write a statement to the insurance company.
If necessary, provide documents that characterize the occupation, health status and lifestyle of the client and the persons included in the contract.
Make a list of risks to be insured.
Determine the amount of insurance.
Calculate the insurance premium and its payment scheme.
Pay.

If a person is in a high-risk area, then the organization has the right to request additional documents, the same applies when the insurance amount is several million.

The client must also meet some requirements:

Be between 18 and 65 years of age.
Do not have serious illnesses.
Disability of groups I and II excludes the possibility of insurance.

We receive payments

To obtain insurance, the organization must provide the following documents:

Policy.
Passport or other identification document.
A completed application form for the occurrence of an insured event.
A reference base confirming the nature of the damage caused from the institution providing medical care or treating the victim.
Certificate of form N-1 in case of an incident at the workplace or another document confirming the circumstances of the situation.
A document from the authorized official body in case of an accident establishing the fact of the accident and its nuances. If, as a result, the victim acquired a disability group, then it is necessary to provide copies of the outpatient treatment card, the medical history and documents proving the relationship between the occurrence of the insured event and the assignment of disability.

In cases where the client died as a result of NS, the following documents must be brought:

Original or notarized copy of the death certificate.
Identity card of the heir - beneficiary.
An act containing information about the causes of death of the insured.
Certificate of right to inheritance certified by a notary office.

The investigation into the circumstances of the death may require the opinion of medical experts.

After submitting a package of documents, payments must be made within 10 days.

Pros and cons of insurance

Collective insurance

Positive sides:

The number of claims is reduced or they are paid by insurance.
Allows you to cover losses for an employee who is temporarily disabled or has completely lost this ability.
Covers part of the compensation in the event of the death of an employee (payments are made to the heir - the beneficiary).
Helps improve the quality of medical care.
Due to the improvement in the quality of health of employees, their productivity increases.
Adds prestige to the company.
Good tax benefits.
Financial responsibility is transferred to the insurance company.

Minuses:

It is difficult to select a specific category of persons to be insured. We have to insure everyone, which increases expenses.
Many people have superstitions about this type of insurance. Insurance is not relevant for single people in the event of their death - they have no interest in the beneficiaries.

Individual insurance

Advantages:

Providing financial assistance in difficult life situations.
Covering expenses spent on treatment or rehabilitation.
In case of temporary or permanent disability, regular payments are made. This allows you to adapt during the first difficult times.
Increasing the credit limit.
Financial compensation in the event of the death of the insured.

Minuses:

The need for regular contributions.
In controversial cases, it is necessary to collect documents confirming the occurrence of an insured event.
The investigation may take longer than expected.
High tariffs for children and elderly people.

Accident insurance provides for (full or partial) payment of the insured amount in connection with the occurrence of adverse events (or their consequences) related to the life and health of the policyholder or the insured. Accident insurance can be provided in:

individual and group(insurance against accidents at work) forms;
mandatory(passenger insurance, military insurance) and voluntary.

Accident- a sudden, unforeseen external impact on the human body, the consequence of which is temporary or permanent health disorder or death of the insured.

The consequence of any accident that causes harm to the health or life of a citizen will be a decrease (temporary or permanent) in income and (or) additional expenses arising in connection with the disability or death of the insured. And if the harm caused to health or life cannot be compensated, then the associated material losses are quite possible.

Property interests of citizens associated with such expenses, are subject to accident insurance. An accident can be considered injury, acute poisoning, etc. As a rule, harm to health as a result of an acute or chronic disease, as well as death resulting from suicide, is not an insured event.

Accident insurance is a set of types that provide for obligations for insurance payments in a fixed amount or in the amount of partial or full compensation for additional expenses of the insured person caused by the occurrence of an insured event.

Accident insurance is provided in a voluntary and mandatory manner. may be concluded in one’s own favor or in favor of a third party. The insured has the right to designate any person as the recipient of the insurance amount in the event of his death. In the contract, this person will be called the beneficiary. If the beneficiary is not specified in the contract, and the insured person has died, then in such a situation the recipients of the funds will be his heirs by law. Accident insurance can be carried out in a collective form (at the expense of the enterprise) and individually.

