If a person is injured, how to get insurance? If you are injured at home, you can get compensation from life insurance. What do you need to get insurance for an injury?

Insurance payment is made on the basis of a written application from the recipient of the payment and supporting documents.

The list of documents that must be provided is given in the Rules (Policy Conditions) of insurance on the basis of which your insurance contract was concluded or in the insurance contract (policy).

List of supporting documents (in accordance with the current Insurance Rules):

  • “Permanent total disability”, “Disability” as a result of illness:

§ A certified copy of a certificate from a branch of the Bureau of Medical and Social Expertise on the assignment of a disability group.

§ Inspection report (ITU Bureau Branch). A document on 4 sheets, certified by this medical institution.

§ A copy of the Referral to MTU (form 088/u-06) (a document issued by a hospital, clinic, oncology clinic or other medical institution certified by this medical institution) and a return coupon for it.

§ A copy of an outpatient card or an extract from an outpatient card at the place of residence (certified by the given medical institution).

§ A copy of the return coupon from the ITU Bureau, which is sent to the medical institution that sent the insured for examination and assignment of a disability group.

§ A copy of the hospital card or Extract from the hospital card (medical history) (certified by the given medical institution).

ADDITIONAL DOCUMENTS

§ A certificate from a medical institution or a copy certified by this medical institution, indicating the diagnosis for which the disability was established.

§ A copy of the rehabilitation program for a disabled person (which indicates which institution sent the insured person for examination to assign a disability group).

§ A copy of the outpatient card or extract from the outpatient card (certified by the given medical institution).

  • When the risk “Permanent total loss of ability to work” or “Disability” as a result of an accident is realized.

ADDITIONAL DOCUMENTS

  • "Death" due to illness

§ A copy of the post-mortem epicrisis from the hospital (certified by the given medical institution).

§ A copy of an outpatient card or an extract from an outpatient card at the place of residence (certified by this educational institution).

§ A copy of the hospital card or Extract from the hospital card (medical history).

ADDITIONAL DOCUMENTS

§ If the death of the insured occurred at home, on the street, in a country house, metro and other public places (NOT in a hospital), the following is required:

2. Act of forensic chemical research (internal description of the corpse with examination of blood, organ fragments for the content of alcohol, narcotic and toxic substances).

§ A copy of the resolution to initiate/refuse to initiate a criminal case from the investigative authorities (OVD, Prosecutor's Office, Investigation Department and other law enforcement agencies) certified by this institution.

§ A copy of an outpatient card or an extract from an outpatient card (certified by the given medical institution) from the place of work (VHI insurance).

§ Certificate of right to inheritance by law (if the Beneficiary is not appointed)

  • "Death" due to an accident

§ A copy of the death certificate, notarized or the original from which a copy is taken by an employee of the claims department and certified by an employee of the claims department.

§ A copy of the Death Certificate and/or a copy of the medical death certificate indicating the cause of death.

§ A copy of the resolution to initiate/refuse to initiate a criminal case from the investigative authorities (OVD, Prosecutor's Office, Investigation Department and other law enforcement agencies) certified by this institution.

§ Copy of the Autopsy Report (certified by this medical institution):

Forensic medical examination report (external description of the body, injuries).

Act of forensic chemical research (internal description of the corpse with examination of organ fragments for the content of alcohol, narcotic and toxic substances).

ADDITIONAL DOCUMENTS

§ A copy of the driver's license in the event of an accident, if the insured was driving the vehicle.

§ A copy of the court decision, certified by this institution.

§ Certificate of right to inheritance by law (if the Beneficiary is not appointed).

  • “Permanent total disability”, “Disability” as a result of an accident:

§ A copy of the Certificate from the branch of the Bureau of Medical and Social Expertise (assignment of a disability group).

§ Extract from the Inspection Report (ITU Bureau Branch). A document on 4 sheets, certified by this medical institution.

§ A copy of the Referral to Medical Examination (a document issued by a hospital or clinic, certified by this medical institution).

§ A copy of the outpatient card or extract from the outpatient card (certified by this educational institution).

§ A copy of the hospital card or Extract from the hospital card (medical history) (certified by the given medical institution).

ADDITIONAL DOCUMENTS

§ A copy of the Industrial Accident Report (Form-N1), certified by the institution or enterprise where the accident occurred.

§ Original or copy of a certificate (certified by the insurance company) about the content of alcohol, narcotic, or toxic substances at the time of the insured event.

§ A copy of the accompanying sheet/coupon of the emergency medical service, which indicates what state (alcohol, narcotic or toxic substances) the insured was in at the time of the insured event.

