The contract about insurance of tourists
1. THE SUBJECT OF INSURANCEThe insurer of Joint-Stock Company « Insurance company " Galaxy " and the Insurant (further - the Parties(Sides)) have concluded the given Contract of complex insurance of the persons(faces) who are on vacation outside of a constant place of residing, (further - the Contract) about the following: the Insurer, according to the Law of Ukraine “ About insurance ”, the license series AV № 299060 from 13.11.06г., the given out State commission on settlement of the markets of financial services of Ukraine, “ Rules of voluntary insurance of medical expenses ” № 20/2005 from 21.11.05г., “ Rules of voluntary insurance upon accidents ” № 7 from 26.11.07г., “ Rules of voluntary insurance of the responsibility before the third parties (except for the responsibility of proprietors ground, air, a sailing charter and the responsibility of a carrier) ” № 11 from 11/21/2005 (Further - Rules), undertakes to make at approach of an insurance case insurance payment according to treaty provisions, and the Insurant undertakes to pay insurance payment on the conditions certain by the Contract, and to carry out other treaty provisions.
The specialized Service of the Insurer (the Assisting company) - the legal person(face) whom Joint-Stock Company “ Insurance company " Galaxy " operates(works) on behalf of and by proxy and coordinates actions Zastrahovannogo of the person(face) and persons(faces) which give to it(her) the help or services, in case of approach of an insurance case.
Zastrahovannoe the person(face) - the physical person(face) about which insurance the Contract is concluded. Zastrahovannoe the person(face) can get the rights and duties of the Insurant.
The franchise - a part of losses which are not compensated by the Insurer.
2. CONDITIONS OF VOLUNTARY INSURANCE MEDICAL
EXPENSES DURING TRAVEL
2.1. Object of insurance
Object of insurance are property interests of the Insurant (Zastrahovannogo persons(faces)) which do not contradict the current legislation of Ukraine, connected with a life, health both unforeseen medical and additional expenses Zastrahovannogo of the person(face) during stay on rest.
2.2. Insurance cases
2.2.1. Insurance risk (insurance event) - the certain event on which case insurance is carried out and which has attributes of probability and accident of approach.
2.2.2. On conditions of the present(true) Contract insurance event (insurance risk) is:
2.2.2.1. Sudden disease Zastrahovannogo of the person(face);
2.2.2.2. Physical injury Zastrahovannogo of the person(face) owing to accident;
2.2.2.3. Death Zastrahovannogo of the person(face) owing to sudden disease or accident that have come(stepped) during stay on rest during and in territory of action of the Contract.
2.2.3. Insurance cases are documentary confirmed expenses on given Zastrahovannomu to the person(face) medical and additional services.
2.2.3.1. Fast medical service or transportation by a vehicle to the nearest medical institution if it(this) is demanded with state of health Zastrahovannogo of the person(face);
2.2.3.2. The urgent stationary help in medical institution, namely: necessary consultations, diagnostics, treatment, urgent operative intervention, medicamentous maintenance, stay in chambers of standard type, a feed(meal) on the norms(rates) accepted in given medical institution;
2.2.3.3. Emergency medical evacuation of citizens of Ukraine to the hospital nearest to a permanent address if necessity of evacuation proves to be true corresponding(meeting) documents, and also transport expenses for the accompanying person(face) at presence of the medical information(inquiry) on necessity of support. For foreign citizens emergency medical evacuation up to the nearest from vacation spot or treatment of the airport or station (depending on it is made by what type of transport the further transportation) for sending Zastrahovannogo of the person(face) in the country of constant residing is provided;
Medical evacuation Zastrahovannogo of the person(face) is carried out only in coordination with Specialized Service of the Insurer (Insurer).
If the doctors authorized(commissioned) by Specialized Service of the Insurer (Insurer), consider(count), that evacuation Zastrahovannogo of the person(face) is possible(probable), and Zastrahovannoe the person(face) refuses it(her), the Insurer immediately stops payment of services for out-patient or hospitalization Zastrahovannogo of the person(face).
2.2.3.4. Repatriations of a body, in case of death Zastrahovannogo of the person(face) during stay on rest, the citizen of Ukraine up to a permanent address. For foreign citizens repatriation of a body is provided up to the nearest airport from a permanent address or railway station (depending on presence of regular routes and from it was made by what type of transport transportation territory of Ukraine);
Repatriation of body Zastrahovannogo of the person(face) is carried out only in coordination with Specialized Service of the Insurer (Insurer). A necessary condition for the organization of repatriation is reception from relatives of the died application(statement) of-acknowledgement on readiness to take away body Zastrahovannogo of the person(face).
