Wenn Sie die Allgemeinen Geschäftsbedingungen beim Kauf akzeptieren, ist unsere Police:
ausgegebene Versicherungen sind nicht rückerstattungsfähig.
Sie können Ihre Versicherungsdaten innerhalb von 72 Stunden nach dem Aktivierungsdatum ändern. Wenn die Tage kürzer sind, kann die Differenz nicht erstattet werden.
Es ist möglich, die Deckungsdauer der Versicherung zu verlängern, die zusätzlichen Tage müssen Sie bezahlen.
Sie können Ihrer Versicherungspolice innerhalb von 24 Stunden nach Reiseantritt weitere Namen hinzufügen.
Es ist nicht möglich, die Namen der Versicherten in der Police zu ändern.
Korrekturen von Namen und Geburtsdatum sind möglich und kostenlos, spätestens 24 Stunden vor Abflug.
Versicherte über 65 Jahre zahlen doppelt so viel.
Minderjährige können ohne die Anwesenheit eines Erwachsenen nicht in die Versicherung aufgenommen werden.
Über 1 Jahr Mehrfachversicherung
Geschäftsvisa können je nach Einladung einfach, doppelt oder mehrfach ausgestellt sein.
Visa können für einen Zeitraum von höchstens 90 Tagen gültig sein. Ein einjähriges mehrgängiges Geschäftsvisum ermöglicht es einem Ausländer, innerhalb des festgelegten Zeitraums mehrmals in die Russische Föderation einzureisen. Dies bedeutet nicht, dass der Visuminhaber ein Jahr in der Russischen Föderation bleiben darf. Nach dem russischen Einwanderungsgesetz darf ein Inhaber eines Mehrfachvisums bis zu 90 Tage alle 180 Tage in Russland bleiben.
Die Versicherung ist für einen Zeitraum von 365 Tagen gültig, mit einer medizinischen Versorgung von 180 Tagen gemäß dem Einwanderungsgesetz der Russischen Föderation.
Wenn Sie eine 365 Tage Krankenversicherung benötigen, kontaktieren Sie uns bitte!
VERSICHERUNGSPLÄNE FÜR DIE VERSICHERUNG VON KRANKHEITSKOSTEN UND ANDEREN EVENTUALITÄTEN VON BÜRGERN, DIE DIE GRENZEN DES STÄNDIGEN AUFENTHALTS VERLASSEN
- AlfaTRAVEL Multi
Die AlfaTRAVEL Multi Policy sieht die Erstattung der folgenden Eventualitäten vor:
1) medizinische Kosten für ambulante und/oder stationäre Behandlung (mit Ausnahme der Klauseln 4.1.1.1.-4.1.1.7. der Regeln);
2) Gebühren für zahnärztliche Notfallhilfe (Ziffer 4.1.2. der Regeln):
а) für das Trauma eines Zahnes infolge eines Unfalls;
- b) bei akuter Entzündung eines Zahnes und von Gewebe, das einen Zahn umgibt;
3) Gebühren für medizinische Transporte (außer Klausel 4.1.3.2. ,4.1.3.5 der Regeln);
4) Transportkosten (außer Klausel 4.1.5.2. -.4.1.5.4., 4.1.5.6. der Regeln);
5) Gebühren für die posthume Rückführung (mit Ausnahme von Ziffer 4.1.4.2, 4.1.4.3 der Regeln);
6) Gebühren für die Bezahlung von dringenden Nachrichten (Ziffer 4.1.7 der Regeln);
- Versicherungsprämien für die Versicherung von Bürgern, die die Grenzen des ständigen Aufenthalts verlassen:
Versicherungssumme pro Versichertem in Euro 30 000,- pro Stück
RULES OF INSURANCE OF CITIZENS TRAVELING OUTSIDE THEIR PERMANENT PLACE OF RESIDENCE |
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1. GENERAL PROVISIONS |
1.1. Under these Rules and applicable legislation of the Russian Federation, AlphaStrakhovanie, PLC hereinafter referred to as the Insurer, enters into Agreements on Insurance of Citizens Traveling outside Their Permanent Place of Residence with capable individuals and legal entities (hereinafter referred to as the Policyholders). Insurance in respect of citizens traveling outside their permanent place of residence who have a permanent or temporary residence permit and/or citizenship in the country to which the Trip is made (except for the territory of the Russian Federation) does not apply to the territory of the country in which the Insured person has a permanent or temporary residence permit and/or citizenship. |
1.2. Under the Insurance Agreement (hereinafter referred to as the Insurance Agreement, the Agreement) concluded on the basis of these Rules, the Insurer undertakes to, for a payment stipulated in the Agreement (the insurance premium) and in the case of an event specified in the Agreement (the insured event), pay insurance indemnity, including payment and (or) reimbursement of medical costs for emergency and urgent care rendered to the Insured Person. The fact of conclusion of the Insurance Agreement is confirmed by the insurance policy issued to the Policyholder, unless otherwise provided for in the Insurance Agreement. |
1.3. Policyholders are entitled to conclude insurance agreements with the Insurer for the benefit of third parties (hereinafter referred to as the Insured Persons). If an individual Policyholder concluded the insurance agreement in respect of the property interests, the Policyholder shall also be deemed an Insured Person. |
Policyholders being legal entities conclude insurance agreements with the Insurer for the benefit of third parties – the Insured Persons. |
1.4. The basic terms and the concepts used in these Rules: |
Luggage shall mean personal belongings of the Insured Person transported by him/her during a Trip and registered as baggage with the transport organization. |
Family members shall mean father, mother, children (including adopted), lawful spouse, siblings, grandparents, grandchildren. |
Hospital shall mean a medical institution, which: |
– operates in accordance with the law to provide care and treatment for the sick and injured; |
– has diagnostic and surgical departments; |
– provides 24-hour care by qualified nurses; |
– is supervised by one or more doctors. |
The hospital shall not refer to: obstetric department, recovery department or department of geriatrics, in the case where the patient mainly adheres to bed rest and needs the care of nurses, sanatorium, recreation institution, nursing home. |
Sudden acute disease shall mean a disease firstly-diagnosed and developed in the validity period of the Insurance Agreement in the territory of the Insurance Agreement that is not a result of exacerbation or complication of another pathological condition. |
Doctor shall mean an expert with completed and properly registered medical education not related to the Policyholder or the Insured and acting within the limits of the license for treatment of accident consequences. |
Insured trip or Trip shall mean departure of the Insured outside the place of permanent residence due to tourist trip, business trip, under the labor contract etc. for which the Insurance Agreement is concluded, within the limits of Territory and during the Validity Period specified in the Insurance Agreement. |
The fact of a Trip on the territory of the Russian Federation, as well as on the territory of the border countries with which a a treaty on freedom of movement is concluded, must be documented by providing personal transport documents (plane, railway tickets) and documents confirming accommodation in the place of temporary stay. |
A trip of the Insured Person with a view to changing the place of permanent residence shall not be deemed a Trip. |
The number of Trips during the Validity Period of the Insurance Agreement shall not be limited. The Insurance Agreement may provide for maximum number of days per Trip. |
Medical costs shall mean costs on treatment made or prescribed by the qualified doctor. |
Medical institution shall mean a medical institution licensed for providing outpatient surgical treatment and care. |
Urgent medical care shall mean medical care provided in case of sudden acute diseases, exacerbation of chronic diseases that do not threaten the life of a patient. |
Accident shall mean a sudden physical effect of various external factors (mechanical, thermal, chemical, etc.) on the Insured, which was beyond the control of the Insured and resulted in bodily injuries, physiological malfunctions in the body or death of the Insured. |
Accidents shall not include any forms of acute, chronic and hereditary diseases. |
Poisoning (intoxication) shall mean a disease that develops as a result of effects on the body of toxic doses of chemicals (including pharmaceuticals), plant poisons and venoms of insects, bacteria, etc. |
Carrier shall mean any registered carrier engaged in the carriage of passengers by land, water or air, which also has a license for this type of transportation and carrying it out on a schedule. |
Insurance Agreement Validity Period/ Validity Period shall mean the term of the Insurance Agreement, during which one or more Trips are insured, depending on the terms of the Insurance Agreement. Insurance Agreement Validity Period shall always be specified according to the Moscow time. |
Planned medical care shall mean medical care provided in the course of preventive events, diseases and states that do not threaten the life of a patient and do not require emergency or urgent medical care, delay of which shall not cause aggravation of the health state or threaten the life and health of a patient. |
Permanent place of residence shall mean a place within the administrative boundaries of the Russian Federation where the citizen permanently resides (which is confirmed by documents of temporary or permanent registration or certificate of employment/study), the country of second citizenship and/or the country in which the permanent or temporary residence permit is issued |
Prescription shall mean a written doctor’s instruction on the use of medications. |
Service company shall mean a specialized organization specified in the Insurance Agreement, which, on behalf of the Insurer, provides round the clock arrangement of the services provided by these Rules. |
Joint trip shall mean a trip to the same location (city, resort, hotel) and at the same time, which is confirmed by travel documents (travel voucher, travel package, travel documents, hotel documents and etc.). |
Urgent message shall mean the initial application of the Insured to the Service Company by means of telephone, Fax or other available communication. |
Country of permanent residence shall mean a country of citizenship of the Insured Person, or in which the Insured Person resides without citizenship (a person is deemed permanently residing in the country, if he/she is actually staying in the territory of the country for at least 183 calendar days during 12 consecutive months), or the country in which the Insured Person has a permanent or temporary residence permit. |
Physical injury shall mean an injury received by the Insured due to an accident. |
Insurance Territory shall mean a territory within which the Insurer in case of an insurance event is liable for the payment of insurance indemnity. The Insurance Territory shall be indicated in the Insurance Agreement. |
An Injury shall mean damage to organs and tissues with the damage to the integrity thereof and impairment caused by exposure to environmental factors (mechanical, thermal, chemical, exposure to any kind of radiation, electric current and the change in atmospheric pressure). |
Physiotherapy shall mean the treatment rendered by the licensed Physiatrist and recommended by the doctor on the basis of medical conditions resulting from the insured event. |
Chronic diseases shall mean diseases that have no recognized method of absolute treatment and proceed with periods of exacerbation and remission. |
Emergency medical transportation or evacuation shall mean charges necessary from the medical point of view on the urgent transportation set by the Service Company or the Insurer and medical care during transportation of the Insured Person in critical condition to the nearest suitable hospital having the necessary care conditions that may be located outside the country of residence of the Insured. |
Emergency medical care shall mean medical care provided in case of sudden acute diseases, exacerbation of chronic diseases that threaten the life of a patient. |
Iatrogenic injuries are deterioration of patient’s health state caused by reckless act of a physician. |
1.5. By concluding the Insurance Agreement on the basis of these Rules, the Policyholder expresses to the Insurer its consent to the processing of its personal data contained in the documents transferred to the Insurer for the purpose to promote goods, works, services on the market, as well as for the purpose of assessing the Net Promoter Score (NPS) through the Insurer’s direct contacts with the Policyholder via communication means, in order to ensure the performance of the Insurance Agreement, notification of new insurance programs and insurance products. |
Personal data shall be processed through the collection, systematization, accumulation, storage, clarification (update, change), use, distribution (including transfer), depersonalization, blocking, destruction of personal data stored on both paper and electronic media. The specified consent of the Policyholder shall be valid during the Validity Period of the Insurance Agreement and for 5 years upon its expiry. The Policyholder may revoke this consent by sending a written request to the Insurer. |
1.6. The Insurer may hereunder develop individual insurance programs applying and/or combining individual insurance terms and conditions set forth herein, with commercial names given. |
The Insurance Agreement under these Rules shall be deemed executed, if it expressly states the application thereof and if the Rules are set out in the same document or on the back page or annexed thereto. The delivery of these Rules to the Insured upon execution of the Insurance Agreement shall be confirmed by a record therein. |
The Policyholder agrees that the execution of the Insurance Agreement shall not exempt the parties from, nor limit their liabilities for violation of their obligations, nor does it set out any terms and conditions that are explicitly burdensome for the Policyholder (the Insured Person), which might be repudiated by the Policyholder based on their interests reasonably comprehended if they had an opportunity to participate in determining the terms and conditions of the Insurance Contract. |
1.7. The terms and conditions of these Insurance Rules that contravene Law of the Russian Federation No. 2300-1 dd. February 7, 1992 “On Protection of Consumer Rights” shall not apply to the legal relationships arising between the Insurer and the Consumer with regards to the execution, performance, modification and termination of the Insurance Contract executed in accordance with the terms and conditions of these Insurance Rules. |
1.8. The Consumer hereunder shall mean a citizen who intends to enter into or has entered into an Insurance Agreement or is using services thereunder in accordance with the terms and conditions hereof exclusively for their personal, family, household and other needs that are not related to entrepreneurial activities. |
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2. INSURANCE OBJECT, RISK INSURED |
2.1. The objects of insurance shall be the property interests of the Insured traveling outside his/her permanent place of residence and g a Trip for a period not exceeding one (1) year, which are not in conflict with the legislation of the Russian Federation and are related to the following: |
2.1.1. the risk of occurrence of contingencies of the Insured (“Insurance against Contingencies”/“Medical and Other Costs”); |
2.1.2. Risk of contingencies related to cancellation of the Insured Trip or change of the terms of the Insured Trip (“Insurance of losses from Involuntary Cancellation of the Trip”/“Cancellation of the Trip”); |
2.1.3. Obligation of the Insured to compensate for damage caused to life, health and/or property of third parties (“Insurance of Civil Liability of the Insured”/“Civil Liability”); |
2.1.4. risk of total loss (disappearance) or delay of luggage (“Insurance of Luggage” /”Luggage”). |
2.2. Insured risk is an assumed incident in case of which the insurance shall be carried out. The list of the insured risks shall be stated in the Insurance Agreement. The Insurance Agreement may be concluded for one of the risks or for any set of risks provided for in these Rules, namely: |
2.2.1. occurrence of contingencies of the Insured (“Insurance against Contingencies”/“Medical and Other Costs”); |
