THIS INSURANCE WILL COVER THE FOLLOWING EXPENSES
1. For any Policyholder:
1.1.
Program A:
1.1.1. Emergency medical care;
1.1.2. Emergency Dental treatment:
- to relieve pain up to 150 USD/EUR
or
- any dental treatment costs caused by accident up to 300 USD/EUR
1.1.3. Pregnancy aid up to 28-th week;
1.1.4. Transportation in case of clinical necessity caused by the medical state to the
nearest hospital or to the doctor;
1.1.5. Repatriation;
1.1.6. Human remains repatriation.
1.2.
Program B:
Services are foreseen in a program A and additional services:
1.2.1. Visit of a close relative;
1.2.2. Return before the due date;
1.2.3. Evacuation of children;
1.2.4. Replacement of the Policyholder;
1.2.5. Compensation cost of telephone services.
CHAPTER 1. GENERAL PROVISIONS
1. DEFINITIONS OF TERMS USED IN INSURANCE AGREEMENT
1.1.
Insurance contract (hereinafter —
Agreement) — a written agreement between the Insurer
and Insured, according to which the Insurer undertakes upon the occurrence of an insured event to
carry out insurance payment, and the Insured (Policyholder) undertakes to pay insurance premiums
within certain Agreement terms and comply with all other terms of the Agreement.
1.2.
Medical expenses — voluntary insurance of medical costs. The program "Insurance of
medical expenses of individuals engaged in foreign travel". Terms and Conditions of the Agreement
for this type of insurance are set out in Chapter 2 of this Part of the Agreement.
1.3.
Accident insurance — voluntary accident insurance. The program "Accident insurance of
individuals engaged in foreign travel". Terms and Conditions of the Agreement for this type of
insurance are set out in Chapter 3 of this Part of the Agreement.
1.4.
Additional medical insurance — voluntary medical insurance (permanent health insurance).
The program "Additional medical insurance of individuals engaged in foreign travel". Terms and
Conditions of the Agreement for this type of insurance are set out in Chapter 4 of this Part of the
Agreement.
1.5.
Trip cancellation insurance — voluntary insurance of financial risks. The program "Foreign
trip’s cancellation insurance". Terms and Conditions of the Agreement for this type of insurance are
set out in Chapter 5 of this Part of the Agreement.
1.6.
Financial risks during trips — voluntary insurance of financial risks. The program "Financial
risks during foreign trips". Terms and Conditions of the Agreement for this type of insurance are set
out in Chapter 6 of this Part of the Agreement.
1.7.
Assistance company — a legal entity acting on behalf of the Insurer and coordinating the
activities of the Insured (Policyholder) during the occurrence of events specified by the Agreement
as insurance events, provides services to the Policyholder (Insured) abroad upon the occurrence of
an insured event, and also pays for the services granted to the Insured (Policyholder) on behalf of
the Insurer.
1.8.
ID card — a document that may be issued to the Insured (Policyholder), in accordance with
the terms of Agreement as confirmation of the conclusion of insurance agreement with that
individual.
1.9.
Accident — a sudden unexpected event caused by external circumstances independent of the
will of the individual and is accompanied by the human body tissues’ damage with violation of their
integrity and function, deformities and disorders of the musculoskeletal system. Accidents also
include random penetration of foreign bodies into airways, drowning, heat stroke, burns, bites of
animal, poisonous insects, snakes, frostbite, hypothermia, electric shock or lightning, accidental
poisoning by toxic substances, gases, drugs, poor quality food, tick-borne or after vaccination
encephalitis (encephalomyelitis), tetanus, botulism.
1.10.
STA — the subject of tourism activity, which under the laws of Ukraine has the right to provide
services for organizing foreign trips for its citizens.
1.11.
Agreement for travel services — agreement of the parties, concluded in writing under which
one party (STA) is obligated to provide set of travel services for a fee fixed by the agreement by
request of the other party (the tourist — Insured (Policyholder)). Agreement for travel services can
be concluded by issuing vouchers.
1.12.
Tourist voucher ("
voucher"), hereinafter
voucher— a document confirming the status
of a person or group of persons as tourists, payment for services or its warranty and is the basis for
obtaining of travel services by a tourist or a group of tourists.
1.13.
Single foreign trip — a trip that is carried by the Insured (Policyholder) with clearly defined
terms of stay abroad, with the possibility of a single entry for a limited period to the selected country
for trip (area (place) of Agreement). Typically, these trips can be done by a guest, travel, work and
other types of visas, entitling for single entry into the territory of the selected country.
1.14.
Multiple foreign trip — a trip that is carried by the Insured (Policyholder) with an open date
of the stay abroad, i.e. the Insured (Policyholder) can stay in a selected country (area (place) of
Insurance Agreement) repeatedly but within limits (days) determined in the Insurance agreement,
and the every time one goes abroad the term of the insurance coverage is automatically reduced by
the number of days spent by the Insured (Policyholder) in the (place) of Insurance Agreement.
Typically, these trips can be done by a guest, tourist, work or other types of visas, entitling for
multiple entry into the territory of the selected country
1.15.
Insurance Rules (hereinafter the
Rules) — Insurer Rules for Insurance, duly registered in
the National Commission for the State Regulation of Financial Services Markets, under which the
Insurer concludes the Insurance Agreements. This Agreement is concluded under such Rules of the
Insurer:
1.15.1. Rule 1 — " Rules for voluntary insurance of medical expenses";
1.15.2. Rule 2 — "Rules for Voluntary accident insurance";
1.15.3. Rule 3 — "Rules of voluntary insurance of financial risks";
1.15.4. Rule 4 — "Rules of voluntary medical insurance (permanent medical insurance)";
1.15.5. Rule numbers and dates of their approval by the Insurer referred to in the paragraphs
1.15.1–1.15.4 of this Chapter are indicated in the paragraph 1 of this Agreement.
1.16.
Sudden illness — sudden unexpected sharp deterioration of health of the Insured
(Policyholder) that threatens the life and health of the person and requires emergency treatment.
1.17.
Insurer — Joint-Stock Company "Insurance company "Alfa Insurance".
1.18.
Insured — legal or competent natural individual who has entered into an Insurance Agreement
with the Insurer.
1.19.
Policyholder — the person to the benefit of whom the agreement has been concluded. If the
Insured enters into agreement of insurance with respect to himself, he is also the Policyholder. The
policyholder under the terms of the Agreement may acquire rights and obligations of the Insured.
1.20.
Closest relatives — relatives of the person of the first line relationships such as husband /
wife, children, parents, brothers / sisters.
1.21.
Third party — any person other than the Insurer, the Insured and the Policyholder.
1.22.
Place of residence — residence of an individual in the territory of a State not less than one
year, who has no permanent residence in other states and intends to reside in the territory of that
State for unlimited term, not restricting such residence by a purpose, and provided that such
residence is not a consequence of fulfilment by this person of official duties or obligations under the
agreement (contract).
1.23.
Sports at the amateur level (
sport A) — irregular (including once) activity in any sport
(including during the holidays), or regular exercises (visiting sports section), when the sport is not
the main activity of the Insured (Policyholder) and Insured (Policyholder) is not involved in
competitions.
1.24.
Sports at the professional level (
sport P) — regular activity in any sport when the sport is
the main occupation of the Insured (Policyholder) or the Insured (Policyholder) takes part in
competitions.
1.25.
Reduction franchise — this is part of the losses that are not reimbursed by the Insurer under
the Agreement. If the franchise is denominated in a foreign currency, franchise in hryvnas is adjusted
under the official exchange rate of the National Bank of Ukraine (NBU hereinafter) on the date of
occurrence of the insured event.
2. PLACE AND TERM OF AGREEMENT
2.1. Place and term of agreement referred to in this paragraph shall not apply to the program "
Foreign trip’s cancellation insurance" and the program " Additional medical insurance of individuals
engaged in foreign travel", conditions of which are set out in Chapter 4 and 5 of this part of the
Agreement respectively.
2.2. This Agreement is valid only in the countries listed in Part 1 of the Treaty as "Place of
Agreement"
2.3. Areas of the Agreement may be areas defined in paragraph 2.2 of Chapter 1 of this Part of
the Agreement, with the exception of the country, where military operations are conducted and
which are under UN sanctions (except when provided in the special conditions of the Agreement and
payment of additional insurance payment) and the area of country of the place of residence of the
Insured (Policyholder).
2.4. Term of the Agreement is stated in Part 1 of this Agreement.
2.5. The agreement shall enter into force on 00 hours 00 minutes (local time) the day following
the date of receipt of the insurance payment in full amount to the current account or in cash to the
Insurer.
2.6. The Insurer is liable under the Agreement within the period (number of days), as indicated in
Part 1 of the Agreement "Restriction of days." The liability of the Insurer starts from the moment the
Insured (Policyholder) crosses border control while leaving the place of residence, provided that the
Insured has paid insurance payment to the Insurer in full amount, and ends with the moment when
the Insured (Policyholder) undergoes customs control when entering into a place of permanent
residence, or at 24-00 hours 00 minutes (Kyiv time) on the date specified in Part 1 of this Agreement
like expiration date, depending on which of these events occurred first. Each travel abroad from a
permanent residence place the term of the Agreement in terms of the Insurer liabilities reduces by
the number of days spent by the Insured (Policyholder) in the area of the Agreement (outside the
place of residence).
3. RIGHTS AND DUTIES
3.1.
The Insurer shall:
3.1.1. inform the Insured (Policyholder) the terms and rules of insurance;
3.1.2. within two (2) working days as soon as it becomes known about the occurrence of the insured
event, take steps to execute all necessary documents for the timely payment of the insurance;
3.1.3. upon the occurrence of the insured event, make an insurance payment:
3.1.3.1. to Assistance company – under procedure and within the period specified in the agreement
concluded between the Insurer and Assistance company or
3.1.3.2. to the Insured (Policyholder) or a third party that is actually paid for services received by
the Insured (Policyholder) and provided by the Agreement — to the extent of the expenses, if the
actions of the Insured (Policyholder) were consistent with the paragraph 4.3 of the Chapter 2 of this
Part of the Agreement and the incident that happened with the Insured (Policyholder) will be
recognized as insurance. Payment is made after return the Insured (Policyholder) from a trip abroad
– costs are incurred by compensation within the sum insured and limits set out in the Agreement.
The Insured (Policyholder) shall within fifteen (15) calendar days after returning from a trip to provide
the Insurer with the documents confirming fact, cause and circumstances of the insured event and
the amount of damages under this Agreement.