2.2.3.5. Telecommunication Zastrahovannogo of the person(face) or the person(face) which represents its(his) interests, with Specialized Service of the Insurer (Insurer) in occasion of the message on an insurance case.
2.2.4. Medical expenses which are compensated by the Insurer at approach of an insurance case regarding voluntary insurance of medical expenses.
2.2.4.1. Under the Contract of a category "EKONOM" at approach of an insurance case the Insurer compensates such expenses on:
Urgent (fast) medical service at the pre-hospital stage, given by a brigade of first aid and-or in branch of medical institution (the review and consultation of the medical personnel, urgent laboratory, tool researches, purchase of medicines);
Urgent hospitalization;
The medical leaving(care) intended by the doctor, purchase of medicines; thus the Insurer reserves the right to itself to pay hospitalization Zastrahovannogo of the person(face) within the limits of the insurance sum (a limit of the insurance sum);
Time(Temporary) maintenance Zastrahovannogo of the person(face) with subjects of the medical equipment, devices and auxiliary means to destination the doctor for medical transportation;
Expenses for visit in Zastrahovannoe the person(face) and medical services of the doctor-expert of a narrow structure if it is necessary for an establishment of the diagnosis or granting of the qualified help, thus Zastrahovannoe the person(face) behind a medical conclusion are nontransportable;
Medical evacuation Zastrahovannogo of the person(face) from a place of occurrence of force majeure by specialized medical transport in medical institution or to the doctor who can give adequate medical service;
Transportation of remains Zastrahovannogo of the person(face) in case of its(her) death during travel to a place, the nearest to a place of its(her) constant residing or burial.
2.2.4.2. Under the Contract of a category "STANDARD" at approach of an insurance case the Insurer compensates expenses on:
Urgent (fast) medical service at the pre-hospital stage, given by a brigade of first aid and-or in branch of medical institution (the review and consultation of the medical personnel, urgent laboratory, tool researches, cost of stay in branch of medical institution, purchase of medicines);
Urgent out-patient treatment at a pre-hospital stage and-or in conditions of an ambulance station, in branch of a day time hospital of medical institution (visit of the doctor, the review and consultation, urgent diagnostic (laboratory, tool) research, out-patient surgical, therapeutic treatment, purchase of medicines);
Urgent hospitalization: urgent diagnostic (laboratory, tool) research, surgical, therapeutic treatment in a hospital, services of the medical personnel, the medical leaving(care) intended by the doctor, purchase of medicines); thus the Insurer reserves the right to itself to pay hospitalization Zastrahovannogo of the person(face) within the limits of the insurance sum (a limit of the insurance sum) until condition Zastrahovannogo of the person(face) will not allow to transport it(her) to a place of its(her) constant residing;
Expenses for visit in Zastrahovannoe the person(face) and medical services of the doctor - the expert of a narrow structure if it is necessary for an establishment of the diagnosis or granting of the qualified help, and thus Zastrahovannoe the person(face) behind a medical conclusion are nontransportable;
The urgent stomatologic help at a sharp toothache for the sum up to 300 (three hundred) griven;
Purchase of the medical means intended by the doctor, for granting the urgent help for the sum which does not exceed 300 griven;
Delivery of the medical means intended by the doctor, for granting the urgent help, in a place of an insurance case if medical means cannot be got on a place;
Time(Temporary) maintenance Zastrahovannogo of the person(face) with crutches, invalid carriages, other subjects of the medical equipment, devices and auxiliary means for medical transportation to destination the doctor;
Medical evacuation Zastrahovannogo of the person(face) from a place of occurrence of force majeure by specialized medical transport in medical institution or to the doctor who can give adequate medical service;
Transportation of remains Zastrahovannogo of the person(face) who have died during travel, to a place nearest to settlement of its(her) constant residing or a place of its(her) burial.
The decision on the organization and payment of the медицинско-transport help and way of its(her) granting are accepted by the doctors intended by the authorized(commissioned) Representative of the Insurer (directly Insurer).
Compensation of expenses for medical evacuation, transportation of remains Zastrahovannogo of the person(face) in case of its(her) death during travel are carried out only under condition of the organization of such transportation by the authorized(commissioned) Representative of the Insurer (directly Insurer).