2.2.2. occurrence of costs related to cancellation of the Insured Trip or change of the terms of the Insured Trip (“Insurance of losses from Involuntary Cancellation of the Trip”/“Cancellation of the Trip”); |
2.2.3. Obligation of the Insured to compensate for damage caused to life, health and/or property of third parties (“Insurance of Civil Liability of the Insured”/“Civil Liability”); |
2.2.4. total loss (disappearance) or delay of luggage (“Insurance of Luggage” /”Luggage”); |
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3. INSURED EVENT |
3.1. Insured events are the events specified in the Insurance Agreement, upon the occurrence of which the Insurer’s obligation to pay the Insurance Indemnity arises. |
3.2. The Insured Events under the Insurance Agreement concluded on the basis of these Rules shall include: |
3.2.1. on insurance of contingencies – an event caused by injury, poisoning, sudden acute disease, exacerbation of chronic disease, accident or death of the Insured, loss or theft of documents, the need for legal assistance, damage to a personal vehicle as a result of an accident or breakdown, as well as the loss (theft) of the vehicle, as a result of which the Insured or the Beneficiary faces a necessity to bear the following contingencies: |
3.2.1.1. medical expenses for outpatient and/or inpatient treatment; |
3.2.1.2. expenses for emergency dental care: |
(a) in case of a tooth damage due to an accident; |
(b) in case of acute inflammation of the tooth and surrounding tissues; |
3.2.1.3. medical transportation/evacuation expenses; |
3.2.1.4. expenses for posthumous repatriation (return of body/remnants); |
3.2.1.5. transportation expenses; |
3.2.1.6. expenses in the event of loss or theft of documents; |
3.2.1.7. expenses for payment of urgent messages; |
3.2.1.8. legal assistance expenses; |
3.2.1.9. transportation expenses related to the damage to a personal vehicle as a result of an accident or a breakdown, as well as the loss (theft) of a vehicle. |
3.2.2. On insurance of losses of involuntary cancellation of a Trip – the event which caused incurrence by the Insured of costs related to cancellation of the Insured Trip or change of the terms of the Insured Trip. Such events are the following events which occurred upon the commencement of the Insurance Agreement Validity Period and confirmed by the documents issued by the competent authorities: |
(a) Death, sudden decay of health followed by hospitalization, except for daycare hospitalization, of the Insured or his/her family member, arisen not earlier than 15 days prior to beginning of a Trip and interfering with the fulfillment of the intended Trip and no later than the date of commencement of the intended Trip, unless otherwise provided by the Insurance Agreement; |
(b) Death, sudden decay of health followed by hospitalization, except for daycare hospitalization, of the Insured’ spouse or his/her family member, arisen not earlier than 15 days prior to commencement of a Trip and interfering with the fulfillment of the intended Trip and no later than the date of commencement of the intended Trip, unless otherwise provided by the Insurance Agreement; |
(c) injuries of any complexity of the Insured or his/her family member participating in the Joint Trip as a result of accident, not earlier than 15 days prior to the commencement of a Trip and no later than the date of commencement of the intended Trip, unless otherwise provided by the Insurance Agreement, but only in the case there are medical contraindications to the planned Trip; |
(d) infectious diseases of the Insured that occurred not earlier than 15 days prior to the commencement of a Trip, unless otherwise provided by the Insurance Agreement; |
(e) damage to or loss of property of the Insured (other than vehicle), that occurred not earlier than 15 days prior to the commencement of a Trip, unless otherwise provided by the Insurance Agreement, resulting from: |
– fire ( fire means rise of fire which is capable to independently spread out of the places which are specially intended for its making and maintenance); |
– acts of nature (earthquake, landslip, storm, hurricane, flooding, inundation, hail or downpour); |
– flooding from water, sewer, heating systems; |
– illegal actions of the third parties, on the assumption that damage is significant (destruction of more than 70% of property) and influences materially the financial position of the Policyholder or in cases when presence of the Policyholder is necessary for establishment of the fact of damage; |
(f) judicial proceeding which falls within the period of an Insured Trip in which the Policyholder participates under court decision which was accepted after enforcement of the Insurance Agreement; |
(g) military conscription or reserve training of the Insured upon commencement of the Insurance Agreement Validity Period; |
(h) refusal to issue an entry visa to the Insured Person upon timely submission of all necessary documents for issuance in accordance with the requirements of the Consulate of the destination country; |
(i) early return of the Insured from the trip because of a disease followed by hospitalization and/or death of a Family Member; |
(j) delay with the return of the Insured from Trip after the termination of a Trip because of death, accident or illness of a spouse or a Family Member travelling with him/her; |
(k) Death, sudden decay of health (hospitalization) of an individual participating in a Joint Trip with the Insured, arisen not earlier than 15 days prior to commencement of a Trip and no later than the date of commencement of the intended Trip, unless otherwise provided by the Insurance Agreement and interfering with the fulfillment of the intended Trip; |
(l) injuries of any complexity of an individual participating in a Joint Trip with the Insured as a result of accident, not earlier than 15 days prior to the commencement of a Trip and no later than the date of commencement of the intended Trip, unless otherwise provided by the Insurance Agreement, but only in the case there are medical contra-indications to the planned Trip; |
(m) refusal to issue an entry visa to the Insured Person’s Family Member or an individual participating in a Joint Trip with the Insured Person upon timely submission of all necessary documents for issuance in accordance with the requirements of the Consulate of the destination country; |
(n) delay in the issuance or issuance of an entry visa within the terms other than the requested, by the Insured Person, his/her Family Member or an individual participating in a Joint Trip with the Insured Person upon timely submission of all necessary documents for issuance in accordance with the requirements of the Consulate of the destination country. |
3.2.3. for the insurance of civil liability of the Insured – the obligation of the Insured, in the manner established by the legislation in force in the territory of insurance, to compensate for harm caused to life, health and/or property of third parties when the Insured is staying outside his/her permanent place of residence. |
The Insurer’s obligation to pay Insurance Indemnity (coverage) shall arise only in the case of unintended damage caused by the Insured to third parties on the territory stipulated in the Insurance Agreement and during the period (stipulated in the Insurance Agreement) of the Insured’s stay outside his/her permanent residence, which resulted in the following: |
(a) death, disability of, or injury to third parties (physical damage); |
(b) destruction of or damage to property belonging to third parties (property damage). |
The event is being insured if the fact of damage and/or harm is confirmed by an enforced decision of judicial bodies or recognition of the Insured with a written approval of the Insurer of the proved property claim about compensation of harm caused to lives and health or property of the third parties. |
3.2.4. for luggage insurance – an event that caused the following: |
3.2.4.1. full loss (disappearance) of luggage confirmed by respective carrier’s documents; |
3.2.4.2. delay of luggage (delay in delivery of luggage confirmed by respective carrier’s documents) delivered to the carrier under the passenger carriage contract, for more than 4 hours from the actual time of arrival of the flight – for each full hour of delay after the first 4 hours, but not exceeding Agreement. |
3.3. The specific list of insured events, upon occurrence of which the Insurer is obliged to pay the insurance indemnity to the Insured, is defined in the Insurance Agreement. |
3.4. The Insurer shall be entitled to develop special insurance programs based on the territory of insurance, a set of insurance risks, the amount of the sum insured, the validity period of the Insurance Agreement and other criteria. In this case, the name of the relevant insurance program may be specified in the Insurance Agreement when determining the insurance risk, and the territory code may be specified in the Insurance Territory. |
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4. INSURANCE LIABILITY SCOPE |
4.1. Upon occurrence of an insured event for insurance of contingencies, the Insurer shall compensate: |
4.1.1. medical costs in respect of payment for emergency and urgent medical care on outpatient and/or inpatient treatment due to injury, including maxillofacial, poisoning, sudden acute disease or exacerbation of a chronic disease prior to elimination of threat to the Insured’s life which include: |
4.1.1.1. expenses for carrying out surgeries; |
4.1.1.2. expenses for carrying out diagnostic tests; |
4.1.1.3. expenses for payment of medical services, including outpatient treatment; |
4.1.1.4. expenses for local ambulance services; |
4.1.1.5. expenses for payment of the medicines and dressing means prescribed by a doctor; |
4.1.1.6. expenses for payment of the immobilization devices prescribed by a doctor (the Insurer may pay for both the purchase or hire of immobilization devices). Immobilization devices for the purposes hereof shall mean, among other things, crutches, special footwear for walking, wheelchairs and other orthopedic equipment; |
4.1.1.7. expenses for stay of the Insured Person in a hospital; |
4.1.1.8 post-hospital home nursing of the Insured within the limits of the sum stipulated in the insurance agreement; |
4.1.1.9. antenatal and postnatal monitoring within the limits of the sum stipulated in the insurance agreement, but not later than the Validity Period of the Insurance Agreement; |
4.1.1.10. expenses on normal delivery within the limits of the sum stipulated in the insurance agreement, but not later than the Validity Period of the Insurance Agreement; |
4.1.1.10. medical expenses at complication during pregnancy and/or delivery within the limits of the sum stipulated in the insurance agreement, but not later than the Validity Period of the Insurance Agreement; |
4.1.1.12. If the Insured is a child under 16 who needs hospitalization, the Insurer shall pay daily stay of one parent at the same hospital during all period of stay of the insured child at hospital. |
4.1.1.13. If an accident/physical injury or illness leads to a chronic disease, the entire coverage shall be limited by the sum insured stipulated in the Insurance Agreement for each chronic disease for each Trip insured in respect of all necessary and reasonable expenses. |
4.1.1.14. Other medical expenses which include: |
(a) expenses on annual check of sense of sight and expenses on purchase of glasses or contact lenses within the limits of the sum stipulated in the Insurance Agreement; |
(b) expenses on one annual dental check, as well as treatment and prosthetics within the limits of the sum stipulated in the Insurance Agreement; |
(c) expenses on annual check of sense of hearing and expenses on purchase of a hearing kit within the limits of the sum stipulated in the Insurance Agreement; |
All medical actions conducted should be expedient, justified by the attending physician and coordinated with the Insurer. |
4.1.2. the Insurer shall compensate expenses on emergency and urgent dental care within the limits of indemnity set forth in the Insurance Agreement, namely: |
4.1.2.1. expenses related to soothing treatment of natural tooth in case of tooth injury as a result of an accident; |
4.1.2.2. the costs associated with soothing treatment of a natural tooth and an associated sealing, in acute inflammation of the tooth and the tissue surrounding the tooth; |
4.1.3. the Insurer shall compensate expenses for medical transportation/evacuation within the limit of indemnity set forth in the Insurance Agreement, namely: |
4.1.3.1. costs of search, rescue and movement (transportation by the ambulance car or other vehicle) from the scene to the nearest medical institution or to the doctor who is in close proximity in the country or the place of temporary stay; In this case, the transportation/evacuation costs specified in this clause, not agreed with the Insurer or the Service Company, shall be covered by the Insurer in the amount not exceeding the amount in Russian rubles equivalent to USD 200; |
4.1.3.2. costs of search, rescue and movement (transportation by the ambulance car or other vehicle) from the scene to the nearest medical institution or to the doctor who is in close proximity in the country or the place of temporary stay, as well as from a medical institution or from a doctor to the place of residence during the Insured Trip. In this case, the transportation/evacuation costs specified in this clause, not agreed with the Insurer or the Service Company, shall be covered by the Insurer in the amount not exceeding the amount in Russian rubles equivalent to USD 400; |
4.1.3.3. expenses for emergency medical transportation by an appropriate vehicle, including expenses for accompanying person (if such company is prescribed by the doctor) from the place of stay of the Insured to the place of his permanent residence or to the nearest medical institution at the place of residence subject to impossibility to provide the necessary medical treatment in the place of temporary stay. Emergency medical transportation shall be carried out exclusively in cases when its necessity is confirmed by the opinion of the Insurer’s doctor on the basis of documents provided by the local attending physician and subject to the absence of medical contraindications; |
4.1.3.4. expenses for medical transportation of the Insured from place of temporary stay to the place of his/her permanent residence or to the nearest medical institution at the residence, in case when expenses for stay in a hospital are likely to exceed the limit of compensation specified in the Insurance Agreement, or in cases where treatment abroad exceeds the cost of emergency medical transportation. Medical transportation shall be possible only subject to the absence of medical contraindications. |
4.1.4. the Insurer shall compensate expenses for posthumous repatriation within the limit of indemnity set forth in the Insurance Agreement, namely: |
4.1.4.1. expenses authorized by the Service Company for the return of the body/remnants of the Insured Person, as well as personal belongings of the insured person which he/she had during the Trip, to the permanent residence of the Insured person, if his/her death occurred as a result of the insured event. In this case, the Insurer shall not pay the costs of funeral services at the place of permanent residence of the Insured. |
4.1.4.2. The Insurer also undertakes to arrange and pay for additional travel expenses of a third party round trip (1st class by train or economy/tourist class by plane) to accompany the coffin with the Insured and/or attend the funeral, if it is provided for in the Insurance Agreement. |
4.1.4.3. compensation of expenses authorized by the Service Company and related to payment of funeral services (coffin payment, cremation, local burial), including at the place of permanent residence of the Insured. |
