Accident insurance: basic concepts, types, conditions, risks covered, rules for the payment of compensation, tariffs, the best insurers
Our life is full of dangers. In the car and airplane, at work and at home, on vacation and business trip – everywhere a person can be injured, injured, infected with an acute infection.
Temporary disability or disability can hurt affordably, endanger close relatives, who will be forced to take the cost of medical services, rehabilitation, maintenance of the patient’s life.
Accident insurance will help to cope with such emergency situations and cover unforeseen expenses.
What is accident insurance?
Anyone can enter into a voluntary accident insurance contract by issuing a policy in their own name or on any other person.
The amount is selected by the policyholder. At the same time, his financial capabilities and risks to which a person is exposed due to professional employment and the presence of extreme hobbies are taken into account.
Insurance indemnity is paid in case of an incident with the following consequences:
- receipt by the insured of an injury leading to temporary disability,
- hospitalization, surgery,
Optionally, risks such as a newly discovered dangerous disease, such as cancer, can be included in an accident insurance contract.
The rules of most insurers have conditions under which compensation is not paid.
In particular, the insured person cannot count on receiving insurance compensation if he:
- was intoxicated
- intentionally injured himself,
- broke the law
- He applied for insurance in case of an exacerbation of his previous chronic illness.
Varieties and forms
Accident insurance comes in two forms:
The first option is practiced for one person. The insurance premium is paid by him or the policyholder – it can be both a private person and an organization.
Collective insurance is issued for a group of people, more often for employees of the same company. Money for the service is transferred from the organization’s account.
Making insurance of employees against accidents and illnesses, the employer has the right to limit the effect of the policy only to the time that its staff spends at work.
In all Western countries, companies take care of corporate insurance for their employees. Many large Russian organizations and enterprises also include insurance in the social package.
This can serve as a serious support to an employee who was injured at the workplace, temporarily disabled or has a disability.
In the event of the death of the insured, his relatives will receive the money.
An organization that takes care of accident insurance for its employees also benefits.
She shifts the care of paying compensation to the injured to the insurer, while taking advantage of tax benefits. In addition, the price of a group policy is lower than an individual.
The insured person may indicate the beneficiary who will receive reimbursement after his death. Thus, after the death of the breadwinner, the family will not be left without money, but will receive support from the insurer.
The following types of accident insurance are distinguished:
The presence of a policy is mandatory for certain categories of people. The legislation prescribes insurance for military, police, rescuers and other representatives of dangerous professions.
Previously, passengers were insured, but now only the carrier’s liability is insured.
Compulsory accident insurance is provided by the support of the Russian Social Insurance Fund. It is from him that money for compensation is issued.
Refunds may be:
- monthly (for temporary disability),
- as an additional rehabilitation allowance.
The cost of the policy is established by law. It may depend on the professions of the insured and the regions.
The insurance includes all the main risks:
- temporary or complete disability,
Unlike mandatory, voluntary insurance implies complete freedom of choice of the client. He chooses the amount, term, risks to be covered.
The contract is concluded on the basis of the application of the insured and is not regulated by law.
Terms & Conditions
Anyone can apply for a policy. To do this, write an application and present your passport.
However, if the insured belongs to the category of high-risk persons or he wants to set the insurance amount too high, then the insurer has the right to demand additional documents.
Before signing the contract, it is better to inquire about the presence of restrictions provided by the rules of the company.
They can relate to the size of the limit, the age of the insured, the state of health (disabled people of 1.2 groups and people with serious illnesses will be denied insurance).
The term of the policy can be selected from the following options:
- round the clock
- only during business hours,
- during work, including round trip
- at a separately agreed time (for example, for the period of training in the gym).
The contract can be concluded for a period of 1 day to a year or more. Voluntary accident insurance is usually issued in an individual form for a period of 1 year.
Options with shorter periods are less often chosen, and only in exceptional cases the policy is drawn up for life.
The contract shall indicate the moment when it enters into force. Usually, insurance begins on the day after the payment of the premium.
Given the list of covered risks, the price of the policy can be 0.12-10%.
The policyholder has the right to choose round-the-clock coverage, valid in all countries of the world, with the maximum number of risks, including extreme sports.