§ A copy of the resolution to initiate/refuse to initiate a criminal case from the investigative authorities (OVD, Prosecutor's Office, Investigation Department and other law enforcement agencies) certified by this institution.

§ A copy of the court decision, certified by this institution.

  • “Death” as a result of an accident or illness in the territory of another state

§ Death certificate translated into Russian, certified by a notary.

§ Death certificate translated into Russian, certified by a notary.

§ Medical documents and documents from police authorities translated into Russian, certified by a notary.

§ A copy of the document confirming repatriation (transportation of the body to the territory of registration and residence of the insured person, i.e. the Russian Federation).

§ If the autopsy was carried out on the territory of another state, then the autopsy data translated into Russian and certified by a notary are required.

§ If the autopsy was carried out on the territory of the Russian Federation, a copy of the autopsy from the forensic medical examination (certified by this institution) is required.

  • “Trauma (Temporary disability as a result of an accident)”

1. Bodily injuries of the insured, payment according to Table No. 1 (extended) or Table No. 5.

2. The amount of insurance payment for certificates of incapacity for work, which is from 0.2% of the insured amount (specified in the Agreement), for each day of temporary incapacity for work, starting from the day of incapacity specified in the agreement and no more than 90 days.

§ Information about the risk for which the insurance payment is made is indicated in the Policy (Agreement) of the Insured.

§ A copy of the certificate(s) of incapacity for work with all the seals of the LU, certified by the personnel department at the place of work. If the amount of insurance payment is calculated based on certificates of incapacity for work.

§ Conclusion of X-ray and/or ultrasound, computed tomography and/or magnetic resonance imaging, depending on the nature of the injury, confirming the diagnosis

§ A copy of the decision to initiate/refuse to initiate a criminal case from the investigative authorities (OVD, Prosecutor's Office, Investigation Department and other law enforcement agencies) certified by this institution, if the injury is of a criminal nature.

§ A copy of the court decision (certified by this institution) if law enforcement authorities opened a criminal case.

  • "Partial permanent disability" resulting from an accident

Insurance payment is carried out according to Table No. 3 (short).

§ Original or copy of a detailed extract from the outpatient card indicating the circumstances, date of injury, and diagnosis (certified by the institution).

§ Original or copy of a certificate from a trauma center (certified by this institution) indicating the date of injury and first aid provided.

§ Original or copy of a detailed extract from the hospital card (medical history), certified by this institution.

§ A copy of the accompanying sheet/couple of the emergency medical service, which indicates what condition (alcohol, narcotic or toxic substances) the insured was in at the time of the insured event, if the insured was delivered by an emergency medical service squad to a medical institution.

§ Radiographs with descriptions for fractures of any location.

§ The original report of a neurologist and an encephalogram with a conclusion (for concussion, contusion and crushing of the brain.

§ A copy of the Industrial Accident Report (Form-N1) certified by the institution or enterprise where the accident occurred.

  • "Temporary disability due to accident or illness"

§ Completed application for insurance payment indicating bank details for transfer of insurance payment.

§ Copies of all sick leave certificates certified by the HR department.

§ An extract from the medical history/certificate from the trauma center with the diagnosis.

§ Radiographs with a description, results of laboratory, biochemical studies confirming the occurrence of an accident or illness.

§ Medical report on the results of a blood test of the Insured on the presence/absence of alcohol, narcotic or toxic substances in the blood on the date of opening the certificate of incapacity for work.

§ Conclusion of a neurologist, encephalogram with a conclusion (required for closed craniocerebral trauma-concussion, contusion, crushing of the brain).

§ Report on an insured event at work (form N1), if the realization of the insurance risk is associated with an accident during the performance of official duties by the Insured.

§ A copy of the resolution to initiate/refuse a criminal case or other documents from the relevant internal affairs body, if the death of the Insured or its circumstances are recorded by the internal affairs body in accordance with current legislation.

§ If temporary disability occurs as a result of illness, then an official medical document about the health status of the Insured.

  • "Diagnosing BOS"

§ A copy of the hospital card or Extract from the hospital card (medical history) (certified by the given medical institution).

§ A copy of the outpatient card or extract from the outpatient card (certified by this educational institution).

§ Documents resulting from machine processing:

electrocardiograms, radiographs, results of examination on a computed tomograph and other documents/images resulting from machine processing, the name and date of birth must be made in a manner that does not allow any changes, that is, they must form a single whole with the document/image without the possibility of changing them.

§ Any available medical documents confirming the established diagnosis.

  • "Death as a result of SOB"

§ A notarized copy of the death certificate or a copy of the original certified by a Claims Officer.

§ A copy of the Death Certificate and/or a copy of the medical death certificate indicating the cause of death.

