"LIMITED LIABILITY COMPANY "INSURANCE COMPANY "SIV LIFE" LIFE, HEALTH AND WORK INSURANCE RULES for insurance programs: "City Accumulative..."
LIMITED LIABILITY COMPANY
"INSURANCE COMPANY "SiV LIFE"
LIFE INSURANCE RULES,
HEALTH AND WORK ABILITY
for insurance programs:
"City Savings Program "Comfort"
“City Savings Program Comfort+”,
"City Savings Program "Children"
"City Savings Program "Children+"
"City Savings Program "Premium"
GENERAL PROVISIONS
The limited liability company "Insurance Company "SiV Life", operating on the basis of the Charter and in accordance with the legislation of the Russian Federation (hereinafter referred to as the Insurer), enters into life, health and disability insurance contracts on the basis of these Life, Health and Disability Insurance Rules ( (hereinafter referred to as the Rules).1. INSURANCE SUBJECTS
1.1. In accordance with these Rules, the Insurer enters into life, health and disability insurance contracts (hereinafter referred to as the Insurance Contracts) with legal entities of any organizational and legal forms, as well as with capable individuals (hereinafter referred to as the Policyholders).
1.2. Insurance contracts can be concluded by the Policyholders in favor of individuals (Insured) aged from 18 to 70 years on the date of conclusion of the Insurance Contract, with the exception of the insurance programs “City Savings Program “Children+”, “City Savings Program “Children”, where the age of the Insured must be from 18 to 99 years old and from 18 to 60 years old, respectively.
The insurer has the right not to conclude an Insurance Agreement in relation to persons suffering from cancer, AIDS and other diseases associated with the human immunodeficiency virus, diseases caused by exposure to radiation, as well as persons susceptible to mental disorders, registered in a psychoneurological and/or drug treatment clinic .
If the Policyholder, an individual, has entered into an Insurance Agreement in relation to his property interests related to his life and health, then he is also the Insured.
1.3. When concluding Insurance Contracts, the Policyholders (Insured) have the right to appoint individuals or legal entities (Beneficiaries) to receive the insurance payment established in the event of the death of the Insured, as well as replace Beneficiaries at their own discretion before the occurrence of an insured event in accordance with the current legislation of the Russian Federation.
2. OBJECT OF INSURANCE The object of insurance is property interests associated with the death of the Insured, his survival to a certain date, as well as damage to his life and health.
3. INSURANCE RISKS. INSURANCE EVENTS
3.1. An insurance risk is an expected event that has characteristics of probability and chance, in the event of which insurance is carried out.
3.2. Insured events are completed events stipulated by the Insurance Agreement, upon the occurrence of which the Insurer’s obligation arises to make an insurance payment to the Insured or the Beneficiary.
3.3. According to these Rules, the following events that occur during the validity period are recognized as insurance risks:
Insurance contracts:
3.3.1. Survival of the Insured until the end of the insurance period.
3.3.2. Death of the Insured in the following cases:
3.3.2.1. Death of the Insured for any reason.
3.3.2.2. Death of the Insured due to natural causes.
3.3.3. Death of the Insured for any reason (with deferred insurance payment).
3.3.4. Permanent total disability of the Insured for any reason/Disability (with exemption from payment of insurance premiums).
3.3.5. Permanent Total Disability Due to Accident/Disability.
Note: in relation to children's insurance, the insured event is called “Disability”.
3.3.6. Death of the Insured as a result of an accident.
3.3.7. Primary diagnosis of deadly diseases in the Insured.
3.3.8. Permanent total disability of the Insured as a result of an accident/Disability (with exemption from payment of insurance premiums).
3.4. The insurance contract may include the following combinations of main insurance risks (clauses of the Rules):
a) 3.3.1, 3.3.2.1, 3.3.4 (for the insurance program "City Savings Program "Premium");
b) 3.3.1, 3.3.3, 3.3.4 (for the insurance program “City Savings Program “Children””);
c) 3.3.1, 3.3.2.2, 3.3.5, 3.3.6, 3.3.8 (for the City Savings Program “Comfort” insurance program).
d) 3.3.1, 3.3.3, (for the insurance program “City Savings Program “Children +”).
e) 3.3.1, 3.3.2.1 (for the insurance program "City Savings Program "Comfort+").
3.4.1. Insurance risks specified in paragraphs. 3.3.2.2, 3.3.5, 3.3.6, 3.3.7 and 3.3.8 of these Rules, in agreement with the Insurer, may be additional risks for the insurance programs specified in subparagraphs “a”, “b”, “c” of paragraph.
3.4 of these Rules (hereinafter referred to as Additional Risks), and these risks may be included as Additional Risks in the Insurance Contract when it is concluded under the programs: “a”, “b”, “c”, clause 3.4 of these Rules.
3.4.2. Insurance of the risks specified in clause 3.3 of these Rules is carried out provided that the age of the Insured at the time of concluding the Insurance Agreement exceeds 18 years, and his state of health meets the Insurer's insurance criteria.
3.5. Basic concepts used in these Rules when determining the insured events specified in clause 3.3 of these Rules:
3.5.1. An accident is understood to mean an actually occurring, sudden, unforeseen, instantaneous event, external to the Insured, resulting in death, traumatic injury or other health disorder of the Insured.
3.6. Permanent total disability means the inability of the Insured to perform any paid work, which will last until the end of the Insured’s life, provided that this disability occurs within 180 (one hundred and eighty) days from the day the insured event occurred.
Permanent total disability as a result of an accident means the inability of the Insured to do any paid work, resulting from an accident, which will last until the end of the Insured’s life, subject to the establishment of disability of the 1st group with the establishment of the 3rd degree of limitation of ability to work according to the order of the Ministry of Health RF No. 1013n dated December 23, 2009
3.6.1. The events provided for in paragraphs. 3.3.4, 3.3.5, 3.3.8 of these Rules are recognized as insured events on the basis of the conclusion of the medical and social examination bureau on the establishment of disability and subsequent written confirmation of the results of the above conclusion by an expert doctor of the Insurer, which guarantees the compliance of the health status of the Insured as specified in clause. 3.6 criteria.
3.6.2. Death from natural causes means death that occurred for reasons other than an accident, and if this event is not specified in clause 3.7 of these Rules.
3.6.3. The primary diagnosis of deadly diseases in the Insured means the following events:
3.6.3.1. Oncological diseases - the presence of one or more malignant tumors, including leukemia (except chronic lymphocytic leukemia), lymphomas, Hodgkin's disease, characterized by uncontrolled growth, metastasis and invasion of healthy tissue. The diagnosis must be confirmed by a qualified doctor (oncologist) based on histological examination. Exceptions: tumors with malignant changes of carcinomas in situ (including cervical dysplasia stages 1, 2, 3) or histologically described as adnexal; melanoma, the maximum thickness of which, according to the histological conclusion, is less than 1.5 mm, or which does not exceed the development level T3N(0)M(0) according to the TNM classification; any other tumor that has not penetrated the papillary reticular layer; all hyperkeratoses or basal cell carcinomas of the skin; all epithelial cell skin cancers in the absence of invasion into other organs; Kaposi's sarcoma and other tumors associated with HIV infection or AIDS; prostate cancer stage T1 (including T1a, T1b) according to the TNM classification.
3.6.3.2. Myocardial infarction is an acute necrosis of part of the heart muscle due to absolute or relative insufficiency of coronary blood flow. The diagnosis must be justified by the presence of all three symptoms: a prolonged attack of characteristic chest pain, new typical ECG changes, for example, changes in the ST segment or T wave with characteristic dynamics, the formation of a pathological, persistent Q wave, a typical increase in the activity of cardiac-specific blood enzymes. The diagnosis and examination data must be confirmed by a qualified physician (cardiologist).
3.6.3.3. Coronary artery disease is stenosis or occlusion of the coronary arteries requiring direct heart surgery. Exceptions: balloon angioplasty (dilatation) of the coronary arteries, laser use, other non-surgical procedures. The diagnosis must be confirmed by a qualified physician (cardiac surgeon).
