Accident insurance. Accident insurance: making the right choice Accident insurance for children

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

Accident and illness insurance provides additional financial support to the victim or his family members. Such insurance acquires particular relevance in the event that someone close becomes disabled or completely dies as a result of unforeseen circumstances. Payments from the fund of the insurance company according to the purchased policy will help a person or his relatives to partially reimburse suddenly incurred expenses and not be left without the means necessary for subsistence.

The essence of insurance programs from the National Assembly

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

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

NS insurance can be carried out in several forms and types. The main forms of NS insurance include:

• individual - in this case, the insured (which can be both an individual and a legal entity) acquires a policy in order to insure himself or another entity. At the same time, he pays contributions to the insurance fund of the company independently;
• group - provides insurance for a group of people (often employees), for whom a 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 are possible - within 24 hours a day or during the working hours established by the labor schedule.

In terms of varieties, NS 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. In the event of an insured event, material compensation is accrued to the insured at the expense of 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 concludes an insurance contract based on personal motives, and not by virtue 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 wants to insure.

The cost of an individual HC insurance policy depends on the list of risks, the amount insured, gender, age of the insured subject. With group insurance, the tariff is affected 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 be different - from several days to several years. The first option is optimal for those who intend to protect themselves for the duration of a specific task, business trip, etc. The most common document validity period is one year, after which it can be extended or terminated relations with this organization.

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

Accident insurance provides for the presence of insurance risks, which can be conditionally classified into four groups: injury, disability, disability, death. But not all situations that lead to these consequences can be classified as insured events.

Insured events are:

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

Insurance cases do not include:

• injury to the insured when performing actions that are qualified 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;
• intentionally harming oneself or being traumatized when trying to commit suicide;
• death for the reasons listed above;
• the consequences of medical procedures and manipulations that were not aimed at eliminating the insured event;
• injury and death during hostilities, riots, nuclear and other explosions.

Accident insurance provides for the payment of compensation only when the events of the first group take place. If the circumstances do not belong to the group of insured events, material 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 market of insurance services 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:

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 an insurance policy from the National Assembly, you can additionally compensate for the costs that accompany expensive treatment that goes beyond the scope of the medical insurance policy.

What is Accident and Health Insurance?

Accident and sickness insurance is a voluntary type of personal insurance.

With temporary disability payment is made in the format "% of the sum insured for each day of incapacity for work". At the same time, the insurance rules of most companies limit the maximum number of days of disability covered by the HC policy. For example, in the company RESO-Garantia this period is limited to 100 days.

In case of disability (permanent disability) The amount of the payment depends on the assigned disability group. Group I - 100%, Group II - 75%, Group III - 50%.

Upon the occurrence of death The insured company pays the full amount of the sum insured. This amount is received by the Beneficiary specified in the insurance contract.

What are the grounds for refusing to pay?

Of course, HC insurance has its own exceptions to insurance coverage when the insurer refuses to pay compensation. Such cases include:

accidents as a result of being in a state of alcoholic and / or drug intoxication,

suicide or attempted suicide,

injuries resulting from illegal actions of the insured person,

intentional bodily injury,

taking medications without a doctor's prescription,

hostilities,

participation in sporting events, competitions, training.

Accident insurance is the main means of supporting the insured person and / or his close people in the event of certain circumstances. It is issued on a voluntary basis, taking into account the level of income and exposure to professional risks. Types of policies - collective, individual, family, children's, sports and travel. About accident insurance will be discussed in the article.

Definition

Individual insurance

Individual policies can be issued in the following forms:

1. Full insurance- it applies to all periods of the professional and private life of a person during the validity of the contract.
2. Partial Insurance– the guarantee of compensation is given only for a certain period (for example, during a tourist trip abroad).
3. - issued as an addition to package and combined policies if they do not provide protection for the necessary risks.

Personal accident insurance is the most popular type of voluntary package in the UK.

Group (collective) - insurance of employees against industrial accidents

Corporate or collective insurance of employees is in the area of ​​social responsibility of the organization. It is usually issued only by large companies that provide their employees and are interested in maintaining a certain level of prestige. Also, the presence of such policies is necessary if the professional field of activity of employees is associated with significant risks.

Almost all modern hazardous industries issue collective accident protection policies for their employees.

Group insurance guarantees financial support to the employee and his family in case of temporary or complete disability. Tariffs for collective policies are always lower than for individual ones.

Family

This type of policy applies immediately to all family members. Its presence guarantees you and your loved ones the maximum level of security, the payment of monetary compensation in the event of an insured event in full. The main ones are death, serious injuries and mutilations. Under one policy, an unlimited number of relatives aged 1-70 years can be insured.

Family accident insurance is one policy for the whole family.

