Online accident insurance policy. What is the difference between accident and health insurance? Sports – how to insure a person against accidents in sports

The life insurance market is actively developing in Russia. If just a few years ago it was possible to insure your own well-being in separate companies, now such insurance has finally and irrevocably entered our lives.

The insured person - depending on the chosen program - may not have to worry about his own well-being and the future of his family in the event of an emergency.

But which insurance should you choose – to insure yourself against an accident or against illness? After reading our material, you will learn about the main differences between the two policies mentioned above.

Unfortunately, there are indeed many situations that can lead to accidents in everyday life. That is why this type of insurance is popular.

It covers expenses in the event of a tragic set of circumstances, if it leads to disability or even death of the policy owner.

The main legal source of such insurance is the Federal Law “On Insurance in the Russian Federation”.

What does it cover?

Road accidents, work incidents and any other accidents. It is important to remember that the policy does not apply to situations in which the insured person is at fault (the rule familiar to holders of compulsory motor liability insurance applies - compensation is not paid to the culprit of an accident, even if he himself was injured), and to suicide.

What can the insured person count on?

The payment amount is negotiated at the stage of concluding the contract; it can be any within the boundaries with which a particular company operates.

In case of disability, insurance will provide:

• money for treatment;
• means to live if you can’t go to work.

If the accident results in death, the relatives specified in the policy receive compensation.

That is why breadwinners of families are often insured; insurance payment will become indispensable in the event of an emergency.

Features of health insurance

Illness is another risk that can lead to disability, disability, and even death. Insurance companies offer insurance in case of the onset of one or another (or several) illnesses.

Since there is compulsory health insurance in the Russian Federation, it covers basic medical expenses.

Its most important advantage is receiving one-time or regular payments to cover the lack of wages.

It is noteworthy that after the occurrence of an insured event, the insurer will require the insured person to undergo a medical examination - this will confirm the presence of a particular disease.

However, do not forget that you will have to visit a doctor before concluding a contract - this way the insurer will be able to make sure that the citizen does not have a predisposition to the disease or the first stages of the disease.

What diseases can you insure against?

Nowadays, insurers offer policies, as they say, for every taste. The list of diseases subject to insurance grows every year and is regularly reviewed. Naturally, the illness must be serious and carry potentially significant consequences.

Let's give an example: it is impossible to insure against colds (expenses for treatment are relatively small, sick leave is given at work), but it is possible to insure against pneumonia, which is sometimes a complication of diseases of the upper respiratory tract.

These days, the list of the main and most popular health policies looks like this:

• stroke;
• heart attack and other heart diseases;
• onset of blindness;
• infection with HIV and AIDS;
• the occurrence of renal failure;
• aortic diseases;
• the need for organ transplantation arises;
• multiple sclerosis;
• paralysis;
• treatment of coronary arteries;
• heart valve problems.

Insurance payments

With insurance payments upon the onset of illness, not everything is so clear; insurance companies offer several possible options for receiving funds.

These include payment of the entire amount, payment of insurance in installments, payment of assigned benefits or daily remuneration (only for the period when a person was declared incapacitated), as well as payment of additional pensions on a temporary or permanent basis in order to maintain health at the proper level (this occurs in Russia very rarely).

We remind you that the amount and frequency of payments are agreed upon directly at the conclusion of the contract. The insurance premium depends on what payments the insured person expects to receive in the event of an illness.

When is it not paid?

If an insured event occurs, then the policyholder is obliged to fulfill the terms of the contract, right? However, there are situations when the company is not required to pay. The basis for such a decision may be a violation of the agreement.

Here are some examples:

1. The illness of the insured person occurred as a result of a violation of the law.
2. The insured person self-inflicted injury.
3. The insured person intentionally violated the doctor's requirement.
4. The illness/injury occurred while under the influence of alcohol or drugs.

Who can get the policy?

On the one hand, the insurance contract is concluded by the company providing such services, on the other - by an individual or legal entity.