3.1.3.3. the Insured (Policyholder) or a third party that is actually paid for services received by the
Insured (Policyholder), if the actions of the Insured (Policyholder) were consistent with the paragraph
4.3 of the Chapter 2 of this Part of the Agreement and the incident that happened with the Insured
(Policyholder) will be recognized as insurance. if the Insured (Insured) p.4.4 consistent with Chapter
2 of this Part of the Treaty and the incident that happened with the policyholder (insured) will be
insured and knowledge. Payment is made after return the Insured (Policyholder) from a trip abroad.
The Insured (Policyholder) shall within fifteen (15) calendar days after returning from a trip to provide
the Insurer with the documents confirming fact, cause and circumstances of the insured event and
the amount of damages under this Agreement.
3.1.3.3.1. At this, the Insurer reimburses to the Insured person the cost of received health care
and (or) additional services and (or) purchased medicines or medical consumable materials only
in
an amount not exceeding the equivalent of U.S. $ 100 or Euro (depending on the currency in which
insurance amount is set).
3.1.3.4. The decision on reimbursement of other expenses made by the Insured (Policyholder) to
pay for medical services abroad, without the Assistance Company (Insurer) and for compensation of
which the Insured (Policyholder) may apply after returning from a trip, is taken at the discretion of
the Insurer, and, in any case,
can not exceed the equivalent of U.S. $ 100 or Euro (depending on
the currency in which insurance amount is set).
3.1.4. The Insurer bears financial responsibility for late insurance payments by payment to the
Insured (Policyholder) of the penalty, in the amount equal to double NBU accounting rate, which
operated during the period of overdue, from the outstanding amount for each day of delay;
3.1.5. not to disclose information about the Insured (Policyholder) and his/her property,
except as required by the law.
3.2.
The Insured shall:
3.2.1. upon conclusion of the Agreement to provide the Insurer with all information concerning the
circumstances having a substantial effect on the degree of risk, such as the purpose of travel
(professional activity abroad, sports activity at amateur and/or professional level, performing work
while travelling, etc.) and provide information about the availability of diseases, including chronic,
identified and existing at the time of registration of Agreement, and continue to keep it informed of
any change in insurance risk;
3.2.2. upon conclusion of the Agreement for the benefit of other persons (Policyholders) — to get
their consent to conclusion of Agreement for their benefit, as well as familiarize them with the
conditions and rules of insurance;
3.2.3. make an insurance payment in full amount in the manner provided this Agreement;
3.2.4. Upon conclusion of the Agreement to notify the Insurer of the other agreements in force in
respect of the subject matter of the Agreement;
3.2.5. take measures to prevent and reduce damages caused as a result of the occurrence of insured
event;
3.2.6. in the event of early termination to return the original Agreement to the Insurer.
3.3.
The Policyholder shall:
3.3.1. notify the Insurer/Assistance company about the occurrence of the event that has features of
an insurance event in the manner and terms provided by the Agreement;
3.3.2. implement all the recommendations of the Assistance company and the Insurer and agree
with them all actions related to the provision of emergence medical and other services provided by
the Agreement;
3.3.3. provide, upon request of the Insurer, any information necessary for the determination of the
insured event or determining the amount of insurance payments;
3.3.4. in the circumstances of the insured event, to release third parties from liability in respect of
medical confidentiality and trade secrets concerning the Insured (Policyholder) and, at the request
of the Insurer, to provide it with the necessary powers to get from the third parties (doctors, medical
institutions and other organizations that provided services to the Insured (Policyholder) under the
Agreement) any information relating to the insured event.
3.4.
The Insurer has the right to:
3.4.1. before the conclusion of the Agreement to require from the Insured (Policyholder) all
necessary information to identify degree of insurance risk;
3.4.2. require from the Insured (Policyholder) information necessary to establish the circumstances
of the insured event, including information constituting a trade secret, and verify the accuracy of
such information;
3.4.3. independently investigate the cause and circumstances of an accident, if necessary, to send
requests to the competent bodies (organizations) to provide relevant documents and information;
3.4.4. delay insurance payments for up to thirty (30) days to ascertain the circumstances of the
incident, if there are reasonable doubts about the authenticity of information provided by the Insured
(Policyholder);
3.4.5. refuse the make insurance payments, if there are any grounds specified in this Agreement and
the Law of Ukraine.
3.5.
The Insured (Policyholder) has the right:
3.5.1. to receive detailed information from the Insurer about services of Assistance company,
provided to the Insured (Policyholder) when travelling abroad;
3.5.2. to make changes and for early termination under the terms of this Agreement;
3.5.3. to receive services provided under this Agreement, if necessary, within the sum insured and
limits of reimbursement for such expenses specified in the Agreement;
3.5.4. to receive from the Insurer the amount of insurance benefit under the terms of the Agreement;
3.5.5. to appeal the decision of the Insurer to refuse to conduct insurance payment in the manner
prescribed by law.
4. MODIFICATION AND TERMINATION OF AGREEMENT
4.1. Validity of the Agreement is terminated and repealed by consent, and in the case of:
4.1.1. overall completion of the Agreement;
4.1.2. use by the Insured (Policyholder) of time limit abroad, pursuant to the Agreement (stay of the
Insured (Policyholder) outside Ukraine or country of residence for a period which equals or exceeds
the stipulated agreement period.
4.1.3. performance by Insurer of obligations to the Insured (Policyholder) under the Agreement in
full;
4.1.4. failure to pay by the Insured (Policyholder) of insurance payments within the period mentioned
in Part 1 of the Treaty;
4.1.5. liquidation of the Insured — legal entity or death of the Insured — individual or loss of capacity,
except cases stipulated in Articles 22, 23 and 24 of the Law of Ukraine "On Insurance";
4.1.6. liquidation of the Insurer under procedure established by the legislation of Ukraine;
4.1.7. judicial decision on the recognition of the Insurance Agreement void;
4.1.8. in other cases stipulated by the legislation of Ukraine.
4.2. The Agreement may be terminated prematurely at the request of the Insured or the Insurer.
4.3. The intention to terminate the Agreement shall be notified to either party at least thirty (30)
days before the date of termination.
4.4. In the event of early termination of the Agreement at the request of the Insured, the Insured
shall provide the Insurer:
4.4.1. original Insurance Agreement;
4.4.2. statement on early termination of the Agreement;
4.4.3. passport or other document that proves identity and under which the Insured (Policyholder)
crossed the border of Ukraine.
4.5. In the event of early termination of the Agreement at the request of the Insured, the Insurer
returns the premiums for the period left before the expiration of the Agreement, exclusive of the
legal costs of the case in the amount of 40 % of the insurance payment, and the actual insurance
payments made under this Agreement.
4.6. If the request of the Insured to terminate the Agreement is due to violation of the Agreement
by the Insurer, the latter returns insurance premiums paid by the Insured in full amount.
4.7. In the event of early termination of the Agreement, by requirement of the Insurer, the Insured
is returned paid insurance premiums in full amount. If the requirement of the Insurer is due to failure
by the Insured to fulfil the terms of the agreement, then the Insurer returns the premiums for the
period left before the expiration of the Agreement, exclusive of the legal costs of the case in the
amount of 40 % of the insurance payment, and the actual insurance payments made under this
Agreement. All changes and additions to the Agreement shall be made with the consent of the
Insured and the Insurer upon application of either party by entering into additional contract to
existing agreement or through renegotiation of the Agreement.
5. GENERAL EXCLUSIONS FROM INSURANCE EVENTS
5.1. Insured events are not recognized and payments are not performed under the Agreement, if
the events occurred under following conditions:
5.1.1. direct or indirect action of radiation;
5.1.2. suicide of the Insured (Policyholder), attempted suicide or intentional infliction of injuries by
the Insured (Policyholder) to oneself;
5.1.3. use of alcohol, drugs or toxic substances by him/her; At this, the state of intoxication is
determined on the basis of the consumption of alcoholic beverages in force in the host country;
5.1.4. participation of the Insured (Policyholder) in offense or fights (other than in self-defence),
mass disorders, insurrections, riots, wars, as well as service of the Insured (Policyholder) in military
structures or groups;
5.1.5. occupation of the Insured (Policyholder) during a stay abroad in any sports at the amateur or
professional level, except as provided in the Agreement, if the Agreement contains special mark and
an additional insurance premium has been paid;
5.1.6. while carrying out or at attempt of the Insured (Policyholder) to carry put illegal actions, which
are in direct causal connection with the insured event, which is set by the competent authorities;
5.1.7. putting the Insured (Policyholder) at deliberate danger, unjustified risk (except for the rescue
of life);
5.1.8. while performing by the Insured (Policyholder) of any individual of employment, unless it is
foreseen by the Agreement (Agreement has a special mark) and an additional insurance premium
has been paid;
5.1.9. while managing any vehicle by the Insured (Policyholder):
5.1.9.1. without having driver's license that is recognized valid in the host country;
5.1.9.2. under alcohol, drugs or toxic influence and in connection with the transfer of its
management to another person who was under influence of alcoholic, narcotic or toxic substances,
or a person who had no driver's license;
5.1.10. as a consequence of force majeure — due to force majeure circumstances (natural disasters,
accidents, fires, war, restrictions and / or forbidding or restrictive regulations or other acts of public
authorities, military authorities or its officials, the actions of individuals for political or terrorist
purposes, and it does not matter whether the damage caused by these actions was intentional or
accidental. In case of force majeure the period of obligations performance under the agreement is
considered to be transferred to the date of expiry of the circumstances. Upon occurrence of a force
majeure as a result of terrorist action, in cases where it was foreseen by the special conditions of
the agreement, and an additional insurance premium was paid — obligations of the parties under this
Agreement are performed under normal conditions stipulated by the Agreement, in case one of the
parties can not fulfil its obligations under the terms and within the time stipulated in the Agreement,
they shall be determined individually and with the consent of the parties set forth in additional
contract to the Agreement.
5.2. The insured persons can not be represented by:
5.2.1. duly qualified as legally incapable;
5.2.2. suffering from the following diseases: brain tumor; tumors of the spinal cord and spinal
column; nervous system in malignant tumors; brain death; trauma of the spine and spinal cord;
acute cerebrovascular accident (stroke), acute necrotizing encephalitis; patients with AIDS,
alcoholism, drug addiction, substance abuse; mentally ill; disabled of I and II groups.
5.3. The Insurer is not obligated, if at the date of signing the Agreement the Insured person had
the disability status of I or II group.
5.4. Is as a result of the insured event the insured person gets disabled status of I or II group, the
effect of this Agreement for the person stops concerning the accidents that may occur with this
person after entry into the specified status.