§ A copy of the post-mortem epicrisis from the hospital (certified by the given medical institution).

If the death of the insured occurred at home, on the street, in a country house, metro and other public places (NOT in a hospital), the following is required:

I. Copy of the Autopsy Report (certified by this medical institution):

1. Forensic medical examination report (external description of the body, injuries).

2. Act of forensic chemical research (internal description of the corpse with examination of organ fragments for the content of alcohol, narcotic and toxic substances).

II. A copy of the resolution to initiate/refuse to initiate a criminal case from the investigative authorities (OVD, Prosecutor's Office, Investigation Department and other law enforcement agencies) certified by this institution.

A copy of the outpatient card or extract from the outpatient card for VHI insurance (if available).

  • "Hospitalization"

§ A copy of an outpatient card from a clinic or an extract from an outpatient card (certified by this educational institution).

  • "Surgery"

§ A copy of the hospital card or Extract from the hospital card (medical history), certified by the given medical institution.

§ A copy of an outpatient card from a clinic or an extract from an outpatient card (certified by this educational institution).

  • Grounds and procedure for receiving insurance payments to employees of the Ministry of Internal Affairs in 2018
  • Payment of insurance to employees of the Ministry of Internal Affairs
  • Insurance payments to military personnel and employees of the Ministry of Internal Affairs in 2018
  • Insurance benefits for police officers
  • List of injuries insured against a police officer
  • Amount of insurance payment to employees of the Ministry of Internal Affairs in case of injury

Grounds and procedure for receiving insurance payments to employees of the Ministry of Internal Affairs in 2018 Attention Such cases include:

  • intentional harm to the health of a police officer by the employee himself;
  • at the time of the incident, the injured employee was under the influence of drugs or alcohol;
  • The harm to the victim was caused by his own unlawful acts.

According to legal requirements, a refusal decision must be made in writing.

Grounds and procedure for receiving insurance payments to employees of the Ministry of Internal Affairs in 2018

The Information Notification must be transmitted to all interested participants in the process within a maximum of 15 days.

  1. Federal Law of March 28, 1998

Payment of insurance to employees of the Ministry of Internal Affairs In addition to one-time insurance payments, in 2018, military personnel who become disabled are entitled to benefits paid monthly. Important Such benefits are also awarded to the families of fallen soldiers. But for a citizen who has received a concussion or other injury, no monthly payments are provided.

The list of injuries and their “category” are fixed in the Russian Federation by law in order to avoid disagreements when establishing the severity of injuries, and, accordingly, the amount of financial compensation.

Payment of insurance to employees of the Ministry of Internal Affairs

  • actions when a police officer suffered as a result of his carrying out socially dangerous actions recognized as such in court;
  • if the victim was intoxicated with alcoholic beverages, narcotic or toxic drugs at the time of injury or injury;
  • in the case where the actions of the insured in relation to harm to his own life and health were intentional (including suicide).

Thus, if any of the listed situations occurred, the insurance company must notify the victim (or the beneficiary of the funds) in writing about the refusal to pay insurance, with the obligatory giving of the reasons for the decision. These actions are carried out within no more than 15 days from the date of receipt of the documents confirming the legality of such a decision.

Insurance payments for domestic injury to a police officer

Thus, funds in the accounts of citizens who carry out entrepreneurial activities are also insured. The purpose of insuring investments against political risks is to protect foreign investments from any serious changes in the political structure of the country, which could lead to losses and non-recoupment of the investor’s project. Details here. If the insurer delays payment for any unjustified reasons, then he is obliged to pay a fine to the insured in the amount of 1% of the insurance amount for each day of late payment.


The fine is paid by the insurance company from its own funds.

Amount of insurance payment to employees of the Ministry of Internal Affairs in case of injury

This will happen if the insurance situation:

  • Occurred as a result of the actions of a serviceman under the influence of alcohol or drugs;
  • She was deliberately provoked by a serviceman with the aim of harming her own health;
  • It was the result of the actions of a serviceman that were recognized as posing a threat to the health of others.

Sometimes the head of a military unit makes attempts to “hush up the matter” in order to avoid paperwork and not record the fact of injury. The command has no right to refuse to prepare the required documents for payment of benefits to an employee of the Ministry of Internal Affairs. The fact of intoxication or other possible reasons for refusal of insurance must be recorded by an expert and transferred to the insurer.
If the trial establishes that the victim was driven to suicide, the insurer will not be able to refuse payment to the relatives.
Mandatory state insurance of the life and health of a police officer is carried out under the conditions and in the manner established by the Federal Law of March 28, 1998 N 52-FZ “On compulsory state insurance of the life and health of military personnel, citizens called up for military training, private and commanding officers Internal Affairs of the Russian Federation, the State Fire Service, employees of institutions and bodies of the penal system." (as amended by Federal Law dated July 3, 2016 N 305-FZ) (see Obtaining the status of a disabled person of group 3 500,000 Minor injury 50,000 Severe injury 200,000 Loss of ability to work and the possibility of further service 50,000 If during the year, after the occurrence of the insured event, the consequences for the victim worsened, then the insurance company will have to pay an additional amount under the contract.

