Completed accident insurance contract. Sample personal accident insurance contract. Subject of the agreement. general provisions

Often on TV or on the Internet you can hear reports that a celebrity has insured himself or some part of his body for a sensational amount. You can follow the example of the stars by concluding an agreement personal insurance.

What is personal insurance

Personal insurance differs from other types of insurance only in that the object of insurance is the person himself, his health and the possibility of its loss. Otherwise, a personal insurance contract is not much different from other insurance contracts.

The insurer is a special organization that has state permission to conduct insurance activities; the policyholder can either be the citizen himself or be insured by someone else, for example, an employer insures the health of a subordinate.

What is covered under personal insurance?

If a citizen has reason to fear for his life due to certain circumstances, life insurance is possible. Although the offensive insured event extremely undesirable for the insured person, since payments will be appropriate in the event of death. But this type of insurance allows you to take care of loved ones in the event of a tragedy, appointing them as recipients of insurance compensation under the contract. This type of insurance contract would be appropriate to conclude for citizens working in potentially hazardous industries, or on duty, risking their lives.

Insurance for loss of health due to accident. That is, in case of certain consequences or accidents in which loss of health occurs, the insurance company compensates for the damage. It is this type of personal insurance that sometimes causes heated discussions, for example, when a famous football player insures his legs against injuries for huge sums.

Finally, another type of personal insurance, known to almost everyone - medical insurance in case of loss of performance. In case of illness, the insurance company will pay the expenses spent on restoring health to the insured citizen. We recommend that everyone conclude such an insurance contract, especially now, during the period of exacerbation of diseases. The benefits of such an agreement are quite high. With a correctly concluded contract, you can undergo treatment in a paid and quite expensive clinic, the costs of treatment will be borne by the insurance company, or it will reimburse the costs you have incurred.

It should be noted that tourists should not neglect personal insurance. Treatment in another country is sometimes very expensive and exceeds the amount that the average traveler can afford. Get insured, and the insurance company will pay for your health restoration, not you out of your own pocket.

Below is located standard sample and a personal insurance contract form, a version of which can be downloaded for free.

city ​​________________ "___"__________ ____ city _______________________________________, license N __________, issued by (name) _____________________________________, hereinafter referred to as "Insurer", (name of body) represented by ___________________, acting__ on the basis of _____________________, (position, full name .) (Charter, power of attorney, etc.) on the one hand, and ______________________________________________________________ (full name of citizen, name of organization) represented by ___________________, acting on the basis of _____________________, (position, full name) ( Charter, power of attorney, etc.) hereinafter referred to as ____ "Policyholder", on the other hand, have entered into this Agreement as follows:

1. THE SUBJECT OF THE AGREEMENT. GENERAL PROVISIONS

1.1. Under this Agreement, the Insurer undertakes, upon the occurrence of one of the insured events stipulated in the Agreement in relation to the person specified in clause 1.2 of the Agreement (hereinafter referred to as the “Insured Person”), to pay the Insured person the insurance amount and pay for medical care in the amount provided for in the Agreement, and the Policyholder undertakes to pay insurance premium in size, order and timing, provided for by the Treaty.

1.2. The insured person is ____________________________.

1.3. Genuine contract concluded in accordance with Insurance Rules No. ___, approved by the Insurer (option: Association of Insurers __________) (hereinafter referred to as the “Insurance Rules”).

2. INSURED EVENTS. RIGHTS AND OBLIGATIONS OF THE PARTIES

2.1. The following events occurring during the validity period of the Agreement are recognized as insured events under this Agreement:

a) temporary loss of general working capacity by the Insured person for more than ________ days, resulting from an accident;

b) permanent loss of general working capacity by the Insured person resulting from an accident;

c) death of the Insured person resulting from an accident.

An accident means _____________________________.

2.2. The events provided for in clause 2.1 of this Agreement are not recognized as insured events if they occur:

a) as a result of the commission by the Policyholder or the Insured person of an intentional act (action or inaction) resulting in the death of the Insured person or the loss of general working capacity by the Insured person, except for the case specified in clause 2.3 of this Agreement;

b) as a result of exposure to a nuclear explosion, radiation or radioactive contamination;

c) as a result of military operations, as well as maneuvers or other military activities;

d) as a result of civil war, popular unrest of any kind or strikes;

e) management of the Insured person vehicle in a state of alcoholic, narcotic or toxic intoxication or transferring control to a person who is in a state of alcoholic, narcotic or toxic intoxication, or to a person who does not have a license to drive this vehicle.

2.3. The death of the Insured person as a result of suicide is not considered an insured event if at the time of death this Agreement had been in force for less than two years.

2.4. The Insurer is obliged to issue an insurance policy to the Policyholder or the Insured Person within _____ days from the date of conclusion of this Agreement.