Most often, individual citizens apply for a policy, but large-scale agreements regarding all employees of a particular enterprise are not uncommon. Or, for example, a football team, students, and so on.

The law does not impose specific restrictions on insurance regarding the identity of the person wishing to purchase the policy. But legal practice allows insurance companies to deny coverage to some people if the policy is deemed too risky.

Programs

You have decided to take out a policy, and you have to choose one of the insurance programs.

Note that the applicant for the policy has the opportunity to insure himself, people close to him, choose the category of only occupational diseases, or (relevant for lenders) take out insurance for his borrowers, so as not to be left without funds if they are unable to repay the loan due to illness.

• Employee insurance

Another special program that brings benefits for the employer. The insured employee will receive all the necessary compensation if the company is found guilty of causing the disease.

• Borrower insurance

It has another undoubted advantage - in the event of illness, the obligation to repay the debt does not burden relatives.

Similarities and differences

We talked about the main features of each type of insurance in the Russian Federation and noted in what situations the policy may be useful.

We offer, as a kind of summary, a summary table that outlines the main differences between accident insurance and illness insurance. Be healthy!

Option	Health insurance	Accident insurance
Subject of insurance	Documented pathology doctor	Accident not due to the fault of the insured person
Insurance case	Diagnostics, revealed the disease	Hospitalization after an accident
Payments	Covers absence of ability to work	Covers lack of wages or loss of a breadwinner
Restrictions for the applicant	A medical examination is carried out; if there are the first stages of the disease or predisposition, the policy is not issued.	There are no restrictions, but applicants working in risky jobs will pay more for insurance.

In contact with

The main purpose of such insurance is to help overcome financial difficulties associated with partial or complete loss of ability to work. Companies engaged in this type of activity provide financial support to the client himself, as well as, if necessary, his immediate relatives.

Dear reader! Our articles talk about typical ways to resolve legal issues, but each case is unique.

If you want to know how to solve exactly your problem - contact the online consultant form on the right or call by phone.

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Types of insurance against illnesses and accidents

Insurance comes in two forms:

1. On personal initiative.
2. As part of a group expression of will.

In the first case, the Policyholder insures himself or another person on his own initiative, paying all premiums independently. And in the second, the organization pays the money and insures its employees. The contract may last a full day, or may be limited to the work schedule.

This type of relationship is resorted to by companies that are conscientiously socially responsible or organizations with an increased risk of injuries and dangers. The group nature of insurance provides powerful support to the employee in the event of an illness or accident, and allows the company to reduce the cost of payments.

It should be noted that collective rates are significantly lower than personal rates.

Insurance cases

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1. Receiving damage to health as a result of an accident - dislocations of joints, fractures of bones or bone apparatus, various types of wounds, burns, etc.
2. Poisoning with chemicals or plants (salmonellosis bacteria, dysentery and other types of toxic poisoning are not included).
3. Tick-borne encephalitis or polio infection.
4. Pregnancy outside the womb or childbirth of a pathological nature leading to loss of reproductive capacity in women.
5. Fatal outcome from the above listed insured events, as well as from suffocation due to the entry of a foreign body into the respiratory system, excessive cooling or due to the onset of anaphylactic shock.

From the list you can see that insurance companies have protected themselves as much as possible from fraudsters, but there are still people who moderately cause injuries or other damage to themselves in order to receive payments.

In order to bring such people to light, if necessary, the organization has every right to conduct its own investigation of the situation, after which a verdict on insurance payment is made. Those who were in any type of intoxication at the time of the insured event will not receive the amount.

For whom is this type of insurance mandatory?

There are 2 types of accident insurance:

1. Mandatory type.
2. Voluntary.

Who is subject to compulsory insurance:

• military;
• law enforcement and court officials;
• emergency workers and many other high-risk categories;

Upon the occurrence of an insured event, payments can be one-time or monthly as a benefit due to temporary disability or to help pay for funds intended for the rehabilitation of the insured.