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Beneficiaries of the Ministry of Internal Affairs insurance In addition to direct insurance payments to employees of the Ministry of Internal Affairs who received injuries or a group of disabilities, other persons may also be beneficiaries of the insurance amount if the police officer himself died as a result of the events mentioned above. The beneficiary may be:

  • A husband or wife who was in an officially registered marriage with the insured at the time of the death.
  • Parents or persons who adopted the insured.
  • The grandfather or grandmother of the injured police officer, but only if the latter did not have parents and was raised or supported by the grandparents for at least 3 years.
  • Stepfather and stepmother, provided that the insured was raised or maintained by them for 5 or more years.
  • Children of the insured.
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  • Military law
  • Hello. I am a police officer in St. Petersburg. I was injured at home. I passed the commission. The injury was mild. At work they say that at the moment there is no contract concluded with the Starokha company and no one can pay. What should I do? Is this legal? compensation for harm to health, employee injury Collapse Victoria Dymova Support employee Pravoved.ru Try looking here:
  • Will I be able to receive insurance compensation for an injury after dismissal from the Ministry of Internal Affairs?
  • Insurance payment for injury in the army

You can get an answer faster if you call the toll-free hotline for Moscow and the Moscow region: 8 499 705-84-25 Free lawyers on the line: 9 Answers from lawyers (1)

  • All legal services in Moscow Challenging medical reports of military medical commissions Moscow from 30,000 rubles.

Currently, the Ministry of Internal Affairs of Russia has concluded a contract valid until December 31, 2015 with the company VTB Insurance LLC for the provision of compulsory insurance services, and accordingly, this company officially provides insurance services for military personnel and police officers. Types of insured events under the insurance of the Ministry of Internal Affairs Payment of funds under the insurance of the Ministry of Internal Affairs and military personnel can be made upon the occurrence of certain cases, which are described in more detail below. The first to be considered are any actions or events that resulted in the death of a police officer.

This insured event covers fatal situations that occurred during service, during participation in military training, as well as within 1 year after the end of these activities.

How to get insurance in case of an accident?

A less severe (in terms of consequences) basis for payment of insurance is the assignment of a disability group to the victim.

Read more about this type of insurance in this article. For police officers who already have a disability group and are injured in service, a medical and social examination is provided for, as a result of which a re-examination can be carried out and a possible increase in the disability group. In the event of such an increase, the insured must be paid the difference in the insurance amounts due under the previous disability group and the newly assigned one.

Those employees who, in the course of performing their duties, received injuries of varying degrees of severity, are provided with insurance payments by the state:

  • for serious injuries – 200 thousand rubles;
  • for minor injuries – 50 thousand.

Child injury insurance

Trauma in a child

Our children are interested in everything, they cannot sit still for a minute: they run through the streets, play ball, roller skate.

Such active exploration of the world does not always pass without a trace: troubles and injuries can happen at any moment.

The “Always Protected” universal insurance card will give you more confidence and peace of mind. If your child is injured, you can count on compensation for minor expenses associated, for example, with the need to organize treatment.

What is covered?

The insurance covers the consequences of an accident, namely the bodily injuries listed in the table. An accident is understood as a sudden short-term external event that is not a consequence of a disease or medical manipulation, resulting in bodily injury or other disruption of the internal and external functions of the body.

In particular, in addition to domestic traumatic situations, events that occur as a result of a traffic accident, terrorist attack, civil unrest, strikes, or playing any sport on a professional or amateur basis are recognized as insured events.

How does insurance coverage work?

If an insured event occurs, the insurance company will pay monetary compensation depending on the severity of the injury.

Insurance coverage is valid 24 hours a day throughout the world.

What is the payout amount?

The insured amount for the risk of bodily injury to children as a result of an accident is 15,000 rubles. In case of injury, the amount of payment is determined depending on the severity of the damage in accordance with the table of insurance coverage amounts. Thus, the insured person can be paid either 4,950 rubles in the case of a minor or moderate injury, or 15,000 rubles in the case of a severe injury.

What is not covered by insurance?