2.5. In case of loss by the Insured person during the validity period of this Agreement insurance policy based on a written application, he is issued a duplicate of the policy. After a duplicate is issued, the lost policy is considered invalid and insurance payments on it are not made.

2.6. The policyholder has the right to receive information from the Insurer regarding his financial stability and is not a trade secret.

2.7. The Policyholder and the Insured Person are obliged to immediately notify the Insurer of any illnesses of the Insured Person that have become known to them, a change of job and other circumstances that may affect the possibility of the occurrence of insured events.

2.8. The insured person and his heirs have the right to make the same claims against the Insurer as the Policyholder.

2.9. When the Insured Person, as well as his heirs, submit claims for payment of the insurance amount, the Insurer has the right to demand from them the fulfillment of obligations under this Agreement that lie with the Policyholder, but were not fulfilled by him. The risk of consequences of non-fulfillment or untimely fulfillment of obligations is borne, accordingly, by the Insured Person.

2.10. The insured person has the right, within _____ (at least three) years from the date of expiration of the insurance period, to receive from the Insurer the insurance amount stipulated by the Contract.

If it is determined that premiums have not been paid for any months of the last three years of the Insurance Contract, they will be deducted from the sum insured.

In the event that the premiums were paid in a smaller amount than it should have been, based on the age of the Insured person on the day of submitting the application for insurance, the sum insured and the period of insurance, total amount shortfalls in premiums for the entire insurance period are withheld upon payment of the insured amount. If premiums were paid in a larger amount than they should have, then the excess premiums received are returned to the Policyholder simultaneously with the payment of the insured amount.

3. INSURANCE PREMIUM

3.1. The insurance premium payable by the Insured under this Agreement is ___________________ (______________) rubles.

3.2. The insurance premium is paid by the Insured in installments in the following order: monthly no later than the _____ day of each month for _______ months in equal installments of _________ (indicate the amount of the installment).

3.3. The policyholder has the right at any time to pay the entire remaining portion of the premium or to pay sums of money towards subsequent premium payment periods.

3.4. The insurance premium is paid by the Insured by transfer Money to the Insurer's bank account or by depositing cash into the Insurer's cash desk.

3.5. If the insured event occurs before the payment of the next insurance premium, the payment of which is overdue, the Insurer has the right to set off the amount of the overdue insurance premium when determining the amount of the insurance amount payable.

4. SUM INSURED

4.1. Upon the occurrence of an insured event provided for in subparagraph. "a" clause 2.1 of this Agreement, sum insured is established in the amount of __________ (____________________) rubles for each day of loss of ability to work until its restoration, but for no more than _____________ (____________________) rubles.

4.2. Upon the occurrence of an insured event provided for in subparagraph. "b" clause 2.1 of this Agreement, the insurance amount is set at ___________ (________________) rubles in the event of a complete loss of general ability to work.

In case of partial permanent disability, the insurance amount is established as a percentage of the insurance amount in case of complete loss of general ability to work, corresponding to the degree of disability in accordance with the Insurance Rules.

4.3. Upon the occurrence of an insured event provided for in subparagraph. "c" clause 2.1 of this Agreement, the insurance amount is set in the amount of _________ (__________________) rubles.

4.4. Upon the occurrence of an insured event provided for in subparagraph. "a" and "b" clause 2.1 of this Agreement, the Insurer is obliged to pay the insured person the insured amount within _____________ after receiving and drawing up all necessary documents specified in this Agreement.

4.5. In the event of the death of the Insured person who did not manage to receive the insurance amount due to him, payment of the insurance amount is made to his heirs.

4.6. Upon the occurrence of an insured event, the Insurer is obliged to pay for medical care to the Insured person in the amount of no more than __________ (___________________) rubles.

4.7. Payment medical care is made to the Insured Person within ________ after receipt and preparation of all necessary documents specified in this Agreement.

4.8. If, as a result of an accident that previously resulted in temporary or permanent loss of general ability to work, permanent loss of general ability to work or death subsequently occurs, respectively, the Insurer is obliged to pay the insured amount for these insured events, taking into account the previously paid, as well as pay for medical care.

4.9. The insured person upon the occurrence of an insured event provided for in sub. “a” and “b” of clause 2.1 of this Agreement are represented by:

b) application for payment of the insurance amount;

c) identification document;

d) a document issued by the competent authority confirming loss of ability to work, or a certified copy thereof;

d) _______________________________________________________.

4.10. In the event that the insurance amount is payable to the heirs of the Insured Person, the heirs present:

b) identification documents;

c) a document confirming the occurrence of an insured event, or a certified copy thereof;

d) death certificate of the Insured person or its certified copy;

e) documents certifying entry into inheritance rights;

e) _______________________________________________________.