6. RESOLUTION OF DISPUTES 6.1. Disputes between the parties to this Agreement shall be settled by negotiation.
6.2. In case of disagreement, disputes are settled in accordance with the legislation of Ukraine.
7. OTHER CONDITIONS
7.1. Pursuant to the requirements of the Law of Ukraine "On Personal Data Protection" by
conclusion of the Agreement the Insured gives consent:
7.1.1. to process his/her personal data (any information relating to the Insured, including surname,
name, patronymic, year, month, date and place of birth, address, marital, social, financial status,
education, occupation, income, etc.) with the aim of insurance proceedings (including the conclusion
and performance of this Agreement), and/or suggesting to the Insured of the Insurer services,
including through direct contact with him/her by means of communication and implementation of
the related financial activities;
7.1.2. to decision-making by the Insurer under the processing of personal data of the Insured (in full
and/or part) in the informational (automated) system and/or in the files of personal data;
7.1.3. the Insurer has the right to perform actions with personal data that are associated with the
collection, recording, accumulation, saving, adapting, modifying, update, use and dissemination
(distribution, sale, transfer), depersonalization, destruction of information about the Insured;
7.1.4. to storage by the Insurer of its personal data for the period of Agreement validity and three
years after its termination;
7.1.5. for implementation and regulation of other relationships that require the processing of
personal data in accordance with this Agreement and effective legislation of Ukraine;
7.1.6. provision by the Insurer of access to his/her personal data to third parties is done at the
discretion of the Insurer, the transfer of the Insured personal data to third parties is made by the
Insurer without notice to the Insured.
7.2. the Insured gives to the Insurer the personal data of the Policyholders insured under the
Agreement and acknowledges that it has received approval for their distribution.
7.3. by signing this Agreement the Insured confirms that he/she is properly informed about the
inclusion of the personal data into the Insurer’s database, about his/her rights, and about the purpose
of collecting such data.
7.4. by signing this Agreement of insurance the Insured confirms that before the conclusion of this
Agreement of insurance he/she was given information provided for by the Article 12 of the Law of
Ukraine "On Financial Services and State Regulation of Financial Services Markets", the right to
information have been explained to the Insured, the nature and volume of the financial services is
clear.
CHAPTER 2. INSURANCE OF MEDICAL EXPENSES OF INDIVIDUALS ENGAGED IN
FOREIGN TRAVEL
1. SUBJECT OF AGREEMENT. INSURANCE EVENTS
1.1. The subject of the Agreement is the property interests that do not contradict the laws and are
related to the life, health and ability to work of the Insured (Policyholder).
1.2. Under the agreement, the expenses medical and other services provided to the Insured
(Policyholder) are subject to reimbursement while travelling abroad upon the occurrence of events
specified in this Agreement.
1.3. Insured event is granting to the Insured (Policyholder) in the course of his trip abroad of
medical and other services provided by paragraph 2 of Chapter 2 of this Part of the Treaty, as a
result of sudden illness or accident threatening to life and/or health of the Insured (Policyholder).
2. SERVICES, COST OF WHICH SHALL BE REIMBURSED BY THE INSURER2.1.
Services, provided by the Program A:
2.1.1.
Emergency medical care — justified first medical aid measures for the Insured
(Policyholder), as well is in critical medical conditions that threatens the life and health of the Insured
(Policyholder);
2.1.2.
Emergency Dental treatment — dental services provided to the Insured (Policyholder) for
medical reasons within the prescribed limits of liability:
2.1.2.1. In the event of acute dental pain requiring emergency dental care – the equivalent of
150 USD / EUR.
2.1.2.2. Because of an accident that requires emergency dental care — the equivalent of 300
USD / EUR.
2.1.3.
Emergency Pregnancy aid provided to the Insured (Policyholder) for medical reasons in
the event of threat to life and health of the Insured (Policyholder), provided that the period of
pregnancy of the Insured (Policyholder) was up to 28 (twenty eight) weeks;
2.1.4.
Transportation of the Insured (Policyholder) in case of clinical necessity caused by
the medical state to the nearest hospital or to the doctor, located in close proximity:
2.1.4.1. by ambulance or other vehicle (while using other, medical, vehicle — the use of such vehicle
shall be agreed with the Assistance company (the Insurer) and expenses reimbursed by the Insurer
do not exceed the equivalent of 50 USD / EUR;
2.1.4.2. by means of air ambulance with necessary medical support.
2.1.5.
Repatriation of the Insured (Policyholder) with the necessary medical support (if such
support is designated by the doctor and agreed with the Assistance company) from the location of
the person abroad to his/her place of continuous residence;
2.1.5.1. Decision on the necessity and possibility of repatriation, as well as the choice of means for
its implementation and the route, are taken by the Insurer in agreement with the Assistance
company, medical facilities and doctor of the Insured (Policyholder);
2.1.6.
Repatriation of human remains of the Insured (Policyholder) in the event of death
due to an accident or sudden illness, to his place of residence or burial (cremation) of the body of
the Insured (Policyholder) in the place of his/her location outside the country (place) of residence of
the Insured (Policyholder). All measures to provide these services are organized exclusively by the
Assistance company, in consultation with the Insurer;
2.1.6.1. Repatriation destination is determined by agreement of the Parties. In particular, it can be
an airport in the place of residence, where the coffin with the deceased shall come, or the customs
point at the place of permanent residence closest to its border.
2.1.6.2. In order to organize repatriation, the relatives of the deceased should as soon as possible
provide the Insurer with duly completed documents to prove their relationship with the Insured
(Policyholder), as well as application-confirmation of readiness to take the body of the deceased after
the coffin transportation to the customs territory of Ukraine, where the Insured (Policyholder) resides.
2.2.
Services provided by the Program B. All services provided by the Program A, and:
2.2.1.
Visit of a close relative of the Insured (Policyholder) to the location of the Insured
(Policyholder). If the Insured (Policyholder) due to an accident or sudden illness is in a medical facility
outside the country (place) of residence for a period of more than ten (10) days and his health by a
medical report is critical, the Assistance company organizes a visit of one of the closest relatives of
the Insured (Policyholder) and the Insurer pays the cost of the return ticket of such close relative
(the ticket to travel on the bus, railroad of 2
nd
class or economy class by plane) and the cost of hotel
accommodation (no more than 4 days, up to 50 euros per day). Mode of transport and route and
hotel accommodation are to be determined by the Insurer;
2.2.2.
Return before the due date of the Insured (Policyholder). If one of the closest relatives
of the Insured (Policyholder) in the place of residence of the Insured (Policyholder) has died or is in
a condition dangerous to life (if there are any documents confirming the fact and family ties with the
Insured (Policyholder), the Insurer pays for additional travel costs on return before the due date of
the Insured (Policyholder) to the country (place) of residence. This service is organized by the
Assistance company. Mode of transport and route and hotel accommodation are to be determined
by the Insurer;
2.2.3.
Evacuation of children. If the Insured (Policyholder) during a trip abroad has suffered in
an accident or due to sudden illness that requires hospital treatment, and his/her children under 16
years are travelling with him/her, the Assistance company organizes the return of children to their
place of permanent residence, and the Insurer incurs the respective travel expenses. Mode of
transport and route of return are determined by the Insurer;
2.2.4.
Replacement of the Insured (Policyholder). If the Insured (Policyholder) in a foreign
business trip has suffered in an accident or due to sudden illness that prevent realization of official
duties, the Insurer will reimburse the cost of his/her replacement by another employee in the amount
of ticket of direct connection – by bus, train (coach of 2
nd
class) or by air (economy class). Mode of
transport and route are determined by the Insurer;
2.2.4.1. Upon occurrence of insured events related to the provision of services referred to in
paragraphs 2.2.2–2.2.4 of Chapter 2 of this Agreement, the tickets of the Insured (Policyholder,
his/her children) for the return journey are to be submitted to the Assistance company. Otherwise
the Assistance company (Insurer) is entitled to refuse to provide services under paragraphs 2.2.2–2.2.4 of Chapter 2 of this Part of the Agreement.
2.2.5. Compensation cost of telephone services of the Insured (Policyholder) or person
representing his/her interests, with the Insurer (Assistance company) regarding notification of the
insured event. The maximum amount of compensation — the equivalent of 10 euros.
