How does accident insurance defend interests of Insured parties?
Accident insurance guarantees that the insurance company will perform insurance indemnity, if any accident occurs with Insured party, causing health disorder (injury, hurt, dysfunction of organism, etc) or Insured party’s death.
Insurance indemnity due to voluntary accident insurance will be received by either Reinsured party or its Beneficiary, determined in the insurance contract. In case of Insured party’s death as a result of any accident, the insurance indemnity in the amount of 100% of Sum insured, determined for Insured party, will be received by Beneficiary, determined in the insurance contract. If Beneficiary has not been determined in the insurance contract, so, in case of Insured party’s death caused by any accident, the insurance indemnity will be received by its heirs due to the law.
What is an accident?
An accident (due to an insurance contract) are sudden, unexpected events, including illegal activities of third parties that have actually occurred during the validity of the insurance contract or caused health disorder of Insured party by any lesion of organism tissues with the solution of their continuity and functions, deformation and damage of locomotor apparatus, caused by external effect, or Insured party’s death. Unexpected penetrations of any foreign body into respiratory tracts, drowning, heat stroke, burn, bites of animals, insects, snakes, kibes, hurt of electrical current and lightning, accidental poisoning by substances, gases, medicines, poor quality food (except, food toxinfection) are also considered as accidents.
Important! Diseases (sudden, chronic, exacerbation of chronic ones), and their consequences are not an accident due to the terms of the insurance contract. Therefore, in case of death or disablement as a result of disease, insurance indemnities due to the terms of such insurance line have NOT been anticipated.
A voluntary accident insurance contract (an insurance contract) is a written agreement between Insured (an enterprise, a legal entity) and Insurer (an insurance company), subject to which Insurer takes obligations, in case if an insured event occurs, to perform insurance indemnity on the terms, determined in the contract, and Insured is obliged to make insurance premiums due to the fixed period and to follow other terms of the contract.
Insured parties are natural persons (employees of an enterprise), in whose favor the insurance contract has been concluded.
A voluntary accident insurance contract may be concluded against the occurrence of the following risks:
a temporal loss of Insured party’s working capacity or any traumatic injury as a result of any accident;
a steady loss of Reinsured party’s working capacity (its determination of I, II or III groups of disablement) as a result of any accident;
Insured party’s death as a result of any accident.
As a rule, by consent of the parties, an insurance contract is concluded as to a certain combination of such risks. Hereat, a death risk is included practically into all insurance contracts. The list of the risks, which are included into the insurance contract, significantly influence the amount of the insurance premium.
How are the amounts of Sum insured and insurance tariff determined?
Sum insured is a money sum, determined in the insurance contract, within the limits of which Insurer is obliged to perform an insurance indemnity, in case if an insured event occurs. The amount of Sum insured is determined by consent of the Parties.
Insurance tariff is an amount of insurance premium (fee for insurance), determined in percentage from Sum insured.
Insurance tariff depends on the list of chosen risks, professional riskiness, period of insurance, other insurance terms. The amount of annual insurance tariff due to a voluntary accident insurance is within the range of 0,15% to 1,5 %.
How is the amount of insurance indemnity determined?
If in the insurance contract it is anticipated an insurance indemnity in case of temporal loss of Insured party’s working capacity as a result of any accident, Insurer performs the insurance indemnity in the amount from 0,05% to 0,7% (the concrete amount is determined in the insurance contract) of Sum insured for each day of working incapacity or treatment but not more than 100% of Sum insured.
In case of Insured party’s traumatic injury as a result of any accident, the insurance indemnity is determined due to an insurance indemnity table (it is the table in which a certain amount of insurance indemnity in % of Sum insured corresponds to each diagnosis of trauma or organism’s injury).
If in the insurance contract it is anticipated an insurance indemnity in case of determining a disablement group to Insured party as a result of any accident, Insurer performs the insurance indemnity, the amount of which is determined in percentage from Sum insured:
from 90 to100% - in case of determining Ist disablement group to Insured party;
from 60 to 80% - in case of determining IInd disablement group to Insured party;
from 40 to 60% - in case of determining IIIrd disablement group to Insured party;
The concrete amount of the insurance indemnity and its restrictions are determined by the insurance contract.
If in the insurance contract it is anticipated an insurance indemnity in case of Insured party’s death as a result of any accident, Insurer pays out 100% from Sum insured to Beneficiary or Reinsured party’s heirs.
You can obtain more detailed information on voluntary personal insurance against accidents from our specialists at your nearest structural subPision of the representative network of "Oranta" Incorporated.