3.6.3.4. Stroke is an acute disorder of cerebral circulation, characterized by persistent neurological disorders resulting from cerebral infarction or embolism of extracranial vessels that persist for more than 24 hours. The presence of permanent neurological impairment must be confirmed by a qualified physician (neurologist) at least 6 weeks after the onset of the stroke. Exceptions: cerebral disorders caused by migraine; cerebral disorders due to injury or hypoxia; vascular diseases affecting the eye or optic nerve; transient cerebrovascular accidents lasting less than 24 hours; attacks of vertebrobasilar ischemia.
3.6.3.5. Terminal renal failure is the last stage of irreversible chronic dysfunction of both kidneys, leading to an increase in the level of creatinine in the blood to 7–10 mg%, impaired excretion of nitrogen metabolism products, impaired water-salt, osmotic, acid-base balance, arterial hypertension, which requires continuous hemodialysis, peritoneal dialysis or donor kidney transplantation. The diagnosis must be confirmed by a qualified doctor (nephrologist).
3.6.3.6. Transplantation of vital organs - transfer as a recipient of heart, lung, liver, kidney, pancreas (excluding transplantation of only the islets of Langerhans), bone marrow.
Exceptions: organ donation. The need for transplantation must be confirmed by a qualified physician. The conditions for payments for the risk of “deadly dangerous diseases” are specified in Article 9 of these Rules.
3.7. Exceptions 3.7.1. The event provided for in clauses is not recognized as an insured event. 3.3.2.1, 3.3.2.2 or 3.3.3 of these Rules, resulting from:
a) suicide or attempted suicide in the first 2 (two) years of validity of the Insurance Agreement, except in cases where the Insured was brought to such a state by illegal actions of third parties;
b) intentional actions of the Policyholder (Insured, Beneficiary) aimed at the occurrence of an insured event;
c) participation of the Insured in civil unrest, strikes, violations of public order, terrorist acts on the side that initiated the above events;
d) the Insured commits actions recognized by the court as criminally punishable;
e) and/or in connection with HIV infection.
3.7.2. Unless otherwise provided by the Insurance Agreement, the insured events specified in clauses are not recognized. 3.3.4, 3.3.5 and 3.3.7 of these Rules, events that occur:
a) as a result of mental illness and nervous system disorders; an accident that occurred during and/or as a result of the Insured being in a state of alcohol, drug or toxic intoxication;
diseases caused by the use of alcohol, medications or drugs; epileptic seizures, convulsions. The conditions of this paragraph do not apply to the above cases caused by taking medications as prescribed by the attending physician;
b) as a result of a health disorder caused by medical procedures, research or surgery, except for cases where the medical procedures, research and surgery were caused by the consequences of an accident that occurred during the validity period of the Insurance Contract;
c) as a result of a direct consequence of a physical impairment or deficiency that the Insured had at the time of concluding the Insurance Contract;
d) as a result of a suicide attempt or intentional self-infliction of bodily harm by the Insured, including those caused by mental disorders;
e) while participating in any speed competitions and in training (preparing for competitions), with the exception of athletics and swimming, as well as as a result of engaging in risky sports and hobbies (for example: parachuting, mountaineering, speleology, hang gliding, paragliding);
f) as a result of professional activities related to atomic energy, radiation, chemical production;
g) during the participation of the Insured in civil unrest, strikes, violations of public order, terrorist acts on the side that initiated the above events;
h) as a result of the Insured committing actions recognized by the court as criminally punishable;
i) during the flight of the Insured on an aircraft, control of it, including when the Insured is performing military service, except for cases of flying as a passenger on a civil aviation aircraft flown by a professional pilot;
j) as a result of driving the Insured source of increased danger, which are vehicles or other motor vehicles, devices, etc., in a state of intoxication and/or without the right to such control, as well as deliberately transferring control to a person who did not have the right to drive or was in a state intoxication;
k) in connection with HIV infection;
l) as a result of an acute or chronic illness during the first year of validity of the Insurance Contract;
m) as a result of deliberate actions of the Policyholder (Insured, Beneficiary) aimed at the occurrence of an insured event;
n) as a result of bodily injuries directly or indirectly caused by the provision of medical care to the Insured, including the conduct of therapeutic, diagnostic, preventive measures and surgical interventions. This paragraph does not apply to cases where the need for medical assistance was caused by bodily injuries received by the Insured as a result of events related to the accident in accordance with the terms of these Rules.
3.7.3. Unless otherwise provided by the Insurance Agreement, in relation to the insurance program "City Savings Program "Comfort" the events specified in clauses 3.3.5, 3.3.6 and 3.3.8 of these Rules, the direct or indirect cause of which are :
a) alcohol intoxication or poisoning of the Insured, or toxic or narcotic intoxication and/or poisoning of the Insured as a result of his consumption of narcotic, potent and psychotropic substances without a doctor’s prescription;
b) disease with AIDS or HIV infection, as defined by the World Health Organization;
c) driving of any vehicle by the Insured without the right to drive or while under the influence of alcohol or drugs, or transfer of control by the Insured to a person who did not have the right to drive the vehicle or who was under the influence of alcohol or drugs;
d) use of any drugs, medications or products not prescribed by a doctor;
e) infectious infection of a bacterial nature, with the exception of infections that occurred through an accidental cut or wound;
f) medical or surgical treatment, excluding treatment that is directly necessary to cure bodily injuries recognized as an insured event in accordance with these Rules, and carried out during the validity of the Insurance Contract;
g) the following circumstances resulting from the accident:
during the participation of the Insured in any professional sports;
during the participation of the Insured in any competition where a motorized land, water or air vehicle was used;
during the flight of the Insured as a passenger in any aircraft that is not owned by the airline, is not properly registered and is not approved for use as passenger transport on regular routes according to the published schedule;
during the active service of the Insured in any armed forces of any state;
during training or use of the Insured as a pilot or passenger of a glider, hang glider, parachute, or if he participates in any air flight other than as a passenger;
while the Insured is on board a sea, river or aircraft other than as a passenger.
h) bodily injury or death arising in connection with:
pregnancy of the Insured;
any methods of treating any nervous or mental diseases, regardless of their classification, psychiatric disorders, depression or mental disorder (psychosis);
being in prison.
3.7.4. They are not recognized as insured events and the Insurer is released from fulfilling obligations under the City Savings Program “Comfort” insurance program if:
events occurred as a result of war, intervention, military actions of foreign troops, armed clashes, other similar or equivalent events (regardless of whether war was declared); civil war, rebellion, putsch, other civil unrest involving the development of a civil or military uprising, riot, armed or other illegal seizure of power, as well as any other similar event associated with the use and/or storage of weapons and ammunition, the events occurred as a result of any damage to health caused by radiation exposure or as a result of the use of nuclear energy.
3.7.5. Unless otherwise provided by the Insurance Agreement, then under these Rules the insured risks listed in clauses are not recognized as insured events. 3.3.2–3.3.8 of these Rules, which occurred as a result of the commission or attempted commission by the Policyholder, the Insured, the Beneficiary of a criminal offense that is in a direct causal connection with the occurrence of the insured event.
4. SUM INSURED
4.1. The insured amount is the amount of money determined by the Insurance Agreement, on the basis of which the amount of the Insurer's obligations under the concluded Insurance Agreement is determined. The amount of the insured amount is determined by agreement between the Insurer and the Policyholder.
4.2. The insurance amount can be established separately for each of the risks listed in clause 3.3 of these Rules, which is determined by the terms of the Insurance Agreement.
4.3. The insurance amount can be set separately for each insurance period, which is determined by the terms of the Insurance Agreement.
5. INSURANCE PREMIUM AND INSURANCE CONTRIBUTIONS
5.1. The insurance premium is the payment for insurance that the Policyholder is obliged to pay to the Insurer in the manner and within the time limits established by the Insurance Agreement.
5.2. The insurance premium under the Insurance Agreement is determined on the basis of the insured amount and insurance rates, which are differentiated taking into account the age and gender of the Insured, as well as the insurance period.
5.2.1. When calculating the insurance premium, the Insurer has the right to take into account the health status of the Insured, as well as other significant factors influencing the likelihood of an insured event occurring. Significant factors are the circumstances specified in the Insurance Agreement, the application for insurance, as well as the written request of the Insurer, which are an integral part of the Insurance Agreement.
5.2.2. Insurance tariff - the rate of insurance premium per unit of sum insured, taking into account the object of insurance and the nature of the insurance risk. The amount of the insurance rate is established in the terms of the Insurance Agreement.
