EMPLOYER S LIABILITY INSURANCE RULES

Transcription

1 EMPLOYER S LIABILITY INSURANCE RULES Baku 2009

2 EMPLOYER S LIABILITY INSURANCE RULES GENERAL Employer s Liability Insurance Rules of the International Insurance Company OJSC, hereinafter referred to as Rules, have been developed in accordance with Civil Code of the Azerbaijan Republic, Law On Insurance Operations, other legislative and regulatory acts, and all Life Insurance Contracts executed by the International Insurance Company OJSC, hereinafter referred to as Insurance Contract shall become the integral part of all the Employer Liabilities under insurance contracts. The type of insurance provided under these Rules shall be classified as the employer insurance. 1. SCOPE AND COVERAGE OF INSURANCE 1.1 The subject of insurance under these Rules shall be the natural persons insured under the insurance contract and their property rights The insurance specified under the present Rules covers for the liabilities of the employer for the amounts specified in the Insurance Certificates for the injuries and death of employees during the execution of their professional duties under the employment contract payable to employees or their heirs. Insurer shall pay for all court and attorney costs of the Insured required for disputes arising in connection with this type of insurance. However, all the specified costs, including the insurance payment shall not exceed the amount of insurance. 2. INSURANCE TERRITORY The Insurance shall be valid on the territory of the Azerbaijan Republic, unless otherwise is stipulated under the insurance contract. 3. LOSSES INCLUDED INTO THE INSURANCE COVERAGE FOR THE ADDITIONAL INSURANCE FEE PAYMENTS Liabilities for following coverages can only be accepted at payment of additional insurance fees: 3.1 Accidents occurred to employee(s) in the employer s transport during the transportation to/from work; 3.2 Accidents occurred to employees while engagement in activities not related to their main duties at locations of assignment by employer; 3.3 Accident occurred outside of the territory of the Azerbaijan Republic; 3.4 Professional illnesses; 3.5 Payment demands for the morale damage. 2

3 4. LOSSES NOT COVERED BY INSURANCE (EXCEPTIONS) No insurance coverage is provided for the following instances: 4.1 Incidents occurring as a result of deliberate actions; 4.2 The exceed by the Insured of his civil liabilities under the provisions of contract or special contract arrangements; 4.3 Wars, military operations, foreign occupation (independent of whether the war was announced), civil war, revolution, revolt, civil unrest and any administrative and military actions performed for their prevention or settlement; 4.4 If not included into the operations sector of the employer, any nuclear explosions, radiation, and, independent of whether this is the operational field of the employer, the radioactive pollution and related administative and military operations. 5. TERM OF INSURANCE, COMMENCEMENT AND ENDING OF COVERAGE Unless otherwise is stipulated under insurance contract, the insurance coverage shall enter into force and shall end at 24:00 hours of the Azerbaijan Time of the contract dates. 6. PAYMENT OF INSURANCE FEE AND ENFORCEMENT OF THE INSURANCE CONTRACT 6.1. The insurance fee is calculated by the insurer on the basis of information submitted by the insured and is provided in the Insurance contract or attachments to insurance contract When it is not provided under the Contract, the insurance fee or its first part the fees payable immediately after execution of the insurance contract and future payments shall be performed in accordance with terms and cycles indicated in the insurance contract. Insurance fee shall be considered paid from the moment of payment of funds to the insurer s bank account. If the payment is performed in cash, the insurance fee shall be considered paid upon handover of funds to authorized representative of the insurer Unless otherwise is stipulated under contract, the insured (insurance holder) shall pay the insurance fee (or its first portion if paid by portions) in accordance with provisions of the account for the payment of the insurance fee (or its portion) as provided by the insurer If the insurance fee or its first part is not paid within the terms stipulated under the insurance contract, the insurer may establish the additional term for payment of the insurance fee in accordance with legislation. If the insurance fee is not paid within this established additional term the insurer shall be entitled to terminate the insurance contract Should the insured delay with payments of the portions of payments and if within such periods the insurance case has taken place, insurer shall be entitled to demand the payment for the unpaid portion of the insurance fee. Meanwhile, during the payment of the insurance coverage the insurer shall be entitled to withheld the amount of the unpaid insurance fee from the insurance payment Termination of the insurance contract by the insurer due to non-payment of the insurance fees by the insured, shall not release the insured (insurance holder) from responsibility to pay to insurer the due payments of the insurance fee. 3