3. EXCLUSIONS FROM INSURANCE EVENTS FOR CHAPTER 2 3.1. The Insurer does not exercise insurance claims for expenses of the Insured (Policyholder)
associated with the provision of medical and other services:
3.1.1. medical treatment for acute condition of disease, which in the past six (6) months before the
date of travel was treated or required treatment. Exceptions are cases where aggravation of the
disease is associated with acute life-threatening condition of the Insured (Policyholder) or may result
in permanent disability. Thus, a prerequisite for compensation of medical costs by the Insurer is the
verification of the critical state of the Insured (Policyholder) by the Assistance company;
3.1.2. provision of dental care except analgesic treatment and sealing of natural teeth only in cases
specified in paragraph 2.1.2. of the Chapter 2 of this Part of the Agreement;
3.1.3. abortion (except cases where it is necessary due to accident or sudden illness) and health
services related to pregnancy, childbirth and act of delivery, starting from 28 weeks of gestation;
3.1.4. planned consultations and examinations during pregnancy, regardless of gestational age;
3.1.5. provision of treatment of nervous and mental diseases and their exacerbations, treatment of
congenital anomalies and mental disorders, convulsive states, neurosis (panic attacks, depression,
hysterical symptoms, etc.) as well as relaxation and conditions under which there is a real risk of
rapid deterioration of health;
3.1.6. treatment of sexually transmitted diseases and diseases transmitted mainly through sexual
contact (including AIDS and HIV infection and its consequences including death) and (or) all forms
of hepatitis and its consequences;
3.1.7. diagnosis and treatment of any cancer;
3.1.8. any prosthesis, including dental;
3.1.9. implementation of medical examination and medical care that is not related to sudden illness
or accident and provision of services not provided for by the paragraph 2 of the Chapter 2 of this
Part of the Agreement;
3.1.10. following the initial diagnosis, if it turns out that the diagnosis established for the Insured
person is not an insurance event, payment for rendered services and further treatment of the Insured
by the Insurer is not carried out;
3.1.11. conducting rehabilitation therapy or physiotherapy, vaccination;
3.1.12. conducting operation associated with cosmetic surgery;
3.1.13. conducting operation associated with plastic surgery;
3.1.14. prosthetics and transplantation of organs;
3.1.15. provision of medical services that are not required for the diagnosis and treatment at the
onset of sudden illness or accident;
3.1.16. conducting preventive vaccinations and disinfections, medical examination;
3.1.17. treatment of the Insured (Policyholder) by his/her relatives;
3.1.18. treatment of the Insured (Policyholder) in health resorts and / or sanatoriums;
3.1.19. acquisition and maintenance of aids (glasses, contact lenses, hearing aids, artificial limbs,
crutches, canes, etc.);
3.1.20. unconventional treatment methods;
3.1.21. treatment of diseases of blood and blood-forming organs;
3.1.22. angiography, as well as costs associated with operations on the heart and blood vessels,
including angioplasty and bypass surgery;
3.1.23. disease of skin and its appendages (including dermatitis, urticaria, erythrocyte), insect bites
and other flora and fauna that cause allergic reactions, which do not threaten the life of the Insured
person;
3.1.24. disease of ears that are not accompanied by an increase in body temperature, intoxication,
presence of fluid or pus (including sulfur plugs and complications due to hypothermia and (or) ingress
of water);
3.1.25. ARD and ARVI without hyperthermal syndrome (temperature over 38 C), and evidence
of respiratory failure of II–III levels, except for children under 16;
3.1.26. mild injury, injury of upper skin tissues that do not need emergency medical care (bruises,
scratches);
3.1.27. diseases of gastro-intestinal tract, not requiring parenteral treatment , except for children under
16 years;
3.1.28. sunstroke, sunburn and other acute changes in integument caused by exposure to ultraviolet radiation;
3.1.29. treating epidemic or pandemic diseases;
3.1.30. treatment of acute and chronic radiation sickness;
3.1.31. treatment of diseases or consequences (complications) of diseases of viral hepatitis,
tuberculosis;
3.1.32. treatment of diseases and disorders of the ear, in addition to acute diseases of the ear;
3.1.33. costs when travel was undertaken with a view to treatment;
3.1.34. artificial insemination, infertility treatment, measures to prevent pregnancy;
3.1.35. repatriation organized without the Assistance company;
3.1.36. providing facilities and services of additional comfort, including: radio, TV, and barber or
beautician services, etc.;
3.1.37. the Insurer is not obligated upon the occurrence of events specified in paragraphs 2.1. and
2.2. of Chapter 2 of this Part of the Agreement, which occurred before the start of the Agreement or
after its validity period or after the return of the Insured (Policyholder) back from trip abroad to a
place of residence as well as non-refundable are the expenses covered by the social and health
insurance, and other support;
3.1.38. the Insurer is not obligated regarding non-pecuniary damage caused to the Insured
(Policyholder) in the course of his/her trip abroad;
3.1.39. effect of the Agreement shall not apply to the territory of the permanent place of residence
of the Insured (Policyholder);
3.1.40. costs of providing services referred to in paragraph 2 of Chapter 2 of this Part of the
Agreement, and which, under the Agreement, shall be reimbursed by the Insurer, shall not exceed
the sum insured regarding reimbursement of expenses (spending limit), provided for in the
Agreement. 9
4. ACTIONS OF THE INSURED (POLICYHOLDER) UPON OCCURRENCE OF INSURANCE
EVENT
4.1. Upon occurrence of the event involving the Insured person that may be recognized as the
insured event (the need to obtain services under the Agreement), the Insured (Policyholder or a third
person representing his/her interests) is obliged, within 24 (twenty-four) hours to contact the
Assistance company or its representative by phone listed in the Agreement and submit the following
information:
4.1.1. Insurer's name, the number of this Agreement;
4.1.2. surname and the name of the Insured;
4.1.3. term of this Agreement;
4.1.4. program of insurance;
4.1.5. circumstances of the case and the nature of the required services;
4.1.6. their address and phone number.
4.2. The Insured (Policyholder) must strictly follow the instructions of the dispatcher of the
Assistance company or its representatives.
4.3. If an appeal to the Assistance company in terms envisaged by paragraph 4.1 of Chapter 2 of
this Part of the Agreement is not possible due to staying of the Insured (Policyholder) in serious
condition (accompanied by a sharp deterioration of health of the Insured (Policyholder) and causes
his/her disability to self service and requires hospitalization), the Insured (Policyholder or a third
party, representing his/her interests) should after stabilization of health, at the first opportunity to
submit the Agreement to the representatives of the medical facility that provided services to the
Insured (Policyholder) and immediately call the Assistant company or the Insurer.
4.4. If the communication with the Assistance company is not possible for any other reason and
timing than those mentioned in paragraph 4.1, 4.3 of the Chapter 2 of this Part of the Agreement
but the state of health of the Insured (Policyholder) needs to receive urgent medical care, the Insured
(Policyholder or a third person, representing his/her interests) may on one’s own appeal and pay for
received medical services, and at the first opportunity to call the Assistance company or the Insurer.
4.5. Communicating the Assistance company, provided by paragraph 4.1 of Chapter 2 of this Part
of the Agreement, shall be realized by the Insured (Policyholder) in each case when there is the need
to obtain medical or other services provided by the Agreement.
4.6. If in accordance with the general conditions of the Agreement, the term of its validity exceeds
the agreed number of days of the Insured (Policyholder) abroad (with multiple overseas trips), then
when referring to the Assistance company to obtain the services, the Insured (Policyholder) shall
submit, together with the Agreement, his/her passport for verification of the named constraint.
5. PROCEDURE AND CONDITIONS OF INSURANCE BENEFITS
5.1.
Recipients of insurance benefits are:
5.1.1. The Assistance company, which performed the costs — to the extent of the value of services
provided by the Agreement, which were granted to the Insured (Policyholder).
5.1.1.1. Procedure for payment of such insurance benefits is regulated under the assignment
contract concluded between the Assistance company and the Insurer.
5.1.2. The Insured (Policyholder) or a third person who actually made the payment for the services
received by the Insured (Policyholder) under agreement — to the extent of the expenses, if the actions
of the Insured (Policyholder) corresponded to the paragraph 4.3 of the Chapter 2 of this Part of the
Agreement and the event occurred with the Insured (Policyholder) is recognized as insurance.
Payment is made after the return of the Insured (Policyholder) from a trip abroad — through reimburse
of incurred expenses within the sum insured and limits set out in the Agreement. The Insured
(Policyholder) shall however within 15 (fifteen) days from the date of return provide the Insurer with
documents that confirm the fact, causes and circumstances of the insured event and the amount of
damages under this Agreement.
5.1.3. The Insured (Policyholder) or a third person who actually paid for the services received by the
Insured (Policyholder), if the actions of the Insured (Policyholder) corresponded to the paragraph
4.4 of the Chapter 2 of this Part of the Agreement and the event occurred with the Insured
(Policyholder) is recognized as insurance. Payment is made after the return of the Insured
(Policyholder) from a trip abroad — through reimburse of incurred expenses within the sum insured
and limits set out in the Agreement. The Insured (Policyholder) shall however within 15 (fifteen)
days from the date of return provide the Insurer with documents that confirm the fact, causes and
circumstances of the insured event and the amount of damages under this Agreement.
5.1.3.1. At this, the Insurer reimburses to the Insured person the cost of received health care and
(or) additional services and (or) purchased medicines or medical consumable materials only
in an
amount not exceeding the equivalent of U.S. $ 100 or Euro (depending on the currency in which
insurance amount is set).
5.1.4. The decision on reimbursement of other expenses made by the Insured (Policyholder) to pay
for medical services abroad, without the Assistance Company (Insurer) and for compensation of
which the Insured (Policyholder) may apply after returning from a trip, is taken at the discretion of
the Insurer, and,
in any case, can not exceed the equivalent of U.S. $ 100 or Euro (depending on
the currency in which insurance amount is set).
5.1.5. If on the date of expiry of the Agreement, the Insured (Policyholder) is still abroad and his/her
condition requires immediate medical care, but under medical examination the person is not subject
to repatriation to the country of residence, the Insurer reimburses the costs of further emergency
treatment of the Insured (Policyholder) abroad for a period of not more than fifteen (15) calendar
days, provided that such costs do not exceed the sum insured. In case of death of the Insured
(Policyholder) during the period referred to in this paragraph as a result of an insured event that
occurred during the period of the Agreement, the reimbursement of expenditures connected to the
repatriation of the body of the deceased is accepted at the discretion of the Insurer.
5.2. Time frames for taking decision to perform or deny payment of insurance benefits:
5.2.1. decision on payment or denial of insurance benefits is accepted by the Insurer within 15
(fifteen) working days from the receipt of all necessary and properly executed documents by the
Insurer;
5.2.2. insurance payment is made by the Insurer within fifteen (15) working days after the decision
on the insurance payments. The Insurer decides on the insurance payments and provides insurance
payment within the actual expenditures consistent with the Assistance company or the Insurer,
according to the official exchange rate on the date of such payment.
5.2.3. if there are reasonable doubts concerning the authenticity and completeness of the submitted
documents, the circumstances and causes of the occurrence of insured event, the Insurer has the
right to delay the decision for another thirty (30) days to fully clarify these circumstances provided it
is necessary to send a letter to the Insured (Policyholder);
5.2.4. in case of denial of insurance benefit the Insurer within five (5) working days after the decision
on denial send to the address of the Insured (Policyholder) with a written notice of the refusal and
the reasons for the refusal.
5.2.5. For receipt of insurance payment the Insured (Policyholder) or a third person representing his
interests) shall apply to the Insurer with an application for payment within 15 (fifteen) working days
from the date of return of the Insured (Policyholder) from abroad.
5.3.
List of documents confirming the occurrence of insurance event and amount of
loss, when receiving the payment of insurance benefit by persons described in paragraph
5.1.2. of the Chapter 2 of this Part of the Agreement.
5.3.1. For receipt of insurance benefits the Insurer, regardless of the Agreement conditions, shall be
provided with the following documents:
5.3.1.1. statement on occurrence of the event that can be recognized as insurance and insurance
benefit;
5.3.1.2. original Insurance Agreement;
5.3.1.3. copy of the passport of the citizen of Ukraine or another country if the Insured (Policyholder)
has another citizenship (or a copy of any other document proving the identity);
5.3.1.4. original or copy of passport with stamps of border crossing;
5.3.1.5. original or a copy of birth certificate if the Insured's age – under 16 years;
5.3.1.6. copy of identification number;
5.3.2. additionally to those specified in paragraph 5.4.1. of the Chapter 2 of this Part of the
Agreement shall be added:
5.3.2.1.