4.1.5. the Insurer shall compensate transportation expenses within the limit of indemnity set forth in the Insurance Agreement, namely: |
4.1.5.1 the expenses of the Insured for travel to the place of permanent residence economy class one way, including transfer to the airport or railway station, if the Insured failed to depart in time, i.e. on the day specified in travel documents of the Insured, due to the insured event which entailed hospitalization of the Insured Person or if the is a relevant prescription of a doctor. The Insured shall make every reasonable effort to return unused travel documents and compensate the cost thereof to the Insurer. At failure to fulfill this condition, the Insurer shall be entitled to deduct the cost of unused travel documents from the indemnity amount compensating for the expenses of the Insured. If the Insured has travelled in a personal vehicle, the Insurer shall reimburse the Insured Person’s expenses for one-way travel to the place of permanent residence in economy class, including transfer to the airport, if there is a doctor’s prescription for such transportation. |
4.1.5.2 expenses for accommodation of an adult third party staying with the Insured outside the Permanent Place of Residence, if the Insured failed to depart in time, i.e. on the day specified in travel documents of the Insured, due to the insured event which entailed hospitalization of the Insured Person. The Insured, as well as an adult third party who is together with the Insured outside the permanent place of residence, are obliged to make every reasonable effort to return (hand over) unused travel documents and reimburse their cost to the Insurer. In this case, the expenses for the stay of an adult third party outside the permanent place of residence shall be covered by the Insurer within 10 nights after the completion of the Insured Trip, and the amount of expenses may not exceed the equivalent of USD 100 per night. |
4.1.5.3. payment for the organization of the necessary travel expenses of an adult third party (relative or acquaintance) specified in the Contract, traveling together with the Insured Agreement to accompany the Insured during transportation. In this case, the costs of accommodation of an adult third party with the Insured Person during the hospitalization of the Insured shall be covered by the Insurer within the amount equivalent to USD 100 per night, but not exceeding 10 nights. |
4.1.5.4. the expenses of organizing and payment for one round-trip ticket (1st class train or economy class by plane) for the full age third party specified by the Insured Person in the Insurance Agreement to the location of the latter as a result of emergency transportation or evacuation, provided that there is no accompanying person of the Insured and provided that the Insured Person is hospitalized more than 400 km away from his/her permanent place of residence. |
In this case, the Insurer undertakes to pay for the necessary daily accommodation of the adult third party specified in the Insurance Agreement by the Insured Person for the period of the Insured Person’s stay in the hospital within the amount equivalent to USD 100 per night, but not exceeding 10 nights. |
4.1.3.3. One way economy class travel expenses for children being with the Insured during the stay outside the permanent residence, to the place of their permanent residence, if the children are left without supervision as a result of an Insured Event occurring to the Insured Person, as well as payment of travel expenses of one adult accompanying the child or children. If the Insured cannot name such a person, the Insurer will organize and pay for the appropriate company. |
4.1.5.6. if, as a result of the insured event, Insured Person’s children are left at home unattended (starting from the date of his/her planned return home, if the insured event had not occurred), the Insurer undertakes to pay for the transfer of the child or children to the place specified by the Insured Person within the territory of insurance, by train or economy class; alternatively, the Insurer may arrange and pay for one round-trip ticket (1st class by train or economy/tourist class by plane) for the person indicated by the Insured so that the Person can come to the Insured’s place of permanent residence and take care of his/her child/children. |
In any case, the Insurer shall pay the travel expenses of one adult accompanying the child or children. If the Insured cannot name such a person, the Insurer will organize and pay for the appropriate company. |
4.1.5.7. expenses for early return of the Insured to the place of permanent residence in case of sudden or unforeseen death of his/her Family Member subject to the return of unused return ticket by the Insured to the Insurer. |
4.1.5.8. costs associated with the cancellation of a scheduled flight departure, which the Insured Person intended to take to go on a Trip and which was subsequently replaced by another flight, subject to the submission of relevant supporting documents issued by an authorized representative of the airline confirming such cancellation, at the rate of RUB 1000 for each full hour of waiting, starting from the 4th hour, from the time specified in the original ticket, but not exceeding 12 hours for one insured event, unless otherwise specified in the Insurance Agreement. |
4.1.5.9. two way economy class travel expenses (from the place of permanent residence and back) of an adult third person, if the term of hospitalization of the Insured traveling alone exceeded 10 (ten) days. |
4.1.5.10. costs associated with the delay of a scheduled flight departure, which the Insured Person intended to take to go on a Trip, for more than 4 hours from the time specified in the initial ticket, subject to the submission of relevant supporting documents issued by an authorized representative of the airline confirming such delay, at the rate of RUB 1000 for each full hour of delay, after the first 4 hours of flight delay, but not exceeding 12 hours. The expenses incurred as a result of the delay in the arrival of the flight to the destination, as well as the expenses incurred due to the late arrival of the Insured for the flight are not subject to compensation. |
4.1.6. the Insurer shall compensate expenses in the event of loss or theft of documents (traveling passport, passport of the Russian Federation) within the limit of indemnity set forth in the Insurance Agreement, namely: |
4.1.6.1. transportation costs for the Insured person’s travel to the nearest Consulate of the Russian Federation or other authorized state institution and back by an adequate vehicle, where the Insured person will be able to obtain a passport-replacement document. |
4.1.6.2. expenses for the purchase of a new ticket to the permanent place of residence, if the Insured Person misses the return flight due to the need to issue a passport-replacement document. |
4.1.6.3. the cost of payment of the stamp duty/fee charged by the Consulate or other authorized state institution for the issuance of the passport-replacement document. |
The Insurer shall pay the costs of search and issuance of duplicates or lost documents (travelling passport, civil passport) within the limits of the indemnity set forth in the Insurance Agreement. |
4.1.7. Expenses for payment of urgent messages, related to the occurrence of an insured event, within the limit of indemnity set forth in the Insurance Agreement. The expenses shall be paid on the basis of documents confirming such expenses and the amount thereof. |
4.1.8. Legal assistance expenses: |
The Insurer shall pay the expenses for the organization and payment of the first legal advice to the Insured within the limit of indemnity set forth in the Insurance Agreement, if the Insured Person is persecuted according to the civil legislation of a host country as a result of the Insured’s unintentional damage to third parties, unintentional infringement of statutory acts of a host country, excluding the damage and infringements connected with the use, possession and storage of motor vehicles. |
4.1.9. The Insurer shall compensate transportation expenses related to the damage to a personal vehicle as a result of an accident or a breakdown, as well as the loss (theft) of a vehicle within the limit of indemnity set forth in the Insurance Agreement, namely: |
4.1.9.1. In case of loss or damage (breakdown or accident) of the personal vehicle of the Insured, the Insurer shall arrange and pay for the transport for the delivery of all passengers, including the driver, to the place of residence in the country of temporary stay. |
4.1.9.2. In case of damage to the personal vehicle of the Insured, the Insurer shall arrange for a tow truck arrival to the breakage location and tow (evacuate) the vehicle to the place of repair or parking in the country of temporary stay. |
4.1.9.3. The Insurer shall arrange and pay for the evacuation of the Insured’s vehicle to the country of permanent residence of the Insured in the following cases: |
– if, according to experts, more than 10-day repair is required or if the actual time of repair takes more than 10 days, and the time of stay of the Insured in the territory of this country is less than the term of repair completion; |
– or if the vehicle of the Insured has been lost, and then found after the departure of the Insured to the permanent place of residence. |
4.1.9.4. The Insurer shall organize and pay the expenses for returning the Insured to the country of permanent residence (by plane in economy class, by train in a compartment or by bus) if the Insured’s personal vehicle remains defective as of the end of the Trip. |
4.2. Upon the occurrence of an insured event for the insurance of losses from the involuntary cancellation of a Trip, the Insurer shall reimburse the following expenses within the limit of indemnity set forth in the Insurance Agreement: |
4.2.1. on compensation of losses incurred as a result of unilateral cancellation by the Insured of the Insured rip outside the permanent place of residence resulting from the following: |
4.2.1.1. provided in clause 3.2.2 (a), (b), (c), (d), (e), (f), (g), (k), (l) hereof and related to the annulment of travel documents, cancellation of the hotel room booking, payment of the consular fee of the Embassy and the cost of the entry visa of the state of destination and cancellation of services paid under the contract with the travel company, non-refundable or subject to partial reimbursement and confirmed by the relevant documents of the transport company, Consulate, hotel, etc.; |
4.2.1.1.1. the expenses provided for in clause 3.2.2 (d) hereof shall be reimbursed directly to the Insured, if he/she is an adult, and if the Insured is a minor, the expenses of one adult accompanying him/her on the Trip shall also be reimbursed. |
4.2.1.2. for reasons provided in clause 3.2.2 (h), (m), (n) hereof the Insurer shall reimburse expenses related payment of the consular fee of the Embassy and the cost of the entry visa of the state of destination, the annulment of travel documents, cancellation of the hotel room booking, as well as cancellation of services paid under the contract with the travel company, non-refundable or subject to partial reimbursement and confirmed by the relevant documents of the transport company, Consulate, hotel, etc. |
4.2.2. additional expenses incurred by the Insured upon his/her early or temporary return from the Trip, caused by the reasons provided for in clause 3.2.2 (i) hereof, within the limits of the sum insured set forth in the Insurance Agreement. In this case, the expenses for the purchase of travel tickets of tourist or economic class, the transfer of one urgent message, as well as the cost of hotel accommodation for the unused part of the period of stay outside the permanent place of residence are to be reimbursed. If the Insured trip is organized through a travel company, the cost of hotel accommodation for the unused part of the period of stay outside the permanent place of residence must be confirmed by the travel company which organized the trip. Expenses for the purchase of travel documents are to be refunded only if initial ticket is not to be refunded. In case of reissue of travel documents, the Insurer shall compensate the expenses documentarily confirmed and associated with the reissue of travel documents. |
4.2.3. documented additional expenses incurred by the Insured as a result of the delay in his/her return after the end of the Trip caused by the reasons provided for in clause 3.2.2 (j) hereof, within the limits of the sum insured set forth in the Insurance Agreement. At the same time, the expenses for accommodation of the Insured in a 3-star hotel for a period not exceeding 5 (five) days, purchase of travel tickets of tourist or economic class, transfer of one urgent message shall be reimbursed. Expenses for the purchase of travel documents are to be refunded only if initial ticket is not to be refunded. In case of reissue of travel documents, the Insurer shall compensate the documented expenses associated with the reissue of travel documents. |
4.3. Upon the occurrence of an insured event for the insurance of civil liability of the Insured, the Insurer shall reimburse the following expenses within the limit of indemnity set forth in the Insurance Agreement: |
4.3.1. direct real property damage caused to a third party as a result of damage (destruction), loss of property owned by a third party (or belonging to him/her on the basis of a legally documented legal relationship), within the actual value of the property net of wear and tear or the cost of its restoration (repair); |
4.3.2. physical harm caused to a third party within: |
(a) the amount of costs required for medical treatment and/or subsequent rehabilitation, provided that such costs are causally related to the event. |
(b) the amount of part of earnings, which his/her dependent persons lose in case of death of the affected person; |
(c) amount of the incurred funeral expenses – in case of death of the affected person. |
4.3.3. necessary and reasonable expenses attributed to property salvage and rescue of the persons who suffered damage due to the Insured Event, or to minimize the damage arising due to the Insured Event; |
4.3.4 reasonable expenses for preliminary investigation of the insured event circumstances and degree of fault of the Insured Person; |
4.3.5 expenses for conducting of proceedings in courts on the alleged harm infliction cases. |
4.4. Upon the occurrence of an insured event for the insurance of luggage, the Insurer shall reimburse the following expenses within the limit of indemnity set forth in the Insurance Agreement: |
4.4.1. In case of total loss (disappearance) of luggage – payment in the amount of RUB 1000 for each kilogram of missing luggage, unless the other amount of payment for each kilogram of luggage is provided for in the Insurance Agreement. |
4.4.2. In case of delay of luggage – payment in the amount of RUB 750 for each hour of delay from the time of actual arrival of the flight, starting from the 4th hour, but not exceeding 12 hours, unless the other amount of payment for each hour of luggage delay or other number of hours of delay is provided for in the Insurance Agreement. |
Indirect expenses (search, examination, shipment of found luggage, hotel accommodation, transport expenses and so forth) are not subject to compensation. |
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5. EXCEPTIONS FROM INSURANCE LIABILITY |
5.1. The Insurer shall in any case be exempt from payment of insurance indemnity in the cases provided for by the legislation of the Russian Federation, as well as in the cases arising as a result of: |
5.1.1. effects of a nuclear explosion, radiation, or radioactive contamination; |
5.1.2. military actions and maneuvers or other military events and consequences thereof; |
5.1.3. civil war, popular unrest of any kind or strikes and consequences thereof, unless otherwise provided for by the Agreement; |