4 6.7. By the assignment of Insured and provided the notice to Insurer the pament of the insurance fee can be performed by any other party, however, this party shall not obtain any rights under the insurance contract For the short term insurance contracts (less than 1 year) the insurance fees shall be calculated on the basis of the schedule, forming the part of this contract (Table 1). 7. RESPONSIBILITIES OF THE INSURED TO PROVIDE THE INFORMATION FOR EXECUTION OF CONTRACT 7.1. Insurer shall base the insurance contract and assess insurance risks on the basis of information provided by the Insured and included in the Insurance Contract and its attachments. If the information provided by the insured (insurance holder) is found to be false or incomplete: if found that this is resulted from deliberate misleading of the insured the insurer shall be entitled to terminate this contract or continue with contract requiring the payment of the insurance fee difference for corresponding period. If provisions of Contract not complied with the Insurer obtains the right to refuse the reimbursement of paid insurance fees and insurance payment in the event of occurrence of the insurance event; If found that this is not resulted from deliberate misleading of the insured the insurer shall be entitled to terminate this contract or continue with contract requiring the payment of the insurance fee difference for corresponding period. If the insured expresses disagreement with amount payable as a insurance fee difference within 5 days, the Insurance contract is terminated If there are no fact of deliberate misleading of Insured established, the insurance event if occurred: - before the investigation of situation by the insured; - Within the period of term of right of termination by the Insurer; - Or within the period required for legal validation of this proposal; the insurer shall provide the payment of insurance pro-rata to difference of must be paid insurance fee calculated on the basis of insured s information and actual insurance fee payments of the insured. 8. RESPONSIBILITIES OF THE INSURED TO PROVIDE THE INFORMATION WITHIN THE TERM OF INSURANCE 8.1. Upon signing of the Contract, if the location or condition of the property insured is changed to what is included in the contract, the insured shall inform, if the change is performed by: - himself, or his open or tacit consent, immediately; 4

5 - third party without his open or tacit consent, immediately upon learning; - but in both cases no later than within 5 days period If upon establishment of the situation by the Insurer, if the change has resulted in violation of the insurance contract or its continuation under more complex conditions:: - to terminate the contract or; - continue with insurance by demanding the payment of the additional insurance fees Should insured express his disagreement with payment of additional insurance fees within 5 days period, the Insurer shall not bear any liabilities for the Insurance event If the Insurer shall accept the change to the conditions and locations to what is specified in the contract without introduction of changes to the Contract and requiring only the additional insurance fee payments, he loses the right to terminate the contract or demand the payment of the insurance fee difference If the change in the location or conditions of the insured property increases the risk of occurrence of the insurance event and Insured has deliverately has failed to inform this, no insurance payment shall be made upon insurance event occurrences after the notification period If notification rules have not been complied with non-deliberately, the difference between the actually paid insurance fee and payable insurance fee shall be deducted from the insurance payment. This rules are applied for insurance holders in the same manner. LOSS AND PAYMENT 9. RESPONSIBILITIES OF INSURED DURING THE INSURANCE EVENT Insured shall take all required reasonable actions to prevent the occurrence of minimize the damage of the insurance event. Costs incurred for the prevention or minimization of losses shall be borne by the Insurer. 10. RESPONSIBILITIES OF INSURED UPON OCCURRENCE OF INSURANCE EVENT In the event of any operational incident that can be classified as insurance event the Insured shall: 10.1 Inform the Insurer in writing about every insurance event that may raise the claim for civil liability within 5 days of date of occurrence or knowledge of the occurrence; 5