The insurance company may set a minimum and maximum age for the insured. There are usually separate insurance rules for children and the elderly, since they represent a high-risk group compared to the bulk of policyholders, since the likelihood of an insured event occurring here increases. Insurance of children against accidents differs in the nature of the insured events included in the terms of the contract.

An insurance contract can be concluded for any period or for the duration of a specific job, trip, etc.

When insuring against an accident, an insured event is recognized as such an external impact on the insured person that entails traumatic injury, injury, other harm to his health or death.

The following events that occurred during the validity period of the insurance contract are recognized as insured events for an individual type of insurance:

temporary loss of general working capacity by the insured person;
permanent loss of the insured person's general ability to work (disability);
death of the insured person resulting from an accident.

When insuring against an accident, damage to health as a result of an acute or chronic disease that may arise or become aggravated during the validity of the insurance contract is not considered as an insured event.

Events must be confirmed by documents issued by competent authorities (medical institutions, court, etc.), which must be submitted by the insured himself.

The insurance company does not make insurance payments in the following cases:

commission by the insured person of an intentional crime that led to the occurrence of the insured event;
commission by the beneficiary of an intentional crime aimed at and resulting in the occurrence of an insured event resulting in the death of the insured person;
the insured person driving a vehicle in a state of any type of intoxication or transferring control to a person who is intoxicated or a person who does not have the right to drive this vehicle;
intentional infliction of bodily harm by the insured person;
military actions, as well as maneuvers or other military events, civil war, civil unrest or strikes;
in case of a nuclear explosion, radiation or radioactive contamination.

If, as a result of an accident, a permanent loss of physical or mental abilities of the insured person or disability occurs, the latter has the right to receive insurance coverage in accordance with the insurance amount established for this risk. Insurance coverage in the event of a risk of disability depends on the degree of disability. If the accident results in temporary disability, the insured person is paid insurance coverage, usually in the form of a daily benefit for the entire period of treatment.

May vary depending on the age, profession, health status of the insured, as well as other factors influencing the degree of risk of an insured event.

Critical illness insurance

The concept of critical illness insurance (hereinafter referred to as CHI) was first proposed by cardiac surgeon Marius Barnard in South Africa in 1983. The market potential of CHI is closely related to the level of development of medical technologies: the more advanced the latter, the greater the likelihood of survival as a result of treatment of the disease. SKZ is an insurance product that is developing at the fastest pace all over the world, compared to other types of life insurance.

Coverage in its basic form is provided as a lump sum, which is paid in the event of the occurrence or diagnosis of one of a number of diseases or medical conditions listed in the policy. Critical illness insurance can act as an elective option to a life insurance policy to provide the policyholder with an additional amount or an advanced portion of the sum insured that is payable upon his death.

The cost of a VHC policy depends on factors such as age, gender, lifestyle, previous medical health conditions, insurance period and sum insured.

TO basic conditions Critical illness insurance includes:

providing the insured with a certain amount of money upon diagnosis of any disease listed in the policy. In this case, the insured must live at least 30 days from the date of diagnosis;
the insured disposes of the amount of money received at his own discretion;
basic coverage covers diseases such as heart attack, stroke, cancer;
additionally, the policy can include over 40 types of diseases;
in the event of the death of the policyholder, the paid premiums are returned;
a critical illness insurance policy can act as a separate insurance product, and any life insurance policies can be added to it as options;

the policy period varies from 5 years until the policyholder reaches 65 or 75;
the possibility of returning insurance premiums in the absence of claims for payment after 10 years or when the policyholder reaches 75 years of age.

TO basic exceptions The following formulations include:

participation in air flights as other than a passenger of a commercial licensed airline;
participation in criminal activity;
drug abuse. Alcohol or drug addiction (substance abuse) or drug use in cases other than as prescribed by a doctor licensed to practice medicine;
non-compliance with medical instructions. Unreasonable failure to comply with or comply with medical or medical orders;
dangerous sports or leisure activities (boxing, rock climbing, cave diving, horse riding, skiing, martial arts, yacht and motor boat racing, underwater diving, car testing, auto racing);
AIDS/HIV. Infection with the human immunodeficiency virus (HIV) or the occurrence of diseases caused by acquired immunodeficiency syndrome (AIDS);
long-term residence abroad;
deliberate self-harm;
war or civil unrest. War, invasion, hostilities (whether war has been declared or not), civil war, riot, revolution, or participation in insurrection or civil commotion.