5.3. The insurance premium can be paid in a lump sum or in installments (in the form of insurance premiums) in cash to a credit institution authorized by the Insurer or by bank transfer to the Insurer's bank account, which is determined by the terms of the Insurance Agreement.
5.3.1. An insurance premium paid at a time, or the first insurance premium when paying an insurance premium in installments, is paid by non-cash payment by transfer to the Insurer's bank account within five days from the date of signing the Insurance Agreement, unless a different period is provided for in the Insurance Agreement.
In case of non-cash payment, the fact of payment of the insurance premium (insurance contribution) must be confirmed by payment documents.
5.3.2. In case of payment of the insurance premium in installments, the terms and frequency of making insurance premiums (schedule for payment of insurance premiums), the use of increasing coefficients are stipulated in the Insurance Agreement. Insurance premiums may be paid once a month, once a quarter, once every six months, once a year or in another manner established in the Insurance Agreement. If insurance premiums are paid less frequently than once a year, an increasing factor may be applied to the insurance premium.
5.4. In relation to these Terms and Conditions of the Insurance Agreement, insurance premiums are allocated for risks, pp.
3.3.1–3.3.8 of these Rules and insurance premiums for Additional risks, clauses. 3.3.2.2, 3.3.5, 3.3.6, 3.3.7 and 3.3.8 of these Rules.
5.5. Payment of annual insurance premiums ahead of schedule.
5.5.1. Upon annual payment of insurance premiums for risks in accordance with paragraphs. 3.3.1–3.3.5 of these Rules, the Policyholder has the right to pay insurance premiums ahead of schedule (at a time for several years) at any time during the validity period of the Insurance Contract.
5.5.2. To pay insurance premiums for risks in accordance with paragraphs. 3.3.1–3.3.4 of these Rules, ahead of schedule, the Policyholder sends to the Insurer an application indicating the number of years for which he plans to make insurance premiums.
In accordance with this, the Insurer calculates the amount of the insurance premium payable for the specified number of years and informs the Insured about the results.
5.6. Grace period.
5.6.1. If the Policyholder does not pay the next insurance premium on time, then a grace period begins, during which the Insurance Agreement remains in force. When paying insurance premiums annually, the grace period is 61 (sixty-one) days, starting from the date following the date of payment of the next insurance premium established in the Insurance Agreement; for monthly, quarterly and semi-annual payment of insurance premiums, the grace period is 30 (thirty) days.
5.6.2. The policyholder must, before the expiration of the grace period, without further notice from the Insurer, pay the insurance premium to maintain the Insurance Agreement in force.
5.6.3. If the debt to pay the next insurance premium is not liquidated by the end of the grace period, then the Insurance Agreement is terminated in accordance with paragraphs. 7.8.4 of these Rules.
5.6.4. In the event of termination of the Insurance Agreement during the grace period, the Policyholder is paid the redemption amount determined in accordance with clause 8.4 of these Rules.
5.6.5. If an insured event occurs during the grace period, the amount of the insurance payment, determined in accordance with the terms of the Insurance Agreement and Article 9 of these Rules, is reduced by the amount of the outstanding debt for payment of the next insurance premium.
5.7. Indexation clause (annual increase in insurance premium) 5.7.1. If the terms of the Insurance Agreement provide for annual indexation of insurance premiums with subsequent changes in the sums insured, then the Insurer, during the validity of the Insurance Agreement, makes annual indexation of the insured amount and insurance premium under the terms of the Insurance Agreement and in the manner set out in these Rules. In this case, the Insurer, two months before the end of the current year of validity of the Insurance Agreement, sends the Insured an information letter and an additional agreement, which indicates the amount of the insurance premium and the insured amount changed taking into account indexation.
5.7.2. The main purpose of indexation is to protect the insurance payment from inflation and changes in exchange rates.
5.7.3. Indexation is carried out annually after each year of validity of the Insurance Agreement.
5.7.4. An increase in the amount of the insurance premium due to indexation entails an increase in the amount of the insured amount.
5.7.5. The Insurer reserves the right to stop indexing one or all Insurance Contracts belonging to one insurance program or reduce the amount of indexation by sending a written notice and additional agreement to the Policyholder two months before the end of the current year of validity of the Insurance Contract.
5.7.6. Right to indexation, right to refuse and change the amount of indexation:
5.7.6.1. The policyholder has the right to refuse indexation of insurance premiums for the next year of validity of the Insurance Contract and pay the next insurance premium without taking into account indexation, which he must notify the Insurer in writing, and this message must be received by the Insurer before the end of the current year of validity of the Insurance Contract.
If the above condition is met, the Policyholder pays the next insurance premium equal to the premium paid in the previous year of validity of the Insurance Agreement in accordance with the terms of the Insurance Agreement.
The insured amount for the next year of validity of the Insurance Contract will be equal to the insured amount for the previous year of validity of the Insurance Contract.
5.7.6.2. If the Policyholder, before the expiration of the next year of validity of the Insurance Agreement, has not informed the Insurer by written notice of his desire to refuse indexation, then the Policyholder is considered to have confirmed the indexation, the insurance premium is payable taking into account the indexation; If the Insured fails to pay the insurance premium taking into account indexation, the difference between the insurance premium paid by the Insured for the next year and the insurance premium calculated taking into account indexation will be considered in this case by the Insurer as the Insured's debt to pay the insurance premium.
5.7.6.3. If the Policyholder refuses two consecutively proposed clauses. 5.7.1 The Insurer makes annual indexations, then in the future the Insurer does not apply indexation to the Insurance Contract of this Policyholder, while the Policyholder pays the next insurance premiums in the amount in which they were established when paying the last insurance premium. The right to indexation may be granted to the Insured with the consent of the Insurer, subject to additional medical examination of the health status of the Insured and/or analysis of the financial capabilities of the Insured.
5.7.6.4. The Policyholder, with the consent of the Insurer, by signing an additional agreement, has the right to change the indexation amount, which he is obliged to inform the Insurer about, and the specified message must be received by the Insurer before the end of the current year of validity of the Insurance Agreement.
5.7.7. If an insured event occurs during the grace period before the Policyholder pays the insurance premium, taking into account indexation, the Insurer will make an insurance payment based on the amount of the insurance premium that was established in the previous year of the Insurance Agreement.
6. TERM OF INSURANCE
6.1. The insurance period under the Insurance Agreement is set at no less than 5 (five) years and no more than 30 (thirty) years. The validity period of the Insurance Agreement is established by agreement of the parties and is indicated in the Insurance Agreement.
6.2. Unless otherwise provided in the Insurance Agreement, the Insurer's obligations under the Insurance Agreement begin from the date specified in the Insurance Agreement, but not earlier than the date of payment of the insurance premium or the first insurance premium.
6.3. Unless otherwise provided in the Insurance Policy, the Insurer's obligations under the Insurance Policy in relation to Additional Risks shall occur only upon payment of the insurance premium for both Additional Risks and the main risks for the relevant insurance period in the amount and terms stipulated by the Insurance Contract.
6.4. The Insurance Agreement is terminated in the cases provided for in clause 7.8 of these Rules.
7. INSURANCE AGREEMENT
7.1. The Insurance Agreement is an agreement between the Policyholder and the Insurer, by virtue of which the Insurer, upon the occurrence of an insured event, undertakes to make an insurance payment to the Insured (the Beneficiary), and the Policyholder undertakes to pay the insurance premium within the established time frame and in the amount specified in the Insurance Agreement.
7.2. The insurance contract may contain provisions other than those in these Rules, determined by agreement of the parties and not contradicting the legislation of the Russian Federation.
7.3. To conclude an Insurance Contract, the Policyholder submits to the Insurer a written statement in the prescribed form about his desire to conclude an Insurance Contract. In case of group insurance, a list of the Insured is attached to the application.
7.4. When concluding an Insurance Agreement, the Insurer has the right to take into account the health status of the Insured, as well as other significant factors influencing the likelihood of an insured event occurring. Significant factors are the circumstances specified in the application for insurance, as well as in the Questionnaire of the Insured, which are an integral part of the Insurance Agreement.
When concluding an Insurance Agreement, the Insurer has the right to require the Insured to undergo a medical examination at the Insurer’s expense in a medical institution specified by the Insurer.