Upon receipt of medical care / services:
5.3.2.1.1. original certificate (medical report) from the medical establishment (on the letterhead
of the institution or with the appropriate stamp) indicating surname of the Insured (Policyholder),
final diagnosis, information about specific treatments and dates of conducting them;
5.3.2.1.2. originals of documents confirming payment of the treatment carried out (payment
stamp, cashier's receipt, bank receipt showing the amount of transfer, etc.);
5.3.2.1.3. recipes with seal, which shows the name of doctor, name of intended drug, pricing,
documents confirming the payment;
5.3.2.1.4. original bills for provision of specialized transport and / or other, which was used by
the Insured (Policyholder), due to sudden illness or accident;
5.3.2.2.
In case of a visit to patient in the hospital by closest relatives:
5.3.2.2.1. documented doctor's advice on the need of visiting the Insured (Policyholder);
5.3.2.2.2. documents confirming the payment of fares for closest relatives when visiting the
Insured (Policyholder);
5.3.2.2.3. documents proving the family relationship with the Insured (Policyholder).
5.3.2.3.
In case of return before the due date of the Insured (Policyholder) to the place
of residence in case of death of closest relatives of the Insured (Policyholder):
5.3.2.3.1. certificate of death of a close relative of the Insured (Policyholder);
5.3.2.3.2. documents confirming the payment of fare by the Insured (Policyholder);
5.3.2.3.3. documents proving the family relationship with the deceased insured (Policyholder);
5.3.2.4.
In case of compensation for telephone services. Telecommunications bill with the
indicated phones of the Assistance company and document confirming its payment.
5.4.
If the clauses of the Agreement envisage unconditional franchise, the insurance
payment is made with its deduction.
5.5. Upon receipt of an application for insurance payment, the Insurer reserves the right to require
translation of the documents related to the insured event (information, medical conclusions, invoices,
etc.) into Ukrainian (Russian) language at the cost of the Insured (Policyholder)or reduce the amount
of insurance premium on the value of the translation.
6. REASONS FOR REJECTION OF INSURANCE BENEFITS OR DETENTION OF
INSURANCE BENEFITS
6.1.
Grounds for refusal in paying the insurance benefits by the Insurer include the
following circumstances:
6.1.1. deliberate actions of the Insured (Policyholder) aimed at occurrence of the insured event. The
above rule does not apply to activities associated with the implementation of
his/her civil or
official duty or in a state of necessary defence (without exceeding its limits) or the protection
of property, life, health, honor, dignity and business reputation. Qualification of such actions is
realized under the legislation of Ukraine;
6.1.2. commission by the Insured (Policyholder) of intentional crime that led to the onset of damage
(loss);
6.1.3. submission by the Insured (Policyholder) of false information about the subject of the
Insurance Agreement or the fact of the insured event, especially when in the process of Agreement
drafting the Insured (Policyholder) has not provided the Insurer with information that was essential
to definition of risk (concerning occupation when making overseas travel, health of the Insured etc.);
6.1.4. the Insured (Policyholder) or a third party that represents his/her interests, did not timely
report or at all did not report the Assistance company about the necessity to apply for medical
assistance (or aid received) due to an accident or sudden illness and about the expenses that have
been made to provide the Insured (Policyholder) with medical assistance or deliberately created
obstacles to the Insurer (Assistance company) in determining the circumstances of the event, its
nature and amount of expenses upon occurrence of insured event;
6.1.5. failure to provide documents mentioned in paragraph 5.4. of the Chapter 2 of this Part of the
Agreement;
6.1.6. failure of the Insured (Policyholder) to perform his/her obligations under the Agreement
referred to in Chapter 1 of this Part of Agreement;
6.1.7. failure of the Insured (Policyholder) to perform the conditions of paragraph 4 of the Chapter
2 of this Part of the Agreement;
6.1.8. existence of circumstances specified in paragraph 5 of the Chapter 1 and paragraph 3 of the
Chapter 2 of this Part of the Agreement;
6.1.9. if it has been established that there is the fact of forgery by the Insured (Policyholder) of the
documents or deliberate distortion of the facts relating to the insured event;
6.1.10. if the Insured (Policyholder) received reimbursement for services provided to him/her from
the person responsible for causing damage to the Insured (Policyholder);
6.1.11. other cases stipulated by the legislation of Ukraine;
6.1.12. evacuation, transportation or repatriation of the Insured (Policyholder) without prior
coordination with the Assistance company and / or the Insurer;
6.1.13. breach by the Insured (Policyholder) of medical prescriptions when providing any kind of
emergency assistance to him/her and exercise of deliberate actions that led to increased of expenses
of the Assistance company (Insurer);
6.1.14. travelling abroad by the Insured (Policyholder) to obtain medical services there.
6.2.
Grounds for detention of insurance benefits by the Insurer are:
6.2.1. reasonable doubt of the Insurer as to the property interest of a person who claims to insurance
benefits: in particular, when the heir to the Insured (Policyholder), who died can not confirm his/her
status as does not have statement of inheritance;
6.2.2. initiation of criminal case by the relevant inter affairs authorities against the beneficiary of the
insurance payments – natural person and conduction of their investigation into the circumstances
that led to the damage, in the presence of illegal actions against life and health of the Insured
(Policyholder) specified in the Agreement. The question on the insurance payments is decided within
15 (fifteen) days after the expiration of the investigation (suspension, drafting the indictment, closing
the criminal case, etc.);
6.2.3. the Insurer’s reasonable doubt about the authenticity of submitted documents or
correspondence of circumstance of the incident to the signs of insurance event, or if there are other
facts that may be grounds for denial of insurance benefits. In this case, the Insurer has the right to
withhold payment of insurance for the period necessary to establish the truth about the real
circumstances of the incident, but no more than six (6) months.
6.2.4. In case of detention of insurance premium, the Insurer shall send written notice to the Insured
(Policyholder) about the reasons for detention.
7. OTHER CONDITIONS
7.1. Other terms of the agreement concerning voluntary insurance of medical expenses during the
trip abroad correspond to the Chapter 1 of this Part of the Agreement.
CHAPTER 3. ACCIDENT INSURANCE OF INDIVIDUALS ENGAGED IN FOREIGN TRAVEL
1. GENERAL PROVISIONS. SUBJECT OF INSURANCE AGREEMENT
1.1. Additional accident insurance in accordance with Chapter 3 of this Part of the Agreement is
based on the "Rules of voluntary accident insurance" of the Insurer hereinafter — Rules 2.
1.2. The subject of insurance agreement is the property interests that are not contrary to the law
relating to the life, health and ability to work of the Insured (Policyholder).
2. DEFINITIONS
2.1.
Successor of the Insured (Policyholder) — a person who receives an insurance payment
under the Agreement on the basis of documents that establishes the right of such person for an
inheritance.
2.2. The definition of "
accident" is provided in the Chapter 1 of this Part of the Agreement.
3. INSURANCE EVENT
3.1. The insurance event is the actual occurrence of the accident with the Insured
(Policyholder) during the term of the Agreement that led to the following consequences:
3.1.1. death of the Insured (Policyholder);
3.1.2. traumatic or other injuries of the Insured (Policyholder).
4. PAYMENT OF INSURANCE BENEFITS 4.1. The Insured (Policyholder) shall notify the Insurer bout the accident within three (3) working
days after returning from a trip abroad, except when:
4.1.1. due to the occurrence of the event the Insured (Policyholder, his representative) addressed
to the Assistance company for medical care;
4.1.2. following the accident the death of the Insured (Policyholder) occurred.
4.2. In case of recognition of accident as insurance event, the insurance benefit is paid to the
Insurer in such amounts:
4.2.1. in case of trauma or other bodily injury — according to the "table of Sizes of insurance benefits
in the event of traumatic or other bodily injury of the Insured person" contained in Annex 2 to Rule
2;
4.2.2. upon the occurrence of death of the Insured (Policyholder) — 100% of the sum insured.
NOTE. Payment indicated in paragraph 4.2.2 of the Chapter 3 of this Part of the Agreement is
realized exclusive of payments previously made, provided under paragraph 4.2.1. of the Chapter 3
of this Part of the Agreement, due to the occurrence of the same accident.
4.3. The Insured (Policyholder) receives insurance benefits, and upon the death of such person as
a result of the occurrence of the accident — his successor.
4.4. For receipt of insurance payment the Insured (Policyholder) or in case of death of the Insured
(Policyholder) — his successor shall provide the Insurer with the following documents:
4.4.1. statement on occurrence of the event that can be recognized as insurance and insurance
benefit;
4.4.2. original Insurance Agreement;
4.4.3. copy of the passport of the citizen of Ukraine or another country if the Insured (Policyholder)
has another citizenship (or a copy of any other document proving the identity);
4.4.4. original or copy of passport with stamps of border crossing;
4.4.5. original or a copy of birth certificate if the Insured's age – under 16 years;
4.4.6. copy of identification number.
4.5. In addition to the documents mentioned in the paragraph 4.4 of the Chapter 3 of this Part of
the Agreement shall be added:
4.5.1. in case of death of the Insured (Policyholder) — certificate of his death and successor’s
certificate of inheritance;
4.5.2. document issued by the medical authority of the host country, confirming the time when the
accident occurred, and that this event was the cause of injury to health (trauma) or death of the
Insured (Policyholder). This document may serve written notice to the Assistance company of the
occurrence of the accident with the Insured (Policyholder);
4.5.3. passport or other identification document of the Insured (Policyholder, his/her heir) – shall be
submitted personally upon receipt of insurance benefit;
4.5.4. certificate concerning giving identification number to the recipient of the insurance payment.
4.5.5. The Insurer has the right to reasonably require other documents not listed in paragraph 4 of
the Chapter 3 of this Part of Agreement if the available evidence is not enough to conclude that the
fact of the insured event have occurred.
4.6. Insurance payment is made in accordance with the Agreement on the basis of a written
statement of the recipient of the insurance benefits (the Insured, Policyholder, other person who is
entitled to receive insurance payments) and draft of the insurance act according to the form
prescribed by the Insurer.
4.7. The decision to pay or deny paying insurance benefits is accepted by the Insurer within 15
(fifteen) working days after receipt of all duly executed documents specified in paragraph 4.4 of the
Chapter 3 of this Part of the Agreement under this section.
4.8. The insurance payment is made by the Insurer within 15 (fifteen) working days after the
decision about payment. In the case of the denial of insurance benefits the Insurer within 5 (five)
working days after the decision informs the Insured (Policyholder) in writing or his successor about
refusal to pay, giving the reasons for it.