VHC policies vary depending on the type of coverage (the list of diseases upon the occurrence of which payment is made) and combinations of risks. The simplest policy covers heart attacks, stroke, cancer (i.e. the most common critical illnesses). The second, more complex type of coverage covers cardiovascular surgery, multiple sclerosis, kidney failure, paralysis, blindness, hearing loss, organ loss or transplantation. Some insurers include coverage for Alzheimer's disease, Parkinson's disease, coma, loss of speech function, and serious burns. This list does not cover all possible diseases, but guarantees payment in case of most of them. Many modern VHC policies provide protection in case of more than 40 diseases.

Chance, accident - always unexpected and, as a rule, at the wrong moment. It is impossible to insure against an incident, but you can at least partially compensate for its consequences. Of course, insurance will not compensate for lost nerves and moral turmoil, but it will provide payment with money that can be spent, for example, on treatment or simply spent while you are “on sick leave” and not working. After all, the employer in such a situation, as a rule, will only offer payment for sick leave, and this is much less than your usual salary. You can buy accident insurance right now. Registration and payment of insurance takes place online, and you receive an email with your insurance. This will be the most modern type of insurance - an electronic policy

How insurance works

If an injury results from an accident, monetary compensation will be paid depending on the damage sustained. The largest payments occur upon the onset of disability, and in the event of death, the payment is 100% of the insured amount.

For example, if you are insured against an accident for 500,000 rubles, then in case of a broken wrist bone we will pay you 15,000 rubles, and in case of a third-degree skin burn with an area of 6 sq.cm. — 25,000 rubles, or if the policy was issued with the risk of “Temporary disability”, and you were on sick leave for 30 days due to an injury, we will pay you 15,000 rubles.

Who can be insured

Yourself or a child, or even a group of children, for example, for a trip to a summer camp or to a sports competition.

How much can you insure?

Depending on the option you choose, you can insure against the consequences of an accident for an amount from 100,000 to 650,000 rubles.

Additional features

The insurance coverage can be extended to cover accidents that occur during active recreation or participation in mass sports at the amateur level.

Leisure— this is insurance for the consequences of an accident that occurs during active recreation: sports games (football, volleyball, tennis, bowling, etc.), visiting water attractions and water parks, riding boats and catamarans, as well as mopeds and scooters.

Mass sports— this is insurance for the consequences of an accident that occurs while playing sports at the amateur level.

Consequences of a tick bite— this is insurance for the consequences of an encephalitis tick bite and diseases resulting from such a bite.

Insurance period

Depending on the option you choose, accident insurance will be valid for 3, 6 or 12 months.

Insurance exclusions

The policyholder cannot be:

foreign citizen;
a stateless person;
entity;
individual entrepreneur;

The following persons are accepted for insurance, subject to written notification of the Insurer about the relevant circumstances:

Foreign citizens;
persons under the age of 3 and over 64 years of age;
persons with established disability group I or II, who are assigned the category “disabled child” or have been referred to undergo a state medical and social examination;
persons serving in the armed forces;
persons in prison;
persons with the following diseases and (or) related conditions: HIV and AIDS, and diseases associated with these diseases, alcoholism, drug addiction, diseases of the nervous system (paralysis, epilepsy, temporary loss of consciousness, seizures), persons registered in a narcological, psychoneurological dispensary;
persons suffering from benign or malignant brain tumors, diseases of bone tissue (osteoporosis, osteomyelitis, benign or malignant bone tumors, including metastases of other tumors in the bones).

Events that occur as a result of:

driving vehicles of categories “A”, “M” with an engine displacement of more than 50 cubic cm;
practicing the following sports: aviation sports, flights on non-motorized aircraft (for example, hang gliders, paragliders), parachuting, mountaineering, all types of alpine skiing and water skiing, all types of watermotor, motorcycle and motor sports, extreme types of cycling (for example, trial ), diving, speleology, as well as activities in mass sports not covered by the Insurance Agreement (Policy);
professional sports

Updated 02/02/2020 Views 2886 Comments 6

Unfortunately, no one is truly insured against an accident. But to mitigate the severity of its financial consequences, it is possible to take out insurance. Especially if you are going on a trip and taking children with you. Of course, there are accident insurances for ordinary life, but it is when traveling that the risk of encountering a not very pleasant surprise from fate increases greatly, so some people choose at least insurance for a child.