Children's - life and health insurance of the child

Child insurance is needed by your children, regardless of their age, and by you personally. It guarantees full compensation for the costs of restoring the health of a child who has suffered as a result of an accident. At the time of the conclusion of the contract, he must be from 1 to 17 years old.

Insurance protection under the children's policy is valid 24 hours a day or during your stay in a preschool, school.

Child protection includes dislocations, fractures, damage to internal organs and soft tissues, poisoning, burns and other consequences of an accident, up to and including death. The policy can be issued for any period - for a year for permanent protection or for 10 days for a trip to the camp.

Sports - how to insure a person against accidents in sports

A voluntary accident insurance policy is also necessary for every professional athlete, since it will save time, money and effort in the event of an insured event (and since this area belongs to areas of increased injury risk, it will definitely come sooner or later). It covers all types of injury, disability, and sports-related death. Validity - from 1 day to a year.

Issuing a policy for one year is the most economical offer for athletes. Also, insurance can be done for any other period - for example, the time of sports camps.

Personal travel insurance in case of death

Most package tours abroad already include insurance, but it would be better to clarify this point.

Features of voluntary accident insurance contracts

To apply for accident insurance, you will need to apply to the UK with a passport and write an application. Be sure to clarify information about the restrictions on the policy - it may apply to the age, state of health of the applicant, the list of insured events. Expiration dates can also be different:

• while at work;
• around the clock;
• while staying at school or children's sections.

The duration of the policy is from one day. Most often, insurance is issued for one year, but this does not mean that you cannot choose any other option.

Insurers who plan to conclude a contract for a million dollars may be required by the UK to present additional documents, except for a passport. This mainly applies to corporate clients.

The date of entry into force of the policy is indicated in the contract, usually the insurance takes effect the next day after payment of the premiums. The fee for a voluntary policy is 0.12-10% and is determined individually, taking into account a set of risks. E

If, as a result of an accident, several events specified in the contract occur at once, payments will be made for each separately.

All insured events covered by the contract must be clearly stated. The main options, as we wrote above, are temporary disability, disability and death. Compensation can take the following forms:

• in cash or by bank transfer as the full insurance amount, part of it (the amount is prescribed in the contract);
• insurance benefit;
• pension;
• daily reward.

The form of payments is also prescribed in the contract and takes into account the nature of the consequences of the injury. So in the event of death, compensation is provided one-time, and in the event of disability, it is also provided.

Video

conclusions

From accidents - the main way of protection in case of complete or temporary loss of working capacity, death. Insurance is issued in the UK, it can be individual, group, children, sports, travel, family. The cost of the policy depends on the width of the coverage.

Updated 02/27/2020 Views 3176 Comments 10

To mitigate the financial consequences of an accident, you can insure. There are insurance against accidents for ordinary life (called life insurance), but it is on travel that such risks increase greatly.

But, on the other hand, as with all insurance in general, you first need to deal with the conditions so as not to pay in vain. Now I’ll tell you what it is, whether you need to take out accident insurance or not.

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 is this insurance

Accident insurance is, as a rule, not a separate insurance, but only an additional option to travel insurance (travel insurance). First of all, you need to choose whether this option will be there is a second matter.

The most important thing you should know! Visiting a doctor abroad, tests and examinations, staying in a hospital hospital are paid on the basis of travel insurance (travel insurance) and within its sum insured. That is, all medical assistance is provided regardless of the presence of the “accident” option in the policy. This option does not help you abroad in any way, it's about something else.

Accident insurance provides compensation after an injury or disability. This payment is made after your return to the motherland. And you can spend this money wherever you want, even for rehabilitation, even for a new wardrobe.

Do I need to buy it

The “Accident” option is an optional option and it increases the cost of the entire policy if you add it. The decision is up to you. Do you need a separate payment after an accident, or will it be enough to cover medical expenses under the usual travel insurance.

If you are initially considering NOT budget insurance, but more expensive, then very often they already include this option. You won't have to pay anything extra. In general, more expensive policies differ in that their cost includes a bunch of different options by default.

It happens that when you buy a plane ticket in any service, then along with it you will be offered to buy accident insurance. It can act both during the flight and for the entire trip (you need to look at the conditions). In exactly the same way they can offer and. Actually, if these options are already included in your main travel insurance, then there is definitely no point in paying for them again.