7.5. To conclude an Insurance Agreement:
7.5.1. Policyholders - legal entities shall present to the Insurer documents allowing the following information to be established:
– name, company name in Russian (full and (or) abbreviated) and (or) in foreign languages (full and (or) abbreviated) (if any);
organizational and legal form;
taxpayer identification number or code of a foreign organization (hereinafter referred to as FIO);
state registration number (OGRN/KIO);
date and place of state registration;
name of the registration authority;
address (location);
Additional information (documents) provided by the insured legal entity:
information about the bodies of the legal entity (the structure and personal composition of the management bodies of the legal entity, with the exception of information about the personal composition of the shareholders (participants) of the legal entity who own less than one percent of the shares (stakes) of the legal entity).
telephone and fax numbers (if available).
other contact information (if available).
7.5.2. Policyholders - individual entrepreneurs present to the Insurer documents that allow them to establish the following information:
citizenship;
Date and place of birth;
position of the Insured (Insured, Beneficiary), who is a foreign public official, an official of public international organizations, as well as a person replacing (occupying) The specified information is provided by the Insured also in relation to persons who are representatives of the Insured, beneficiaries (persons whose liability is insured, Clients ) under the Insurance Contract and/or beneficial owners.
Data from the certificate of state registration of a Russian legal entity; for foreign persons – data contained in the documents on state registration of the state of establishment and/or in the certificate of tax registration in the Russian Federation.
government positions of the Russian Federation, positions of members of the Board of Directors of the Central Bank of the Russian Federation, positions of the federal public service, appointment and dismissal from which are carried out by the President of the Russian Federation or the Government of the Russian Federation, positions in the Central Bank of the Russian Federation, state corporations and other organizations created by the Russian Federation Federation on the basis of federal laws, included in the lists of positions determined by the President of the Russian Federation;
degree of relationship or status (spouse) of the Policyholder (Insured, Beneficiary) in relation to the person specified in the paragraph above;
state registration number of the individual entrepreneur (data from OGRNIP);
date and place of state registration of individual entrepreneurs (data from OGRNIP);
name of the registering authority (data from OGRNIP);
information about the purposes of establishing and the expected nature of business relations with the Insurer, information about the goals of financial and economic activities (information about planned operations).
information (documents) about the financial position (copies of annual financial statements (balance sheet, statement of financial results), and (or) copies of the annual (or quarterly) tax return with or without marks from the tax authority on their acceptance with an attachment or a copy of the receipt about sending a registered letter with a description of the attachment (if sent by mail), or a copy of the confirmation of sending on paper (if transmitted electronically); and (or) a copy of the auditor’s report on the annual report for the past year, which confirms the reliability of the financial (accounting) ) reporting and compliance of the accounting procedure with the legislation of the Russian Federation; and (or) a certificate of fulfillment by the taxpayer (payer of fees, tax agent) of the obligation to pay taxes, fees, penalties, fines, issued by the tax authority; and (or) information about the absence of in relation to a legal entity, insolvency (bankruptcy) proceedings, decisions of judicial authorities declaring it insolvent (bankrupt) that have entered into force, liquidation procedures as of the date of submission of documents to a non-credit financial organization; and (or) information about the absence of facts of non-fulfillment by a legal entity of its monetary obligations due to the lack of funds in bank accounts; and (or) data on the rating of a legal entity posted on the Internet on the websites of international rating agencies (Standard & Poor's, Fitch-Ratings, Moody's Investors Service and others) and national rating agencies ).
information about business reputation (reviews (in any written form, if possible)), about the legal entity of other clients of this Insured who have business relations with him; and (or) reviews (in any written form, if possible) from credit institutions and (or) non-credit financial institutions in which the legal entity is (was) servicing, with information from these credit institutions and (or) non-credit financial institutions on assessing the business reputation of a given legal entity).
7.5.3. Policyholders - individuals provide the Insurer with documents allowing them to establish the following information:
surname, name, and patronymic (unless otherwise follows from the law or national custom);
citizenship;
Date and place of birth;
details of the identity document: series (if any) and document number, date of issue of the document, name of the authority that issued the document, and department code (if available);
migration card data (card number, start date of stay and end date of stay in the Russian Federation);
details of the document confirming the right of a foreign citizen or stateless person to stay (reside) in the Russian Federation: series (if available) and document number, start date of the right of stay (residence), expiration date of the right of stay (residence), in if the availability of the specified data is provided for by the legislation of the Russian Federation;
address of place of residence (registration) or place of stay;
taxpayer identification number (if available);
telephone and fax numbers (if available);
other contact information (if available);
position of the Insured (Beneficiary), who is a foreign public official, an official of public international organizations, as well as a person holding (occupying) government positions of the Russian Federation, positions of members of the Board of Directors of the Central Bank of the Russian Federation, positions of the federal public service, appointment and dismissal from which the President of the Russian Federation or the Government of the Russian Federation holds positions in the Central Bank of the Russian Federation, state corporations and other organizations created by the Russian Federation on the basis of federal laws, included in the lists of positions determined by the President of the Russian Federation;
degree of relationship or status (spouse) of the Policyholder in relation to the person specified in the paragraph above;
the name and details of the document confirming that the person has the authority of a representative of the policyholder.
Individual policyholders also provide the Insurer with the following for concluding an Insurance Agreement:
documents related to the work activity of the Insured;
official documents confirming the income of the Insured from his own professional activities;
medical documents related to the health status of the Insured;
licenses and qualification documents confirming that the Insured engages in risky sports/driving vehicles;
Additional questionnaires filled out by the Insured according to the Insurer's form.
Once the Insured has completed an application for additional information on the Insurer's form, the Insurer has the right to shorten the above list.
7.6. The fact of concluding an Insurance Agreement is certified by an Insurance Certificate.
7.7. If the Insured has provided incomplete or inaccurate information in the application for insurance and additions thereto, or the Insured is required to undergo a medical examination, the Insurer may postpone the execution of the Insurance Agreement until it receives additional and/or clarified information or the results of the medical examination from the Insured/medical institution. The Insurer shall send the Insured a written notice of the need to provide additional and/or updated information or undergo a medical examination by the Insured within 10 (ten) business days from the date of receipt of the insurance premium or the first insurance payment under the Insurance Agreement.
7.8. The Insurance Agreement is terminated in the event of:
7.8.1. The survival of the Insured until the end of the insurance period and the Insurer fulfilling its obligations in full in accordance with clauses. 9.1.1 of these Rules;
7.8.2. Death of the Insured and fulfillment by the Insurer of its obligations under the Insurance Agreement in full in accordance with clauses. 9.1.2.1, 9.1.2.2, 9.1.3 of these Rules;
7.8.3. Termination of the Insurance Agreement from the date specified by the Policyholder in the application. In this case, the original Insurance Certificate must be returned to the Insurer;
7.8.4. Failure by the Policyholder to pay the insurance premium (insurance contribution) in the amount and within the time limits provided for in the Insurance Agreement;
7.8.5. Death of the Policyholder - an individual who has entered into an Insurance Agreement for a third party, if the Insured or another person, in accordance with current legislation, has not assumed the obligations of the Policyholder under the Insurance Agreement, provided for in clause 10.2 of these Rules;
7.8.6. Liquidation, reorganization of the Insured - a legal entity in the manner established by the current legislation, if the Insured or other person, in accordance with the current legislation, has not assumed the obligations of the Insured under the Insurance Agreement, provided for in clause 10.2 of these Rules;
7.8.7. In other cases provided for by the legislation of the Russian Federation.
7.9. The insurance contract may contain other conditions determined by agreement of the parties and not contradicting the legislation of the Russian Federation.
7.10. Refund of the paid insurance premium (insurance premiums) to the Insured-individual is possible if the Insured-individual refuses the Insurance Agreement within the first thirty calendar days from the date of signing the Insurance Agreement, regardless of the moment of payment of the insurance premium (insurance contributions), in the absence of events that have signs of an insured event, in the manner established by these Rules.
The Insurer has the right to provide in the Insurance Agreement a longer period for the return of the insurance premium than the period for the return of the insurance premium established in clause 7.10 above.