Although, on the other hand, as with all insurance in general, you must first understand the conditions so as not to pay for the policy in vain. Let's try to figure out whether it is necessary to take out accident insurance and what it provides.

Accident insurance

First, briefly about what it is and whether it should be done. And in the second half of the article, read the details.

What it is

Accident insurance is designed to alleviate financial losses in the event of damage to health and life from unforeseen dangers. If we are talking about travel, then in addition to travel insurance (traveler’s insurance), it is purchased as an additional option in the form of a separate insurance with its own sum insured. That is, a doctor’s visit and hospital stay are paid on the basis of travel insurance and its insured amount, and accident insurance implies an additional cash payment in the event of any injury. And you can then spend this money wherever you want.

However, you need to know an important nuance when purchasing accident insurance - most often, not the entire sum insured is paid, but a percentage, which depends on the type of injury. The maximum amount of payments (100% of the insured amount) will only be in the event of the death of the insured (will be received by the heirs or the beneficiary specified in the contract). Therefore, do not think that if you are insured for $1000, then if you break your arm, you will receive it all. No, a percentage will be paid depending on the severity of the injury, for example, for a leg/arm injury they can pay only 10-20% of the insured amount, that is, only $100-200 of $1000.

By the way, when you buy a train or plane ticket, they often sell you accident insurance along with it. This is voluntary insurance and is not always refused, because the price is low and many simply do not pay attention. With this insurance you can receive payments if an accident occurs. It can also be sold in exactly the same way. Sometimes they are sold together, sometimes separately. Actually, if both of these insurances are already included as options in your main travel insurance for the entire trip, which you bought through the same, then there is definitely no point in paying for them again.

Is it necessary to do it?

While travel accident insurance can come in handy, not everyone is willing to pay for it. This is an additional option, not a mandatory one, so the decision will be up to you. Do you want to be on the safe side and pay money for it or not, do you need a separate payment of money or will it only be enough to cover medical expenses under regular traveler’s medical insurance.

The situation here is the same as with life insurance when you are in Russia. Some people buy such insurance so that the family receives financial assistance in the event of the loss of a breadwinner or loss of his ability to work. But this insurance product is not yet very popular in our country, because not everyone will be ready to bear additional financial costs. But we must remember that when traveling, the risks increase.

All the nuances when purchasing accident insurance

What to consider when choosing insurance

First of all, you are NOT choosing accident insurance, but traveler's travel insurance. Be sure to read where I told you what assistance is, which insurance company to choose, where to buy a policy, how to use insurance correctly, etc.

Insurance companies generally consider an accident to be an event that occurs SUDDENLY and results in serious injury, illness, disability, disability or death. Injuries that are considered an insured event can occur in an accident, from an attack by a criminal, a fall from a height, or from household injuries (for example, a burn with boiling water).

As a rule, insured events also include situations resulting in the death of the insured or the assignment of disability within one year after the end of the insurance. All these terms are in the contract.

If you decide to add the option of accident insurance, then the most important thing you need to know is this. The injury that occurs must be included in the payout table. If it is not, then insurance does not cover this injury. Therefore, it is important to familiarize yourself with the table, asking for it to be provided to you explicitly, and in the event of an injury, keep in mind that the payment may depend on the wording of the diagnosis in your documents. In controversial cases, the insurance company will interpret the doctor’s opinion in its favor, so it is better that it most closely matches the column in the payment table of your insurance company.

Most standard programs do not cover accidents that occur due to the consequences of pre-existing diseases (chronic diseases). Some insurance companies limit the amount of insurance, the age, health status of the insured, etc.

The amount of the insurance amount for accident insurance is set at your request. The larger the amount of insurance payment the insurance provides you with, the higher the payment for it will be. Therefore, it is important to strike a balance so that insurance costs are not unreasonably high, but at the same time, the insurance payment is not too small.

You can insure both yourself and a family member: parent, wife, child. If you buy travel insurance for several people (family) at once and add the option of accident insurance, then this option applies to everyone. To use this option for one person, for example, a child, you will need to issue him a separate policy with this option, and for the others a policy without the option. Since the option makes insurance more expensive, you can save money this way.