4.11. To pay for medical care, in addition to the above documents, documents confirming the cost must be submitted. medical services that need to be paid or that have already been paid.

4.12. The Insurer has the right to check any information communicated to it by the Policyholder, the Insured Person and their heirs, as well as information that has become known to the Insurer that is related to this Agreement. The Policyholder, the Insured Person and their heirs are obliged to give the Insurer the opportunity to unimpededly verify the information and provide all necessary documents and other evidence.

5. RESPONSIBILITY OF THE PARTIES

5.1. If the Insurer violates the deadline for payment of the insured amount established by clause 4.4 of this Agreement, the Insured has the right to present to the Insurer a demand for payment of a penalty in the amount of ___% of the unpaid insured amount for each day of delay.

5.2. If the Insured violates the deadline for paying the next insurance premium established by clause 3.2 of this Agreement, the Insurer has the right to present the Insured with a requirement to pay a penalty in the amount of ____% of the amount of the unpaid insurance premium for each day of delay.

5.3. Collection of penalties does not relieve the Party that violated the Agreement from fulfilling its obligations in kind.

5.4. For non-fulfillment or improper fulfillment of other obligations under this Agreement, the Parties bear the responsibility established current legislation Russian Federation and Insurance Rules.

6. TERM OF THE AGREEMENT

6.1. This Agreement comes into force from the moment of signing and is valid until "___"__________ ____.

6.2. The expiration of this Agreement does not relieve the Parties from liability for its violation.

7. CHANGE AND TERMINATION OF THE AGREEMENT

7.1. The Policyholder, in agreement with the Insurer, has the right to increase the amount of the insured amount. In this case, an additional insurance premium must be paid in the amount and manner stipulated by agreement of the Parties.

7.2. The Policyholder, in agreement with the Insurer, has the right to reduce the amount of the insured amount. In this case, the Insurer must return to the Policyholder the overpaid part of the insurance premium in proportion to the reduction in the sum insured.

7.3. The insurer, notified of the circumstances specified in clause 2.7 of this Agreement, has the right to demand changes to the terms of the Agreement, including the payment of an additional insurance premium in proportion to the increase in the risk of an insured event in accordance with the legislation of the Russian Federation.

If the Policyholder objects to changing the terms of this Agreement or additional payment of the insurance premium, the Insurer has the right to demand termination of the Agreement.

The Insurer has no right to demand changes to this Agreement if the circumstances specified in clause 2.7 of the Agreement have already disappeared.

7.4. This Agreement is terminated early if, after its entry into force, the possibility of an insured event no longer exists and insurance risk terminated due to circumstances other than an insured event.

7.5. The policyholder has the right to cancel this Agreement at any time, if by the time of refusal the possibility of the occurrence of an insured event has not disappeared due to the circumstances specified in clause 7.4 of this Agreement.

In case of early termination of this Agreement on the grounds specified in this paragraph, the Insurer has the right to a portion of the insurance premium in proportion to the time during which the insurance was in force.

7.6. This Agreement may be terminated or terminated on the basis of a written agreement of the Parties or on other grounds established by the current legislation of the Russian Federation.

7.7. Any changes and additions to this Agreement are valid provided that they are made in writing and signed by the Parties or duly authorized representatives of the Parties.

8. PRIVACY

8.1. The terms of this Agreement, additional agreements thereto and other information received by the Insurer in connection with the execution of this Agreement are confidential and not subject to disclosure.

9. DISPUTE RESOLUTION

9.1. All disputes and disagreements that may arise between the Parties on issues that are not resolved in the text of this Agreement will be resolved through negotiations on the basis of the current legislation of the Russian Federation.

9.2. If it is impossible to resolve disputes based on the results of negotiations, the Parties shall submit them for resolution to judicial procedure established by the current legislation of the Russian Federation.

10. ADDITIONAL TERMS AND CONDITIONS

10.1. Additional terms actual agreement: ____________________.

10.2. All notices and communications must be sent by the Parties to each other in writing.

10.3. In all other respects that are not provided for in this Agreement, the Parties are guided by the current legislation of the Russian Federation and the Insurance Rules.

The insurance rules are attached to this Agreement and are an integral part of it.

10.4. The Agreement is drawn up in two copies having equal legal force, one of which is kept by the Insured, the second by the Insurer.

10.5. The Insurer is obliged to provide the Insured person with a copy of this Agreement along with the Insurance Rules.

11. ADDRESSES AND DETAILS OF THE PARTIES

Policyholder: ______________________________________________________________

_______________________________________________________________________

Insurer: _________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

SIGNATURES OF THE PARTIES:

Insurer _________________________________ M.P. Policyholder ______________________ M.P.