6 10.2 To provide the immediate submission to Insurer on his demand, all the available information (originals, approved copies and photocopies) that are necesary to establish the causes, conditions, losses and damages of the insurance event occurrence; 10.3 To protect and submit to Insurer all information and documents required for the establishment of the time and location of incident and required for the use of right of subrogation; 10.4 Provide the conditions for investigation of the insurance event and provide all assistance to the insurer during such investigation; 10.5 if facing the claim or demand for payment in connection with the incurred insurance event or there is a criminal case initiated against him, the Insurer shall be informed immediarely and provided with all documents received and related to the claims and demands; 10.6 provide required authorities to the attorney appointed by the inuser for conducting of investigation and the case related to the claim and demands; 10.8 permit and provide required conditions for the insurer experts to identify the liabilities, amount of payment and establishment of the rights of subrogation; 10.9 If the insured liability has been insured against same risks with other insurers, to inform the Insurer about it. 11. DEFINITION OF THE INSURANCE PAYMENT Within 15 days of submission by the Insured of the documents below, the Insurer shall make the decision on payment or refusal to pay the insurance: Application of the insurance payment; Insurance Contract; Documents by relevant authorities on the event occurrence (Notes, protocols, conclusions etc.); Conclusions and loss calculations made by the independent experts in connection with event; Other event related documents Insurer shall be entitled to agree the insurance payment with the payment claimants directly Insured shall not be entitled to accept the claim for payment fully or partially and cannot make any payments without prior consent of the Insurer Upon raising of claim all issues shall be settled by the insurer. All attorneyand court costs associated with the claim shall be borne by the Insurer as per paragraph 1 of Rules hereof. 6

7 12. RESULTS OF PAYMENT Upon payment the Insurer owns the rights of the Insured to raise claim against guilty party Parties, upon each insurance event requiring the insurance payment shall be entitled to terminate the Insurance Contract. Insurer shall be entitled to his rights for termination only upon the payment of insurance. OTHER PROVISIONS 13. EXECUTION OF THE INSURANCE CONTRACT. EARLY TERMINATION OF THE INSURANCE CONTRACT Execution of the insurance contract Insurer and Insured shall sign the contract on subject of the insurance Unless otherwise is stipulated under the contract, the insurance contract shall enter into force from the moment of complete or partial payment of the insurance fee Upon receipt of the insurance fee or its first portion payment the Insurer, within 3 days, shall submit to Insured the insurance contract containing the information on the effect of contract, term of insurance and other provisions Early termination of the insurance contract In cases stipulated under the Insurance Legislation or voluntary insurance contract, as well as on the basis of other agreed arrangements of parties, in the event of early termination of insurance contract by the demand of insurer or insured, the justified written notification shall be provided by one party to other at least 30 days prior to termination (60 days for insurance contract with terms of 5 years and more and 5 business days for the contracts less than 3 months) If the insurance contract is terminated earlier by the Insured s initiative (in general or towards any portion of thereof), with exceptions stipulated under the insurance legislation, Insurer shall reimburse all overcrhaged insurance fees (in general or portion of thereof); if such requirement of termination is related to non-execution by the Insurer of its obligations under the insurance contract, the Insurer shall reimburse to Insured all insurance fee payments performed (in general or in relation to any portion of the insurance contract) If the insurance contract is terminated earlier by the Insurer s initiative (in general or towards any portion of thereof), he shall reimburse all the insurance fee payments to Insured (fees paid in general or towards any portion of thereof; if such requirement of termination is related to non-execution by the Insured of its obligations under the insurance contract, the Insurer shall reimburse to Insured all insurance fee payments performed (in general or in relation to any portion of the insurance contract) upon deduction of all its costs under the contract. 7

8 If the insurance contract is terminated earlier (in general or towards any portion of thereof), and if the payments (in general or towards any portion of thereof), made by the Insured to Insurer by the time of termination are equivalent or exceed the Insurance Payments made by Insurer, the insurance fee (in general or towards any portion of thereof) shall not be reimbursed to Insured If the insurance contract is terminated earlier and if the payments (in general or towards any portion of thereof), made by the Insured to Insurer by the time of termination are less than the Insurance Payments made by Insurer, the reimbursement of the ainsurance fee to Insured shall be performed in accordance with procedures stipulated under Articles and of the Contract If the insurance contract is terminated in accordance with provisions of the relevant legislation of the Azerbaijan Republic, Insurer shall reimburse to insured the insurance fees paid for the unused portion of the term of contract (in general or towards any portion of thereof) upon deduction of its costs and with consideration of Articles and to the Legal Representative of the Insured Unless otherwise is stipulated under the Insurance Contract, the costs shall mean the administrative costs and insurance payments. 14. RIGHTS AND RESPONSIBILITIES OF PARTIES Rights of the Insured: To monitor the compliance of the Insurer with provisions of the insurance contract and obtain from insurer the information on financial standing, which does not represent the commercial confidentiality; 14.1 In the event of occurrence of the insurance event, require the performance of insurance payment from the Insurer Responsibilities of the Insured: To pay the insurance fee in accordance with amounts and terms stipulated under the insurance contract; To provide to the Insurer all information required for the execution of the insurance contact and other related data; In execution of the insurance contract the Insured shall provide the insurer with all available information that may affect the insurer s decision to execute the Contract or require changes to its contents before execution; To provide the safekeeping of documents related to insurance contract Rights of the Insurer: Check the accuracy of information provided by the Insured and monitor the compliance of the Insured or the Insurance Holder with provisions of the Insurance Contract; To reject the payment of the insurance under conditions stipulated under these Rules and demand the reimbursement if such payments are made; 8

