Accident insurance: basic concepts, types, conditions, risks covered, rules for payment of compensation, tariffs, best insurers
Our lives are full of dangers. In the car and plane, at work and at home, on vacation and business trip – everywhere a person can get injured, wounded, become infected with an acute infection.
Temporary disability or disability can hurt your pocket, jeopardize close relatives who will be forced to take on the costs of medical services, recovery, and life support of the patient.
Accident insurance will help to cope with such emergencies and cover unforeseen expenses.
Content
What is accident insurance?
Varieties and forms
Terms & Conditions
Insured event
Payment of compensation
Insurance rates
The best insurers
How to insure yourself against an accident (video)
What is accident insurance?
Anyone can enter into a voluntary accident insurance contract by issuing a policy in their own name or to any other person.
The amount is chosen by the policyholder. At the same time, his financial capabilities and risks are taken into account, to which a person is exposed due to professional employment, the presence of extreme hobbies.
Insurance indemnity is paid in case of an incident with the following consequences:
receipt by the insured of an injury that led to temporary disability, hospitalization, surgery, disability, death.
If desired, risks such as a newly diagnosed dangerous disease, such as cancer, can also be included in the accident insurance contract.
In the rules of most insurers there are conditions under which compensation is not paid.
In particular, the insured person cannot expect to receive insurance compensation if he/she:
was in a state of intoxication,
intentionally injured himself,
violated the law,
He applied for insurance in case of exacerbation of his previous chronic illness.
Varieties and forms
Accident insurance comes in two forms:
Individual group.
The first option is practiced in relation to one person. The insurance premium is paid by him or by the insured – it can be both an individual and an organization.
Collective insurance is issued for a group of persons, more often for employees of one company. Money for the service is transferred from the organization’s account.
By taking out insurance of employees against accidents and illnesses, the employer has the right to limit the validity of the policy only to the time that his staff spends at work.
In all Western countries, companies take care of the corporate insurance of their employees. Many large Russian organizations and enterprises also include insurance in the social package.
This can serve as a serious support for an employee who has been injured at work, temporarily incapacitated or disabled.
In the event of the death of the insured, his relatives will receive the money. An organization that takes care of the accident insurance of its employees also benefits.
She shifts the concern for the payment of compensation to the victim to the insurer, while at the same time taking advantage of tax benefits. In addition, the price of a group policy is lower than that of an individual policy.
The insured person may specify the beneficiary who will receive compensation 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.
There are the following types of accident insurance:
Mandatory
Voluntary.
The presence of a policy is mandatory for certain categories of people. The legislation prescribes to insure the 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 supported by the Russian Social Insurance Fund. It is from him that money for compensation is issued.
Reimbursement can be one-time, monthly (in case of temporary disability),
as an additional allowance for rehabilitation.
The cost of the policy is established by law. It may depend on the professions of insured persons and regions.
All major risks are included in the insurance: temporary or total incapacity for work, death.
Unlike compulsory, voluntary insurance implies complete freedom of choice of the client. He chooses the amount, term, and risks covered. The contract is concluded on the basis of the application of the policyholder and is not regulated by law.
Terms & Conditions
Anyone can apply for a policy. To do this, you need to write an application and present your passport.
However, if the insured belongs to the category of high-risk persons or he wants to set too high the sum insured, the insurer has the right to require additional documents.
Before signing the contract, it is better to inquire about the restrictions provided for by the company’s rules.
They may relate to the size of the limit, the age of the insured, the state of health (disabled people of groups 1.2 and persons with serious illnesses will be denied insurance).
You can choose from the following options:
round-the-clock
only during working hours,
during work, including the way back and forth,
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.
Less often, options with shorter terms are chosen, and only in exceptional cases the policy is issued for life.
The contract specifies the moment when it will enter into force. Usually, the insurance begins to be valid the day after the premium is paid. Taking into account the list of covered risks, the price of the policy may 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.
Read also: Survival insurance – material support for family members in the event of the loss of a breadwinner
Such a program guarantees payment for all insured events that entailed the need for hospitalization, surgery, treatment, rehabilitation.
Another option for obtaining accident insurance is a contract “from and to”, 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, since it is limited by the list of covered risks, the insurance period, and the territory in which it operates.
Insured event
If an accident occurs with the insured, he must act as follows:
take advantage of the necessary medical services;
inform the insurer about the incident 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 the enterprise, and so on. Compensation for these facts will be paid to the insured himself;
If the death of the insured has occurred, then the beneficiary or, if it is not specified, the heirs, claims to receive compensation. Applicants are required to provide proof of their eligibility to obtain insurance;
When applying, be sure to show your passport and the original policy.
Applications are considered no more than 60 days, during this period of time the insurer is obliged to calculate the loss and transfer funds.
Conducting a trial on the fact of an incident may increase the period, since the insurer does not have the right to pay compensation until it is completed.
If the insured disagrees with the amount of compensation or the insurer’s refusal to pay compensation, you can file a complaint with the Central Bank of the Russian Federation, which is the supervisory authority.
Payment of compensation
After the insured event has occurred and the loss has been registered, the insured person has the right to expect compensation. It can be paid:
temporary disability – as a daily benefit 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, which can be used to easily determine 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 death of the insured occurs, the beneficiary or heir can receive the entire amount specified in the policy, or the amount from which all previously made payments will be withheld.
It depends on the terms of the contract. Also, the amount can be doubled if the contract provides for such a condition as death due to a traffic accident, criminal assault or other incident.
Insurance rates
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 himself:
If a person wants to insure only in case of death, then the price will be calculated at the minimum rate (from 0.12%).
If the list of risks covered is wide enough, the price of the policy can be up to 10%.
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There are a number of factors that can affect the cost of insurance:
- type of professional activity (dangerous work can increase the price);
- lifestyle (the more active a person is, the more expensive insurance is for him);
- age (most of all you have to pay for the elderly and children);
- gender (for men 40 years and older, the policy will cost more);
- health status (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 (the 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);
- the policy of the insurer (each company in the struggle for the client can offer its own programs and promotions).
- You can pay for accident insurance at a time, or you can purchase a policy in installments 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 matter. Since there are quite a lot of interesting options 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, Soglasie Insurance Company and other companies. Each insurer has its own programs that may be of interest to clients of different levels and professional activities.
For example, VTB Insurance offers as many as 6 options designed for protection:
- sports fans – “Physical Culture-Privet!”.
- summer residents and mushroom pickers – “Tick-borne encephalitis”;
- children – “From Personal Junior Protection”;
- all family members – “Personal Family Protection”;
- one person – “Personal Protection”.
- in case of detection of cancer – “Manage your health!”.
- One policy can provide protection for both an individual and an entire family, a sports team, a school team.
Individual policies under the “Personal Protection” program can already be purchased online.
The insurance policy is a guaranteed support in case of injury, injury, disability, death of the insured.
In order to avoid material expenses for hospitalization, treatment and recovery, in order to provide for the family after the loss of the breadwinner, it is recommended to enlist the support of an insurer who will pay compensation in case of an accident.