Please note that the insurance company has the right not to recognize an event as an insured event and refuse to pay if the event occurred as a result of:

  • suicide attempts;
  • participation in hostilities and/or armed clashes;
  • administration of alcohol, narcotic substances, unknown poison, unidentified substance or medication not properly prescribed by a doctor;
  • actions/inactions of the insured person who was in a state of intoxication resulting from the use of alcohol, any substitutes for alcohol, narcotic, psychotropic and toxic substances, as well as as a result of a disease caused by the use of alcohol, narcotic substances or medications not properly prescribed by a doctor;
  • driving by the insured person any vehicle without the right to drive, or while under the influence of alcohol or drugs, or transferring control to a person who did not have the right to drive a vehicle of this category, or who was under the influence of alcohol or drugs; as well as driving by the insured person while intoxicated, any power-driven vehicle, or transferring control of a power-driven vehicle to another person who is in a state of intoxication;
  • causes directly or indirectly caused by mental illness, paralysis, epileptic seizures, unless they were the result of an accident that occurred during the insurance period.

Activate the service

One card allows you to connect several insurance services and only for one individual (in this case, the same person can have several cards)

What to do if an insured event occurs?

Within 24 hours of the occurrence of an event that has signs of an insured event, you must seek medical help. Please ensure that the incident is properly documented by the healthcare facility.

Rules and procedure for receiving insurance payments for military personnel

Within 30 calendar days from the date of the event, you must notify the insurance company about this in any available way:

  • call 8 800 700 77 60
  • send a letter/telegram to the address 107023, Moscow, st. Malaya Semenovskaya, 9, building 1
  • send an email to [email protected]
  • inform the consultant in the online chat on the website

To receive an insurance payment, you must provide the insurance company with a completed application about the occurrence of an insured event, as well as documents confirming its occurrence and consequences:

  • a certificate from the trauma center, an extract from an outpatient card or an extract from the medical history (discharge summary), issued by the medical institution that provided first aid, indicating the date of application and the diagnosis/assistance provided, prescribed and performed treatment, certified by the signature of the head of the medical institution, who issued the document, and the seal of the medical institution;
  • X-ray (for fractures of any location);
  • certificates of incapacity for work issued based on the injury, including primary and closed certificates of incapacity for work.

Please note that in order to make a decision, the insurance company may require additional documents confirming the occurrence and consequences of the accident (for example, a certificate from the relevant authority of the Ministry of Internal Affairs, etc.

Within 30 days after receiving the documents specified above, the insurance company makes a decision on recognizing or not recognizing the event as an insured event.

Within 10 working days after recognizing the event as an insured event, the company will make an insurance payment.

DOCUMENTS REQUIRED TO RECEIVE INSURANCE PAYMENT

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9.1. To receive an insurance payment, the Insurer must submit an Application for Insurance Payment in the established form; identification document of the applicant; original insurance contract (insurance policy) and additional agreements thereto, as well as the following documents:

9.1.1. In case of death of the Insured person:

a) a notarized copy of the death certificate;

b) a notarized copy of a medical death certificate (or post-mortem epicrisis), issued by the medical institution where the death was registered, or another document establishing the cause and circumstances of death, issued by a medical institution or other authorized government body;

c) a certified copy of the postmortem autopsy report; if an autopsy was not performed, then a copy of the relatives’ statement refusing the autopsy and a copy of the certificate from the pathology department, on the basis of which a death certificate is issued, is provided;

d) an extract from the medical record of an outpatient and/or inpatient patient, discharge summary, x-rays, results of laboratory and diagnostic tests confirming the occurrence of an insured event, duration of treatment, therapeutic and diagnostic measures taken (if necessary).

e) the order of the Insured person to appoint a Beneficiary (if any) or a notarized copy of the Certificate of Inheritance (to be presented only by the heir or heirs).

9.1.2. If the Insured Person is diagnosed with disability:

a) a copy of the ITU certificate on establishing the disability group, certified by the ITU Bureau or notarized;

b) the certificate of inspection of the ITU bureau with an insert attached to the certificate of inspection of the ITU bureau (if issued by the latter bureau) and the Protocol of the ITU or duly certified copies of the documents specified in this paragraph (by the institution that issued this document);

c) an extract from the medical history/outpatient card issued by the medical institution that referred the Insured person for a medical and social examination;

d) a certificate from the medical institution of initial treatment or a document confirming the fact and circumstances of the accident, drawn up by a competent institution or government body.