Funds are contributed from the Social Insurance Fund of the Russian Federation, and the tariff depends on the category of the victim, his regional location and is established by legislative acts of the Russian Federation. Payments are made in connection with the loss of ability to work, temporary or full, as well as due to the death of the victim.

Voluntary insurance implies an independent choice of an insurance company, the amount of insurance, the duration of the contract and a list of risks that the client wants to cover. The conclusion of an agreement is made on the basis of an application, and not in accordance with a legal requirement.

Insurance period and tariff schedule

Dates:

1. 24-hour insurance.
2. For the period of the working day and the time spent on transfer from home to work and back.
3. Only for working hours.
4. For a specific period of time (for example, during a workout).

An insurance contract can be concluded for a period from one day to several years. For individual insurance, the most popular term is 1 year. In the Russian Federation, the practice of concluding this type of relationship for life is not yet sufficiently developed.

The period from which the insurance begins to be in force is indicated in the document; traditionally, this is the next day after payment of the premium - its amount ranges from 0.12 to 10% of the insurance amount.

The percentage depends on the list of risks. It is possible to include support in the list within 24 hours, anywhere on planet Earth, whether a person is at home, on a trip or in training.

In cases where an insured event occurs simultaneously in two categories, payments are made for each separately in full.

This is the first option for issuing a policy, but there is also a second, less expensive option - it is issued for a specific period and is most often initiated by companies seeking to reduce their financial liability to a minimum. Incidents that occur outside of the time limit or outside the insurance coverage area are not eligible for payment.

Tariff fee schedule

The amount insured is the main subject of the contract. The policyholder can determine it for himself individually, depending on his desires and means.

The tariff is set by the organization and it depends on the list of included risks - the more points, the larger the contribution. Usually it is no more than 10% of the insurance amount.

Factors influencing the amount of contribution:

1. Client's professional activity– the more risky the work, the higher the tariff.
2. Lifestyle and hobbies. For example, a person likes to travel to exotic countries or is interested in a dangerous extreme sporting activity, this also raises the ante.
3. Age category of citizen– the percentage is higher for the elderly and children.
4. Gender– in men after they reach 40 years of age, the risks increase.
5. Depending on the state of the client’s health. For people with serious illnesses, the percentage is higher.
6. History of insurance. It must be flawless. The more accurately the payment of deductions is made, the greater the likelihood of receiving a discount from the company; in addition, it looks at how much a person takes care of himself and does not get involved in risky activities.
7. Number of people willing to insure themselves– rates are lower for package offers.
8. Terms of cooperation– to its regular customers, upon expiration of the insurance period with subsequent repeated or extended conclusion of the contract. In such situations, organizations provide discounts as a percentage of the contribution amount.
9. List of risks specified in the document– the more, the higher the cost of the policy.
10. You can pay contributions using three schemes– one-time, annually, after a quarter or monthly.

Before concluding an agreement, you should carefully read the agreement, preferably in the presence of a legally competent person, and discuss all the nuances.

Registration of an insurance policy

It is best to contact a company that has been engaged in this activity for many years, which has an impressive base and a good reputation.

You can specify any amount not exceeding RUB 3,000,000. in currency - rubles, US dollars or the single European currency. Payments are made within 10 days from the date of delivery of the required package of documents in the event of an insured event.

You can draw up a contract by contacting the insurance company in person.

What to do for this:

1. Provide a document confirming your identity.
2. Write a statement to the insurance company.
3. If necessary, provide documents that characterize the occupation, health status and lifestyle of the client and the persons included in the contract.
4. Make a list of risks to be insured.
5. Determine the amount of insurance.
6. Calculate the insurance premium and its payment scheme.
7. Pay.

If a person is in a high-risk area, then the organization has the right to request additional documents, the same applies when the insurance amount is several million.

The client must also meet some requirements:

1. Be between 18 and 65 years of age.
2. Do not have serious illnesses.
3. Disability of groups I and II excludes the possibility of insurance.