2.2.4.3. Under the Contract of a category "ELIT" at approach of an insurance case the Insurer compensates expenses on:
Urgent (fast) medical service at the pre-hospital stage, given by a brigade of first aid and-or in branch of medical institution (the review and consultation of the medical personnel, urgent laboratory, tool researches, cost of stay in branch of medical institution, purchase of medicines);
Urgent out-patient treatment at a pre-hospital stage and-or in conditions of an ambulance station, in branch of a day time hospital of medical institution (visit of the doctor, the review and consultation, urgent diagnostic (laboratory, tool) research, out-patient surgical, therapeutic treatment, purchase of medicines);
Urgent hospitalization: urgent diagnostic (laboratory, tool) research, surgical, therapeutic treatment in a hospital, services of the medical personnel, hotel services (cost of stay in chamber of standard type, chamber of intensive therapy, reanimatsionnoj to chamber), the medical leaving(care) intended by the doctor, purchase of medicines); thus the Insurer reserves the right to itself to pay hospitalization Zastrahovannogo of the person(face) within the limits of the insurance sum (a limit of the insurance sum) until condition Zastrahovannogo of the person(face) will not allow to transport it(her) to a place of its(her) constant residing;
Expenses for visit in Zastrahovannoe the person(face) and medical services of the doctor - the expert of a narrow structure if it is necessary for an establishment of the diagnosis or granting of the qualified help, and thus Zastrahovannoe the person(face) behind a medical conclusion are nontransportable;
The urgent stomatologic help at a sharp toothache for the sum up to 300 (three hundred) griven;
- Urgent gynecologic and akusherskuju the help in time pregnancy which does not exceed 7 (seven) months;
Purchase of the medical means intended by the doctor, for granting the urgent help for the sum which does not exceed 300 griven;
Delivery of the medical means intended by the doctor, for granting the urgent help, in a place of an insurance case if medical means cannot be got on a place;
Time(Temporary) maintenance Zastrahovannogo of the person(face) with crutches, invalid carriages, other subjects of the medical equipment, devices and auxiliary means for medical transportation to destination the doctor;
Medical evacuation Zastrahovannogo of the person(face) from a place of occurrence of force majeure by specialized medical transport in medical institution or to the doctor who can give adequate medical service;
Transportation of remains Zastrahovannogo of the person(face) who have died during travel, to a place nearest to settlement of its(her) constant residing or a place of its(her) burial.
Compensation of expenses for medical evacuation, transportation of remains Zastrahovannogo of the person(face) in case of its(her) death during travel are carried out only under condition of the organization of such transportation by the authorized(commissioned) Representative of the Insurer (directly Insurer).
Expenses for visit in Zastrahovannoe the person(face) of one of its(her) close relatives if hospitalization Zastrahovannogo of the person(face) lasts not less than 10 (ten) day, its(her) medical condition behind a medical conclusion is recognized critical and any of full age (capable) members of family Zastrahovannogo of the person(face) does not accompany with it(her) during a trip; the Insurer compensates a fare of one person to settlement in which Zastrahovannoe the person(face) is hospitalized (a kind, the class of transport, a route are defined(determined) by the authorized(commissioned) Representative of the Insurer);
Expenses for a burn, the qualified support and-or returning to a place of constant residing minor children which have remained without supervision owing to urgent hospitalization or death Zastrahovannogo of the person(face) during travel if Zastrahovannoe the person(face) was their uniform accompanying;
Expenses for the medical control over a condition hospitalized Zastrahovannogo persons(faces) and informing of its(her) family on a course of disease and treatment.