5. OTHER CONDITIONS
5.1. Other terms of the agreement concerning voluntary insurance of medical expenses during the
trip abroad correspond to the Chapter 1 of this Part of the Agreement.
CHAPTER 4. ADDITIONAL MEDICAL INSURANCE OF INDIVIDUALS ENGAGED IN
FOREIGN TRAVEL
1.GENERAL TERMS 1.1. Additional medical insurance is based on the "Rules of voluntary medical insurance (permanent
medical insurance)" of the Insurer hereinafter — Rules 4.
2. SUBJECT OF INSURANCE AGREEMENT
2.1. The subject of insurance agreement is the property interests that are not contrary to the law
relating to the life, health and ability to work of the Insured (Policyholder) and which consist in
reimbursement for medical services after the return of the person from a foreign trip if health disorder
occurred with the Insured (Policyholder) during the foreign trip.
3. CONDITIONS AND TERMS OF AGREEMENT
3.1. Insurance under this program is carried out simultaneously with the program "Insurance of
medical expenses of individuals engaged in foreign travel".
3.2. The Insured persons under this program may be only citizens of Ukraine.
3.3. The obligations of the Insurer under this program in accordance with the terms of this
Agreement, start with 00-00 hours of the day when the Insured (Policyholder) passes the border
control when entering the territory of Ukraine and continue, upon recognition of occurrence of the
insurance event with the Insured (Policyholder), till the moment the Insurer fulfils its obligations
under this program, under the terms of this Agreement in its entirety — namely, conducting insurance
payments in accordance with paragraph 6 of the Chapter 4 of this Part of the Agreement.
4. INSURANCE EVENTS
4.1. Insured event is recognized in case of occurrence of health disorder of the Insured
(Policyholder) due to sudden illness or accident, concerning which was conducted the treatment of
that person during his/her stay abroad and that require further treatment of that person after a trip
abroad and return to the place of residence.
4.2. The event specified in paragraph 4.1 of the Chapter 4 of this Part of the Agreement is
recognized as the insured event under the following conditions:
4.2.1. medical care and services to the Insured (Policyholder)during a trip abroad were given with
involvement of the Assistance company;
4.2.2. Assistance company or medical institution which is a partner have recognized the need for
additional treatment of the Insured (Policyholder) after his return to place of residence.
5. ACTIONS OF THE PARTIES UPON OCCURRENCE OF INSURANCE EVENT5.1. In the case of occurrence of an event that can be recognized as insured event under this
program, the action mentioned in paragraphs 4.1 – 4.3 of the Chapter 2 of this Part of the Agreement
shall be made.
5.2. If the health of the Insured (Policyholder) due to the occurrence of events stipulated by
paragraph 1.2 of the Chapter 2 of this Part of the Agreement requires treatment in a hospital abroad,
which can be done for a long time or costly, the Assistance company organizes the repatriation of
this person to Ukraine to continue treatment at a medical facility, defined by the Insurer. Repatriation
should be done only under the circumstances, if the state of health of the Insured (Policyholder)
allows his/her transportation, and with the consent of the Insurer for repatriation.
5.3. If, according to the Assistance company, the Insured (Policyholder) requires additional
outpatient treatment after returning to Ukraine, the Insurer organizes and pays for the associated
services, provided that medical assistance abroad was organized by the Assistance company, and
the latter controlled the course of the provision of medical services till the time of departure of the
Insured (Policyholder) from his/her location.
5.4. Copies of medical documents confirming provision of medical services to the Insured
(Policyholder) abroad and the need to continue treatment after returning to the place of residence
must be submitted to the Insurer by fax no later than 24 hours before the arrival of the Insured
(Policyholder) in Ukraine. The originals of these documents are provided to the Insurer by that person
(his/her representative) after arrival in Ukraine.
6. PAYMENT OF INSURANCE BENEFIT. LIST OF DOCUMENTS
6.1. The Insurer provides insurance payment by paying for medical services provided to the
Insured (Policyholder), medical facility, to which the Insured (Policyholder) was sent by the Insurer
to continue treatment, or directly to the Insured (Policyholder, his representative) within the sums
insured (limits) established for the program, under this Agreement.
6.2. The decision to pay or deny paying insurance benefits is accepted by the Insurer within 15
(fifteen) working days after receipt of all duly executed documents specified in paragraphs 6.4, 6.5.
Chapter 4 of this Part of the Agreement. The insurance payment is made by the Insurer within 15
(fifteen) working days after the decision about payment. In the case of the denial of insurance
benefits the Insurer within 5 (five) working days after the decision informs the Insured (Policyholder)
in writing and medical facility (if it is indicated as the recipient of insurance payments) about refusal
to pay, giving the reasons for it.
6.3. In case of conducting outpatient treatment of the Insured (Policyholder), the obligation of the
Insurer shall not apply to payment of the cost of medicines.
6.4.
For the payment of insurance benefits the Insurer shall be provided with the
following documents:
6.4.1. statement to obtain insurance payment amount;
6.4.2. originals of the documents mentioned in paragraph 5.4. of the Chapter 4 of this Part of the
Agreement;
6.4.3. medical facility report on services provided to Insured (Policyholder) — when making the
payment to medical facility;
6.5. If, with the consent of the Insurer and the Insured (Policyholder), treatment of the latter, after
his return from the trip abroad was carried out at the cost of the Insured (Policyholder or any other
person), the beneficiary of the insurance payments is the person, at whose expense the treatment
was carried out. At this, in addition to the documents mentioned in paragraphs 6.4.1., 6.4.2. of the
Chapter 4 of this Part of the Agreement, the Insurer shall be also provided with:
6.5.1. document that identifies the recipient of insurance benefits (passport, military ID, temporary
identification of citizen of Ukraine, etc.) – in case of insurance payment in cash at the cash desk of
the Insurer;
6.5.2. certificate ascribing identification number to the recipient of the insurance payments;
6.5.3. medical certificate of medical facility with a list of medical services and medicines prescribed
because of injury to health of the Insured (Policyholder);
6.5.4. fiscal receipt (cash receipt) for payment of the cost of medical services received by the Insured
(Policyholder) (in the absence of names of purchased medicines in fiscal check, an additional receipt
shall be provided);
6.5.5. doctor's prescription with a personal stamp;
6.5.6. in case of additional purchase of medications (medical supplies) during treatment of the
Insured (Policyholder) in inpatient facilities, the recipient of insurance benefit additionally provides
an extract from the clinical record of the Insured (Policyholder), the list of designated medications
(medical supplies) required for the intended treatment.
6.6. The overall size of insurance payment may not exceed:
6.6.1. 40% of the sum insured – in case of outpatient treatment of the Insured (Policyholder);
6.6.2. 100% of the sum insured — in case of hospitalization of the Insured (Policyholder).
6.7. The Insurer is released from the obligation to organize and pay for medical services of the
Insured (Policyholder) after his/her return to Ukraine (make an insurance payment) in the following
cases:
6.7.1. medical treatment abroad was provided to the Insured (Policyholder) without involvement of
the Assistance company;
6.7.2. The Insured (Policyholder) during his/her stay abroad has not complied with requirements of
medical facilities where the services were provided;
6.7.3. The Insured (Policyholder) appealed to the Insurer regarding receipt of additional health
services not later than three (3) days after return from a trip abroad;
6.7.4. The Insurer was not provided medical records of medical services provided to the Insured
(Policyholder) and documents that confirm the need for continuation of treatment of the Insured
(Policyholder) after his return from a trip abroad. This condition does not apply to the case where
the part of the relevant documents was not given due to the fault of the Assistance company.
7. OTHER CONDITIONS
7.1.1. The conditions of additional medical insurance, which are not defined in paragraphs 1, 6 of
the Chapter 4 of this Part of the Agreement, shall be regulated in accordance with Rule 4 and
legislation of Ukraine.
7.1.2. Limitation and exclusions from insurance events, under the terms of the program, are fully
consistent with the similar terms for the program of medical expenses insurance referred to in
Chapter 2 of this Part of the Agreement.
7.1.3. Other conditions of this Agreement regarding additional voluntary medical insurance of
persons engaged in foreign trips correspond to Chapter 1 of this Part of the Agreement.
CHAPTER 5. FOREIGN TRIP’S CANCELLATION INSURANCE
1.
GENERAL TERMS
1.1. Voluntary insurance of financial risks associated with the cancellation of a trip abroad, in
accordance with Chapter 5 of this Part of the Agreement is based on the "Rules of voluntary insurance
of financial risks" of the Insurer, hereinafter — Rules 3.
2. SUBJECT OF INSURANCE AGREEMENT
2.1. The subject of insurance agreement is the property interests that are not contrary to the law
relating to the life, health and ability to work of the Insured (Policyholder) which are necessary for
the implementation of the Insured’s (Policyholder’s) planned a trip abroad.
3. INSURANCE RISK. INSURANCE CASE
3.1. The insurance risk is probable occurrence of loss of the Insured (Policyholder) due to the
inability of realizing the trip abroad planned by the Insured (Policyholder).
3.2.
The insured event is the actual occurrence of loss the Insured (Policyholder) caused due to
the inability of realizing the trip abroad by hi/her, resulting in the Insurer's obligation to make an
insurance payment.
3.3. The onset of loss of the due to the inability of realizing the trip abroad, which was caused by
the inability to exercise his scheduled trip abroad is recognized as insurance event if the imability of
the Insured (Policyholder) to realize the trip is associated with the following events:
3.3.1. sudden illness, accident or death, which occurred with the Insured (Policyholder);
3.3.2. sudden illness, accident or death that occurred with one of the closest relatives of the Insured
(Policyholder);
NOTE. The circle of persons identified as the closest relatives the Insured (Policyholder) shall be
defined in accordance with p. 1.20. of the section "Definitions" of Chapter 1 of this Part of the
Agreement;
3.3.3. receipt of summons by the Insured (Policyholder), according to which he/she should be
involved in the court proceedings, or the decision of the internal affairs bodies to limit the rights of
the Insured (Policyholder) in terms of the freedom of travel due to the opening of a criminal case;
3.3.4. refusal of the Insured (Policyholder) from the trip abroad, associated with the damage to the
part of the person's personal property due to fire, natural disaster, accident of water supply, heating,
or sewerage, road traffic accidents and malicious acts of third parties;
NOTE. The occurrence of such damage is considered to be insurance event if the amount of damage
caused to the Insured (Policyholder) exceeds by more than two (2) times the size of the financial
losses associated with the cancellation of that trip abroad. At this, the amount of damages referred
to in the first paragraph of this subsection shall be not less than the equivalent of 2,000 (two
thousand euros) in hryvnas under at the official exchange rate on the date of occurrence of losses;
3.3.5. missed departure of the Insured (Policyholder) for plane, train, boat or bus, due to delay in
arrival of intercity or commuter vehicle. At this, the expected time of arrival of this vehicle (under
normal conditions) must differ by at least half an hour from the time of departure of the vehicle for
onward travel of the Insured (Policyholder);
3.3.6. events specified in paragraph 3.3. of the Chapter 5 of this Part of the Agreement are
recognized as insurance events if they occured (or the Insured (Policyholder) became aware of them
during the term of the Agreement, under which the Insurer is bound by the risk specified in paragraph
3.1 of the Chapter 5 of this Part of the Agreement.