When accident insurance doesn't work

When planning to take out insurance, you need to understand that the contract contains a list of situations that will not be considered insured events:

An event that occurs outside the territory and insurance period specified in the policy.

Accidents that cannot be considered unforeseen are not taken into account. For example, due to mental disorders of the insured, hypertension, chronic epilepsy, etc. The consequences of infectious diseases, strokes and heart attacks may also be included in the list of exclusions from insurance events.

Almost all insurance companies do not consider personal injury during force majeure circumstances - military actions, civil unrest, strikes, etc. - to be an insured event.

Often, injuries during sports, including mountaineering and diving, are not taken into account. For those who plan to engage in sports while traveling, there are separate, more expensive insurance programs.

If at the time of injury the insured was in a state of alcohol, narcotic or toxic substance, if the insured was injured while committing criminal acts, in the event of death as a result of suicide or injuries received during a suicide attempt, if the insured was intentionally harmed to his health.

Cost of insurance, sum insured and amount of payments

I would not buy accident insurance separately, since it does not replace medical travel insurance, in fact, on the basis of which medical care will be provided. Therefore, it is better to take out accident insurance as an additional option to the main insurance. In this case, your travel insurance simply becomes a little more expensive. You can compare for yourself how the inclusion of various additional options in the price affects the price.

Accident insurance - an additional option for extra money
The insured amount is determined by the policyholder, that is, you. If you choose insurance online, then, for example, the Cherehapa () service allows you to choose whether you want to be insured for the entire duration of the trip or for the duration of the flight. In the screenshot above you can see what it looks like. You can choose an insurance amount from $1000 to $10,000. On the websites of some insurance companies you can choose a larger amount. The cost of insurance will depend on the insured amount and the payment in the event of an accident will be calculated from this amount.

Accident insurance payments are proportional to the damage caused to the health of the insured person. The more severe the injury and its health consequences, the greater the insurance compensation, which is paid either in a certain amount specified in the contract, or taking into account the period of incapacity for work. When the insured is hospitalized, payments from the insurance company are calculated in accordance with the contract; first, when he is undergoing treatment, this is one rate; if the period of treatment in a medical institution is longer than specified in the contract, then this is a different, higher rate.

Examples of payments. With the second group of disability, you can receive about 75% of the sum insured, with the third group - 50%, for a leg/arm injury you can only pay 10-20%. Payment for “temporary disability” is, as a rule, 0.2–0.3% of the insured amount for each day of disability, but the period of payments is usually limited to 60-100 days and insurance companies in such cases often use a temporary deductible - from 10 to 30 days, this the period is not taken into account when calculating the insurance payment. For 1-2 degree burns, the rate may be 0.3% of the total insurance amount. For injuries to the face, neck, ears, the tariff is 0.5%.

An example in numbers from the websites of insurance companies to make it clearer. If you insure a person for a period of 3 months in the amount of 200,000 rubles, then the cost of insurance will be 570 rubles. If, for example, there is a fracture based on the payment table, the company pays 20,000 rubles - 10% of the insured amount. Another example. When purchasing an annual insurance policy (in case of frequent trips) for 1 million rubles, its cost will be 7,000 rubles. Let’s say that upon the occurrence of an insured event, the insured spent 5 days in intensive care, 14 days in the hospital and 30 days in outpatient treatment. The insured amount paid by the insurance company is 58,000 rubles.

Sequence of actions in the event of an accident

The first thing to do after an accident is to call assistance () and find out which hospital you need to go to. If this is impossible (for example, unconscious), then the ambulance itself will decide where to take you. Medical assistance will be provided to you as part of your travel insurance. As soon as the opportunity arises, you need to contact the assistance and resolve questions about your stay in the current hospital, will they immediately pay for the treatment or will you have to pay for it yourself and then receive reimbursement.

After you have resolved all the issues regarding treatment, you can already think about payment in connection with the accident. You should notify the insurance company (not assistance) about this and write a statement. The deadlines for filing an application and the list of documents required to receive insurance payment are indicated in the insurance contract and in the insurance rules attached to it. Typically, the need for payment must be reported no later than 30 days after returning to your home country. Even if you cannot meet the deadline for submitting a written statement, you should definitely contact a company representative by phone, notify him of what happened and consult on how best to proceed. To be on the safe side, it is better to immediately write down the name of the company representative with whom you spoke, the date and time of your call to the insurance company.