Such a program guarantees payment for all insured events that entailed the need for hospitalization, operations, treatment, and rehabilitation.
Another option for registration of accident insurance is the “from and to” contract, that is, for a specific period of time during which the insured person is going to go on vacation, business trip, attend an event, play sports.
Such a policy costs less because it is limited by the list of covered risks, the insurance period, and the territory in which it operates.
If an accident occurs with the insured, he must act as follows:
- use the necessary medical services;
- inform the insurer about what happened without violating the deadlines (usually 1 month);
- write a statement, attach the available documents on this fact: a certificate from the hospital, an accident report, an accident report from an enterprise, etc. Compensation for these facts will be paid to the insured himself;
- if the insured person dies, then the beneficiary or, if not specified, the heirs claims to receive compensation. Applicants must provide proof of eligibility for insurance;
- when applying, it is necessary to show the passport and the original policy.
Applications are considered no more than 60 days, for this period of time the insurer is obliged to calculate the loss and transfer funds.
Litigation on the fact of the incident may increase the period, since before its completion the insurer does not have the right to pay compensation.
If the insured does not agree with the amount of compensation or the insurer refuses to pay compensation, you can file a complaint with the Central Bank of the Russian Federation, which is the controlling body.
After the occurrence of the insured event and registration of the loss, the insured person is entitled to rely on compensation. It can be paid:
- temporary disability – as a daily allowance in the form of a fixed percentage of the sum insured);
- disability – in the form of a lump sum payment in accordance with the disability group:
I – 70, 80,100%,
II – 60, 70, 75%,
III – 40, 45, 50%.
Each insurer has its own table, according to which it is easy to set the amount of compensation depending on the nature of the damage and its severity.
Such a table is used when the insured person receives a fracture, injury, or other injury.
If the insured dies, the beneficiary or heir may receive the full amount specified in the policy, or the amount from which all payments made earlier will be withheld.
It depends on the terms of the contract. Also, the amount may be doubled if the contract provides for such a condition as death due to a traffic accident, criminal attack or other incident.
The price of the policy will depend on the number of risks included in it. It is calculated as a percentage, and the amount of the sum insured is set by the client:
- If a person wants to insure himself only in case of death, then the price will be calculated at the minimum rate (from 0.12%).
- If the list of covered risks is wide enough, the price of the policy can be up to 10%.
There are a number of factors that can affect the cost of insurance:
- type of professional activity (hazardous work can increase the price);
- lifestyle (the more active the person, the more expensive insurance for him);
- age (most have to pay for the elderly and children);
- gender (for men 40 years and older, the policy will cost more);
- state of health (the presence of serious problems can increase the price);
- insurance history (regular customers who have not previously applied for compensation receive a discount);
- the number of insured people (a policy for the whole family or a work team will be cheaper);
- insurance period (premium for insurance for several months is calculated at a short-term rate);
- the number of risks (with an increase in their number, the cost of the service increases);
- policy of the insurer (each company in the fight for the client can offer its own programs and promotions).
You can pay for accident insurance at a time, but you can purchase an installment policy and make contributions every month, quarter, year. This is negotiated with the insurer additionally.
The best insurers
Choosing an insurer is a responsible and serious business. Since quite a lot of interesting options are presented on our market today, it is important not to make a mistake and give preference to a reliable and experienced company.
Accident insurance is offered by Ingosstrakh, RESO-Insurance, IC Concord and other companies. Each insurer has its own programs that may interest clients of different levels and professional activities.
For example, VTB Insurance offers as many as 6 protection options:
- sports fans – “Fizkult-Hello!”;
- summer residents and mushroom pickers – “Tick-borne encephalitis”;
- children – “Excellent Defense Junior”;
- all family members – “Excellent Family Protection”;
- one person – “Excellent Defense”;
- in case of cancer detection – “Manage your health!”.
One policy can provide protection for both an individual person and the whole family, sports team, school team.
Individual policies under the Excellent Defense program can already be bought online.
Insurance policy – guaranteed support in case of injury, injury, disability, death of the insured.
In order to avoid material costs for hospitalization, treatment and recovery, to ensure the family after the loss of a breadwinner, it is recommended to enlist the support of an insurer who will pay compensation in the event of an accident.