CONDITIONS OF FLIGHT ACCIDENT INSURANCE

Transcription

1 CONDITIONS OF FLIGHT ACCIDENT INSURANCE 1. GENERAL PROVISIONS 1.1. These Conditions of the flight accident insurance (hereinafter referred to as Conditions) were developed pursuant to the Rules of the Passenger accident insurance (hereinafter referred to as the Insurance Rules). These Conditions are deemed an integral part of the contract of the passenger accident insurance (hereinafter referred to as the Policy) In compliance with the current laws and regulations of the Russian Federation and pursuant to the present Conditions LLC Insurance Company Surgutneftegas, hereinafter referred to as the Insurer, concludes contracts of the passenger accident insurance with legal individuals, hereinafter referred to as the Insured, on the voluntary basis Insured person shall mean an individual who is a passenger of an aircraft and in whose favor the insurance contract is concluded Beneficiary shall mean the Insured person. In the event of death of the Insured person the Beneficiary shall be Legal heirs of the Insured Principal terms and notions used in the present Conditions: Passenger shall mean a person travelling by any means of transport (air, rail, sea, inland waterways, road) with a valid travel document (ticket) or having travel document (ticket) Accident shall mean a sudden, unexpected event actually which occurred against the will of the Insured during the insurance period and caused damage to health of the Insured or led to his/her death; Insurance risk shall mean a probable event following which the insurance is concluded; Insurance event shall mean an event covered by the insurance contract following which the Insurer shall pay the insurance benefit to the Insured, the Insured person, the Beneficiary; Insurance coverage shall mean an amount of money agreed by the Parties and specified in the insurance contract within which upon insurance event occurrence the Insurer is to pay the Insurance benefit and pursuant to which the sum of the Insurance premium (payment) is set; Insurance premium (payment) shall mean payment for the insurance which is to be paid by the Insured to the Insurer in accordance with the procedure and terms specified in the insurance contract Flight is the period of time from the moment when the Insured undergoes the security check to board the aircraft until the Insured leaves the airport at the destination point being accompanied by the carrier's authorized personnel. 2. OBJECT OF THE INSURANCE shall be property interests which do not contradict the laws and regulations of the Russian Federation and which relate to cause of damage to life or health of the Insured as a result of an accident occurred during the flight. 3. INSURANCE CONDITIONS. INSURANCE RISKS 3.1. The insurance contract is concluded in respect to the following events (insurance risks): Temporary disability of the Insured as a result of an accident occurred during the insurance period and led to the temporary disability in the insurance period - hereinafter referred to as temporary disability as a result of an accident: traumatic injuries: mechanical (injuries, contusion, sprains, dislocations, fractures, bursting, wound of organs and tissue, tissue and/or internals compression, total and/or partial organ loss, commotion); thermal injuries (burns, frostbite); chemical injuries; electric injuries; drowning; accidental acute poisoning by chemicals, including biogenic toxins Permanent disability (disability group I, II, III or category of a disabled child), which the Insured was first diagnosed with, caused by an accident occurred in the insurance period and led to the assessment of disability in the insurance period - hereinafter referred to as permanent disability as a result of an accident;