If the Policyholder-individual refused the Insurance Agreement within the first thirty calendar days from the date of signing the Insurance Agreement, and before the start date of the insurance, then in the absence of events in this period that have signs of an insured event, the paid insurance premium (insurance contributions) is subject to return To the insured individual in full.
If the Insured-individual refused the Insurance Agreement within the first thirty calendar days from the date of signing the Insurance Agreement, but after the date of commencement of the insurance, the Insurer, when returning the paid insurance premium (insurance premiums) to the Insured-individual, has the right to withhold its part in proportion to the period validity of the Insurance Contract that has passed from the date of commencement of the insurance to the date of termination of the Insurance Contract. At the same time, the Insurer, when returning the paid insurance premium (insurance premiums) to the Insured-individual, does not withhold its part in proportion to the period of validity of the Insurance Agreement that has passed from the date of commencement of the insurance until the date of termination of the Insurance Agreement, in the event that the Insured-individual has refused the Agreement insurance within the first thirty calendar days from the date of signing the Insurance Agreement, but after the start date of the insurance.
In case of early refusal of the Policyholder-individual from the Insurance Agreement after the first thirty calendar days from the date of signing the Insurance Agreement, the redemption amount provided for in Section 8 of these Rules is paid. The insurance premium (insurance premiums) paid to the Insurer is not refundable unless otherwise provided by the Insurance Agreement.
In case of return of the insurance premium in accordance with this paragraph, additional investment income is not paid.
7.11. If the Insured-individual refuses the Insurance Agreement, the Insurance Agreement is considered terminated from the date the Insurer receives a written application from the Insured-individual to renounce the Insurance Agreement (application for termination of the Insurance Agreement) or another date established by agreement of the Parties, but no later the period determined in accordance with clause 7.10. of these Insurance Rules.
7.12. In case of return to the Insured-individual of the paid insurance premium (part of the insurance premium), if the Insured-individual refuses the Insurance Agreement, the return of the insurance premium (part of the insurance premium) is made at the choice of the Insured-individual in cash or by bank transfer, on time , not exceeding 10 (ten) working days from the date the Insurer receives a written application from the Insured-individual to cancel the Insurance Agreement (application for termination of the Insurance Agreement). The return of the insurance premium (part of the insurance premium) in cash is carried out by contacting the Insured-individual to a credit institution authorized by the Insurer.
8. REDEMPTION AMOUNT
8.1. The redemption amount is the amount paid by the Insurer in the event of early termination of the Insurance Agreement for the reasons specified in clauses. 7.8.3, 7.8.4, 7.8.5, 7.8.6 of these Rules, or in the event of the death of the Insured for the reasons specified in clause 3.7 of the Rules, as well as in other cases expressly provided for in these Rules.
8.2. The procedure for determining and paying the redemption amount.
8.2.1. The amount of the redemption amount is determined by the Insurer within the limits of the insurance reserve formed in accordance with the established procedure on the day of termination of the Insurance Agreement and is indicated in the Insurance Certificate.
8.2.2. For Insurance Contracts with a one-time payment of the insurance premium, payment of the redemption amount is made in the event of early termination of the contract, starting from the first year of validity of the Insurance Contract.
8.2.3. For Insurance Contracts with payment of the insurance premium in regular installments, concluded for a period of 6 (six) years or more, payment of the redemption amount is made in the event of early termination of the contract, starting from the third year of validity of the Insurance Contract.
8.2.4. For Insurance Contracts with payment of the insurance premium in regular installments, concluded for a period of 5 (five) years, payment of the redemption amount is made in the event of early termination of the contract starting from the second year of validity of the Insurance Contract.
8.2.5. Simultaneously with the payment of the redemption amount, the amount of additional income is paid, which was determined by the Insurer in accordance with clause 8.5 of these Rules on the date of early termination of the Insurance Agreement or the decision to pay the redemption amount in connection with the death of the Insured for the reasons specified in clause 8.3 of these Rules .
8.3. The redemption amount is paid:
8.3.1. To the policyholder or, on his behalf, to any other capable individual or legal entity.
8.3.2. To the beneficiary - in the event of the death of the Insured for the reasons listed in paragraphs. 3.7.1 of these Rules.
8.4. The procedure for determining the redemption amount taken into account when calculating the redemption amount payable (clause 8.2 of these Rules):
8.4.1. When paying the insurance premium annually, the redemption amount is taken into account in the amount specified in the Insurance Contract for the last year of validity of the Insurance Contract for which the insurance premium was paid.
8.4.2. When paying the insurance premium in installments (quarterly, semi-annually) during the insurance year, the guaranteed redemption amount is taken into account in the amount of the difference between the guaranteed redemption amount specified in the Insurance Agreement for the year of insurance in which the last installment was paid and the insurance premiums not paid in the insurance year in which the last premium was paid.
8.4.3. When paying the insurance premium at a time when concluding the Insurance Agreement, the redemption amount is taken into account in the amount specified in the Insurance Agreement for the current insurance year.
8.5. Additional redemption amount (Investment income).
8.5.1. Based on the results of the calendar year, the insurer may announce an additional rate of return and determine the appropriate amount of the additional redemption amount under the current Insurance Agreement, which includes the survival risk (clause 3.3.1 of these Rules).
8.5.2. The additional redemption amount under the Insurance Contract is determined on the basis of the additional rate of return announced by the Insurer and is calculated based on:
the amount of the insurance reserve at the end of the calendar year (December 31) preceding the year for which the additional rate of return was announced; or the amount of the insurance (mathematical) reserve at the beginning of the Insurance Contract for contracts with a lump sum payment in the case of the first calculation of the additional redemption amount. (The insurance reserve is calculated on the basis of Order of the Ministry of Finance No. 32n dated April 9, 2009, based on the difference between the actuarial value of insurance payments for future insured events and the actuarial value of future receipts of the reserved net premium, taking into account zillmerization) the amount of the additional redemption amount at the end of the calendar year ( December 31) preceding the year for which the additional rate of return was announced.
8.5.3. The calculation of the additional redemption amount under Insurance Contracts with a one-time payment of the insurance premium is made starting from the first year of insurance, provided that the Insurance Contract was valid for at least 91 (ninety-one) days during the year for which the additional rate of return is announced; under Insurance Contracts with payment of the insurance premium in installments, provided that the Insurance Contract is valid for at least 3 (three) full calendar years, the last of which is the year of announcement of the additional rate of return.
8.5.4. Calculation of the additional redemption amount under existing Insurance Contracts, under which the payment of insurance premiums for the main risks has been stopped due to the occurrence of an insured event for the risk specified in paragraphs. 3.3.3, 3.3.4 and 3.3.8 of these Rules, is made based on:
the amount of the insurance reserve at the end of the calendar year (December 31) preceding the year for which the additional rate of return was announced, calculated in accordance with the assumption of maintaining the schedule for payment of insurance premiums for the main risks;
the amount of the additional redemption amount at the end of the calendar year (December 31) preceding the year for which the additional rate of return was announced.
the value of the annual guaranteed rate of return, which is 3% and on the basis of which the insurance and redemption amounts specified in the Insurance Agreement were calculated.
8.5.5. The amount of the additional redemption amount as of the start date of the Insurance Contract is zero.
8.5.6. The Insurer notifies the Policyholder of the additional rate of return and/or the amount of the additional redemption amount under the current Insurance Contracts.
If at the end of the calendar year the Insurer did not announce an additional rate of return, the Insured is not notified of the amount of the additional rate of return and/or the additional redemption amount.
8.5.7. The amount of the additional redemption amount under the Insurance Contract as of the current date is determined as the additional redemption amount calculated by the Insurer in accordance with the last announcement of the additional rate of return.
8.5.8. The amount of the additional redemption amount is not determined for Insurance Contracts that expired on the date of announcement of the additional rate of return in accordance with paragraphs. 7.8.1, 7.8.2, 7.8.3 of these Rules.
9. PROCEDURE FOR INSURANCE PAYMENT
9.1. The amount of insurance payment upon the occurrence of an insured event is determined:
9.1.1. For the risk “Survival of the Insured until the end of the insurance period” (clause 3.3.1 of these Rules) - in the amount of 100% of the insured amount established for this risk, plus an additional redemption amount determined in accordance with clause 8.5 of these Rules for expiration date of the Insurance Agreement.