4. CONDITIONS AND TERMS OF AGREEMENT
4.1. The agreement under this program is entered into in conjunction with the program "Insurance
of medical expenses of individuals engaged in foreign travel" for the period of his/her trip abroad not
later than fourteen (14) calendar days prior to the start of the scheduled trip abroad.
4.2. This program is for insurance of persons aged from 1 year to 60 years at the moment of
concluding the Agreement.
4.3. According to this Agreement under this program the Insurer has an obligation during the
Insured’s (Policyholder’s) single trip abroad, starting from 00-00 hours of the day following the date
of payment of the insurance premium, up to the moment of crossing the border control by the
Insured (Policyholder) at the exit from the territory of Ukraine.
5. EXCLUSION FROM INSURANCE EVENTS
5.1. In addition to Chapter 1 of this Part of the Agreement, the Insurer shall be exempt from the
obligation to make indemnity payments under this program, if the events that led to the cancellation
of the Insured’s (Policyholder’s) trip abroad, have occurred as a result of:
5.1.1. alcoholic, narcotic or toxic poisoning of the Insured (Policyholder) or one of his closest relatives
(except case when this condition was caused by malicious actions of third parties);
5.1.2. exacerbation of chronic diseases and the onset (cases) of mental illnesses of the Insured
(Policyholder) or one of his closest relatives;
5.1.3. complications related to pregnancy of the Insured (Policyholder), except emergence of a direct
threat to the life of the Insured (Policyholder) if the term of her pregnancy is up to 28-weeks;
5.1.4. planned hospitalization of the Insured (Policyholder) or one of its closest relatives.
6. ACTIONS OF THE PARTIES UPON OCCURRENCE OF LOSSES
6.1. The Insured (Policyholder) shall notify the Insurer in writing of the event which caused the
failure of the Insured (Policyholder) to perform the trip abroad and may be recognized as an
insurance event, within one (1) working day from the time of its occurrence, or moment when the
Insured (Policyholder) received the news of this event, and to take all possible actions to reduce the
size of the losses that occurred as a result of cancellation of the planned trip, such as:
6.1.1. if the agreement was concluded with STA, to cancel (terminate) the agreement of tourist
services under the terms defined by such Agreement with STA;
6.1.2. if the trip was to be made by the Insured (Policyholder) for his/her own account or for the
account of the third parties, to make every possible action to cancel the planned visit and return
costs (partially) for trip, such as: return cost (partially) of the ticket for the vehicle to travel to
destination place and back to the country of residence; return cost (partially) of booking and
accommodation in the country of temporary stay.
6.2. The Insurer has the right to refuse to refund that part of the damage which was caused by
the complete or partial failure to perform duties of the Insured (Policyholder) specified in paragraph
6.1.1–6.1.2. of the Chapter 5 of this Part of the Agreement.
7. PROCEDURE AND CONDITIONS OF INSURANCE BENEFITS 7.1. Under this program such property damages shall be reimbursed that has occurred as a result
of inability to exercise by the Insured (Policyholder) of trip abroad for reasons set out in paragraph
3.3. of the Chapter 5 of this Part of the Agreement:
7.1.1. monetary amount that is deducted by STA in the event of termination of the contract on
provision of tour to the Insured (Policyholder) in accordance with the agreement of insurance. At
this, the amount of insurance compensation can not exceed the total cost of the tour.
7.1.2. amounts of money spent by the Insured (Policyholder) for foreign travel for its own account
or for the account of a third party and are not returned by the relevant institutions and organizations
in the case of cancellation of the trip, such as:
7.1.2.1. visa application costs;
7.1.2.2. costs (partial cost) of the ticket for a vehicle to travel to the destination and return to the
country of residence that is not returned by the transport organization in the case of cancellation of
the trip;
7.1.2.3. costs (partial cost) of booking and accommodation in the host country.
7.1.3. The total amount of insurance benefit can not exceed the insured amount, equivalent of which
is calculated in hryvnas, under the official exchange rate of the National Bank for the currency, in
which the insured sum is defined, as of the date, from which the Insurer shall be obliged under the
Agreement in accordance with the paragraph 4.3 of the Chapter 5 of this Part of the Agreement.
7.2. In order to receive insurance benefits, the Insurer must be submitted the following documents:
7.2.1. statement of the Insured (Policyholder) for insurance payment. If such application is submitted
by the heir to the Insured (Policyholder), a copy of the death certificate of the Insured (Policyholder)
and a copy of the certificate of the heir to the inheritance shall be attached;
7.2.2. for reimbursement of amounts specified in paragraph 7.1.1 of the Chapter 5 of this Part of the
Agreement — a copy of the travel vouchers purchased by the Insured (Policyholder) and financial
documents that certify the amounts paid by tourists and returned to STA after the termination of the
provision of tourism services;
7.2.3. for reimbursement of amounts specified in paragraph 7.1.2 of the Chapter 5 of this Part of the
Agreement — documents confirming the total amount of expenses of the Insured (Policyholder) for
the trip abroad, and the partial return of these funds to the said person in case of cancellation of the
trip;
7.2.4. in case of deterioration in health of the Insured (Policyholder) – certificate of medical
institution bearing the seal and signature of the head, concerning the presence of contraindications
for the person to exercise this trip abroad. In this case, the certificate must indicate the date when
these contraindications have emerged; in case of death of the Insured (Policyholder) — copy of his/her
death certificate;
7.2.5. deterioration in the health of closest relatives of the Insured (Policyholder) — certificate of
medical institution bearing the seal and signature of the head, concerning existence of serious health
condition of a relative and the need for his/her treatment in inpatient medical facility or permanent
care at home. In this case, the certificate must indicate the date when these complications have
emerged;
7.2.6. death of a closest relative of the Insured (Policyholder) — copy of his/her death certificate;
7.2.7. in case of refusal from the trip abroad by the Insured (Policyholder) because of receipt of
summons or decision of the internal affairs bodies — copies of relevant documents;
7.2.8. in case of causing damage to the property of the Insured (Policyholder) — a certificate from
the competent authorities (fire brigade, housing offices, police, etc.) with respect to the reasons for
the occurrence of losses and their size. The latter may be determined by agreement of the parties
of the Agreement (in particular, using independent experts);
7.2.9. in case of late arrival of the Insured (Policyholder) — information of the transport organization
about the expected and actual time of arrival of the vehicle to go to the airport, railway station, bus
station or passenger port in the country of residence, where the Insured (Policyholder) was to
continue travelling abroad;
7.2.10. document that identifies the individual – recipient of insurance benefits, namely passport
or military ID or temporary ID card of the citizen of Ukraine or residence permit in Ukraine or refugee
certificate;
7.2.11. certificate of identification number of the payer of income tax (submitted by an individual — the recipient of the insurance premiums);
7.3. documents specified in paragraph 7.2 of the Chapter 5 of this Part of the Agreement are
provided to the Insurer in the form of originals or certified copies or copies certified by the
organization that issued the relevant document or simple copies, subject to an opportunity of
verification of the copies with the originals copies by the Insurer.
7.4. If documents specified in paragraph 7.2 of the Chapter 5 of this Part of the Agreement are
provided to the Insurer in not proper form or are issued in violation of existing rules (absence of
number, date, stamp, there are corrections in the text, etc.), the insurance payment is not made
until these shortcomings are eliminated.
7.5. The decision to pay or deny in paying insurance benefits is accepted by the Insurer within 15
(fifteen) working days after receipt of all duly executed documents specified in paragrapg 7.2 of the
Chapter 5 of this Part of the Agreement, according to this section. The insurance benefit is paid to
the Insurer within 15 (fifteen) working days after the decision about payment is taken. In case of
denial to pay insurance benefits, the Insurer within 5 (five) working days after taking decision shall
notify in writing the Insured (Policyholder) and medical facility (if it is defined as a beneficiary of the
insurance benefit) about refusal to carry out payment, indicating the reasons for refusal.
8. GROUNDS FOR DENIAL OF INSURANCE BENEFITS ARE: 8.1. deliberate actions of the Insured (Policyholder) aimed at occurrence of the insured event. The
above rule does not apply to activities associated with the implementation of his/her civil or official
duty or in a state of necessary defence (without exceeding its limits) or the protection of property,
life, health, honor, dignity and business reputation. Qualification of such actions is realized under the
legislation of Ukraine;
8.2. commission by the Insured (Policyholder) of intentional crime that led to the onset of damage
(loss);
8.3. submission by the Insured (Policyholder) of false information about the subject of the
Insurance Agreement or the fact of the insured event;
8.4. late notification about the insured event without valid reason or creation of interference for
the Insurer in determining the circumstances and the nature and size of losses;
8.5. getting by the Insured (Policyholder) of full compensation from the person guilty of causing
them. If the loss is compensated in part, the payment of insurance claim is realized exclusive of
amounts received as compensation for inflicted loss;
8.6. existence of circumstances specified in paragraph 5 and paragraph 6.2 of the Chapter 5 of
this Part of the Agreement and paragraph 5 of the Chapter 1 of this Part of the Agreement;
8.7. deliberate failure to take reasonable and available measures provided for in paragraph 6 of
the Chapter 5 of this Part of the Agreement;
8.8. complete or partial failure of the Insured (Policyholder) to fulfil his/her duties under this
Agreement;
8.9. complete or partial failure to provide the Insurer with the documents mentioned in paragraph
7.2 of the Chapter 5 of this Part of the Agreement;
8.10. Others cases stipulated by the legislation of Ukraine.
9. OTHER CONDITIONS
9.1. Others conditions of the Agreement regarding the foreign trip’s cancellation insurance
correspond to the Chapter 1 of this Part of Agreement.
CHAPTER 6. FINANCIAL RISKS DURING TRIPS ABROAD
1. GENERAL TERMS 1.1. Voluntary insurance under this Chapter of Agreement, is based on the "Terms of voluntary
financial risks insurance" of the Insurer, hereinafter — Rule 3.