2 Death of the Insured caused by an accident occurred in the insurance period and led to death in the insurance period - hereinafter referred to as death as a result of an accident Events provided for in Art of the Conditions shall be deemed insured losses if they occurred during the insurance period and supported by the documents, issued by the authorized bodies (carrier, airport, medical treatment facilities, court etc.) in accordance with the procedure established by law. Events provided for in Art , of the Conditions caused by an accident and occurred in the insurance period shall be also deemed insurance events if they took place within one year after the accident In compliance with the present Conditions the event shall not be deemed an insurance event if: The Insured (the Insured person) was in a state of alcoholic, narcotic or other intoxication and/or poisoning as a result of alcohol, narcotic, superpotent and psychotropic substances consumption without prescription unless the Insured (the Insured person) took the abovementioned substances against his will; The Insured (the Insured person) did not apply to the Medical treatment facility timely, worsening the posttraumatic state; The Insured disobeyed the orders of the pilot-in-command or other authorized personnel; The Insured violated travel, embarking-disembarking or luggage transportation rules The insurer shall be exempt from paying the insurance benefit in cases where the insurance event occurred due to: impact of the nuclear explosion, radiation or radio-contamination; military actions, a as well as maneuvers or other military activities; civil war, civil commotion of any kind or strikes; the Insured (the Insured person's or Beneficiary s) intent led to the insurance event. 4. INSURANCE COVERAGE. INSURANCE PREMIUM The insurance coverage is agreed between the Parties The insurance premium (payment) is paid by a lump sum payment by bank transfer to the Insurer's settlement account or in cash at cash desk of the Insurer or its representative. 5. INSURANCE PERIOD. CONCLUSION PROCEDURE FOR THE INSURANCE CONTRACT 5.1. The insurance contract comes into force when the full premium payment is being made and as the Insured person undergoes the pre-flight security check until the Insured person leaves the airport at the point of destination accompanying by the carrier's authorized personnel. Transit passengers shall be deemed insured on the territory of the intermediate airport for the whole period of holding and boarding a vehicle (under all circumstances not more than for 24 hours). The insurance of the transit passengers shall cease as they leave the specified territory (building) and shall be renewed as they return. The territories (premises) that are not meant for the passengers shall be excluded from the airport territory (premises) The insurance contract is concluded for one flight. Flight number and departure date are specified in the Policy. In case the flight number or the departure date is not specified in the insurance contract, the insurance contract shall be held invalid. A passenger shall be deemed insured during the flight specified in the insurance contract as well as during his travel from home to the departure point (airport) The concluded insurance contract may be terminated in the event of: Flight cancellation or at the option of the Insured - before the insurance period starts. Upon termination of the insurance contract the Insured shall be refunded 100% of insurance premium paid for each part (segment) of the flight, providing that the flight has not started on the date of the insurance contract termination If the Insured (the Insured person) refuses to fly the complete route/any segment of the route, the insurance contract is terminated automatically before the insurance period starts since a

3 possibility of insurance loss has disappeared after the contract becomes valid and insured risk ceased to exist due to circumstances other than an insurance event. In this case the supplementary documents are not executed by the Parties In case of voluntary or involuntary changes made to the flight date specified in the insurance contract and in the e-ticket of the Insured person (if the order number and/or airline ticket remain unchanged) the insurance contract shall not be reconcluded and remain valid in respect to the changed flight dates In case of voluntary or involuntary changes being made to the flight date specified in the insurance contract and in the e- ticket of the Insured person (if the order number and/or airline ticket remain unchanged) the insurance contract shall not be reconcluded and remain valid in respect to the changed flight dates. However, if the insurance event occurs, the Insured person shall provide all necessary documents supporting the changes (copy of the changed ticket). 6. RIGHTS AND OBLIGATIONS OF THE PARTIES 6.1. The Insured (the Insured person) is entitled to: terminate the insurance contract at his wish. In this case the insurance premium paid to the Insurer shall be refunded in full provided that the insurance policy is returned to the Insurer before insurance contract becomes valid The Insured (the Insured person) is obliged to: pay insurance premium (insurance payments) by the date specified in the insurance contract; immediately apply to the medical treatment facility and strictly comply with the recommendations of the medical facility specialists performing treatment associated with the occurred insurance event; if the insurance event occurs inform the Insurer any possible way within 30 working days, or, if the Insured underwent impatient treatment, within 30 working days after discharge from the hospital; 6.3. The Insurer is entitled to: ask the Insured (the Insured person) for the information required to determine the degree of insurance risk, insurance rate and sum of the insurance benefits; if so required seek information related to the Insurance event from the law-enforcement agencies, medical facilities and other enterprises, institutions and organizations, possessing information regarding the circumstances of the occurred insurance event, as well as has the right to investigate the cause and circumstances of the insurance event in its sole discretion; demand to terminate the insurance contract in accordance with the procedure established by the Insurance rules and current laws and regulations of the Russian Federation; demand to hold the insurance contract invalid, if concluding the insurance contract the Insured presented knowingly false information regarding the circumstances highly important to determine the probability of insurance events occurrence and the sum of prospective losses incurred as a result of its occurrence (insurance risk), if these circumstances were unknown or should not be unknown to the Insurer refuse to pay the insurance coverage as provided by the Insurance rules and current laws and regulations of the Russian Federation; suspend payment of the insurance benefit in case if the Insured (the Insured person, the Beneficiary) did not provide the documents and information, required to determine the cause, nature of the happened event or presented the knowingly false documents and information; suspend payment of the insurance benefit if the Insured person (the Beneficiary), having an opportunity, failed to apply or timely apply to the competent authority, that makes it impossible to assess the circumstances of the occurred event, having characteristics of an insurance event in the event of insurance event, if required, demand the Insured person to undergo medical investigation. 7. PROCEDURE AND CONDITIONS OF THE INSURANCE BENEFIT 7.1. If the occurred event has been qualified as the insurance event and the decision on the