2.3. The reasons of refusal in insurance payment
2 3.1. The insurant does not compensate the expenses connected with:
2.3.1.1. Treatment of chronic diseases, congenital anomalies (lacks of development), deformations and chromosomal infringements;
2.3.1.2. New growths;
2.3.1.3. Illnesses endokrinnoj systems;
2.3.1.4. Nervous diseases (except for nevritov), mental diseases, and also traumatic damages connected with them,
2.3.1.5. Venereal diseases;
2.3.1.6. A tuberculosis;
2 3.1.7 illnesses of blood and krovetvornyh bodies, imunnodefitsitnymi conditions;
2 3 1.8. Epidemic and pandemicheskimi illnesses;
2.3.1.9 sharp and chronic radiation sickness;
2.3.1.10. Pregnancy (except for extrauterine pregnancy), sorts after 28 weeks of pregnancy, interruption of pregnancy;
2.3.1.11. Any frustration of health, complications or death which have occured(happened) because of default of recommendations of the attending physician, collateral actions of medicines which have not been appointed(nominated) by the doctor, collateral actions of food additives;
2.3.1.12. Diseases or consequences (complications) of diseases by a virus hepatites;
2.3.1.13. Diseases and frustration of ears;
2.3.1.14. Fungoid and dermatological illnesses, including allergic dermatitami, caused by influence of ultra-violet radiation, solar burns,
2 3.1.15. Events which have arisen prior to the beginning of term of insurance and-or in territory of a constant residence which have led to medical and additional expenses during travel;
2.3.1.16. Events which have arisen after the termination(ending) of action of the Contract, and also that took place after returning Zastrahovannogo of the person(face) from travel;
2.3.1.17. Out-patient or hospitalization Zastrahovannogo of the person(face) if last refuses medical evacuation to a permanent address;
2.3.1.18. Medical surveys which are not consequences(investigations) of a sharp pain, sudden disease and a physical injury, and also granting of services which are not obosnovanno necessary or urgent from the medical point of view, or do not enter into the treatment intended by the doctor;
2.3.1.19. Services which can be postponed before returning from travel, including carrying out of surgical operations with which at the given stage probably to replace with a rate of conservative treatment;
2.3.1.20. Carrying out of preventive vaccination, medical examinations and the laboratory researches which have been not connected with an insurance case;
2.3.1.21. All kinds of plastic and cosmetic operations and procedures, all kinds of prosthetics;
2.3.1.22. Granting of the stomatologic help except for the emergency help (removal of a sharp pain), according to the Program And;
2.3.1.23. Physiotherapeutic treatment and treatment by nonconventional methods;
2.3.1.24. Purchase and repair of auxiliary means (glasses(spots), contact lenses, hearing aids, artificial limbs, measuring devices, etc.), purchase obshcheukrepljajushchih preparations, means of hygiene, a children's feed(meal), maintenance with the dosed out inhalers for removal of a bronchospasm, spejserami, nebulajzerami;
2.3.1.25. Artificial fertilisation, treatment of barreness, actions on prevention of pregnancy;
2.3.1.26. Medical either additional services or medicamentous maintenance which exceed the sufficient and proved sizes of their payment;
2.3.1.27. Medical evacuation or the repatriation organized without participation of Specialized Service of the Insurer (Insurer);
2.3.1.28. Expenses if travel has been carried out with intention to receive treatment.
2.3.2 Insurer does not compensate an expense for continuation of treatment Zastrahovannogo of the person(face) after its(his) returning to a permanent address.
2.4. Actions Zastrahovannogo of the person(face) at approach of an insurance case
2.4.1. In case of approach of events which has attributes of an insurance case. The insurant (Zastrahovannoe the person(face) or the person(face) who represents its(his) interests) addresses to the on duty manager of establishment in whom officially temporarily lives Zastrahovannoe the person(face).
The on duty manager immediately, at any time, will inform on event in Specialized Service of the Insurer by phone specified in the Basic part of the Contract, or otherwise.
2.4.2. In case of absence of an opportunity of the reference(manipulation) to the on duty manager, the Insurant (Zastrahovannoe the person(face) or the person(face) who represents its(his) interests) by phone specified in the Basic part of the Contract, at any time, addresses directly in Specialized Service of the Insurer (to the Insurer).
2.4.3. At the reference(manipulation) in Specialized Service of the Insurer (to the Insurer) it is necessary to inform the following information:
2.4 3.1. A surname, name Zastrahovannogo of the person(face);
2.4.3.2. Site Zastrahovannogo of the person(face) and number of contact phone;
2.4 3.3. Number of the Contract;
2.4.3.4. The detailed description of a case and character of the necessary help;
2.4.3.5. Validity of the Contract
And to follow the instruction(indication) of Specialized Service of the Insurer (Insurer)
2.4.4. If such message cannot be carried out, for the objective reason, by the moment of reception of medical or additional services, it is necessary for making at the first opportunity, not later than 24 hours as soon as these reasons will cease to operate(work). To the objective reasons in this case concern:
2.4.4.1. Absence of an operating(a working) communication facility in a place of stay of the Insurant (Zastrahovannogo persons(faces));
2.4.4.2. Unconsciousness Zastrahovannogo of the person(face) (at absence of persons(faces) which could represent its(her) interests).
2.4.5. In case of independent payment Zastrahovannym by the person(face) of the given medical or additional services the Insurer compensates, in writing proved and confirmed by corresponding(meeting) documents, expenses which do not exceed 50 griven. Expenses which exceed the specified limit. The insurer has the right to not compensate, if realization of such expenses has not been preliminary in writing coordinated(agreeed) with it(him) or with Specialized Service of the Insurer.
2.4.6. In case of non-observance of terms of the message the Insurant (Zastrahovannoe the person(face)) should prove it in writing, on demand of the Insurer.