9.1.2.1. For the risk “Death of the Insured for any reason” (clause 3.3.2.1 of these Rules) - 100% of the insured amount established for this risk, plus an additional redemption amount determined in accordance with clause 8.5 of these Rules on the date of occurrence of the insurance case. For the insurance program "City Savings program "Comfort+"
the insurance amount is considered equal to the amount of insurance premiums paid until the date of death of the Insured.
9.1.2.2. For the risk “Death of the Insured due to natural causes” (clause 3.3.2.2 of these Rules) - 100% of the insured amount established for this risk, plus an additional redemption amount determined in accordance with clause 8.5 of these Rules on the date of occurrence of the insurance case. For the City Savings Program “Comfort” insurance program, the insured amount is considered equal to the amount of insurance premiums paid until the date of death of the Insured.
9.1.3. For the risk “Death of the Insured for any reason with deferred payment of insurance benefits” (clause 3.3.3 of these Rules) - 100% of the insured amount established for this risk, plus an additional redemption amount determined in accordance with clause 8.5 of these Rules Rules as of the expiration date of the Insurance Contract. Insurance payment for this risk is made upon expiration of the Insurance Agreement in accordance with clause 9.3 of these Rules.
9.1.4. For the risk “Permanent total disability of the Insured for any reason / Disability with exemption from payment of insurance premiums” (clause 3.3.4 of these Rules), the Insured is exempt from further payment of insurance premiums for the main risks in accordance with the conditions of this paragraph of the Rules:
9.1.4.1. Exemption from payment of insurance premiums for basic risks arises provided that the age of the Insured at the time of establishment of permanent total incapacity/disability does not exceed 55 years for women and 60 years for men.
9.1.4.2. Exemption from payment of contributions for main risks occurs after 6 (six) months from the date of determination of total permanent disability/incapacity. If the Insurer is notified in writing of the establishment of total permanent disability/disability later than 6 (six) months from the date of its establishment, then exemption from payment of contributions begins on the first day of the month following the one in which the notice was received.
9.1.4.3. If the established total permanent disability of the Insured requires re-examination within the established time frame, the Insured (Policyholder) is obliged to inform the Insurer about the results of the re-examination and provide documents confirming the decision of the medical and social examination bureau within 1 (one) month following the month on which a re-examination was ordered, in any available way that allows the fact of the report to be objectively recorded.
9.1.4.4. Exemption from payment of insurance premiums for main risks becomes invalid:
9.1.5. For the risk “Permanent total disability of the Insured as a result of an accident” (clause 3.3.5 of these Rules) - 100% of the insured amount established for this risk.
9.1.6. For the risk “Death of the Insured as a result of an accident” (clause 3.3.6 of these Rules) - 100% of the insured amount established for this risk, plus an additional redemption amount determined in accordance with clause.
8.5 of these Rules on the date of the insured event.
9.1.7. For the risk “Primary diagnosis of diseases in the Insured” (clause 3.3.7 of these Rules) - 100% of the insured amount established for this risk for the conditions specified in clauses. 3.6.3 of these Rules. The Insurer will make a payment, provided that the Insured remains alive for 30 (thirty) days after the diagnosis of diseases or the date of surgical operations for the conditions specified in clause 3.6.3 of the Rules. Diagnosing the Insured with diseases or performing surgical operations for the conditions specified in clauses. 3.6.3 of these Rules, will be recognized as an insured event only if the first symptoms of diseases or conditions appeared, and surgical operations were performed no earlier than 90 (ninety) days from the date of entry into force of the Insurance Agreement, and the age of the Insured does not exceed 55 years.
If symptoms of one or more diseases or conditions occur simultaneously or sequentially one or more times, payment will only be made once. The Insurer has the right, at its own expense, to conduct a medical examination of the Insured during the period of consideration of the application for insurance payment. If the Insured refuses a medical examination, the Insurer may refuse the payment provided for in the Insurance Agreement.
9.1.8. For the risk “Permanent total disability of the Insured as a result of an accident/Disability (with exemption from payment of insurance premiums)” (clause 3.3.8 of these Rules), the Insured is exempt from further payment of insurance premiums for the main risks in accordance with the terms of this paragraph of the Rules :
9.1.8.1. Exemption from payment of insurance premiums for basic risks arises provided that the age of the Insured at the time of establishment of permanent total incapacity/disability does not exceed 55 years for women and 60 years for men.
9.1.8.2. Exemption from payment of contributions for main risks occurs after 6 (six) months from the date of determination of total permanent disability/incapacity. If the Insurer is notified in writing of the establishment of total permanent disability/disability later than 6 (six) months from the date of its establishment, then exemption from payment of contributions begins on the first day of the month following the one in which the notice was received.
9.1.8.3. If the established total permanent disability of the Insured requires re-examination within the established time frame, the Insured (Policyholder) is obliged to inform the Insurer about the results of the re-examination and provide documents confirming the decision of the medical and social examination bureau within 1 (one) month following the month on which a re-examination was ordered, in any available way that allows the fact of the report to be objectively recorded.
9.1.8.4. Exemption from payment of insurance premiums for main risks becomes invalid:
a) if the Insured’s total permanent disability/disability of the 1st (non-working) group is removed - from the first day of the month following the month in which the decision of the medical and social examination bureau was made;
b) if the Insured (Policyholder) did not report the results of the re-examination within the established time frame - from the first day of the month following the month for which the re-examination was scheduled.
9.2. General procedure for insurance payment.
9.2.1. Upon the occurrence of an insured event, the Insurer must be notified of such an event by the Policyholder/Insured or another person within 30 (thirty) days from the date of the insured event, in any available way that allows the fact of notification to be objectively recorded. If there is a good reason, the above period may be extended by the Insurer, for example, in the event of the simultaneous death of the Policyholder and the Insured and/or the Beneficiary or in other cases.
9.2.2. To resolve the issue of insurance payment, the Policyholder (Insured, Beneficiary, Legal Representative) must send a written application to the Insurer indicating the surname, name and patronymic of the person with whom the insurance event occurred, the date, place and circumstances of the occurrence of the insurance event, the desired method of receiving insurance payment from indicating all the necessary details, as well as providing the documents specified in clause 9.4 of these Rules.
9.2.3. If the Insurer requires additional information to resolve the issue of insurance payment, it has the right to require the Insured to undergo a medical examination. The medical examination is carried out in a medical institution specified by the Insurer at the expense of the Insurer.
9.2.4. Insurance payment (for all risks, with the exception of the risk specified in clause 3.3.3 of these Rules) is made within 5 (five) working days from the date the Insurer makes a decision on payment. The Insurer makes a decision on payment or refusal of insurance payment within 30 (thirty) working days from the date of submission of all necessary documents provided for in the Insurance Policy, which is documented in the insurance act, and informs the Beneficiary (or the Insured, if the Beneficiary is not specified in the Policy) of its decision. .
9.2.5. The decision on insurance payment may be delayed by the Insurer if, based on the facts related to the occurrence of the insured event, the Insurer ordered an additional inspection, initiated a criminal case or initiated a lawsuit, until the end of the investigation or trial, or until other circumstances that prevented payment are eliminated. In this case, the Insurer sends a notification letter to the Insured (Policyholder) indicating the reason for the delay in insurance payment.
The insurance payment may be made by one of the Insured (the Insured, 9.2.6.
Beneficiary) methods (except for the cases discussed in clause 9.1.4 of these Rules): by non-cash transfer to a bank account or by postal transfer.
9.2.7. If the Beneficiary is a minor at the time of insurance payment, the amount due to him is transferred to a bank deposit in his name with notification of his legal representatives.
9.3. The procedure for insurance payment for the risk specified in clause 3.3.3 of these Rules.
9.3.1. When an insured event occurs for the risk specified in clause 3.3.3 of these Rules, notification of the insured event and consideration of the issue of insurance payment is carried out in accordance with the procedure established in clause 9.2 of these Rules.
9.3.2. If a decision is made on insurance payment, the Insurer, within 10 (ten) business days from the date of drawing up the insurance act, sends the Beneficiary a corresponding notification about the possibility of receiving insurance payment upon expiration of the Insurance Agreement.
9.3.3. To receive an insurance payment, the Beneficiary, upon expiration of the Insurance Agreement, sends an application for insurance payment to the Insurer, attaching an identification document of the Beneficiary.