4 insurance benefit has been made, the Insurer is obliged to draw up a Claim report and calculate the sum of the insurance benefit or decide to refuse to pay the insurance benefit within 10 working days after all required documents have been received If the decision on the payment of the insurance benefit has been made The Insurer shall pay the insurance benefit within 7 working days from the Claim report signature If the decision to refuse to pay the insurance benefit has been made the Insurer shall forward to the Insured and/or the Beneficiary a written notice providing sufficient reason for the refusal to pay the insurance benefit If the insurance event occurs the Insurer pays the insurance benefit: to the Insured (if the Insured person is underage - to the Beneficiary) if any event provided for in Art , of the Conditions occurs; to the Beneficiary (the Beneficiaries) (in accordance with the proportion specified by the insurance contract or testament; if such proportion has not been specified the insurance benefit is divided equally) - in the event of death of the Insured Insurance benefit related to the temporary disability caused by an accident is calculated pursuant to the Tables of insurance benefit sum in % of the insurance coverage (hereinafter referred to as Tables). In case the injuries occur simultaneously in different organs and systems the sums of the insurance benefits are calculated separately in relation to each injury and then summarized. The total sum of the insurance benefits cannot exceed the insurance coverage The insurance benefit related to the assessment of disability caused by the insured loss is paid to the Insured over 18 years old in the following amounts of the insurance coverage for the risk concerned: - 100% - I group of disability; - 70% - II group of disability; - 40% - III group of disability. If the Insured under 18 years old has been assessed as a disabled child the insurance benefit shall be paid in the following amounts of the insurance coverage: - 100% - if the category is assigned before the Insured reaches 18 years old; - 70% - if the category is assigned for 2 years; - 40% - if the category is assigned for 1 year in the event of death of the Insured the insurance benefit is paid in the amount of 100% of the insurance coverage taking into account all payments previously made The insurance benefit is paid by bank transfer to the settlement account or in cash at the option of the Insured person (the Beneficiary, heir). The insurance benefit may be paid to the Insured representative (Beneficiary's, heir's) acting under the Power of Attorney executed in accordance with the procedure established by the laws and regulations of the Russian Federation. 8. DOCUMENTS REQUIRED FOR THE INSURANCE BENEFIT RECEIPT. To receive the insurance benefit, the following documents shall be submitted to the Insurer: 8.1. In the event of temporary disability caused by an accident: - Proof of loss; - Insurance contract (insurance policy); - Identity document of the Insured (the Beneficiary) or their Representatives; - Medical note from the medical and preventive treatment facility in relation to the injury treatment, or any other medical document, where the date and the circumstances of the insured loss shall be specified, diagnosis, treatment period, diagnostic and treatment (medical) measures; - Sick leave certificate or Ф 095у medical note (if required); - Travel documents In the event of permanent disability in addition to the documents provided for in Art of the Conditions the following documents shall be submitted: - Medical note proving disability certification issued by the Medical and Social Examination Service of the Federal State institutions.

5 8.3. In the event of death of the Insured the Beneficiary shall submit: - Proof of loss; - Insurance contract (insurance policy); - Copy of the medical document specifying the cause of death (if required); - Testamentary prescription if it was made separately from the insurance contract; - Copy of the death certificate of the Insured, issued by the Civil registry office; - Identity document of the Beneficiary; - Copy of the certificate of inheritance rights. 9. DISPUTE RESOLUTION 9.1. Disputes related to the conclusion, execution and termination of the insurance contract (Insurance policy) made in compliance with the present Conditions shall be settled through negotiations. If the agreement has not been reached the case shall be submitted to the court at the Insurer s location A legal action in relation to claims arising out of the insurance contract can be commenced in compliance with the current laws and regulations of the Russian Federation LLC Insurance Company Surgutneftegas Phone: (3462) Fax:(3462) Е-mail: pochta@sngi.ru