2.5. Conditions of realization of insurance payment
2.5.1. In case Zastrahovannoe the person(face) used the medical or additional services organized by Specialized Service of the Insurer, calculations for rendered services are carried out without participation Zastrahovannogo of the person(face).
2.5.2. In case of independent payment Zastrahovannym by the person(face) of medical or additional services the Insurer carries out insurance payment Zastrahovannomu to the person(face) on the basis of following documents:
2.5.2.1. Applications(statements) on reception of insurance payment behind the form established(installed) by the Insurer which moves within 15 (fifteen) days after the termination(ending) of treatment.
2.5.2.2. Contracts;
2.5.2.3. Information-accounts(information-invoices;inquiries-accounts) from medical institution (on the firm form or with a corresponding(meeting) stamp) with specified: a surname of the patient, the exact diagnosis, date of the reference(manipulation) behind medical service, duration of treatment, detailed data about the given medical services, the appointed(nominated) медикаментозно-diagnostic means with the instruction(indication) of their quantity(amount) and costs;
2.5.2.4. The recipes which have been written out Zastrahovannomu to the person(face) by the attending physician, on purchase of medicines with the instruction(indication) of the name of each medical preparation;
2.5.2.5. The detailed accounts(invoices) for other services with their breakdown on dates and the cost specified by a total sum for payment;
2.5.2.6. The detailed accounts(invoices) for telephone conversations which phone numbers are specified, date, time and cost of each conversation;
2.5.2.7. Documents which confirm the fact of payment for the medicines, rendered medical and other services (settlement-cash documents, commodity checks);
2.5.2.8. The document which proves the identity, and the information(inquiry) on assignment of identification number.
2.5.3. In view of circumstances of a taken place event, the Insurer has the right to demand additional documents which confirm the fact of approach of an insurance case, circumstance of its(his) approach, the size of expenses and performance by the Insurant of treaty provisions.
3. CONDITIONS OF VOLUNTARY INSURANCE
FROM ACCIDENTS DURING TRAVEL
3.1. Object of insurance
Object of insurance are property interests which do not contradict the current legislation of Ukraine, connected with a life and health Zastrahovannogo of the person(face).
3.2. Vygodopriobretatelem is the successor (successors) according to(agree) with the current legislation.
3.3. Insurance cases
3.3.1. Accident considers sudden casual, short-term (limited in time), persons(faces) unintentional and independent of will Zastrahovannogo event which actually took place and owing to which there has come(stepped) frustration of health Zastrahovannogo of the person(face) or its(his) death, namely: traumas; wounds from cold and fire-arms; loss of body (), a contusion; obmorozhenija; ozheg (except for solar); a sharp poisoning which demands hospitalization: chemical substances, a medicine, poisoning plants, substandard foodstuff; utoplenie, anafilaktichesky a shock; asfiksija owing to hit of extraneous subjects or liquids in the top respiratory ways; stings: the snakes poisoning insects, entsefalitnyh ticks; defeat by a lightning or an electric current
3.3.2. Insurance cases are:
3.3.2.1. Time(temporary) frustration of health Zastrahovannogo of the person(face) owing to accident;
3.3.2.2. Establishment Zastrahovannomu to the person(face) of primary physical inability owing to accident;
3.3.2.3. Death Zastrahovannogo of the person(face) owing to accident.
3.4. Exceptions of insurance cases
3.4.1. Diseases Zastrahovannogo of the person(face) (except for a tetanus, furiousness, kleshchevogo entsefalita and other illnesses which are transferred(transmitted) through stings of animals and insects).
3.5. Actions Zastrahovannogo of the person(face) at approach of an insurance case
3.5.1. At approach of event which has attributes of an insurance case. The insurant (Zastrahovannoe) is obliged to inform the person(face), the person(face) who represents its(his) interests about it(this) to the Insurer within 15 (fifteen) days from the moment of its(his) approach, in case of non-observance of terms of the message to prove it in writing.