We receive payments

To obtain insurance, the organization must provide the following documents:

1. Policy.
2. Passport or other identification document.
3. A completed application form for the occurrence of an insured event.
4. A reference base confirming the nature of the damage caused from the institution providing medical care or treating the victim.
5. Certificate of form N-1 in case of an incident at the workplace or another document confirming the circumstances of the situation.
6. A document from the authorized official body in case of an accident establishing the fact of the accident and its nuances. If, as a result, the victim acquired a disability group, then it is necessary to provide copies of the outpatient treatment card, the medical history and documents proving the relationship between the occurrence of the insured event and the assignment of disability.

In cases where the client died as a result of NS, the following documents must be brought:

1. Original or notarized copy of the death certificate.
2. Identity card of the heir - beneficiary.
3. An act containing information about the causes of death of the insured.
4. Certificate of right to inheritance certified by a notary office.

The investigation into the circumstances of the death may require the opinion of medical experts.

After submitting a package of documents, payments must be made within 10 days.

Pros and cons of insurance

Collective insurance

Positive sides:

1. The number of claims is reduced or they are paid by insurance.
2. Allows you to cover losses for an employee who is temporarily disabled or has completely lost this ability.
3. Covers part of the compensation in the event of the death of an employee (payments are made to the heir - the beneficiary).
4. Helps improve the quality of medical care.
5. Due to the improvement in the quality of health of employees, their productivity increases.
6. Adds prestige to the company.
7. Good tax benefits.
8. Financial responsibility is transferred to the insurance company.

Minuses:

1. It is difficult to select a specific category of persons to be insured. We have to insure everyone, which increases expenses.
2. Many people have superstitions about this type of insurance. Insurance is not relevant for single people in the event of their death - they have no interest in the beneficiaries.

Individual insurance

Advantages:

1. Providing financial assistance in difficult life situations.
2. Covering expenses spent on treatment or rehabilitation.
3. In case of temporary or permanent disability, regular payments are made. This allows you to adapt during the first difficult times.
4. Increasing the credit limit.
5. Financial compensation in the event of the death of the insured.

Minuses:

1. The need for regular contributions.
2. In controversial cases, it is necessary to collect documents confirming the occurrence of an insured event.
3. The investigation may take longer than expected.
4. High tariffs for children and elderly people.

Updated 02/27/2020 Views 3176 Comments 10

To mitigate the financial consequences of an accident, you can take out insurance. There are accident insurances for ordinary life (called life insurance), but it is when traveling that such risks greatly increase.

But, on the other hand, as with all insurances in general, you first need to understand 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 kind of insurance is this

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

The most important thing you should know! Visits to a doctor abroad, tests and examinations, hospital stays are paid on the basis of travel insurance (travel insurance) and within its insured amount. 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 completely different.

Accident insurance involves paying compensation after injury or disability. This payment is made after your return to the homeland. And you can spend this money wherever you want, even on rehabilitation, or on a new wardrobe.

Do I need to buy it?

The Accident option is an optional option and will increase the cost of the entire policy if you add it. The decision is yours. Do you need a separate payment of money after an accident or will only be enough to cover medical expenses under regular travel insurance.

If you are initially considering NOT budget insurance, but more expensive ones, 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 price includes a bunch of different options by default.

It happens that when you buy a plane ticket in some service, along with it you will be offered to buy accident insurance. It can be valid both during the flight and for the entire trip (you need to check the conditions). In exactly the same way they can offer. Actually, if these options are already included in your basic 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 occur in a road accident, an attack by a criminal, a fall from a height, or domestic injuries (for example, a burn with boiling water).
• Insured events can also be situations that occurred during the validity of the contract, but resulted in the death of the insured or the assignment of disability for some time after the end of the insurance. All these terms are in the contract.
• The injury must be on the payout schedule, otherwise there will be no payment. You must keep in mind that the payment may depend on the wording of the diagnosis in your medical documents. In controversial cases, the insurance company will interpret the doctor’s conclusion in its favor, so it is better that the diagnosis most closely matches the column in the payment table.
• If you buy a policy for the whole family at once and add the option of accident insurance, then this option applies to everyone. To use this option for one person, for example, a child, you will need to issue him a separate policy with this option, and for the others a policy without the option. This way you can save money.