9.3.4. Insurance payment is made within 10 (ten) working days from the date the Insurer makes a decision to recognize an insured event, which is documented in an insurance act, but not earlier than the expiration date of the Insurance Agreement. The insurer is obliged to make a decision on payment or refusal of insurance payment, to draw up an insurance act within 30 (thirty) working days from the date of receipt of all necessary documents provided for in the Insurance Agreement.
9.4. Documents provided to the Insurer to resolve the issue of insurance payment.
9.4.1. If the issue of insurance payment is resolved in accordance with paragraphs. 3.3.1 of these Rules:
Identification document of the Insured Person (notarized copy or original);
Original Insurance Certificate;
A copy of the Beneficiary's passport (if the Beneficiary is not the Insured);
A copy of the passport of the recipient of the insurance payment (if the Beneficiary indicates the details of another person) 9.4.2. If the issue of insurance payment is resolved in accordance with paragraphs.
3.3.2.1, 3.3.2.2, 3.3.3, 3.3.6 of these Rules:
Application for receiving insurance payment from the Beneficiary;
Identification document of the Beneficiary;
A notarized copy of the death certificate of the Insured;
A document indicating the cause of death of the Insured Person - a copy certified by the issuing institution or notarized (death certificate from the registry office indicating the cause of death, medical death certificate, post-mortem epicrisis);
An extract from the outpatient card of the Insured Person at the place of residence or place of observation, indicating all past diseases and the dates of their diagnosis;
9.4.3. In the event of resolving the issue of insurance payment for insured events in accordance with paragraphs. 3.3.4, 3.3.5, 3.3.8 of these
Rules:
Application for receiving insurance payment from the Insured;
A notarized copy of the conclusion of the Bureau of Medical and Social Expertise (MSE) on the assignment of a disability group to the Insured;
A medical document indicating the reason (diagnosis) for assigning a disability group - a copy certified by the institution that issued the original;
A document from law enforcement agencies describing the circumstances of the event - a copy certified by the issuing institution (Resolution to initiate / refuse to initiate a criminal case, Protocol from the scene of the event, Certificate of an accident indicating the participants in the event);
An extract from the outpatient card of the Insured at the place of residence or place of observation indicating all past diseases and the dates of their diagnosis - original or copy certified by the issuing medical institution 9.4.4. In the event of resolving the issue of insurance payment for insured events in accordance with paragraphs.
3.3.7 of these Rules:
Application for insurance payment from the Insured;
Identity document of the Insured;
A medical document indicating the established diagnosis, a description of the diagnostic and laboratory tests performed and a medical history - the original or a copy certified by the issuing medical institution;
An extract from the outpatient card of the Insured at the place of residence or at the place of observation, indicating all past diseases and the dates of their diagnosis - original or copy certified by the issuing medical institution;
9.4.5. The Insurer has the right to reasonably request the following documents from the Insured / Beneficiary:
Forensic medical examination report - original or duly certified copy;
A copy of the Outpatient Card of the Insured at the place of residence or place of observation certified by the issuing institution;
A copy of the medical history of the inpatient patient of the Insured, certified by the issuing institution;
Report on an industrial accident - original or duly certified copy;
A medical report on the health status of the Insured 6 weeks after his stroke was diagnosed, indicating the existing permanent neurological disorders;
Medical report on the health status of the Insured 30 days after the diagnosis of a fatal disease in the Insured;
Court decision/decree describing the circumstances of the incident and indicating the persons found guilty; a copy certified by the issuing institution or notarized;
A document confirming the right to drive a vehicle for the person who was driving - original or duly certified copy;
A certificate of the results of a blood test of the person who was driving for the presence of alcohol and drugs, the original or a duly certified copy;
Certificate of right to inheritance in the form of an insurance payment - original or notarized copy;
Application for insurance payment from an heir under the Law;
9.5. The insurer has the right to refuse insurance payment if:
a) The policyholder provided knowingly false information in the insurance application;
b) The Policyholder (Beneficiary) had the opportunity, but did not provide the documents and information provided for in the Insurance Agreement and necessary to establish the fact of the occurrence of an insured event, within 1 (one) month from the date of notification of the Insurer about the insured event.
9.6. Insurance payment options:
9.6.1. Risk payment pp. 3.3.1 of these Rules “Survival of the Insured until the end of the insurance period” can be paid in the form of a lump sum payment, or with the consent of the Insurer upon a written application of the Beneficiary (hereinafter referred to as the recipient of the insurance payment) in the form of an annuity according to one of the following options:
Option 1: Deferred lump sum payment;
Option 2: Payment in agreed installments;
Option 3: Payment in installments within the agreed time frame;
Option 4: Lifetime annuity;
Option 5: Lifetime annuity with a guaranteed payment period;
Option 6: Lifetime annuity with 60% transfer to surviving spouse.
9.6.2. The insured amount (the amount of the annual annuity) is calculated on the basis of the tariffs in force with the Insurer at the time the annuity begins.
9.6.3. Lifetime annuity (Option 4) is paid in equal monthly payments, provided that the recipient of the Insurance payment survives until the date of the next annuity payment; in the event of the death of the recipient of the Insurance payment, the payment of the lifelong annuity is terminated. A lifetime annuity with a guaranteed payment period (Option 5) is paid in equal monthly payments to the recipient of the Insurance payment, subject to his/her survival until the date of the next annuity payment, and in the event of his/her death, the annuity is paid to his/her heirs during the guaranteed period. A lifetime annuity with the transfer of 60% to the surviving spouse (Option 6) is paid in equal monthly payments to the recipient of the insurance payment, provided that he survives until the date of the next annuity payment. If the beneficiary's spouse survives him/her, she/he will receive a life annuity equal to 60% of the original annuity. After the first annuity payment, no changes are made to the terms of payment.
9.6.4. The choice of payment option is fixed in the additional agreement to the Insurance Agreement.
9.6.5. For all options described in paragraphs. 9.6.1 of these Rules, the recipient of the payment has the right to investment income (additional redemption amount), which is accrued on the reserves remaining in the insurance company. Investment income is accrued in accordance with the conditions described in clause 8.5. of these Rules, taking into account the technical rate of return used by the Insurer to calculate annuities determined on the day when the additional agreement specified in clauses. 9.6.4, was concluded.
9.6.6. The recipient of the insurance payment cannot transfer or delegate the rights to the annuity to other persons. The funds at the disposal of the Insurer and the right to annuity are subject to legal requirements.
9.6.7. The options described in paragraphs. 9.6.1 of these Rules do not apply if the recipient of the insurance payment is a legal entity. When the rights to receive insurance payments are transferred to a legal entity, the application of the recipient of the insurance payment for the annuity program becomes invalid.
9.6.8. This section becomes invalid if the amount of monthly payments does not exceed the amount determined as the minimum monthly payment by the Insurer for the calendar year in question.
10. RIGHTS AND OBLIGATIONS OF THE PARTIES:
10.1. The insurer is obliged:
10.1.1. Familiarize the Policyholder with the terms of the Insurance Contract;
10.1.2. In the event of an insured event, make an insurance payment within the period established by the Insurance Agreement;
10.1.3. Do not disclose information about the Insured and his property status, unless this conflicts with the legislative acts of the Russian Federation;
10.1.4. Do not disclose medical information provided by the Insured, except in cases where it becomes necessary to transfer medical data on the Insured to the reinsurer or other insurer to assess the degree of risk and to draw up a reinsurance agreement, co-insurance, etc. Transfer of data about the Insured is permitted only to the extent necessary for drawing up the Reinsurance/Coinsurance Agreement or justifying the insurance payment and does not contradict the current legislation of the Russian Federation.
10.2. The policyholder is obliged:
10.2.1. Pay the insurance premium (insurance premiums) in a timely manner in the amount specified by the terms of the Insurance Agreement;
10.2.2. Notify the Insurer of the occurrence of an insured event within 30 (thirty) days, starting from the day when it became aware of the occurrence of an insured event, and provide the Insurer with the necessary documents in accordance with clause 9.4 of these Rules. Notification of the Insurer about the fact of the occurrence of an insured event must be made by the Insured in any way available to him, allowing him to objectively record the fact of the notification.
The Insured's obligation to report the occurrence of an insured event may be fulfilled by the Beneficiary or another person.