5.1.4 withdrawals, confiscations, nationalization, requisition, arrest or destruction of the insured property under the order of the state authorities and other similar measures of political nature undertaken under the order of military or civil authorities and political organizations; |
5.1.5 suffering of traumas or diseases caused by criminal or illegal actions of the Insurant or the Insured Person. |
5.1.6. in respect of the harm arising from the fact the Policyholder (the Insured) deliberately abstained from taking any reasonable and available measures to reduce possible losses; |
5.1.7. if the Policyholder (Insured Person) has waived the right of claim against the person responsible for the losses compensated by the Insurer, or the exercise of such right has become impossible due to the fault of the Policyholder (Insured Person). The Insurer shall be released from payment of the insurance indemnity in full or in the relevant part and shall have the right to demand the refund of the overpaid indemnity amount. |
5.1.8. if the information and documents submitted by the Insured Person to the Insurer for the purpose of receiving the insurance indemnity contain contradictory, unreliable or knowingly false information about the causes and circumstances of the insured event, as well as the types and costs of the services rendered in connection with the insured event. |
5.2. The Insurance Agreement shall not cover moral harm (it is not considered an insured event) which shall not be included (not subject to compensation) in the amount of insurance indemnity. |
5.3. The Insurance Agreement shall not cover losses incurred by the Insured as a result of the event having signs of an insured event, although occurring during the Validity Period of the Insurance Agreement, but the reasons of occurrence of which existed before the Insurance Agreement entered into force (they shall not be considered an insured event) and such losses shall not be subject to reimbursement. |
5.4. The Insurance Agreement shall not cover (the following shall not be considered insured events) and the amount of insurance indemnity shall not include losses that are caused, arising or the amount of which increases directly or indirectly due to a terrorist attack and/or terrorism, despite any other simultaneous applicable circumstances or events; actions on control, prevention, suppression or any other actions associated with the terrorist attack and/or terrorism; acts of violence or acts threatening human life, tangible and intangible property with the purpose or desire to influence any government or with a view of intimidation of population or any strata, are to be additionally covered, unless otherwise stipulated by the Insurance Agreement. |
5.5. The Insurance Agreement shall not cover any expenses that are not individually specified in the Insurance Agreement and such expenses shall not be included in the amount of insurance indemnity (shall not be considered insured events). |
5.6. For insurance of contingencies, the following expenses shall not be covered (shall not be considered insured events) by the Insurance Agreement: |
5.6.1. Expenses related to the treatment of a chronic disease that does not pose a threat to the life of the Insured. If the need for emergency and/or urgent medical care is associated with a threat to the life of the Insured, the maximum limit of indemnity is 5% of the total sum insured, unless otherwise specified in the Insurance Agreement. |
5.6.2. costs associated with the provision of a planned form of medical care. |
5.6.3. expenses associated with the treatment of consequences of accidents at occurred prior to the Insured Trip. |
5.6.4. Costs associated with the treatment of nervous, mental diseases, unless otherwise provided by the Agreement, or an attempted suicide. |
5.6.5. Expenses for evacuation/repatriation in case of insignificant disease or injuries which in the opinion of the medical adviser appointed by the Insurer can be treated locally and do not prevent further travelling of the Insured Person. |
5.6.6. Expenses in respect of any evacuation and/or repatriation not arranged by the Insurer or the Service Company, as well as subsequent expenses incurred as a result of such evacuation and/or repatriation, expenses incurred as a result of the voluntary refusal of the Insured to be evacuated to his/her permanent place of residence, as well as subsequent expenses incurred after such refusal. |
5.6.7. Expenses for the arrangement of planned transportation. |
5.6.8. Costs for the transportation of the Insured to the selected country, which is not approved for any reason by a medical expert of the Insurer; |
5.6.9. Any costs associated with the care of a child without accompanying persons, within clause 4.1.1.12 hereof, in case of provision of planned medical care, which is not associated with the emergency medical transportation of the Insured; |
5.6.10. Any costs associated with subsequent relocations in connection with the same insured event after the Insured Person returns to his/her permanent place of residence; |
5.6.11. Any additional transport costs according to cl. 4.1.5.4 hereof, incurred as specified in the Insurance Agreement by a third party adult, if later t is necessary to arrange for the relocation of the Insured Person to another hospital in the same country. |
5.6.12. expenses connected with plastic and regenerative surgery and any sort of prosthetics, including dental, in particular tooth crown installation, eye prosthetics, hearing aid, joint prosthetics. |
5.6.13. Expenses for payment of surgical interventions on the heart and blood vessels (including coronary artery bypass grafting, balloon angioplasty, stenting, etc.) even if there are medical indications therefor, except in cases where the coverage of such expenses is expressly provided for in the Insurance Agreement; |
5.6.14. expenses related to the services not necessary from the medical point of view or to treatment which was not prescribed by a doctor. |
5.6.15. The costs associated with any claims that may arise in the course of the Trip undertaken against medical contraindications. |
5.6.16. Expenses related to the treatment of alcoholism, drug addiction and other abuse/addictions or other condition related to addiction or treatment of painful conditions caused by the use of narcotic, toxic substances, alcoholic beverages, as well as the treatment of injuries received by the Insured Person who was injured under the influence of the above substances. |
5.6.17. costs of cesarean section carried out in a planned manner not agreed upon with the specialists of the Insurer as required, and follow-up care after such delivery. |
5.6.18. The cost of prenatal classes; obstetric costs not directly associated with delivery. |
5.6.19. Costs incurred due to complications during or as a result of a planned home delivery. |
5.6.20. expenses related to pregnancy, birth, induced abortion, except for cases of sudden sequelae menacing life or a documented accident (however, in all cases term of pregnancy should not exceed 8 weeks), unless otherwise stipulated by the Insurance Agreement. Miscarriage and ectopic pregnancy are no exception and are covered at any stage of pregnancy. |
5.6.21. expenses related to treatment of traumas, diseases caused by direct or indirect influence of radiation of any sort, including solar irradiation, unless otherwise stipulated by the Insurance Agreement. |
5.6.22. Expenses related to the purchase of glasses, contact lenses, hearing aids, prostheses, as well as expenses for all types of prosthetics, unless otherwise provided for by the Insurance Agreement. |
5.6.23. Expenses related to treatment in sanatoriums and dispensaries, accommodation and treatment in facilities for disabled persons, water, Spa, natural clinics, sanatoriums or similar institutions or hospitals, accommodation in which has actually become a home or the permanent residence for the Insured Person, and the stay of the Insured in such institutions in whole or in part resulted from family reasons. |
5.6.24. Costs associated with contraception, sterilization (or reverse procedure), fertilization, vasectomy, venereal diseases, sexually transmitted diseases, gender change or other sexual conditions, infertility or related health states or other forms of artificial reproduction. Care or treatment costs associated with an immunodeficiency virus or HIV disease, including acquired immunodeficiency syndrome (AIDS) or AIDS-associated complex, and other similar infections, diseases, injuries or indications arising from these conditions, regardless of the causes thereof. |
5.6.25. expenses related to any preventive examination, general health check-ups and vaccinations, unless otherwise provided for by the Insurance Agreement. |
5.6.26. Expenses related to cosmetic or plastic surgery, acupuncture and physiotherapy, unless otherwise provided for by the Insurance Agreement. |
5.6.27. Expenses related to the provision of dental care, unless otherwise provided by the Agreement, except for emergency dental care, |
5.6.28. Costs associated with the treatment of injuries, diseases caused by any sport (as a professional or an amateur), as well as costs associated with driving a moped, motorcycle, snowmobile, ATV, jet ski during the Trip, unless otherwise provided by the Insurance Agreement, which shall be reflected in the Insurance Agreement and entail an increase in the rate. |
5.6.29. Expenses associated with the treatment of injuries, diseases caused by air sports, flying on an aircraft, operating it (except for the cases of flight as a passenger on a civil aviation aircraft operated by a professional pilot), flying on non-motorized aircraft, motor gliders, super-light aircraft, skydiving, mountaineering, ice climbing, climbing, any kind of activity at an altitude of more than 3,500 meters, moto- and car racing, diving at a depth of more than 30 meters or without a certificate of the association of divers, any sports related to animals and other dangerous sports, unless otherwise provided by the Insurance Agreement, which shall be reflected in the Insurance Agreement and entail an increase in the rate. |
5.6.30. Costs associated with the treatment of injuries, diseases caused by participation in officially held sports competitions, unless otherwise provided for by the Insurance Agreement, which shall be reflected in the Insurance Agreement and entail an increase in the rate by 3 times. |
5.6.31. Any costs associated with search and rescue activities for the purpose of locating the Insured in the mountains, in the sea, in the desert, in the jungle or other remote areas, including the cost of air/sea search and evacuation to shore from a ship or from the sea. |
5.6.32. expenses related to examination and treatment of diseases by non-scientific methods and expenses for the purchase of non-certified medical products. |
5.6.33. expenses related to treatment of diseases and traumas caused by criminal or illegal actions of the Policyholder, the Insured Person or the Beneficiary. |
5.6.34. expenses related to treatment of injuries and diseases received in a car accident, if: |
(a) the Insured drove a vehicle without having a driver’s license, or in case of having a driver’s license, not having the right to drive the vehicle of the corresponding category or subcategory; |
(b) the Insured has been driving being under the influence of alcohol, drugs or toxic substances; |
(c) The Insured Person was (as a passenger) in a vehicle operated by a person not having a driving license or under the influence of alcoholic, narcotic or toxic substances, except for public transport. |
5.6.35. expenses related to the Insured Person’s infringement of rules for prevention of diseases endemic for the country of temporary stay, which he/she has been aware of, as well as failure to follow doctor’s instructions. |
5.6.36. Costs associated with seizures in epilepsy. |
5.6.37. expenses related to medical manipulations in case of iatrogenic damages. |
5.6.38. expenses related to infringement of safety precautions when working for hire. |
5.6.39. expenses related to rendering of services by medical institution (doctor) without corresponding license or suspended license. |
5.6.40. expenses for the purchase of medications, if prescribed, with the composition not revealed by the manufacturer and expenses associated with the purchase of foodstuff, antasthenics, weight-loss drugs and laxatives given under prescription, cosmetic means, mineral water and additives to bath water. |
5.6.41. expenses related to artificial insemination, treatment of sterility and contraception. |
5.6.42. Expenses associated with rehabilitation, medical or physical therapy, unless otherwise provided for by the Insurance Agreement, hydrotherapy and heliotherapy. |
5.6.43. expenses associated with the treatment of oncological diseases including those newly diagnosed. |
5.6.44. expenses caused by deterioration of health connected with treatment which the Insured Person had received before the commencement of insurance. |
5.6.45. Costs of inpatient treatment not authorized by the Insurer. |
5.6.46. Expenses incurred as a result of intent of the Policyholder, Insured, Beneficiary; |
5.6.47. Expenses arising from the performance of professional activities under a contract or Agreement involving increased risk, unless otherwise provided for in the Insurance Agreement, which shall be reflected in the Insurance Agreement and shall entail an increase in the rate. |
5.6.48. The cost of providing additional comfort during the stay in hospital, namely, but not limited to, the provision of a high-comfort ward. |
5.7. The following expenses shall not be covered by the Insurance Agreement for transport expenses related to loss or damage to a personal vehicle as a result of an accident or a breakdown (shall not be considered insured events): |
5.7.1. vehicle repair costs. |
5.7.2. expenses related to the breakdown or loss of a vehicle older than 5 years and in case of damage as a result of an accident of a vehicle older than 10 years. |
5.7.3. expenses associated with the damage to a vehicle with a maximum permissible weight exceeding 3.5 tonnes; |
5.7.4 expenses related to compensation of losses associated with civil liability of vehicle owners; |
5.7.5 expenses associated with the breakdown and/or accident of a vehicle carrying passengers for a fee, with or without a permit. |
5.7.6. costs associated with damage to the vehicle received when parked. |
5.7.7 expenses not agreed upon with the Insurer. |
5.8. For posthumous repatriation, the following expenses shall not be covered (shall not be considered insured events) by the Insurance Agreement: |
5.8.1. expenses at symptoms of nervous or mental diseases, and due to suicide, attempt of suicide, intentional self-harm; |
5.8.2 expenses resulting from taking narcotic, toxic, strong substances, alcoholic drinks, and due to treatment of traumas at reception of which the Insured Person was under influence of the above-stated substances; |
5.8.3. costs due to sexually transmitted diseases and AIDS; |
5.8.4 expenses for receiving planned medical care; |
5.8.5. expenses due to air sports, skydiving, mountaineering, ice climbing, climbing, any kind of activity at an altitude of more than 3,500 meters, motor- and car racing and other dangerous sports, unless otherwise provided for by the Insurance Agreement; |
5.8.6 Costs associated with the participation in officially held sports competitions, unless otherwise provided for by the Insurance Agreement, which shall be reflected in the Insurance Agreement and entail an increase in the rate. |
5.8.7. Expenses arising from the performance of professional activities under a contract or Agreement involving increased risk, unless otherwise provided for in the Insurance Agreement, which shall be reflected in the Insurance Agreement and shall entail an increase in the rate. |