9 If there is an established fact of provision by the Insured of the false information that affects the risk assessment or the information on the insurance event, to refuse to make the insurance payment; If any unpaid portion of the insurance fee is not paid within the term established under the insurance contract, to suspend the provision of services to the Insured or terminate the insurance contract; To terminate the Insurance Contract under the provisions of these Rules Responsibilities of Insurer:: To issue to Insured the appropriately made insurance certificate in timely manner; In occurrence of the insurance event, on the basis of relevant documentation to perform the payment of insurance; Provide the confidentiality of relations with insured; In the event of early termination of the insurance contract, shall reimburse to the Insured the amount calculated under these Rules within 30 (thirty) banking days. 15. SEVERAL INSURANCES If the Insured has insured his civil liabilities against the same risks with other Insurers he shall immediately inform the Insurer about it. 16. INFORMATION AND NOTICES Notices and information from the Insured shall be submitted to insurance company or insurance agent by registered mail Information from the insurance company shall be delivered to Insured at his registered legal address or the last legal address known to the insurance agent by registered mail If signed by parties the letters and telegraph communications made for notices and information shall have the legal status of the registered mail. 17. CONFIDENTIALITY OF BUSINESS INFORMATION Insurer shall be liable for all losses and damages incurred by the Insured as a result of disclosure of his confidential business information. 18. LIABILITIES OF PARTIES This Contract has been developed in accordance with legislation of the Azerbaijan Republic and shall be complied with by parties In the event of failure by one of the parties of this Contract to comply with its provisions or in the event of insufficient compliance with hereof the defaulting party shall compensate all losses incurred to other party in accordance with legislation of the Azerbaijan Republic. 9

10 18.3. None of the parties to this contract shall be entitled to transfer its rights and title under hereof to third party without prior written consent of the other party. 19. SETTLEMENT OF DISPUTES All disputes arising from the execution of the insurance contract shall be settled by negotiations between the parties. In the event of impossibility of such settlement the disputes shall be settled in accordance with existing legislation of the Azerbaijan Republic. 20. TERM All claims arising from the Insurance Contract shall be settled within terms stipulated under the civil legislation of the Azerbaijan Republic. 21. SPECIAL PROVISIONS Under special provisions of the Insurance Contract can be provided the other responsibilitiues assigned to the Insured as well as requirements associated with existing risks. Table 1 INSURANCE FEE CALCUILATION SCHEDULE APPLIED FOR THE SHORT TERM INSURANCE CONTRACTS Term of insurance contract Interest applied to annual insurance fee 1 to 30 days 20% of annual insurance fee 30 to 45 days 25% of annual insurance fee 45 to 60 days 30% of annual insurance fee 60 to 75 days 35% of annual insurance fee 75 to 90 days 40% of annual insurance fee 90 to 105 days 45% of annual insurance fee 105 to 120 days 50% of annual insurance fee 120 to 135 days 55% of annual insurance fee 135 to 150 days 60% of annual insurance fee 150 to 165 days 65% of annual insurance fee 165 to 180 days 70% of annual insurance fee 180 to 195 days 75% of annual insurance fee 10

11 195 to 210 days 80% of annual insurance fee 210 to 225 days 85% of annual insurance fee 225 to 240 days 90% of annual insurance fee 240 to 270 days 95% of annual insurance fee More than 270 days 100% of annual insurance fee 11