9.1.3. If the Insured person receives bodily injury (injury), hospitalization, or surgical intervention:

a) an extract from the medical history/outpatient card, discharge summary, x-rays, results of laboratory and diagnostic tests confirming the occurrence of an insured event, duration of treatment, therapeutic and diagnostic measures taken;

b) a copy of the surgical operation protocol from the medical institution where the operation was performed (for the insurance risk “Surgical interventions as a result of an accident”);

c) a certificate from the medical institution of initial treatment or a document confirming the fact and circumstances of the accident, drawn up by a competent institution or government body.

9.1.4. In case of temporary impairment of the health of the Insured person as a result of infection:

a) a copy of the certificate of incapacity for work, a certificate of form 095/y or an extract from the medical record of an outpatient or inpatient patient, form 027/y.

b) an extract from the medical history/outpatient card, discharge summary, results of laboratory and diagnostic tests confirming the occurrence of infection, duration of treatment, therapeutic and diagnostic measures taken;

9.2. If an event that has signs of an insured event occurs with an Insured person under 18 years of age, along with the documents specified in paragraph 9.1 of these Rules, a copy of a document confirming the authority of the legal representative of the Insured person (a document certifying the relationship with the Insured person ( birth certificate); document certifying the status of a guardian (trustee)).

9.3. Additionally, upon the occurrence of the events specified in paragraphs 3.3.7-3.3.9 of these Rules, the applicant must submit to the Insurer documents issued by the authorized body, allowing to establish where and when the accident occurred, persons injured as a result of the accident, a law enforcement agency protocol confirming the fact of the accident transport accident with the Insured person; a decision to initiate a criminal case, if one has been initiated, or to refuse to initiate a criminal case (if the initiation of a criminal case was refused based on the fact of the accident).

The submitted documents must also contain information about the driver’s refusal to undergo a medical examination for intoxication or the results of such an examination. The insurer is provided with original documents or duly certified copies thereof.

Payment of insurance to a police officer in case of injury at home

If an investigation was carried out into the occurrence of an accident, the Insurer must be provided with a duly certified copy of a document issued by the relevant authorized body, reliably indicating the fact and circumstances of the accident (an act on an industrial accident, a court decision in a criminal/administrative case, a resolution on initiation/suspension of a criminal case).

9.5. All extracts (copies) submitted from medical institutions must be certified by the signature of the head of the medical institution and the round seal of the medical institution.

9.6. All documents provided to the Insurer in connection with the occurrence of an insured event must be drawn up in Russian or have a notarized (apostilled) translation. The costs of collecting these documents and translating them are paid by the applicant.

9.7. If the documents and information necessary to establish the causes and nature of an event that has signs of an insured event have not been submitted, the Insurer does not make an insurance payment, since it is not possible to establish a cause-and-effect relationship and determine whether the event that occurred is an insured event.

If documents are provided that cannot be read by the Insurer due to the handwriting characteristics of the person filling out the document, as well as due to violation of the integrity of the document (torn, crumpled, erased, etc.), the Insurer has the right to postpone the decision on payment until the documents are provided of proper quality.

9.8. Within 10 (ten) working days from the date of receipt of all necessary and properly executed documents specified in paragraphs 9.1 - 9.4 of these Insurance Rules, as well as written documents requested by the Insurer in agreement with the Insured from organizations and institutions that have information about the circumstances of the insurance case, and establishing the fact of the occurrence of an insured event, the Insurer:

— draws up an insurance act, thereby recognizing the event as an insured event;

- makes a decision to defer the insurance payment, of which the Insured Person (the Beneficiary) notifies in writing if, based on the facts related to the occurrence of the event, in accordance with the current legislation, an additional inspection has been appointed, a criminal case has been initiated or a trial has been initiated, until the end of the inspection, investigation or judicial proceedings (but for a period not exceeding 12 months);

— makes a decision to refuse insurance payment, which is notified in writing to the Insured Person (Beneficiary) within 10 (ten) working days.

9.8. Insurance payment is made within 10 (ten) banking days from the date of signing the insurance act by transfer to the recipient's bank account, unless the insurance contract provides for a different payment procedure. The day of payment is considered to be the day the funds are written off from the Insurer's current account.

Telephone consultation 8 800 505-91-11 Free call 1 2 3 4 Topic: Sick leaveIf an employee is injured at home. He did not go to work for 4 days, and then brought a sick leave certificate, which indicated that the injury was received at home. read answers (1) Topic: They require an explanatory note. I was injured at home, I was on sick leave for a month, at work they require an explanatory note with the signatures of witnesses to the incident. Do I have to write it? Gentlemen, lawyers! read the answers (2) Topic: How to pay for sick leave if a domestic injury is indicated. read the answers (1) Topic: Is it necessary to fill out accident investigation reports for injuries sustained at home? read the answers (1) Topic: Absence of an event Crimes Please, what to do in such a situation.