When insurance doesn't work

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

• Events that occur outside the territory or insurance period specified in the policy.
• Accidents that cannot be considered unforeseen. For example, due to mental disorders of the insured, chronic diseases, etc. The consequences of infectious diseases, strokes and heart attacks may also be included in the list of exclusions from insurance events.
• Insured events during force majeure circumstances: military actions, strikes, natural disasters, etc.
• Insured events during sports activities, if these sports are not initially included in the traveler’s insurance itself. To enter, you need to add a separate option “Sports”, “Active recreation”, etc.
• If at the time of injury the insured was under the influence of alcohol or drugs. If the insured was injured while committing criminal acts. In case of death as a result of suicide, or if the insured intentionally caused harm to his health.

Cost and sum insured

I would not buy accident insurance separately, since it does not replace medical travel insurance, on the basis of which medical care will be provided. Therefore, it is better to take out 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 higher 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.

Typically, the choice of 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 is in no way related to the sum insured for the entire insurance.

Accident insurance - an additional option for extra money

Payment amount

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

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

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

If you receive the second group of disability, you can receive about 75% of the sum insured, with the third - 50%, and for a leg/arm injury you will pay only 10-20%. For 1-2 degree burns, the rate may be 0.3% of the total insurance amount. For injuries to the face, neck, ears, the tariff is 0.5%. Payment for “temporary disability” is considered to be 0.2–0.3% of the insured amount for each day of disability, 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 you need to do is get medical care, which will be provided as part of your travel insurance. I repeat, the presence of the “accident” option does not matter.

Therefore, call assistance () and go to the designated hospital. If this is impossible (for example, if you are unconscious), then the ambulance will decide where to take you. As soon as the opportunity arises, you will need to contact the assistant and resolve questions about your stay in the current hospital, whether they will pay, whether they will transport you to another, or whether you will have to pay for it yourself and then receive reimbursement.

And only after you have resolved all the treatment issues, you can start thinking about payment in connection with the accident. This is usually done when returning home from a trip. But it’s 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 payment.

Payments for an accident are made by the insurance company (not assistance), so you must notify them of the accident and that you want to request 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 vary depending on the insurance company, so I can't give an exact list. I'll write what might happen.

— Application, passport and insurance policy.
— Certificate from the doctor who provided first aid. Or a certificate from the medical institution where the inpatient treatment was carried out. The certificate must indicate a medical report and diagnosis.
— Accident report, an official document confirming the circumstances of the 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 outpatient and medical records, 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 inheritance

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

Life hack #1 - how to buy good insurance

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

The life and health of an individual in the event of an accident, illness, disability or death. The beneficiary can be either the Bank or another person determined by the insured.

Insurance cases

• Death of the insured person (borrower) as a result of an accident or illness
• Loss of ability to work by the insured person (borrower) and the establishment of disability of group I or II as a result of an accident or illness
• Temporary disability

New services

• Remote medical consultation
• Second remote medical opinion

Tariff for connecting to the insurance program

Voluntary life and health insurance of the borrower - 2.4% per year

Voluntary life insurance, health insurance and in connection with involuntary loss of work - 3.6% per year

Voluntary life insurance and in case of diagnosis of a critical illness – 3.6%.

Voluntary life and health insurance of an individual with a choice of parameters - 2.6% per year

The program is carried out in partnership with Sberbank Life Insurance LLC (licenses Central Bank SZh No. 3692 dated 07/04/2016, SL No. 3692 dated 07/04/2016. Address: 121170, Moscow, Poklonnaya St., 3 building 1).

The client has the right to purchase protection from any insurance company.

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