10.3. The policyholder has the right:
10.3.1. Check the Insurer's compliance with the requirements of the terms of the Insurance Agreement.
10.3.2. Receive a duplicate of the Insurance Certificate in case of its loss.
10.3.3. Receive from the Insurer information regarding its financial stability, which is not a commercial secret.
10.3.4. Terminate the Insurance Contract early with written notification to the Insurer and indicating the date of early termination of the Insurance Contract.
10.3.5. In agreement with the Insurer, make changes to the terms of the Insurance Contract regarding changes in the amount of the insurance premium, frequency of payment or insurance period from the beginning of the next insurance year.
10.4. The insurer has the right:
10.4.1. Check the information provided by the Policyholder, as well as the performance by the Policyholder of its obligations under the Insurance Agreement.
10.4.2. By agreement with the Policyholder, amend the Insurance Agreement in connection with new changes in the legislation of the Russian Federation, which directly or indirectly affect the scope of the obligations of the Insurer or the Policyholder.
10.4.3. Refuse insurance payment if the Policyholder had the opportunity in the manner prescribed by current legislation, but did not provide, within the period established by the Policy, the documents and information provided for in the Insurance Contract and necessary to establish the causes of the insured event, or provided knowingly false information.
10.4.4. Postpone the decision on the issue of insurance payment (on refusal of insurance payment) in the event of a criminal case being initiated upon the occurrence of the event specified in clause 3.3 of these Rules, until the relevant decision is made by the competent authorities.
10.4.5. Require the Insured to undergo a medical examination in accordance with paragraphs. 3.3.4, 3.3.7, 3.3.8, 3.6, 7.7, 9.2.3 of these Rules.
10.4.6. Require the Insured to reimburse the costs of a medical examination in case of refusal to conclude an Insurance Agreement on the proposed conditions, if the medical examination was carried out at the expense of the Insurer and in a medical institution specified by the Insurer.
11. PROCEDURE FOR RESOLUTION OF DISPUTES All disputes under the Insurance Agreement between the Parties, if mutual agreement on their settlement is not reached, shall be resolved in court by the competent judicial authority in accordance with the current legislation of the Russian Federation.
12. FINAL PROVISIONS
12.1. All statements and notifications made to each other by the Insurance Subjects must be made in writing, in ways that allow the fact of communication to be objectively recorded.
12.2. Each Party is responsible for delivering its message to the other Party at the address reflected in the Insurance Agreement.
12.3. In the event of a change of address without informing the other Party, the unnotified Party is exempt from
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During long-term loan repayments, various unpleasant life situations may occur to the borrower, which cause a difficult financial situation - for example, dismissal from work or serious illness. The programs being developed at VTB Insurance are designed to help the borrower. If the event specified in the contract occurs, the insurance company will pay monetary compensation to the bank client.
Connecting to the insurance program at VTB 24
Insurance programs are designed to provide financial assistance to the borrower; they protect the payer from various life troubles. Currently, three VTB 24 insurance programs are being implemented, which cover various risks: Life, Life+ and Profi.
Benefits of purchasing a policy
Advantages of purchasing an insurance policy from VTB 24:
- complete protection and confidence in the future - in the event of troubles or the death of the borrower, guarantors or heirs will not have to take on loan obligations: everything will be paid by the insurance company;
- transparency of pricing: there is a single tariff for insurance, regardless of the payer’s age, health status, type of loan and other factors;
- a wide range of risks, if desired, you can select only the necessary positions;
- minimum documentation and ease of connection to the VTB 24 insurance program - to purchase a policy, just tell the loan officer about it.
The duration of the insurance depends on the duration of the loan obligations and is equivalent to it. Insurance premiums are already included in the payment schedule, so you won’t have to pay a large amount up front. However, if desired, you can choose a different payment plan, when the insurance amount is repaid using the loan provided. In accordance with the conditions, the bank receives a reward of 20%.
Requirements for clients
The requirements for clients becoming participants in insurance programs at VTB 24 are as follows:
- age – from 18 to 55 years (Profi), from 18 to 80 years (Life and Life+);
- presence of Russian citizenship;
- absence of disability, cancer, diabetes, atherosclerosis and a number of other diseases;
- absence of HIV infection;
- work experience over 1 year (Profi).
Military personnel and persons subject to bankruptcy proceedings are not allowed to participate in collective insurance programs.
Types of insurance
The Life and Pro programs are collective insurance programs of VTB 24, since their conditions are the same for all clients and cannot be configured individually. Another disadvantage of collective insurance is the inability to obtain a tax deduction for the amount of contributions paid.
If it is fundamentally important for you to obtain insurance with the possibility of obtaining a deductible, then it is worth considering the possibilities of individual insurance, for example, under the Excel Personal Protection program. However, in this case the cost of contributions will be much higher. The price of insurance under collective insurance programs is quite low - about 50% cheaper than individual policies.
Life
Payments under the Life collective insurance program at VTB 24 are made upon the occurrence of the following risks:
- permanent loss of ability to work (including those associated with disability);
- death of the insured person.
In this case, the insurance situation is considered to be the situation that arose as a result of illness or an accident, and in this case the payer was not intoxicated and did not commit suicide.
Life+
The Life+ VTB 24 insurance program offers coverage for more risks, in addition to death and disability:
- hospitalization of the insured person;
- temporary disability due to injury or accident.
Moreover, in the event of death or disability, payment is made in the amount of 100% of the balance of the debt, and in the event of hospitalization or temporary disability, the insurance company pays the monthly minimum premiums instead of the insured person.
Collective insurance Pro
Under the Profi collective insurance program at VTB 24, the same risks are insured, but additional protection is provided for the borrower from financial losses in the event of loss of employment. Naturally, the policy only covers those cases of job loss that are not dependent on the payer.
In other words, insurance is provided not in case of voluntary dismissal, but, for example, in the following situations:
- liquidation of an enterprise or its reorganization, resulting in the closure of the division where the borrower worked;
- staff reduction;
- reinstatement of the previous employee (for example, if he appealed against illegal dismissal);
- refusal of the payer to move with the employer to another area;
- dismissal from service due to absence from work for more than 4 months due to temporary disability, etc.
The full list of risks in the VTB 24 Pro insurance program is consistent with the Labor Code and Federal Law No. 79-FZ.
How to cancel insurance
Despite the fact that in general insurance is very beneficial for the client, especially over the long term, the cost of the policy can be a significant part of the loan, so many VTB clients are interested in whether it is possible to refuse insurance.
In accordance with the Civil Code, insurance is a purely voluntary matter. If bank employees convince you to purchase a policy from the Life VTB Insurance or Pro program, citing the fact that you will allegedly be denied a loan, then their actions are illegal.
You can file a complaint against the actions of a specialist:
- to the conflict manager;
- to the head of the department;
- to the VTB Bank hotline 8-800-100-24-24.
Consent or refusal to issue a policy does not affect the likelihood of loan approval, however, the bank can compensate for its risks by increasing the interest rate.
How to refuse life and health insurance offered by the bank when concluding a loan agreement and return the money for insurance
The decision to refuse insurance must be announced at the application stage, since the interest rate is calculated based on this. This is why employees say that you cannot refuse insurance - in reality, you can, but to do this, send a new request, and credit specialists will recalculate the loan parameters.
How to get your insurance money back
But if you have already taken out a loan, then how to return the money under the Life VTB Insurance program? Since this agreement is a collective agreement, it will not be possible to refuse it within 14 days, relying on the law on the protection of consumer rights.
In accordance with its terms, the insurance contract can only be terminated within 5 days. To do this, you need to write an application in the prescribed form and send the request to the VTB Insurance company itself.
You will have to respond to the request within 30 days and transfer the money to the specified bank account. However, please note that the amount for the days of actual insurance in force will be deducted from the refund.
Conclusion
So, today there are three VTB insurance programs: Life, Life+ and Profi. They include the most common risks - the death of the borrower, loss of ability to work, forced dismissal from work. Each borrower can choose a program based on their personal life situation. They are universal, i.e. offer a standard amount of insurance premiums, regardless of the client’s status, and 100% coverage of insurance risks. Signing up for a policy is voluntary; you can cancel it and return the money immediately or within 5 days after signing the loan agreement.