How to get insurance in case of an accident?

How to receive compensation for life and health insurance, sample When an insured event occurs, established by the contract, in order to receive the appropriate payments, it is necessary to perform a number of certain actions. First, you need to prepare an application to the insurance company to receive an insurance payment.
Often, when concluding a contract, the insurance company provides the appropriate form. If there is no such form, then you should draw up a document yourself or fill out a standard sample.
Download a sample application Next, you need to prepare a package of documents for the application:

  • Passport or other identification document of the insured person
  • Copy or original of the contract
  • If there is a beneficiary, documents confirming this right.

Personal Injury Insurance

Read more about insurance in this article. If the authenticity of the documents provided is in doubt and the contrary is not proven in court, then the insured person has no right to receive insurance payment. This also applies to clarifying the circumstances why the insured event occurred.

After receiving and considering all documents and circumstances of the case, the insurance company makes a decision on payment. In any case, she is obliged to notify the insured person of her decision in writing.
If the response to the request for insurance payment is positive, then the contractual payment for accident insurance will be transferred to the bank account of the insured person within the allotted time, usually within 5-10 business days after approval.

Life and health insurance - in what case can you receive compensation?

To receive insurance payment in connection with temporary disability as a result of an accident, poisoning or illness, you will need to submit a certificate from a medical institution to the insurance company. In addition to or instead of a certificate, an extract from your medical record may be required.


If the amount of insurance coverage is calculated based on the number of days of incapacity for work, you will need to attach the original sick leave certificate to the application for insurance payment. If you were injured in an accident, you will need to provide a certificate from the emergency room or an extract from your medical record to the insurance company. If the injury or poisoning occurred during work, you will most likely have to supplement the medical documents with a report of an industrial accident.

Insurance

Traditionally, the time allotted for notifying the insurance company of the occurrence of an insured event is 30 days, although there may be other options specified in the insurance contract. If for some reason you do not meet the allotted deadline, contact a company representative by phone, describe your problem to him and get advice on what to do.

So that in the future, if disagreements arise, you have someone to refer to, be sure to write down the name of the company representative with whom you spoke, the exact date and time of the conversation. Most insurance companies have standard requirements - the application must indicate the number and date of the contract, the last name, first name and patronymic of the insured person, the date and circumstances of the accident.

The application must be accompanied by documents confirming that an accident occurred with the insured person.

Trauma at home

Attention

In the event of the death of the insured person, the beneficiary specified in the insurance receives the money. If no other beneficiaries, except the insured person, were specified in the contract, the insurance payment will be received by his heirs.


Life insurance: the time has come to receive compensation Receiving payment under a life insurance policy can occur in three different scenarios, depending on the insurance program. An insured event occurred, as a result of which your health was damaged - this is one thing, the insured died - this is another.


The third possibility concerns those who have entered into an accumulative life insurance agreement with the condition that the insured amount or annuity will be paid upon reaching a certain age. If the insured event involves damage to your health, the procedure for receiving payment will be similar to receiving payment under accident insurance.

Insurance in case of injury

Important

If you are not satisfied with the amount of insurance payment or you do not agree with the reasons for refusal to pay insurance coverage, you must send a claim to the insurance company in writing. If the response to your claim does not satisfy you, you can file a complaint with the Federal Insurance Supervision Service.


You can compare insurance conditions in different companies using a free service on the website 123strahovka.ru.
Payment under insurance may be delayed even if a criminal case has been initiated and an investigation is underway into the circumstances that led to the occurrence of the insured event. Then you will have to wait until the issuance of a procedural act ending or suspending the criminal proceedings.

After reviewing the insurance application, the company decides whether to pay insurance coverage or not. The insurance company's decision is communicated by telephone or mail.

If the insurance company makes a positive decision regarding the insurance payment, the money is transferred to your bank account. “In some insurance companies you can get money in cash,” says Svetlana Khokhlova, a lawyer for the 123Strahovka.ru portal. Payment under accident and life insurance contracts is usually made within 5–10 days from the date of the decision to make it.

If you are injured at home, you can receive compensation from life insurance

The company representative is required to register your application and provide you with the registration number. This number will be useful to you if you need to find out at what stage the consideration of your application is, or vice versa - you need to provide the insurance company with any information about your insured event.

If you know the registration number of your application, communication with the insurance company will be faster, since its specialists will have less hassle in searching for your case. Both the deadlines for filing an application and the list of documents required to receive insurance payment are indicated either in the insurance contract or in the insurance rules attached to it.

Sometimes insurance companies issue their clients a special reminder about the procedure for receiving insurance payments.