The application must be accompanied by official documents confirming that an accident occurred with the insured person. The company representative, in turn, must register your application and provide you with its registration number, which will be useful in the future to simplify interaction with the insurance company. Using this number, you can find out the status of consideration of your application and provide the insurance company with additional information about your insured event.

The insurance company usually reviews the application for payment within 1-2 months, calculates the amount of the insurance payment and pays it to the client if they have presented all the necessary documents and there are no circumstances that refute the occurrence of an insured event.

Documents required to receive payment

In order to receive compensation from the insurance company, it is very important, immediately after the accident, to correctly fill out and collect all the necessary documents, in addition to passports and the insurance policy itself. A list of documents can and should be requested from the insurance company. Usually it will be something like this:

— Accident report, an official document confirming the circumstances of the accident. With signatures, if possible, of all witnesses and responsible persons (original)
— Certificate from a doctor or honey. the institution that conducted the initial examination and provided first aid. The certificate must indicate a medical report and diagnosis
- For treatment - a certificate from an official medical institution, which must confirm the diagnosis and terms of treatment
— Prescriptions for medications and receipts from pharmacies
— When establishing disability, it is necessary to provide copies of the medical history and extracts from outpatient and medical records, as well as documents confirming the connection between the accident and the assignment of a disability group

If the insurance payment is made upon the death of the insured person, you will additionally need:

— Original or notarized copy of the death certificate of the insured
— Identification document of the beneficiary (heir)
— Notarized copy of the certificate of inheritance

Life hack #1 - how to buy good insurance

Choosing insurance now is incredibly difficult, so to help all travelers. To do this, I constantly monitor forums, study insurance contracts and use insurance myself.

Every person can become a victim of unforeseen situations - both at work and in a comfortable, seemingly 100% safe home environment. An accident or an “unplanned” illness, in addition to physical harm, also entails significant material damage. The question arises about how to protect yourself and your loved ones from such circumstances and reduce the burden on your budget?

Accident and illness insurance allows you to provide additional financial support to the victim or his family members. Such insurance becomes especially relevant if someone close to you becomes disabled or dies altogether as a result of unforeseen circumstances. Payments from the insurance company's fund in accordance with the purchased policy will help the person or his relatives partially reimburse unexpected expenses and not be left without the funds necessary for subsistence.

The essence of insurance programs against accidents

Accident insurance (hereinafter referred to as AC) is one of the types of insurance of subjects designed to provide compensation for damage received as a result of their loss of health, as well as the ability to perform work duties. This type of insurance differs from medical insurance - both compulsory and voluntary.

A standard health insurance policy ensures the provision of medical care to a person on the territory of medical organizations provided for by the policy. Accident insurance provides financial compensation, i.e. payment of funds either to the victim himself or to his relatives.

Insurance against accidents can be provided in several forms and types. The main forms of personal liability insurance include:

individual - in this case, the policyholder (which can be both an individual and a legal entity) purchases a policy in order to insure himself or another entity. At the same time, he pays contributions to the company’s insurance fund independently;
group - provides insurance for a group of people (often employees), for whom the policy is issued, and insurance premiums are paid from the budget of the organization in which they work. In this case, several options for the policy validity are possible - within 24 hours a day or during working hours established by the labor regulations.

In terms of types, insurance is:

mandatory - applies to such categories of the population as employees of military units, law enforcement agencies, the Ministry of Emergency Situations, and courts. If an insured event occurs, financial compensation is accrued to the insured from funds accumulated by the Social Insurance Fund of the Russian Federation. The nature of payments may differ for different categories of the population and be one-time or periodic (once a month, for example). The amount of compensation is also determined by the category of citizens and the region of coverage;
voluntary - in this case, an individual or legal entity enters into an insurance contract based on personal motives, and not by force of law. At the same time, each subject retains the opportunity to independently choose a specialized organization for cooperation, determine the amount, as well as the list of risks that he wishes to insure.