3.5.2 Insurant (Zastrahovannoe the person(face)) is obliged to submit to the Insurer within 15 (fifteen) days after the termination(ending) of treatment all necessary documents for decision-making concerning realization of insurance payment
3.6. Conditions of realization of insurance payment
3.6.1. The insurant makes a decision on insurance payment on the basis of following documents:
3.6.1.1. Applications(statements) on reception of insurance payment behind the form established(installed) by the Insurant;
3.6.1.2. Contracts;
3.6.1.3. The document which proves the identity and confirms the right to reception of insurance payment;
3.6.1.4. Information(inquiries) on assignment of identification number;
3.6.1.5. Information(inquiries) on approach of accident;
3.6.1.6. Results of the analysis on the maintenance(contents) of ethanol in blood (urine) Zastrahovannogo persons(faces);
At time(temporary) frustration of health Zastrahovannogo of the person(face) owing to accident:
3.6.1.7. Information(inquiries) from medical institution with the instruction(indication) of surname Zastrahovannogo of the person(face), the diagnosis, date of the reference(manipulation) and the duration of treatment certified by the signature, a press(seal) of the responsible(crucial) person(face) (attending physician) and a stamp of medical institution;
In case of establishment Zastrahovannomu to the person(face) of primary physical inability owing to accident:
3.6.1.8. The conclusions of the medical-advisory commission (VKK) about an establishment of primary physical inability Zastrahovannomu to the person(face) owing to accident;
3.6.1.9. The conclusions of a медико-social commission of experts (MOK) about an establishment of primary physical inability Zastrahovannomu to the person(face) owing to accident;
In case of death Zastrahovannogo of the person(face) owing to accident:
3.6.1.10 certificates on death;
3.6.1.11. The conclusions of responsible(crucial) establishment which confirms the fact of death Zastrahovannogo of the person(face) owing to accident;
3.6.1.12. Certificates on the right to the inheritance;
3.6.1.13. Other documents on demand of the Insurer.
3.6.2. The insurer carries out insurance payment to the Insurant/Застрахованному litsu/Vygodopriobretatelju;
3.6.2.1. At time(temporary) frustration of health Zastrahovannogo of the person(face) - under “ the Table of insurance payments » (addition № 2 to “ to Rules of voluntary insurance upon accidents ”);
3.6.2.2. In case of an establishment of primary physical inability;
I groups - 100 % of the insurance sum;
II groups - 80 % of the insurance sum;
III groups - 60 % of the insurance sum;
3.6.2.3. In case of death Zastrahovannogo of the person(face)-100 % of the insurance sum - Vygodopriobretatelju.
4. THE GENERAL(COMMON) CONDITIONS
4.1. Term and a scene of action of the Contract
4.1.1. The contract acts the territory specified in the Basic part of the Contract, except for, territories of settlement - on places of constant residing (training, work) Zastrahovannogo persons(faces).
4.1.2. Insurance protection begins from the moment of settlement (registration) Zastrahovannogo persons(faces) in establishment, but not earlier the moment of payment of insurance payment.
4.1.3. Insurance protection comes to an end in day of departure Zastrahovannogo of the person(face) from establishment, or at 24 o'clock on Kiev time of the day specified as the termination(ending) of action of the Contract (by date of which has come earlier).
4.2. The rights and duties of the Parties(Sides) and the responsibility for default or inadequate performance of treaty provisions
4.2.1. The insurer is obliged;
4.2.1.1. To acquaint the Insurant with treaty provisions and Rules;
4.2.1.2. During two working days as soon as it becomes known about approach of an insurance case to arrange concerning registration of all necessary documents for duly realization of insurance payment (insurance compensation);
4.2.1.3. At approach of an insurance case to carry out insurance payment (payment of insurance compensation) in time, stipulated by section 4 3. The present(true) Contract;
4.2.1.4. For untimely realization of insurance payment (insurance compensation) to pay to the Insurant (Zastrahovannomu to the person(face)) penju at a rate of 0,05 % from the sum which is a subject to payment, per every day of delay, but it is no more 10 % from the sum of insurance payment (insurance compensation);
4.2.1.5. To not disclose data on the Insurant (Zastrahovannom the person(face)), except for the cases stipulated by the current legislation of Ukraine
4.2.2. The insurer has the right:
4.2.2.1. To give up in insurance payment (insurance compensation) in the cases stipulated by the present(true) Contract and the current legislation of Ukraine;
4.2.2 2. To check the information given by the Insurant for the conclusion of the Contract;
4.2.2.3. To submit inquiries to competent bodies concerning the information necessary for finding-out of circumstances of approach of an insurance case;
4 2.2 4. In case of infringement by the Insurant (Zastrahovannym the person(face)) treaty provisions
To demand preschedule cancellation of the Contract;
4.2.2.5. In case of need to appoint(nominate) a medical board for inspection Zastrahovannogo of the person(face), and also other examination concerning insurance event;
4.2.2 6. To carry out photographing, audio and videorecording of events and the conversations connected with performance by the Parties(Sides) of conditions of the present(true) Contract;
4.2.2.7. To not compensate any indirect losses Zastrahovannogo of the person(face)
4.2.3. The insurant is obliged:
4.2.3.1. At the conclusion of the Contract in favour of Zastrahovannogo persons(faces) - to acquaint it(him) with conditions of insurance;
4.2.3.2. In due time to pay insurance payment;
4 2.3.3. At the conclusion of the Contract to give to the Insurer the information on all circumstances known to it(him) which have great value for an estimation of insurance risk, and and the further to inform on any change of insurance risk;
4.2.3.4. At the conclusion of the Contract to inform the Insurer on other contracts of insurance, prisoners concerning object of insurance;
4.2.3.5. To inform on approach of event which has attributes insurance, and to follow the instruction(indication) of Specialized Service of the Insurer (Insurer) on the order of reception of medical or other services;
4.2.3.6. To give to the Insurer all necessary documents and the information on an insurance case for decision-making on realization of insurance payment (insurance compensation);
4.2.3.7. On demand of the Insurer to prove the fact of approaches of an insurance case, impossibility of an establishment of communication(connection) with Specialized Service of the Insurer (Insurer), to prove necessity or the size of the carried out expenses;
4.2.3.8. To transfer(transmit) the Insurer, in borders of actual expenses, the right of the requirement to compensation of damage which the Insurant to the person(face) has, responsible(crucial) for the caused damage.