2. SUBJECT OF INSURANCE AGREEMENT
2.1. The subject of insurance agreement is the property interests that are not contrary to the law
and relating to the possession, use and disposal of funds of the Insured (Policyholder) during the
Insured's trip abroad.
3. INSURANCE RISKS. INSURANCE EVENTS
3.1. The insurance risk is the probability of occurrence during the term of this Agreement of the
events specified in paragraph 3.2. of the Chapter 6 of this Part of Agreement that do not fall under
the exclusions and limitations of insurance and which result in the direct loss or missed profit by the
Insured (Policyholder) and during the onset of which the liability of the Insurer for compensation of
caused losses shall appear.
3.2. The insurance event is the actual occurrence during the term of this Agreement of the events
set forth below resulting in the direct loss or missed profits of the Insured (Policyholder):
3.2.1. postponement or cancellation of a flight for more than four (4) hours;
3.2.2. delayed baggage delivery for more than four (4) hours beyond standard time of waiting for
baggage arrival in airport;
3.2.3. baggage loss, damage or destruction at a time when the airline was responsible for the
carriage of baggage;
3.2.4. loss or theft of such documents of the Insured (Policyholder) in the place of temporary
residence:
3.2.4.1. passport;
3.2.4.2. travel document;
3.2.4.3. banking card;
3.2.4.4. driving license, certificate of registration of a vehicle owned by the Insured (Policyholder)
on property rights, full economic ownership, operational control or on other legal grounds (lease
agreement, orders, etc.).
4. EXCLUSION FROM INSURANCE EVENTS AND RESTRICTIONS OF INSURANCE 4.1. In addition to the exclusions and limitations of insurance events referred to in paragraph 5 of
the Chapter 1 of this Part of the Agreement, the insurer will not reimburse services related
inconveniences of use of air transport in the case of postponement or cancellation of flight if:
4.1.1. the Insured (Policyholder) did not pass the registration, except in cases where it was not
possible to pass it due to announcement of strike or for technical reasons;
4.1.2. delayed flight was the result of a strike or technical reasons, are the Insured (Policyholder)
was notified prior to registration;
4.1.3. the Insured (Policyholder) refused to fly before departure of his/her airplane.
4.1.4. the Insurer will not reimburse expenses related to inconvenience of use of air transport in case
of delays in baggage delivery if:
4.1.4.1. baggage is carried by the flight, the ultimate destination of which is the place of residence
of the Insured (Policyholder);
4.1.4.2. damage of baggage, if the baggage was transported without relevant packaging (blockage)
of baggage or sending baggage in damaged condition;
4.1.4.3. damage or destruction of baggage caused by any liquids that may be transported in
baggage;
4.1.4.4. the Insured (Policyholder) did not inform the authorised representative of the air carrier of
the delay in delivery or loss of baggage;
4.1.4.5. baggage of the Insured (Policyholder) delayed due to customs inspection;
4.1.5. the Insurer will not reimburse the Insured (Policyholder) for services related to the
inconveniences of use of air transport, in the case of baggage loss, damage or destruction which
occurred due to confiscation and / or destruction of baggage by customs authorities or other
government officials at the place of temporary residence;
4.1.6. the Insurer will not reimburse the cost of lost documents of the Insured (Policyholder), namely:
personal, administrative and business records (including commercial or scientific materials), traveler's
checks, airline and train tickets, securities, coupons for payment of fuel, cash, etc.
4.1.7. the Insurer will not reimburse document recovery for the Insured (Policyholder) in case of:
confiscation of documents by government officials at the place of temporary residence;
4.1.8. failure of the Insured (Policyholder) to inform the relevant services about the lost (lost, stolen)
documents, and the failure of the Insured (Policyholder) to submit relevant application about loss of
documents;
4.1.9. the Insurer will not indemnify damages to the Insured (Policyholder), resulting from the
unlawful realization of transactions by third party using lost or stolen banking card of the Insured
(Policyholder);
4.1.10. the Insurer will not reimburse the cost of documents replacement, if such change is due to
their damage, leading to the possibility of using the documents as intended.
5. ACTIONS OF THE INSURED (POLICYHOLDER) UPON THE OCCURRENCE OF EVENTS
THAT HAS FEATURES OF INSURANCE EVENTS 5.1. When an event occurs that has signs of an insurance event, the Insured (Policyholder) shall,
within 24 hours:
5.1.1. apply to the Specialized service of the Insurer (Assistance) or to the Insurer by phone specified
in the Insurance Agreement and get information as to the following actions and report about the
incident that has occurred.
NOTE. If the Insured (Policyholder) must urgently make payment and it is impossible to notify about
it, such message shall be conveyed to the Specialized service of the Insurer (Assistance) or to the
Insurer as soon as possible but no later than within 24 hours upon its occurrence. Such notice may
be delivered by any person acting on behalf of the Insured (Policyholder).
5.1.2. It is necessary to notify the Insurer or Specialized service of the Insurer (Assistance) about:
5.1.2.1. number of the Insurance Agreement and its validity, the title insurance company (when
appealing Assistance);
5.1.2.2. surname and the name of the Insured (Policyholder);
5.1.2.3. territory (location) of validity of the Insurance Agreement;
5.1.2.4. description of the event that occurred, and the nature of the required services;
5.1.2.5. exact location of the Insured (Policyholder), contact phone number.
5.1.3. Upon appeal to the Insurer or Specialized service of the Insurer (Assistance), to carry out their
recommendations for further actions. At the request of the Insurer or Specialized service of the
Insurer (Assistance) an insured person must submit his/her documents to prove his/her identity.
5.1.4. To confirm the term of his/her location in the place of temporary stay by documents, to provide
a passport or other document confirming this fact.
5.1.5. To take measures to prevent and reduce damages caused as a result of an event that has
features of insurance event.
6. LIST OF DOCUMENTS CONFIRMING THE FACT OF OCCURRENCE OF THE
INSURANCE EVENT AND THE AMOUNT OF DAMAGE
6.1. In order to receive insurance benefits the Insurer, regardless of the Agreement conditions,
shall be provided with the following documents:
6.1.1. statement on occurrence of the event that can be recognized as insurance and insurance
benefit;
6.1.2. Insurance Agreement;
6.1.3. copy of the passport of the citizen of Ukraine or another country if the Insured (Policyholder)
has another citizenship (or a copy of any other document proving the identity);
6.1.4. original or copy of passport with stamps of border crossing;
6.1.5. original or a copy of birth certificate if the Insured's age – under 16 years;
6.1.6. copy of identification number;
6.2. In addition to the documents mentioned in the paragraph 6.1. of the Chapter 6 of this Part of
the Agreement shall be added:
6.2.1.
in case of flight or baggage delay:
6.2.1.1. documents confirming such delay for some time (mark on the ticket, certificate from the
airport or airline etc., indicating the exact time of delay and the reasons for delay).
6.2.2.
in case of lost luggage:
6.2.2.1. documents proving the loss of registered baggage and weight of luggage (certificate from
the airport or airline etc.);
6.2.3.
in case of loss or theft of documents specified in paragraph 3.2.4 of the Chapter 6 of this Part
of the Agreement and receipt of temporary documents:
6.2.3.1. bills, receipts, checks, etc., confirming the provision of services to the Insured (Policyholder)
related to the replacement of lost documents (the lack of which makes it impossible to return for the
Insured (Policyholder) to the country of permanent residence.
6.3. The documents, referred to in paragraphs 6.1.– 6.2. of the Chapter 6 of this Part of the
Agreement, are provided to the Insurer in the form: originals; notarized copies; simple copies
certified by body/organization that issued the relevant document, or simple copies provided if the
Insurer has the possibility of verification with original copies.
7. PROCEDURE AND CONDITIONS OF INSURANCE BENEFITS
7.1. Terms for taking decision about payment or refusal to pay insurance benefits.
7.2. For receipt of insurance payment the Insured (Policyholder) shall apply to the Insurer with an
application for payment and provide the documents mentioned in paragraphs 6.1.– 6.2. of the
Chapter 6 of this Part of the Agreement within 15 (fifteen) working days from the date of return of
the Insured (Policyholder) from abroad.
7.3. The decision on payment or denial of insurance benefits is accepted by the Insurer within 15
(fifteen) working days from the receipt by the Insurer of all necessary and properly executed
documents referred to in paragraphs 6.1.– 6.2. of the Chapter 6 of this Part of the Agreement.
7.4. The insurance payment is made by the Insurer within fifteen (15) working days after the
decision on the insurance payments, according to the official exchange rate on the date of the
insurance event.
7.5. If there are reasonable doubts concerning the authenticity and completeness of the submitted
documents, the circumstances and causes of the occurrence of insured event, the Insurer has the
right to delay the decision for another thirty (30) days to fully clarify these circumstances provided it
is necessary to send a letter to the Insured (Policyholder).
7.6. In case of denial of insurance benefit the Insurer within five (5) working days after the decision
on denial send to the address of the Insured (Policyholder) with a written notice of the refusal and
the reasons for the refusal.
7.7.
The amount of insurance payment shall be determined as follows:
7.7.1. in case of flight and/or baggage delays — the equivalent of ten (10 euros) for each full hour of
delay starting from the fifth but not more than the equivalent of 150 euros. At this, the insurance
payment is not counted for less than an hour delay;
7.7.2. in case of loss of baggage — the equivalent of twenty (20 euros) per kilogram of lost luggage,
but not more than the equivalent of 300 euros;
7.7.3. in case of loss or theft of documents specified in paragraph 3.2.4. of the Chapter 6 of this Part
of the Agreement — the actual amount of documented expenses to obtain temporary documents, but
not more than the equivalent of 200 euros;
7.8. Grounds for delay in payment of insurance benefits by the Insurer are as follows:
7.8.1. reasonable doubts of the Insurer about the authenticity of submitted documents or
correspondence of the circumstances to the signs of insurance event, or if there are other facts that
may be the ground for denial in payment of insurance benefits. In this case, the Insurer has the right
to withhold payment of insurance for the period necessary to establish the truth about the real
circumstances of the event, but no more than six (6) months.
7.9. In case of delay in the payment of insurance benefits, the Insurer shall send to the Insured
(Policyholder) written notice about it, indicating the reasons for detention.
8. OTHER CONDITIONS 8.1. Other terms of the Agreement concerning voluntary insurance of financial risks during the trip
abroad correspond to the Chapter 1 of the Part 2 of the Agreement.