The cost of an individual NS insurance policy depends on the list of risks, the amount of the insured amount, gender, and age of the insured subject. With group insurance, the tariff is influenced by the selected combination of risks, the duration of the policy (number of hours per day), the average sum insured, the duration of the contract, and the qualifications of the employee.

The duration of the contract can vary - from several days to several years. The first option is optimal for those who intend to protect themselves while performing a specific task, business trip, etc. The most common validity period of the document is one year, after which it can be extended or the relationship with this organization can be terminated.

What is included and what is not included in the list of insured events?

Accident insurance provides for insured risks, which can be roughly classified into four groups: injury, disability, loss of ability to work, and death. But not all situations that lead to these consequences can be classified as insured events.

Insured events are considered:

injury to the insured person as a result of an accident;
poisoning that occurred as a result of unintentionally taking low-quality medicine, eating spoiled food (except for toxic infections), staying in an area exposed to chemicals (in industrial or domestic conditions);
infection with tick-borne encephalitis, as well as polio;
cases of pathological pregnancy and childbirth, as a result of which the pelvic organs are removed from women;
fractures and dislocations, burns, injuries to organs, their removal as a result of improper medical procedures during the liquidation of the consequences of an insured event;
entry of foreign bodies into the respiratory tract;
hypothermia of the body;
anaphylactic shock;
death of the insured from the events listed above (except for colds), including within a year from the moment they occurred.

Insured events do not include:

the insured is injured when performing actions that are classified as criminal by law enforcement agencies or courts;
damage received while driving a vehicle under the influence of drugs, alcohol, psychotropic substances or as a result of transferring control of it to someone who was in such a state;
deliberately harming oneself or causing trauma while attempting to commit suicide;
death from the causes listed above;
consequences of medical procedures and manipulations that were not aimed at eliminating the insured event;
injuries and death during military operations, riots, nuclear and other explosions.

Accident insurance provides compensation only when events of the first group occur. If the circumstances do not fall within the group of insured events, financial assistance will not be provided. In the event of the death of the insured person, the right to receive funds passes to his relatives or heirs.

Accident insurance programs

The modern insurance market in the Russian Federation is represented by a wide variety of specialized companies that provide accident insurance. The TOP 5 reliable organizations, as well as some of their most profitable programs, are presented in the table below:

Insurance Company	Program name	Program conditions	Policy cost
Ingosstrakh	"Individual"	simplified online registration procedure with documentation sent to the policyholder’s email; the opportunity to insure yourself or a close relative with a minimum set of insurance risks (trauma, disability of groups I, II, III, death from accidents) with an insured amount of 50 thousand rubles.	500 rubles
RESO-Garantiya	"Family protection - Universal"	the possibility of issuing one contract and policy for all family members (unlimited number of relatives aged 1 to 70 years); insured risks include injury, disability and death from accidents; the right to choose the amount of the insurance amount in the range from 30 thousand to 200 thousand rubles; The policy is valid for 1 year 24/7 throughout Russia.	Depends on the insured amount and can be 1.5 thousand, 4.5 thousand and 6 thousand rubles
Zetta Insurance	"Express Help"	the opportunity to insure yourself, a relative, or a friend for one year. The age of the insured is from 1 to 65 years; insured events include death, permanent disability, bodily injury, risk of hospitalization as a result of accidents; quick registration procedure (you only need a passport); insurance amount – without setting limits; The policy is valid 24/7 all over the world.	Determined depending on the sum insured and amounts to 0.5% of its amount
Insurance group "Max"	“A year without worries”	the opportunity to insure yourself, family and friends for one year; The policy can be purchased online. Its activation occurs a month after purchase; insured risks include loss of working capacity, treatment as a result of the onset of NS; the insurance amount ranges from 100 thousand to 500 thousand rubles.	From 799 rub.
VTB Insurance	"Excellent Personal Protection"	the opportunity to insure both yourself and a group of up to 50 people aged 18 to 55 under one policy; operates 24/7 worldwide; insurance period – from one month to one year; the insured amount can be up to 1 million rubles.	From 624 rub.

Finally

Accident insurance can become an additional guarantee that allows a citizen of the Russian Federation to increase the level of confidence in the future. Having a compulsory medical insurance policy and receiving free medical care, with the help of a health insurance policy, you can additionally compensate for the costs that accompany expensive treatment that goes beyond the scope of the health insurance policy.