5.8.8 expenses resulting from participation in civil wars, popular unrest, military operations, riots, revolts. |
5.8.9 expenses due to treatment of diseases by non-scientific methods and taking of non-certified medical products. |
5.8.10 expenses associated with consequences of oncological diseases. |
5.8.11. the expenses incurred during the Trip taken for the purpose of receiving treatment. |
5.9. For insurance of losses from involuntary cancellation of a Trip shall not be covered by the Insurance Agreement (shall not be considered insured events), if they arise in connection with: |
5.9.1. alcoholic, narcotic or other intoxication of the Insured; |
5.9.2 intentional actions of the Insured Person or the Beneficiary aimed at causing the occurrence of an Insured Event; |
5.9.3 suicide (attempt of suicide) of the Insured Person or his/her Family Members; |
5.9.4 acts of nature and consequences thereof, epidemics, quarantine, weather conditions. This exception shall not apply to the cases provided for in sub-clause 3.2.2 (e) hereof; |
5.9.5 Acts of any public or government authorities except for the cases listed in sub- clause 3.2.2 (f) and (g) hereof; |
5.9.6. failure to obtain an entry visa, if the Insured had previously recorded cases of visa refusal or violation of the visa regulations, as well as if there were cases of criminal, administrative or any other liability in the territory of the host country. |
5.9.7 committing illegal acts by the Insured Person that are in a direct causation with an Insured Event; |
5.9.8 flight of the Insured Person before the beginning of a trip on a flying device of any sort, including engineless, except for cases of flight as the passenger on a civil aviation plane operated by a professional pilot; |
5.9.9 parachute jumps prior to the beginning of a trip; |
5.9.10. exacerbation of chronic diseases, mental disorders, mental illness. |
5.10. For the insurance of civil liability of the Insured, the expenses shall not be covered by the Insurance Agreement (shall not be considered insured events), if they arise in connection with: |
5.10.1 performance of professional (labor) activity by the Insured Person under an agreement or a contract; |
5.10.2 infliction of moral harm; |
5.10.3 indirect losses including lost profits; |
5.10.4 liability arising from the Insured Person’s use or operation of auto, moto, air and water vehicles; |
5.10.5 liability of any sort arising directly or indirectly or partially as a result of pollution of atmosphere, water or soil; |
5.10.6. damage or harm caused by the actions or inaction of the Insured in a state of alcoholic, toxic or narcotic intoxication or consequences thereof; |
5.10.7 commission by the Policyholder, the Insured Person, the Beneficiary of any deliberate action or crime which are in direct causal relationship with an Insured Event. |
5.10.8 certain family relations of the Insured Person regarding members of his/her family. |
5.10.9 damages or losses of the property belonging the Insured Person by proxy or transferred to him/her for maintenance or management, for any commercial, professional or business activity. |
5.11. For insurance of luggage, the following expenses shall not be covered (shall not be considered insured events) by the Insurance Agreement: |
5.11.1 expenses due to damage to the luggage integrity; |
5.11.2 expenses due to partial loss of individual luggage items. |
5.11.3. indirect costs for search, examination, transfer of found luggage, hotel accommodation, transportation costs and other related search and waiting for delayed/lost luggage costs. |
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6. SUM INSURED |
6.1. Sum Insured is a monetary amount set forth in the Insurance Agreement, within the limits of which the Insurer is liable for the performance of its obligations under the Insurance Agreement and on the basis of which the amount of the insurance premium (insurance premium installments) and the insurance indemnity are determined. |
6.2. At conclusion of the Insurance Agreement, the parties may set the limit of Insurance Indemnity for one insured event, for one insured risk, etc. (limits of indemnity). The indemnity limit shall be established in the Insurance Agreement. Under no condition shall the insurance indemnity exceed the corresponding limits of indemnity set forth in the Insurance Agreement. |
6.3. The equivalent of the sum insured and the indemnity limit shall be set at the official rate of the Central Bank of the Russian Federation as of the date of the insurance policy for each insured person. |
6.4. The maximum indemnity limit for an insured event that occurred due to an exacerbation of a chronic disease, if the need for emergency and/or urgent medical care is associated with a threat to the life of the Insured, shall be 5% of the total sum insured, unless otherwise specified in the Insurance Agreement. |
6.5. If total treatment or other expenses exceed the Sum Insured (limit of indemnity) set forth in the Insurance Agreement, the share of expenses exceeding the Sum Insured shall be borne by the Insured Person. |
6.6. At the conclusion of the Insurance Agreement, the parties may provide for the insured’s own participation in the payment of losses (deductible) for the package of risks in general, and for certain risks. The deductible is usually fixed in cash or as a percentage of the sum insured. The insurance agreement may establish a deductible that is a part of the losses determined by the insurance agreement, which is not subject to compensation by the Insurer. The deductible may be conditional (the Insurer shall be exempt from indemnification if its amount does not exceed the deductible amount but shall compensate it in full if the amount of loss exceeds the deductible amount) and unconditional (the amount of insurance indemnity is defined as the difference between the amount of losses and the deductible amount). The specific type and amount of the deductible shall be determined in the Insurance Agreement. If the type of deductible is not defined in the Insurance Agreement, the deductible shall be deemed unconditional. |
In case the Insurance Agreement provides for the percentage deductible and does not specify, to which amount such percentage applies, the percentage shall apply to the total sum insured under the Agreement. |
Unless otherwise provided for under the Insurance Agreement, the deductible shall be specified for each insured event. |
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7. INSURANCE PREMIUM |
7.1. The Insurance Premium is payment for insurance which the Policyholder shall pay the Insurer in accordance with the Insurance Agreement. |
7.2. When determining the amount of the insurance premium payable under the insurance agreement, the Insurer may apply the insurance rates developed by it, which determine the premium charged per exposure unit, taking into account the interest insured and the nature of the insurance risk. Insurance rate is the insurance premium rate of an exposure unit taking into account the insured object and the nature of insured risk as well as other insurance terms and conditions, including the availability and amount of the deductible in accordance with the insurance terms and conditions. The specific amount of the insurance rate shall be determined in the Insurance Agreement. |
7.3. The Policyholder shall pay the insurance premium (insurance premium installments) in the currency of the Russian Federation, except for cases provided by the currency legislation of the Russian Federation and the regulations of the foreign exchange control authorities adopted in accordance with the currency legislation. |
7.4. The insurance premium (insurance installments) can be paid in cash to the Insurer (its authorized representative) or on a cashless basis by transfer to the settlement account of the Insurer (its authorized representative). The insurance premium is paid by a one-time payment or in installments (two or more insurance installments) in the amount and in the time period established by the Insurance Agreement. |
7.5. The day of payment of the insurance premium (installments, in case of payment by installments) is: |
– if paid by a legal person and as the individual entrepreneur in a non-cash form – the day the funds are credited to the Insurer’s account, unless otherwise specified in the Insurance Agreement; |
– if paid by an individual by a transfer of funds in an applicable wire transfer form (non-cash form) – the moment of confirmation of execution of the Policyholder’s transfer by the credit organization; |
– in case of payment by an individual by transfer of funds without opening a bank account – the moment of depositing funds to a credit organization or a bank payment agent (subagent) operating in accordance with the legislation of the Russian Federation on the national payment system; |
– in case of payment by an individual in cash – the time of payment of funds to the Insurer or its representative or payment agent (subagent), accepting payments of individuals. |
7.6. y concluding the Insurance Agreement, the parties determined that failure to pay the insurance premium, the next insurance installments by the Policyholder within the period specified in the Insurance Agreement shall for the parties to the Insurance Agreement be an expression of the Policyholder’s will to repudiate the Insurance Agreement. In this case, the Insurance Agreement shall be terminated from 00 hours 00 minutes of the day following the end of the period of payment of the insurance premium, the next insurance installments which was not paid in full or in part, established by the Insurance Agreement. The date of payment of the insurance premium is the date of issue of the policy. |
7.7. Unless otherwise established by the Insurance Agreement, the following consequences of non-payment of the insurance premium (the first insurance installment), the next due insurance installment are established: |
7.7.1. In case of failure to pay/ incomplete payment of the insurance premium (the first insurance installment), if the insurance premium (the first insurance installment) is payable before the commencement of the Insurance Agreement Validity Period, the Insurance Agreement shall be deemed not to have entered into force. |
7.7.2. Non-payment/incomplete payment of the insurance premium (the first insurance installment) during the Validity Period of the Insurance Agreement, as well as of the next insurance installment, shall entail consequences provided for in cl. 7.6 hereof. |
In this case, the Policyholder shall, within the period established by the Insurer, pay the due portion of the insurance premium for the period during which the Insurance Agreement was in force. The insurer shall not be liable for insurance events that have occurred since the termination of the Insurance Agreement for the reasons specified in cl. 7.7.2 hereof. In the event of payment of the Insurance Premium after termination of the Insurance Agreement, the funds paid after the termination date shall be refunded to the Policyholder in full. |
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8. CONCLUSION AND TERMINATION OF THE INSURANCE AGREEMENT, COMMENCEMENT AND COMPLETION OF THE INSURANCE AGREEMENT VALIDITY PERIOD, THE INSURED TRIP |
8.1. As a rule, the Insurance Agreement is concluded for one year, unless another term is specified in the Insurance Agreement, or for the period of stay of the Insured outside the permanent residence. The Insurance Agreement shall be concluded for a period not less than the period of temporary stay of the Insured Person outside the territory of the Russian Federation specified by the Policyholder. |
8.2. If the Insurance Agreement concluded for a period of one year provides for multiple trips of the Insured abroad, the coverage shall apply to the first 91 days of each Trip, unless otherwise provided for by the Insurance Agreement; |
8.3. To conclude an Insurance Agreement and assess the risks, the Policyholder shall submit an application to the Insurer orally or in writing. When submitting an application in writing, the application in the prescribed form shall be used. The form of the application submitted shall be determined by the Insurer in each case. |
In case of collective insurance, the list of Insured Persons shall be attached to the application. |
8.4. The Insurance Agreement shall enter into force upon payment by the Policyholder of the insurance premium (at payment of the insurance premium in the form of a lump-sum payment)/the first insurance premium installment (at payment of the insurance premium in installments), unless otherwise provided for by the terms of the Insurance Agreement. The Insurance Agreement shall enter into force not later than the date of crossing the state border of the Russian Federation by the Insured Person, unless the terms of the Agreement provide for its conclusion for the benefit of the Insured Person located outside the territory of the Russian Federation or for the benefit of the Insured Person taking the Insured Trip on the territory of the Russian Federation. |
8.4.1. If the Insurance Agreement effect on the other date stipulated in the Insurance Agreement, the failure to pay the insurance premium (its first installment) by the Insured within the term stipulated in the Insurance Agreement shall be an expression of the Policyholder’s will to repudiate the Insurance Agreement. In this case, the Insurance Agreement shall be terminated from 00 hours 00 minutes of the day following the end of the period of payment of the insurance premium (the first insurance installment) which was not paid in full, established by the Insurance Agreement. |
When the insurance premium is paid in installments, the failure to pay the insurance premium installment by the Policyholder within the term established in the Insurance Agreement shall be an expression for the parties to the Insurance Agreement of the Policyholder’s will to repudiate the Insurance Agreement. In this case, the Insurance Agreement shall be terminated from 00 hours 00 minutes of the day following the end of the period established by the Insurance Agreement for payment of the next insurance installment which was not paid in full, with the previously paid part of the insurance premium not being subject to refund. |
8.4.2. In case of termination of the Insurance Agreement that has entered into force before its expiration due to the Insurer’s failure to pay the insurance premium (first, next insurance premium installments) within the terms and in amounts stipulated by the Insurance Agreement, the Policyholder shall in any case pay the insurance premium for the period during which the Insurance Agreement was in effect. The Insurer shall not be liable for insured events that have occurred since the termination (cancellation) of the Insurance Agreement for the reasons specified in clause 8.4.1 hereof. |
8.4.3. In the case of payment of the insurance premium (first or next due insurance premium installment) after the termination (cancellation) of the Insurance Agreement, the funds paid after the date of termination (cancellation) of the Insurance Agreement shall be refunded to the Policyholder in full within 10 (ten) business days from the day following the day of receipt from the Policyholder of the application for/notification of the transfer of funds, in which the details for the transfer are specified. |
8.5. The fact of conclusion of the Insurance Agreement shall be certified by the insurance policy or insurance certificate issued by the Insurer to the Policyholder on the day of receipt of the insurance premium/first insurance premium installment on hand or crediting thereof to the account of the Insurer or its authorized representative, unless otherwise provided for by the Insurance Agreement. |
8.6. By entering the Insurance Agreement, the Insured Person releases the doctors from confidentiality obligations (medical confidentiality observance) in relation to the Insurer in part of the insured event. |