Buying insurance

What you need to know

• Insurance companies consider an accident to be an event that occurs SUDDENLY and results in serious injury, illness, temporary disability, disability, or death. Injuries that are considered an insured event can be received in an accident, when a criminal attacks, falls from a height, it can also be domestic injuries (for example, a burn with boiling water).
• Insured events may also be situations that occurred during the validity of the contract, but resulted in the death of the insured or the assignment of disability to him for some time after the end of the insurance. All these terms are in the contract.
• The injury must be on the paytable, otherwise there will be no payout. It must be borne in mind that the payment may depend on the wording of the diagnosis in your medical documents. In disputable cases, the insurance company will interpret the doctor's opinion in its favor, so it is better that the diagnosis most closely matches the column in the payout table.
• If you alone buy a policy for the whole family at once and add an accident insurance option, then this option applies to everyone. To use this option for one person, for example, a child, you will need to issue a separate policy for him with this option, and for the rest of the policy without the option. This way you can save.

When insurance doesn't work

Each insurance contract contains a list of situations that will not be considered an accident.

• Events occurring outside the territory or period of insurance specified in the policy.
• Accidents that cannot be considered unforeseen. For example, due to mental disorders of the insured person, chronic diseases, etc. The consequences of infectious diseases, strokes and heart attacks can also be included in the list of exclusions from insured events.
• Insured events during force majeure circumstances: military operations, strikes, natural disasters, etc.
• Insured events during sports, if these sports are not initially included in the traveler's insurance itself. To enter, you need to add a separate option "Sport", "Active rest", etc.
• If the insured was under the influence of alcohol or drugs at the time of the injury. If the insured has suffered by committing criminal acts. In case of death as a result of suicide, or if the insured has intentionally harmed his health.

Cost and sum insured

Separately, I would not buy accident insurance, since it does not replace medical travel insurance, on the basis of which medical assistance will be provided. Therefore, it is better to take accident insurance as an additional option to the main insurance.

There is a separate sum insured for the "accident" option. You choose it yourself. The larger this amount, the more expensive the policy will cost. Try playing with the filters on the right on or to see how the price changes.

Usually the choice of the sum insured ranges from $1,000 to $25,000. But on the websites of some insurance companies, you can choose a larger amount. And remember, this amount has nothing to do with the sum insured for the entire insurance.

Accident insurance - additional option for extra money

Payout amount

The amount of payment depends on the sum insured. The higher the sum insured, the higher the payout. But most often not the entire sum insured is paid, but a percentage that depends on the type of injury.

The maximum (100% of the sum insured) will be only 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 have insured for $ 1000, then if you break your arm, you will receive them all. No! For a leg / arm injury, only 10-20% of the sum insured will be paid, that is, only $ 100-200.

The amount of the payment is always proportional to the damage caused to the health of the insured person. The more severe the injury and its consequences for health, the greater the insurance indemnity. All information must be specified in the payment tables in the insurance contract or in an annex to it. For example.

Upon receipt of the second group of disability, you can receive about 75% of the sum insured, with the third - 50%, and only 10-20% will be paid for a leg / arm injury. For burns of 1-2 degrees, the rate may be 0.3% of the total amount of insurance. For damage to the face, neck, ears, the rate is 0.5%. The payment for "temporary disability" is considered to be 0.2-0.3% of the sum insured for each day of incapacity for work, but the payment period is usually limited to 60-100 days. Also, in such cases, insurance companies often use a temporary deductible from 10 to 30 days, this period is not taken into account when calculating the insurance payment.

What to do in the event of an accident

The first thing to do is to get medical assistance, which will be provided as part of the travel insurance. I repeat, the presence of the "accident" option does not play a role.

Therefore, call assistance () and go to the designated hospital. If this is not possible (for example, unconscious), then the ambulance will decide where to take it. As soon as possible, you will need to contact the assistance and decide on the stay in the current hospital, whether they will pay, whether they will transport you to another, or you will have to pay on your own and then receive a refund.

And only after you have resolved all the issues of treatment, you can already think about the payment in connection with the accident. Usually they do this when they return home from a trip. But it is better to start the process early, while still in the hospital (if possible), in order to check the availability of all the documents necessary for the payment.

Accident payments are made by an insurance company (not assistance), so you must notify them of the accident and that you want to request a payment. As a rule, you need to provide all documents no later than 30 days after returning to your homeland.

List of documents for payment

When you contact the insurance company, you will be given a list of documents. They differ depending on the insurance company, so I can not give an exact list. I will write what is possible.

- Application, passport and insurance policy.
- Certificate from the doctor who provided first aid. Or a certificate from a medical institution where treatment was carried out in a hospital. The certificate must include a medical report and diagnosis.
- An accident report, an official document confirming the circumstances of an accident. With signatures, if possible, of all witnesses and responsible persons.
– When establishing disability, it is necessary to provide copies of the medical history and extracts from the outpatient and medical cards, 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 the right to inheritance

After submitting the documents, the representative of the insurance company must register your application and tell you its registration number (you can find out the status of the application by it). After that, the insurance company will consider your case within 1-2 months.

Life hack #1 - how to buy good insurance

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