Unlike car insurance, life and health insurance is relatively unpopular in our country - it is often provided by certain companies or required when applying for dangerous jobs. However, voluntary life and health insurance is a guarantee that if an accident occurs, a person will not be left without finances for existence.

Table of contents:

What are the types of life and health insurance?

Chapter 48 of the Civil Code of the Russian Federation provides for the main features of insurance, including life and health. It refers to voluntary personal insurance.

The Civil Code of the Russian Federation indicates that this insurance can be concluded for the fact of insurance:

  • survival
  • life
  • health

When insuring survival, the insured event is the attainment of a certain age by a citizen specified in the contract with the insurer.

Life insurance means that the moment of payment occurs only in the event of the death of the insured person.

Important fact

A life insurance contract can be term. That is, if the death of the insured person occurs during a certain period established by this agreement.

Health insurance is the most common type of personal insurance. It is often referred to as life and health insurance, since the insured event according to the contract is a certain loss of health or death as a result of an accident, serious illness or other cause directly established by the contract.

In addition to personal life and health insurance, a corporate (group) insurance contract can be concluded. In this case, the policyholder is a certain organization that makes contributions to the insurance company’s account for its employees.

With group insurance, insurance that is quite popular is not 24/7, but is valid exclusively during the period the employee performs his/her work duties.

If, with such insurance, a citizen receives a domestic injury, for example, gets into an accident on his day off, insurance payments in this case will not be paid.

Parties to the insurance contract

The following persons may participate in this agreement:

  • Policyholder is a person who has entered into an agreement with an insurance company and undertakes to pay the appropriate insurance amounts.
  • Insurer is an insurance company acting exclusively as a legal entity.
  • The insured person is a citizen in whose favor the insurance contract has been concluded.
  • Beneficiary is a person who has the right to receive insurance payments in the event of an insured event.

Often, a personal insurance contract is concluded between two parties - the insurance company and the citizen, who simultaneously acts as the policyholder, the insured person and the beneficiary. Less often, another person may be appointed as a beneficiary. For example, this case is popular when concluding a life insurance contract.

Important fact

In practice, often the policyholder and the insured person are separate parties to the contract when concluding a group insurance contract or an individual insurance contract concluded by an employer in favor of its employee.

Who can receive payment from life and health insurance?

According to the general rules, the insured person has the right to receive payments (compensation) in the event of an insured event. However, Article 934 of the Civil Code of the Russian Federation establishes that in addition to the insured person himself, a third party (beneficiary) can receive payment if he is indicated as such in the contract.

note

Even if the contract does not indicate a third party as a beneficiary, in the event of the death of the insured person, when the cause and occurrence of death is an insured event, insurance payments are received by the heirs in the form of an inheritance inherited by law.

How to receive compensation for life and health insurance, sample

When an insured event occurs under the contract, in order to receive the appropriate payments, it is necessary to perform a number of certain actions.

First, you need to prepare an application to the insurance company to receive an insurance payment. Often, when concluding a contract, the insurance company provides the appropriate form. If there is no such form, then you should draw up a document yourself or fill out a standard sample.

  • Passport or other identification document of the insured person
  • Copy or original of the contract
  • If there is a beneficiary, documents confirming this right. In the event of death in the absence of a beneficiary, it is necessary to provide a document confirming the right to inheritance of his heirs applying for payment.
  • A document confirming the moment of occurrence of the insured event

The last document is the most important and may vary depending on the type of event that occurred and the type of personal insurance contract. The most popular documents in the case of health insurance in practice include:

  • Conclusion or certificate from the attending physician;
  • Certificate of disability
  • Conclusion of the commission on an industrial accident
  • Traffic police report on the occurrence of an accident.
  • If a citizen died as a result of an insured event established by the contract, a death certificate must be provided in addition to the documents specified above.

Important fact

Often, in addition to the application form, insurance companies, when concluding a contract, issue relevant reminders about what needs to be done in the event of an insured event.

After collecting all the necessary documents, you must contact the insurance company itself directly and notify about the occurrence of an insured event. As a general rule, the notice period is no more than 30 calendar days.

note

The specified period is not final. Often, the insurance contract specifies the possibility of its extension, for example, if the applicant is unable to submit documents due to serious illness or other force majeure. However, in order to avoid possible disagreements, it is better to notify a representative of the insurance company in advance about the extension of the period.

The procedure for consideration and payment of insurance

However, the review process may be delayed if the insurance company has suspicions, for example, that the submitted documents are not forgeries or if a criminal case has been initiated regarding the insured event and a final decision has not yet been made.

Payments are usually made within no more than 15 days from the moment the insurer recognizes the occurrence of an insured event.