8.7. If upon the expiry of the Validity Period of the Insurance Agreement the return of the Insured from a Trip is impossible due to the insured event that is confirmed by medical report, the Insurer shall continue to fulfill obligations associated therewith, including reimbursement of expenses to pay for emergency and urgent medical care rendered to the Insured Person upon occurrence of the insured event resulting from injury, poisoning, sudden acute disease or exacerbation of chronic disease and (or) return of corpse (remnants) to the permanent place of residence. |
8.8. The Insurance Agreement shall be terminated in the following cases: |
– expiry of the Validity Period; |
– upon return of the Insured from the Insured Trip (the mark of border services in the travelling passport on crossing the state border), but not later than 12:00 of the Insurance Agreement Validity Period expiry date specified in the Insurance Agreement; |
– in case of fulfillment by the Insurer of its obligations under the Insurance Agreement; |
– non-payment by the Policyholder of the insurance premium within the terms established hereby, specified in clauses 7.5, 7.6 hereof. |
– repudiation of the Insurance Agreement by the Insured in accordance with cl. 8.4.1 of the Insurance Rules. |
– death of an individual Policyholder (the agreement terminates in the part of risks pursuant to clauses 2.1.1 to 2.1.3 hereof) or liquidation of a legal entity Insured; |
– liquidation of the Insurer in accordance with the procedure established by the legislation of the Russian Federation (except for cases of transfer of the insurance portfolio to another Insurer); |
– by mutual written agreement between the Parties; |
– in other cases, provided for under the applicable laws of the Russian Federation. |
8.9. Unless otherwise provided for by the Insurance Agreement, if an individual Policyholder repudiates the Insurance Agreement within 14 (fourteen) calendar days from the date of conclusion of the Insurance Agreement, the insurance premium shall be refunded to the physical person Policyholder in full, if the insurance period commencement date is later than the date of termination. If the insurance period commencement date is earlier than the date of policy termination, the premium shall be refunded in proportion to the period during which the policy was in force, subject to the absence in the period from the date of conclusion of the Insurance Agreement until the date of repudiation by an individual Insured of the Insurance Agreement of incidents having signs of an insured event, insured events and insurance indemnities paid under the Insurance Agreement. |
Unless otherwise provided by the Insurance Agreement, the Insurance Agreement shall terminate prematurely from 00:00 of the insurance period commencement date (if the insurance period commencement date is earlier than the date of filing of this Application) or from 00:00 of the date of filing of the Application (if the insurance period commencement date is later than the date of filing of this Application), all rights and obligations of the Parties shall cease from this moment, the Insurer shall not be liable for paying insurance indemnities. |
The insurance premium shall be refunded within 10 (ten) business days from the date of receipt by the Insurer of the original written application of an individual Policyholder in cash or by bank transfer using the details provided by the individual Policyholder. |
If the application for Insurance Agreement repudiation of an individual Policyholder does not specify all the data necessary for refund of the insurance premium, the term of refund by the Insurer of the insurance premium shall be calculated from the date of receipt by the Insurer of all necessary data. |
8.10. The Policyholder shall be entitled to repudiate the Insurance Agreement at any time, if by the time of the repudiation the possibility of the occurrence of the insured event has not disappeared due to circumstances other than the insured event. |
8.10.1. In case of early repudiation by the Policyholder of the Insurance Agreement upon the expiration of 14 days from the date of conclusion of the Insurance Agreement and after the commencement of the Insurance Agreement Validity Period, the insurance premium paid to the Insurer shall not be refunded. |
8.10.2. In the event of early repudiation of the Insurance Agreement by the Insured before the commencement of the Insurance Agreement Validity Period, the insurance premium paid to the Insurer shall be refunded in full. The refunded premium shall be returned within 10 business days from the date of signing by the Insured Person of the application for early termination of the Insurance Agreement using the details specified by the Policyholder or at the Insurer’s cashier. |
8.11. In case of presence as of the date of the Insurance Agreement repudiation of an individual Policyholder of the insurance incidents having signs of an insured event (including appeals to the Service Company), the insurance premium shall not be subject to refund. |
8.12. Unless otherwise provided by the Insurance Agreement or the law, in other cases not provided for in clause 8.9 hereof, upon termination of the Insurance Agreement, the insurance premium paid to the Insurer shall not be refunded. |
8.13. The insurance premium shall not be refunded in the event of the Insured’s non-departure to the country specified in the Insurance Agreement, if the Insured has a valid visa for the Trip, as well as if the Insured declares his/her non-departure after the expiration of the Insurance Agreement Validity Period. |
8.14. In cases provided for by the applicable legislation of the Russian Federation, the Insurer may demand early termination of the Insurance Agreement or its invalidation with compensation for losses caused by the termination of the Agreement or its invalidation, in accordance with the applicable legislation of the Russian Federation. |
8.15. The Insurance Agreement Validity Period for the insured events specified in these Rules, except for the cases specified in sub-clauses 3.2.2 (a) – (h), (k) – (n) hereof, commences and ends within the terms specified in the Insurance Agreement. |
8.16. The Insurance Agreement Validity Period for the insured events specified in sub-clauses 3.2.2 (a) – (e), (k), (l) hereof shall commence at 00:00 of the day following the conclusion of the Insurance Agreement, but not earlier than 15 days before the commencement of the Trip, unless otherwise specified in the Insurance Agreement, and shall end with the commencement of the Trip each time such Trip is undertaken. |
8.17. The Insurance Agreement Validity Period for the insured events specified in sub-clauses 3.2.2 (f) – (h), (m), (n) hereof shall commence at 00:00 of the day following the conclusion of the Insurance Agreement and end with the commencement of the Trip each time such Trip is undertaken. |
8.18. The Insured Trip for the insured events specified in these Insurance Rules shall commence: |
8.18.1 when travelling abroad – from the time when the Insured Person crosses the border of the country of permanent residence at departure from the country of permanent residence, as confirmed by the stamp of customs authorities in the travelling passport. |
8.18.2. when traveling within the territory of the country of permanent residence, if the country of permanent residence is included in the insurance territory under the Insurance Agreement, – from the moment of moving of the Insured Person away from permanent residence by more than 90 km, unless otherwise specified in the Insurance Agreement. |
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9. RIGHTS AND OBLIGATIONS OF THE PARTIES |
9.1. The Insurer shall be entitled to: |
9.1.1 Verify the information provided by the Insurant and performance of provisions of the Insurance Agreement; |
9.1.2. After being notified of the circumstances entailing increase in the insured risk (cl. 9.4.3 hereof), the Insurer may demand to modify the terms and conditions of the Insurance Agreement or to pay the additional insurance premium commensurate with the risk increase. If the Insured (Beneficiary) objects to modification of terms of the Insurance Agreement or additional payment of insurance premium, the Insurer may demand termination of the Agreement in accordance with rules stipulated by chapter 29 of the Civil Code of the Russian Federation. |
Should the Policyholder fail to fulfill the obligation, provided for in cl. 9.4.3 hereof, the Insurer shall be entitled to demand the termination of the Insurance Agreement and reimbursement of losses incurred by the termination thereof (cl. 5 of article 453 of the Civil Code of the Russian Federation). The Insurer may demand termination of the Insurance Agreement if the circumstances leading to the insured risk increase have already ceased. |
9.1.3 Demand from the Policyholder the documents certifying the occurrence of an insured event, and confirming the amount of the insurance indemnity payable, as stipulated by the Insurance Agreement; |
9.1.4 Make inquiries with the relevant authorities as regards issues related to investigation of causes and the amount of losses caused; |
9.1.5 Independently establish reasons and circumstances of an insured event, amount of loss; |
9.1.6 Inspect the documents provided; |
9.1.7 Request data from organizations having information on circumstances of an insured event; |
9.1.8 Carry out physical examination of the Insured Person by the doctor of the Insurer; |
9.1.9. If the competent authorities have materials giving grounds to the Insurer to refuse to pay the insurance indemnity, postpone the payment until all the circumstances are clarified, notifying the Insured within 15 business days from the date of receipt by the Insurer of all the documents requested from the Insured; |
9.1.10 Make payment of the Insurance Indemnity without documents of the competent authorities confirming the fact of occurrence of an insured event, if the amount of damage does not exceed five percent (5%) of the Sum Insured (corresponding limit of indemnity); |
9.1.11 File claims by subrogation to the persons responsible for the damage caused within the limits of amounts of the Insurance Indemnity paid; |
9.1.12. Delay the drawing up of the insurance act and payment of insurance indemnity in the event that: |
– independent expert appraisal of reasons and circumstances of an insured event and the amount of damage has been carried out. The postponement shall take place until the examination is completed and the corresponding document is drawn up; |
– court proceedings concerning the insured event have been initiated. The postponement can take place until the enforcement of the judicial ruling in the absence of an appeal. In case of an appeal, the postponement shall be until the effect of the ruling that is not subject to appeal; |
9.1.13 Require the Beneficiary (Insured) to perform the obligations under the Insurance Agreement, including the obligations vested with but not fulfilled by the Insured, upon submission by the Beneficiary (Insured) of the claim for payment of the Insurance Indemnity. The risk of consequences of the failure to perform or untimely performance of obligations which must have been performed earlier, shall be borne by the Beneficiary (Insured); |
9.1.14 Deduct the cost of unused travel documents not transferred to the Insurer from the indemnity amount compensating for the expenses born by the Insured Person at occurrence of events specified in sub-clauses 4.1.5.2–4.1.5.4, 4.1.5.6 hereof. |
9.1.15 take all measures it deems appropriate to reduce the losses, upon written order of the Policyholder (Insured Person, Beneficiary) provide remedies and manage the settlement of losses; |
9.1.16. Demand invalidation of the Insurance Agreement, if upon conclusion of the Insurance Agreement it is established that the Policyholder has provided the Insurer with knowingly false information about circumstances that are significant for determining the likelihood of the insured event and the amount of possible losses from the occurrence thereof, except for circumstances, which have already ceased. In any case, the circumstances shall be deemed significant if they are explicitly specified by the Insurer in the Insurance Agreement standard form or in the written request; |
9.1.17. Demand invalidation of the Agreement, if the Policyholder (Insured) has informed the Insurer of knowingly false information about his/her health (or health of the Insured) and/or about the scope and cost of medical services rendered, other information necessary for the conclusion of the Insurance Agreement. |
9.1.18 Demand transfer of claims within the limits of medical expenses coverage, if the Insured Person has claims to a third party for compensation of damage to his/her health and such claims are not related to the legal aspect of insurance; |
9.1.19 Be relieved from obligations on payment of insurance coverage to the extent the Insured Person could receive indemnity from claims to third parties, if the Insured waives such claims without consent of the Insurer; |
9.1.20 Reject insurance payment, notifying the Insured Person within 15 business days from the date of receipt by the Insurer of all documents requested from the Policyholder, the Insured, if the Insured or a representative thereof: |
(a) has failed to inform the Service Company about an Insured Event in due time (taking the provisions of clause 10.8.3 hereof into account); |
(b) has failed to provide the Insurer with all documents necessary to take a decision on the Insurance Indemnity payment; |
(c) If the insured event occurred by fault of the employer; |
(d) If the insured event occurred at performance by the Insured Person of any kind of works which have not been stipulated in his/her employment contract; |
9.2. The Insurer shall: |
9.2.1. familiarize the Policyholder with these Insurance Rules; |
9.2.2. issue to the Policyholder an insurance policy with the attachment of these Rules within the term specified in the Insurance Agreement; |
9.2.3 pay insurance indemnity in cases of the Insured Events recognized as such by the Insurer within the terms set forth in cl. 10.10 of these Insurance Rules; |
9.2.4. notify the Insured of the refusal to pay the insurance indemnity within the period provided for in the Insurance Agreement, but not exceeding 15 business days from the date of receipt by the Insurer of all the documents requested from the Insured in writing with the reasons for the refusal; |
9.2.5 at drawing of the Insurance Agreement, formulate precise and unambiguous provisions; |
9.2.6 not disclose information about the Policyholder, Insured Person and their property status, except in cases provided for by the laws of the Russian Federation. |
9.3. The Policyholder shall be entitled to: |
9.3.1. familiarize with these Rules; |
9.3.2. choose insured risks at its discretion; |
9.3.3. get a duplicate of the insurance policy in case of its loss (a copy of the insurance policy certified by the Insurer); |
9.3.4 terminate the Insurance Agreement pursuant to these Rules and the legislation of the Russian Federation; |
9.3.5 Receive information about the Insurer in accordance with the legislation of the Russian Federation; |
9.3.6 receive the insurance indemnity in case of an insured event in accordance with the terms of the Insurance Agreement and these Rules; |
9.3.7 require independent expert investigation to precisely establish the reasons of the Insured Event and amount of the losses incurred. The independent expert investigation shall be carried out by an expert (committee of experts) appointed as agreed by the parties. The expert investigation shall be carried out at the expense of the party which has demanded it. If the results of the expert investigation prove the Insurer’s refusal of indemnity payment to be unjustified, the Insurer shall bear such investigation expenses. The expenses for the examination execution for cases that were considered non-insured upon execution thereof, shall be borne by the Policyholder. |