4.2.4. The insurant has the right:
4.2.4.1. In case of approach of an insurance case to receive insurance payment (insurance compensation) at a rate of and the order established(installed) by section 4 3. The given Contract;
4.2.4.2. To appeal against in the judicial order against refusal of the Insurer in insurance payment (insurance compensation);
4.2.4.3. To address to Specialized Service of the Insurer (Insurer) for instructions(indications) on the order of reception of the necessary help;
4.2.4.4. In case of infringement by the Insurer of treaty provisions to demand preschedule cancellation of the Contract;
4.2.4.5. At loss of the present(true) Contract to receive the duplicate of the Contract on the basis of the written application(statement) (the repeated duplicate does not stand out).
4.2.5. For default or inadequate performance of treaty provisions of the Party(Side) bear the responsibility according to(agree) with the current legislation of Ukraine.
4.3. The general(common) conditions of realization of insurance payment
4.3.1. The decision on insurance payment or refusal in payment is accepted by the Insurer within 10 (ten) working days from the date of reception by the Insurer of all necessary documents given by way of, stipulated by conditions by a concrete kind of insurance.
4 3 2. All documents which are given to the Insurer, should be legible
Are written or printed on forms and to have corresponding(meeting) press(seals) and signatures, and also the name, the address and contact phone of the organization which has given out the document.
4.3.3. All documents are given to the Insurer in the form of the original either notarially certified copy, or a simple copy under condition of granting an opportunity of verification of this copy with an original copy of the document.
4.3.4. Documents are given to the official representative of the Insurer or directly Insurer to the address of, specified in the Basic part of the Contract.
4.3.5. At presence of the bases for doubt in validity (legality) of insurance payment the Insurer can postpone decisions on payment before reception of acknowledgement(confirmation) or a refutation of these reasons for the term of no more 45 (forty five) the working days.
4.3.6. The insurer carries out insurance payment within 5 (five) bank days after decision-making on insurance payment (insurance compensation).
4.3.7. In insurance payment (insurance compensation) or decision-making on a delay of payment the Insurer in writing informs on refusal Zastrahovannomu to the person(face) within 5 (five) working days with a statement of motivation of the made decision or a substantiation of the reasons of refusal.
4.3.8. The sum of insurance payment (insurance compensation) cannot exceed, the insurance sum established(installed) by a concrete kind of insurance.
4.3.9. The insurance sum by a concrete kind of insurance decreases for the sum of the insurance payment carried out by the Insurer (insurance compensation). The sum of all insurance payments cannot exceed the insurance sums which sizes are specified in the Basic part of the Contract separately by each kind of insurance.
4.4. The general(common) reasons of refusal in insurance payment
4.4.1 Basis for refusal by the Insurer in realization of insurance payment are:
4.4.1.1. The going actions or a divergence of the Insurant (Zastrahovannogo persons(faces)), directed on approach of an insurance case, except for the actions accomplished in a condition of necessary defense (without excess of its(his) borders) or concerning protection of property, a life, health, honour, advantage and business reputation. Qualification of actions Zastrahovannogo of the person(face) is established(installed) according to the current legislation of Ukraine;
4.4.1.2. Granting by the Insurant (Zastrahovannym the person(face)) obviously inveracious data on object of insurance or on the fact of approach of an insurance case,
4.4.1.3. Creation to the Insurer of obstacles in definition of circumstances, character and the size of damage;
4.4.1.4. Not the message or the untimely message to Specialized Service of the Insurer (Insurer) about approach of an insurance case without valid excuse or untimely granting of documents to the Insurer for reception of insurance payment (insurance compensation),
4.4.1.5. Default by the Insurant (Zastrahovannym the person(face)) the duties under the Contract;
4.4.1.6. Default or infringements of instructions(indications) of Specialized Service of the Insurer (Insurer);
4.4.17. Reception by the Insurant (Zastrahovannym the person(face)) the full indemnification of damage on behalf of, guilty of its(his) causing;
4.4.1.8. Refusal of the Insurant of inspection or the examination appointed(nominated) by the Insurer with the purpose of acknowledgement(confirmation) of the fact and circumstances of approach of an insurance case and the size of expenses;
4.4.1.9 other cases stipulated by the current legislation of Ukraine.