9.4. The Policyholder shall: |
9.4.1 at conclusion of the Insurance Agreement, notify the Insurer on all circumstances, of which it is aware, that have substantial significance for the determination of the probability of the insured event occurrence and the amount of possible losses from the occurrence thereof, if such circumstances are not known and should not be known to the Insurer, as well as of any enforced or being concluded Insurance Agreements in respect of the property being accepted for insurance. Significant circumstances are at least those stipulated in the Insurance Application. Data and circumstances related to determining the degree of risk may also be deemed significant if the Insurer proves that with the knowledge of such data and/or circumstances it would have never accepted the given insurance risk or would have accepted it on other conditions; |
9.4.2 provide the Insurer upon its request with information and documents specified in sub-clauses 10.11 – 10.14 of these Insurance Rules; |
9.4.3 within the Validity Period of the Insurance Agreement inform the Insurer immediately about all substantial changes in the risk insured; |
9.4.4 pay the Insurance Premium (insurance premium installments) in the amount and within the terms agreed upon in the Insurance Agreement; |
9.4.5 comply with the rules and standards of fire safety, premises and valuable items safety, industrial safety or other similar rules set forth in the legislation or other regulations. |
9.4.6. At the request of the Insurer, inform the Insurer in writing of all Insurance Agreements concluded in respect of the object of insurance by the Policyholder with other insurance companies. In this case, the Policyholder shall specify the name of other insurance companies and the material terms of Insurance Agreements (sums insured, Insurance Agreement numbers, Validity Period). |
9.4.7. Immediately inform the Insurer about the incident that has the signs of an insured event, under the insurance of the civil liability of the Insured, with the provision of copies of documents confirming the occurrence of the incident. In this case, the Policyholder is obliged to engage the Insurer in legal proceedings as a third party. |
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10. INSURANCE INDEMNITY |
10.1. Losses shall be understood as follows: |
10.1.1. losses related to contingencies incurred by the Insured; |
10.1.2. losses related to expenses incurred as a result of cancellation of the Insured’s Trip or change of the Trip terms; |
10.1.3. losses associated with the emergence of the Insured’s obligations arising from damage to life, health and/or property of third parties; |
10.1.4. losses incurred as a result of full loss (disappearance), delay of Insured’s luggage. |
10.2. Amount of loss caused to the Insured Person and the Insurance Indemnity shall be determined by the Insurer on the basis of documents received from law enforcement and control authorities (fire, emergency and other services), based on economic and accounting materials and calculations, registration documents, invoices and receipts, opinions and calculations of legal, advisory and other specialized firms (if they have a state license), and regarding insurance of risk of a civil liability under obligations resulting from damage to life, health and/or property of the third parties – on the basis of an enforced court ruling. |
10.3. The Insurer shall be entitled to request information related to the insured event from law enforcement agencies, medical institutions and other enterprises, organizations and institutions possessing information on the circumstances of the insured event, as well as independently establish the causes and circumstances of the insured event. |
10.4. The amount of the insurance indemnity shall be established taking into account the type and amount of the deductible stipulated by the Insurance Agreement. |
When a conditional deductible is stipulated under the Insurance Agreement, the Insurer shall be released from liability for loss, if the amount thereof does not exceed the amount of the deductible, and the loss shall be fully reimbursed if its amount exceeds the deductible amount. |
When an unconditional deductible is stipulated under the Insurance Agreement, the Insurer’s liability shall be determined by the amount of loss net of the deductible. |
The deductible shall be determined by agreement of the parties at the conclusion of the Insurance Agreement as a percentage of the insured amount or in absolute value. |
10.5. The Insurer may pay the insurance indemnity: |
10.5.1. directly to the Insured Person after his/her return to the permanent place of residence in the form of reimbursement of his/her expenses for payment of services rendered to him/her in connection with the occurrence of the insured event and paid by him/her independently, subject to all the rules provided for hereby. In respect of expenses in foreign currency, the insurance indemnity shall be paid directly to the Insured in Russian rubles at the official rate of the Central Bank of the Russian Federation as of the date of the insured event. |
10.5.2. The Service Company specified in the Insurance Agreement, in accordance with the contract concluded between the Insurer and the Service Company, under which the latter, on behalf of the Insurer, ensures the arrangement of the round the clock services rendering to the Insured Person under these Insurance Rules, and primarily pays for services provided by third parties (medical institutions, etc.) and agreed with the Insurer. |
10.5.3. to the third party which suffered property and/or physical damage resulting from the actions of the Insured on the basis of a court ruling made in respect of the Insured. |
10.5.4. to the third party that actually provided services to the Insured, subject to compliance with all the rules provided for hereby. |
10.6. In case of disputes between the parties about the causes and amount of damage, each of the parties shall be entitled to call for expert examination. The expert investigation shall be carried out at the expense of the party which has demanded it. If the results of the expert investigation prove the Insurer’s refusal of indemnity payment to be unjustified, the Insurer shall bear such investigation expenses. The expenses for the examination execution for cases that were considered non-insured upon execution thereof, shall be borne by the Insured. |
10.7. The Insurer shall be entitled to postpone payment of the insurance indemnity, notifying the Insured Person within 15 business days from the date of receipt of all documents, if: |
(a) any disputes related to right of the Insured Person to receive the insurance indemnity arise – until the necessary evidence is submitted; |
(b) If based on facts connected with the occurrence of an insured event, the relevant law-enforcement authorities have initiated a criminal case, proceeding, litigation or administrative investigation against the Insured or his/her authorized persons or investigation of circumstances that caused loss – until the completion of the investigation (process) or proceedings and finding the Insured innocent. |
10.8. All documents submitted to the Insurer shall be translated into the Russian language ad certified by a translation agency. The Insurer shall be entitled to translate the submitted documents into Russian both independently and with the assistance of a specialist. The Insurer shall be entitled to deduct the cost of the translation from the amount of the insurance indemnity, unless the translation has been provided by the Insured. |
Where necessary, documents issued in a foreign country must be legalized with an apostille. |
10.9. The Insurer shall be entitled to check the submitted documents, request data from organizations having information on the circumstances of an insured event; The Policyholder is obliged to give written explanations to the Insurer’s requests related to the insured event. |
10.10. The decision on payment of insurance indemnity shall be made by the Insurer upon receipt of all requested documents in accordance with clauses 10.11-10.14 hereof and, if necessary, translations thereof certified by the translation agency within 15 business days, except for the cases listed in clause 10.7 hereof, and cases of payment of invoices directly to the Service Company. Insurance indemnity in the form of compensation of expenses incurred by the Insured shall be paid within 7 business days from the date of the decision of the Insurer. |
10.11. At occurrence of an event which under provisions of the Insurance Agreement may be recognized as an Insured Event on the insurance of contingencies: |
10.11.1. The Insured shall immediately, at the first opportunity, unless otherwise stipulated by the Insurance Agreement, contact the Service Company or the specialized service center of the Insurer by phone specified in the Insurance Agreement and inform the dispatcher on the accident, giving the data of insurance documents. expenses for communication with the Service Company or the specialized service center shall be compensated to the Insured Person at presentation of confirming documents, if it is set forth in the Insurance Agreement. |
10.11.2. Upon receipt of information, the Insurer or the Service Company (specialized service center) shall arrange the necessary medical, transportation and other services to the Insured as provided for under the Insurance Agreement and reimburse the expenses incurred by the Insured Person according to the Insurance Agreement. |
10.11.3. In case of impossibility to call the Service Company prior to consultation with a doctor or getting to a clinic, the Insured Person shall make it as soon as possible, unless the Insurance Agreement stipulates obligatory notification of the Service Company. In any case, at hospitalization or applying to a doctor, the Insured shall present the Insurance Agreement to the medical personnel for further coordination of actions with the Insurer by means of the Service Company. |
10.11.4. If it is impossible to contact the Insurer’s representative or the Service Company, in the event that the Insurance Agreement does not provide for a mandatory appeal to the Service Company, or in the case when the Service Company recommends the Insured to apply to the nearest medical institution, the Insured may independently apply to the nearest medical institution, presenting the policy. Should the Insured Person independently incur expenses connected with an insured event, he/she shall upon return from the Trip within 30 (thirty) calendar days notify the Insurer in writing about the accident and submit the documents listed in clause 10.11.6 hereof. Should the Insured Person receive an unpaid invoice for the treatment connected with an insured event, he/she shall upon return from the Trip within 15 (fifteen) calendar days notify the Insurer in writing about the accident and submit the documents listed in clause 10.11.5 hereof. |
10.11.5. The application for reimbursement connected with an Insured Event indicating the reasons of failure to contact the Service Company for rendering of the required medical services shall be accompanied by the following documents: |
10.11.5.1. Insurance Agreement or a copy thereof; |
10.11.5.2. a copy of the civil passport; |
10.11.5.3. a copy of the traveling passport; |
10.11.5.4. for the purpose of confirming the Insured Trip on the territory of the Russian Federation – registered transport documents (plane, railway tickets) and documents for accommodation at the place of temporary stay; |
10.11.5.5. original invoice from a medical institution (on a letterhead or certified with a corresponding stamp) indicating the surname of the patient, diagnosis, date of application for medical aid, duration of treatment with a list of services rendered broken down by dates and cost, and the total amount due; |
10.11.5.6. Original prescriptions issued by the doctor for the disease with a stamp of a drugstore and indication of the cost of each purchased medication; |
10.11.5.7. Original appointment cards to laboratory tests issued by a doctor and invoice of laboratory with a breakdown by dates, name and cost of the services rendered; |
10.11.5.8. Documents confirming the fact of payment for treatment, medication and other services (stamp on payment, cash receipt or bank transfer confirmation). The Insured Person shall provide the written comments for the unpaid invoices. The Insurer reserves the right to reject the insurance indemnity if the Insurance Agreement provides for the obligatory contacting of the Service Company. |
10.11.6. Additionally, at occurrence of an event which under provisions of the Insurance Agreement may be recognized as an insured event in terms of cl. 3.2.1.3 hereof, for medical transportation/evacuation, the Insured is obliged to provide the following documents: |
10.11.6.1. in terms of cl. 4.1.3.1 hereof at transportation from the scene to a medical institution or in terms of cl. 4.1.3.2 hereof at transportation from the scene to a medical institution and back – original itinerary (taxi, public transport) receipt and/or an original or a copy of the ticket. |
10.11.6.2. in terms of cl. cl. 4.1.3.3, 4.1.3.4 hereof in case of medical transportation to the permanent place of residence, the Insured shall provide: |
10.11.6.2.1. an original or a copy of the travel document for the originally planned date of completion of the Insured Trip; |
10.11.6.2.2. a copy of the document confirming the return of funds or part of the funds spent on the purchase of a travel document as of the originally planned date of completion of the Insured Trip; |
10.11.6.2.3. an original or a copy of the travel document dated by the day of transportation; |
10.11.6.2.4. an original or a copy of the document confirming the payment of travel documents dated by the day of transportation. |
10.11.7. Additionally, at occurrence of an event which under provisions of the Insurance Agreement may be recognized as an insured event in terms of cl. 3.2.1.4 hereof, for posthumous repatriation, the Insured is obliged to provide the following documents: |
10.11.7.1. original documents confirming the payment for the funeral agency and transport organizations that carried out the transportation of the body/remnants; |
10.11.7.2. a copy of the death certificate received in the country of incident occurrence; |
10.11.7.3 a copy of the document as provided under the applicable legislation of a country, which has issued the document, containing information about the cause of death of the Insured Person (medical certificate of death, opinion of forensic medical examination, legal certificate of death, extract from the report on death, etc.); |
10.11.7.4. A copy of the document required under the applicable legislation, issued by the relevant authority reliably attesting to the fact and circumstances of the accident (a certificate of investigation of the accident, the decision (ruling) on initiation or refusal to initiate criminal/administrative proceedings, etc.); |
10.11.8. Additionally, at occurrence of an event which under provisions of the Insurance Agreement may be recognized as an insured event in terms of cl. 3.2.1.5 hereof, for transport expenses, the Insured is obliged to provide the following documents: |
10.11.8.1. in terms of cl. 4.1.5.1 hereof in case of returning to the permanent place of residence, the Insured shall provide: |
10.11.8.1.1. an original or a copy of the travel document for the originally planned date of completion of the Insured Trip; |
10.11.8.1.2. a copy of the document confirming the return of funds or part of the funds spent on the purchase of a travel document as of the originally planned date of completion of the Insured Trip; |
10.11.8.1.3. an original or a copy of the travel document dated by the day of transportation; |
10.11.8.1.4. an original or a copy of the document confirming the payment of travel documents dated by the day of transportation. |
10.11.8.2. in terms of cl. 4.1.5.5 hereof, in case of evacuation of children to the permanent place of residence, the Insured shall provide: |
10.11.8.2.1. an original or a copy of travel documents for the child and one adult accompanying the child dated by the day of the undertaken Trip; |
10.11.8.2.2. an original or a copy of the document confirming the payment of travel documents dated by the day of medical transportation. |
10.11.8.3. in terms of cl. 4.1.5.7 hereof in case of returning early, the Insured shall provide: |
10.11.8.3.1. an original or a copy of the travel document purchased for the purpose of early return from the Insured Trip; |
10.11.8.3.1. an original or a copy of a document confirming the payment of the travel document purchased for the purpose of early return from the Insured Trip; |
10.11.8.3.3. a copy of the document confirming the return of funds or part of the funds spent on the purchase of a travel document on the originally planned date of completion of the Insured Trip, or a document confirming that the ticket for the originally planned date of completion of the Insured Trip was purchased at a non-refundable rate; |
10.11.8.3.4. official documents confirming the relationship of the deceased with the Insured; |
10.11.8.3.5. a copy of the death certificate of a the Insured’s Family Member. |
10.11.8.4. in terms of cl. 4.1.5.8 hereof in case of flight cancellation, the Insured shall provide: |
10.11.8.4.1. an original or a copy of the document confirming the cancellation of the regular flight, indicating the reason, the time of departure under the original schedule and the fact of replacement of the regular flight with another flight, indicating the time of actual departure. This information may be reflected in one or in several documents; |
10.11.8.4.2. original plane tickets or itinerary receipts for cancelled and actually held flights. |
10.11.8.5. in terms of cl. 4.1.5.9 hereof in case of returning early, in case of a visit by a Family Member, the insured shall provide: |
10.11.8.5.1. an original or a copy of the travel document purchased by a Family Member for the purpose of visiting the Insured; |
10.11.8.5.1. an original or a copy of the document confirming payment of the travel document purchased by a Family Member for the purpose of visiting the Insured. |
10.11.8.6. in terms of cl. 4.1.5.10 hereof in case of flight delay, the Insured shall provide: |
10.11.8.6.1. an original or a copy of the document confirming the fact of delay of the regular flight with indication of the reason and time of delay; |
10.11.8.6.2. the original ticket or itinerary receipt. |
10.11.9. Additionally, at occurrence of an event which under provisions of the Insurance Agreement may be recognized as an insured event in terms of cl. 3.2.1.6 hereof, in case of a loss or theft of documents, the Insured shall provide the following documents: |
10.11.9.1. the original receipt for payment of the stamp duty/fee charged by the Consulate or other authorized state institution for the issuance of the passport-replacement document; |
10.11.9.2. an original or a copy of travel documents purchased for travel to the nearest Consulate of the Russian Federation or other authorized state institution and back; |
10.11.9.2. an original or a copy of a document confirming payment of travel documents purchased for travel to the nearest Consulate of the Russian Federation or other authorized state institution and back; |
10.11.9.4. an original or a copy of the travel document for the flight to the permanent place of residence, if the Insured Person misses the return flight due to the need to issue a passport-replacement document; |
10.11.9.5. an original or a copy of the document confirming payment of the travel document purchased for the purpose of travel to the permanent residence, if the return flight was missed due to the need to issue a passport-replacement document. |
10.11.10. In addition, upon the occurrence of an incident, which under the terms of the Insurance Agreement may be recognized as an insured event within cl. 3.2.1.7 hereof, on payment of urgent messages, the Insured shall provide documents confirming such expenses and the amount thereof. |
10.11.11. Additionally, at occurrence of an event which under provisions of the Insurance Agreement may be recognized as an insured event in terms of cl. 3.2.1.8 hereof, for receiving legal assistance, the Insured shall provide the following documents: |
10.11.11.1. original documents confirming the conclusion of the agreement on the provision of legal assistance in connection with the insured event, the fact of provision and contents of legal assistance, the costs associated with the payment of the first legal advice; |
10.11.11.2. a copy of the court decision confirming the occurrence of civil liability of the Insured and compensable losses in case of completion of the trial or a copy of the documents on the commencement of the trial against the Insured, the current stage of the trial, about the Insured’s summons to court as a defendant – if the process is still in progress. |
10.11.12. Additionally, at occurrence of an event which under provisions of the Insurance Agreement may be recognized as an insured event in terms of cl. 3.2.1.9 hereof, for expenses associated with the personal vehicle, the Insured shall provide the following documents: |
10.11.12.1. copies of documents confirming the ownership of the vehicle (vehicle passport and vehicle registration certificate); |
10.11.12.2 a copy of the driver’s license; |
10.11.12.3. original documents confirming the fact of accident, breakage or theft, including, but not limited to, documents issued by law enforcement agencies, emergency services, report from the scene of the accident, an invoice of the towing company, an invoice of the service center, etc. |
10.11.12.4. an original or a copy of the travel document issued by the transport organization, the services of which the Insured has used; |
10.11.12.5. originals of payment documents confirming payment for the services of the towing company, the transport organization, the services of which the Insured has used. |
10.12. Upon the occurrence of an insured event on the insurance of losses resulting from the forced cancellation of a Trip: |
10.12.1. In case of organization of the Insured Trip through the travel company, the Insured shall immediately cancel the contract with the travel company in writing. |
10.12.2. The Insured Person shall immediately notify the Insurer in writing on the occurrence of an insured event. The application shall specify the character and circumstances of an insured event, the tourist agency, if the Insured Trip was organized by it, date of departure. |
10.12.3. The following documents shall be attached to the application: |
10.12.3.1. Insurance Agreement or a copy thereof; |
10.12.3.2. a copy of the civil passport; |
10.12.3.2. a copy of the traveling passport; |
10.12.3.4. the original contract for the provision of tourist services, as well as documents confirming the payment of a tourist trip, in the case of arrangement of the Insured Trip through a travel company; |
10.12.3.5 documents confirming return of part of payment under the tourist services contract by the travel company to the Insured Person (calculation of return and the cash order), if the trip insured has been organized by a travel company); |
10.12.3.6 documents of the transport company, consulate, hotel and other organizations, the services of which the Insured used for the organization of an overseas trip, confirming the losses connected with the revocation of travel documents, hotel room reservation cancellation, etc.; |
10.12.3.7 documents and information which are necessary for determination the nature of the Insured Event, namely: |
(a) In case of impossibility to make a trip due to disease, injury or death of the Insured Person, his/her Family Members or a person participating in a joint trip with the Insured, in accordance with sub-clause 3.2.2 (a) – (d) hereof – a certificate of the medical institution, notarized copy of death certificate, documents confirming relationship of the Insured Person and the Family Member, documents confirming the Joint trip (travel voucher, package tour certificate, travel documents, hotel documents); |
(b) if the Trip becomes impossible as a result of damage to or loss of property belonging to the Insured, in accordance with sub-clause 3.2.2 (e) hereof – reports of the police or the relevant administrative agencies confirming the fact of damage; |
(c) if the Trip becomes impossible as a result of judicial proceedings in accordance with sub-clause 3.2.2 (f) hereof – court-certified summons; |
(d) if the Trip becomes impossible as a result of a call to the military enlistment office in accordance with sub-clause 3.2.2 (g) hereof – a military enlistment office-certified notice; |
e) in case of refusal to issue an entry visa to the Insured, his/her Family Member or a person participating in a Joint Trip with the Insured, in accordance with sub-clause 3.2.2 (h), (m) hereof – the official refusal of the Consular service of the Embassy (if such was issued to the Insured, his/her Family Member or a person participating in a Joint Trip with the Insured) and the original travelling passport of the Insured, his/her Family Member or a person participating in a Joint Trip with the Insured, documents confirming the relationship of the Insured and the Family Member, documents confirming the Joint Trip (travel voucher, package tour certificate, travel documents, hotel documents). |
f) in case of a delay in obtaining a visa or obtaining a visa within a period other than that requested by the Insured, his/her Family Member or a person participating in a Joint Trip with the Insured, in accordance with sub-clause 3.2.2 (n) hereof – the original traveling passport of the Insured, his/her Family Member or the person participating in a Joint Trip with the Insured, documents confirming the relationship of the Insured and a Close relative, documents confirming the Joint trip (travel voucher, package tour certificate, travel documents, hotel documents); |
(g) in case of early return of the Insured Person from a trip in accordance with sub-clause 3.2.2 (i) hereof – tickets and documents confirming the cost thereof or documents confirming reissue cost of travel documents; a document confirming the cost of one urgent message; a document confirming the cost of unused hotel accommodation. |
(h) in case of delayed return of the Insured Person from a trip in accordance with sub-clause 3.2.2 (j) hereof – tickets and documents confirming the cost thereof or documents confirming reissue cost of travel documents; a document confirming the cost of an urgent single message; a document confirming the cost of additional hotel accommodation. |
10.13. At the occurrence of an insured event on insurance of civil liability of the Insured: |
10.13.1. Insurance indemnity shall be paid to the third party who suffered property and/or physical damage resulting from the actions of the Insured on the basis of a court ruling. The amount of loss and insurance indemnity shall be determined by the Insurer on the basis of a court decision made in respect of the Insured. |
10.13.2. The Insured shall provide the following documents: |
10.13.2.1. Insurance Agreement or a copy thereof; |
10.13.2.2. a copy of the civil passport; |
10.13.2.3. a copy of the traveling passport; |
10.13.2.4. the original document confirming the damage caused; |
10.13.2.5. a copy of the lawsuit filed against the Insured; |
10.13.2.6. a copy of the court decision (judicial act entered into legal force, which ends the case consideration on the merits), confirming the occurrence of civil liability of the Insured and recoverable amounts in connection with the occurrence of the insured event; |
10.13.2.7. other available documents containing information for decision-making on the insured event. |
10.14. In the event of occurrence of an insured event on the insurance of luggage: |
10.14.1. Upon the occurrence of an insured event, the Insured shall apply to the local competent agencies authorized to consider issues related to the loss (disappearance) or delay of luggage (representatives of the carrier, representatives of the airport, railway station, etc.) to obtain documents recording the fact of loss (disappearance) or delay of luggage. |
10.14.2. The application and documents for insurance indemnity shall be submitted to the Insurer within 30 (thirty) calendar days from the date of return of the Insured from the Insured Trip during which the insured event occurred. |
10.14.3. In order to receive the insurance indemnity, the Insured shall report about the insured event in writing to the Insurer and submit: |
10.14.3.1. the Insurance Agreement or a copy thereof; |
10.14.3.2. a copy of the civil passport; |
10.14.3.3. a copy of the traveling passport; |
10.14.3.4. a written application in the form provided by the Insurer, which shall specify the nature, circumstances, date of the insured event and the weight of luggage. |
10.14.3.5. the original or a copy certified by the issuer of the document provided for under the business practice of the carrier, or a certificate issued by the official competent authorities, indicating the loss (disappearance) or delay of luggage. |
10.14.3.6 documents on compensation payment made by the carrier; |
10.14.3.7. ticket (e-ticket itinerary receipt); |
10.14.3.8. copies of the baggage receipts (tags); |
10.14.4. If the Policyholder has received an insurance indemnity for the delay of luggage and subsequently declared an insured event for the loss (disappearance) of luggage, the payment shall be made net of the insurance indemnity received for the delay of luggage. |
10.14.5. If the stolen (missing) item was returned to the Policyholder (Insured), the latter shall return the insurance indemnity to the Insurer not later than 15 (fifteen) calendar days after the return of the lost (missing) item. |
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11. DISPUTE SETTLEMENT PROCEDURE |
11.1. All disputes arising out of performance, non-performance, or improper performance, modification, or termination of the Insurance Agreement concluded on the basis of these Rules shall be settled through amicable negotiations, if such is the intention of the Parties. |
11.2. In the absence of the intention of the parties to negotiate or if it is impossible to resolve the disagreement through negotiations, disputes shall be resolved in court in accordance with the jurisdiction rules stipulated by the legislation of the Russian Federation. |
In this case, if the Policyholder is a legal entity or an individual entrepreneur, the lawsuit shall be filed at the location of the Insurer or, if the dispute arises from the activities of its stand-alone unit, at the location of such unit. |
11.3. If the Policyholder is a legal entity or an individual entrepreneur, the party whose right has been violated shall present a claim to the other party with a statement of its demands before applying to the court. |
The claim must be signed by a duly authorized person and contain the demands of the claimant, calculation of the claim amount, the list of documents attached to the claim. |
The claim shall be sent by registered mail with a notice of delivery. The date of receipt of the claim shall be the date of its delivery to the party specified in the acknowledgment of receipt of the registered letter. The period for response to a claim shall be at least 10 calendar days from the date of receipt thereof. |
The response to a claim shall be sent by registered letter with acknowledgment of receipt. If demands are not satisfied (fully or partially) within the reasonable term specified in the claim, a party whose rights are violated may file a lawsuit in court. |