4.4.2. Do not admit insurance cases of event which have come owing to:
4.4.2.1. Wars (declared(announced) or not declared(announced)), fighting or military actions, civil excitements, strikes or state of emergency, action of nuclear incident or an ionizing radiation;
4.4.2.2. soversheny suicides or attempts at suicide Zastrahovannym by the person(face) (except for cases when Zastrahovannoe the person(face) has been led to such condition by illegal actions of the third parties);
4.4.2.3. Acts Zastrahovannogo of the person(face) at realization or attempt of realization of illegal actions by it(him) which are in a direct causal relationship with an insurance case which is established(installed) by competent bodies;
4.4.2.4. podverganie Zastrahovannogo persons(faces) to unjustified risk, conscious danger (except for rescue of a life),
4.4.2.5. The uses of alcohol, narcotic and toxic substances;
4.4.2.6. Performance Zastrahovannym by the person(face) of any kind of dangerous work, employment(occupations) by professional or amateur sports, mountaneering, a scuba diving, speleology, jumps in water, any forms of flights, winter kinds of sports, owing to participation in competitions, an auto racing if the additional risk has not been paid by additional insurance payment.
4.5. The order of change and cancellation of the Contract
4.5.1. Changes are brought in the Contract under the arrangement of the Parties(Sides) on the basis of the application(statement) of one of the Parties(Sides) and made out by in writing separate document behind signatures of both Parties(Sides) which from the date of signing is an integral part of the present(true) Contract.
4.5.2. The contract stops the action under the consent of the Parties(Sides), and also in case of:
4.5.2.1. The terminations(endings) of validity;
4.5.2.2. Performance by the Insurer of obligations before Zastrahovannym the person(face) in full;
4.5.2.3. In other cases stipulated by the current legislation of Ukraine.
4.5.2.4 Action of the Contract can be stopped ahead of schedule, on demand of the Insurer or the Insurant.
4 5.3 Insurer or the Insurant are obliged to inform other Party(Side) on the intention to refuse the Contract not later than 5 (five) calendar days prior to day of the termination(discontinuance) of the Contract.
4.5.4. If the Insurant has refused the Contract prior to the beginning of action of insurance protection. The insurer returns to the Insurant the insurance payment paid by it(him) and has the right to subtraction of normative expenses for conducting business(affairs) at a rate of, specified in corresponding(meeting) Rules.
4.5.5. If the Insurant has refused the Contract. The insurer returns to it(him) insurance payments for the period which has remained before the termination(ending) of validity of the Contract, with subtraction of normative expenses for conducting business(affairs) at a rate of, specified in corresponding(meeting) Rules, and insurance payments actually carried out by the Insurer.
If refusal of the Insurant of the Contract is caused by infringement of treaty provisions by the Insurer, the Insurer returns to the Insurant the insurance payments paid by it(him) completely.
4.5.6. If the Insurer has refused the Contract. The insurer returns to the Insurant the insurance payments paid by it(him) completely.
If refusal of the Insurer of the Contract is caused by default by the Insurant of conditions
Contracts, the Insurer returns to the Insurant insurance payments for the period which has remained before the termination(ending) of validity of the Contract with subtraction of normative expenses for conducting business(affairs) at a rate of, specified in corresponding(meeting) Rules, and insurance payments actually carried out by the Insurer.
4.6. The order of the decision of disputes
4.6.1. The disputes connected by the handed over Contract, are solved by negotiations.
4.6 2. If the party(side) during negotiations do not send(have come) to the agreement, the decision of disputes is carried out by way of, stipulated by the current legislation of Ukraine.
5. OTHER CONDITIONS
5.1. Treaty provisions are stated in a Ukranian language and Russian languages.
5.2. At revealing divergences the conditions stated in the Ukrainian language have a priority.