Insurance rules handed to:

_________________/_________________________________

2.2 Accident insurance

Voluntary accident insurance has two organizational forms. There are individual and collective accident insurance. An individual insurance contract is concluded by an individual and applies to the policyholder and his family members. Under a collective insurance contract, a legal entity acts as the insured; the insured are individuals, in whose life and health the policyholder has a material interest.

Collective insurance contracts are concluded either by employers or by associations and societies for the benefit of their members, for example sports clubs, trade unions. Insurance coverage under a group insurance contract may be limited only to the period of professional or social activity, or may also extend to the private life of the insured, which depends on the choice of the insured. Limited coverage for accidents at work, while on duty or while participating in competitions is used more often than unlimited.

Under contract voluntary insurance against accidents, the object of insurance is property interests related to the life, health and ability to work of the insured person.

Accidents mean a sudden, unforeseen external impact on the human body, the consequence of which is a temporary or permanent health disorder, as well as the death of the insured. Resolution of the Ministry of Labor of the Russian Federation of October 24, 2002 N 73 “On approval of the forms of documents necessary for the investigation and recording of industrial accidents, and the Regulations on the peculiarities of the investigation of industrial accidents in certain industries and organizations.” (Bulletin of normative acts federal bodies executive power, N 2, 01/13/2003) Suddenness means that the event must be short-term in its destructive effect on the human body and cannot act as a chronic disease or long-term impact environment. Unforeseen means that the harm was caused to a person unintentionally, not at the will of the insured person.

The policyholder, with the written consent of the insured, has the right to appoint any person or several persons as the recipient of the insurance amount (hereinafter referred to as the beneficiary) in the event of his death. If such a person is not appointed, then the recipient of the insurance amount, the beneficiary in the event of the death of the insured, is his heir.

During the validity period of the insurance contract, the beneficiary designated in the insurance contract may be replaced by another person. The insurer must be notified of this in writing. Changing the beneficiary under an insurance contract is permitted only with the consent of the insured. Braginsky M.I., Vitryansky V.V. Contract law. General provisions. Book 1. M., 2000.P.251

This insurance contract is subject to all basic insurance rules and entrusts insurance company obligation to pay insurance compensation as a result of an insured event.

An insured event is an event that occurred during the validity period of the insurance contract, provided for by the insurance contract, upon the occurrence of which the insurer becomes obligated to pay the insurance coverage to the policyholder, the insured person, the beneficiary or other persons.

The policyholder, when concluding an insurance contract, has the right, at his own discretion, to choose an insurance risk or a combination of risks provided for in the tariff rates. When an insured event occurs, as provided for in a subclause of the contract, payment of insurance coverage is made on the basis of documents from the medical institution.

The amount of insurance coverage is determined in accordance with methodological instructions, developed by insurance companies in accordance with the legislation of the Russian Federation.

Events are not insured if they occurred as a result of:

1) commission of an intentional crime by the policyholder (insured) aged 14 years or older;

2) the beneficiary commits an intentional crime resulting in the death of the insured;

3) driving a vehicle by the policyholder (insured) in a state of alcoholic or other intoxication or transferring control of the vehicle to another person who was in the same state;

4) suicide (attempted suicide) of the policyholder (insured aged 16 years or older), if the insurance contract was valid for less than two years, except in cases where it was brought to such a state by illegal actions of third parties;

5) intentional infliction of bodily harm by the policyholder (insured) aged 16 years or older;

6) military operations, as well as maneuvers or other military events;

7) civil war, civil unrest of all kinds or strikes. Decree of the Government of the Russian Federation of December 15, 2000 N 967 "On approval of the Regulations on the investigation and recording of occupational diseases." (Collection of Legislation of the Russian Federation", December 25, 2000, No. 52 (Part II).

The insured amount is determined by the agreement between the policyholder and the insurer on the selected insurance risk or their combination. Fogelson Yu.B. Commentary on insurance legislation. M., 1999. P.147

The insured amounts for each insurance risk (their totality) are given in the list of insured persons, which is attached to the insurance contract concluded in favor of several persons.

The insurance premium is determined as a percentage of the sum insured depending on the insurance period chosen by the policyholder of the insurance risk, based on basic tariff rates. If the insurance period is more than one year, the insurance premium is determined based on the tariff rate calculated for one year and multiplied by the number of years.

The insurer has the right to apply increasing and decreasing coefficients to the base tariff rate depending on the age, type of activity of the insured, the number of insured under one insurance contract and other circumstances that are significant for determining the degree of insurance risk.

The insurance premium under the insurance contract is paid by the policyholder in cash or by non-cash payments in a lump sum if the insurance contract is concluded for a period of less than 12 months, and when concluding an insurance contract for more than long term- at one time or in two terms, and the first part of the premium must be paid in the amount of at least 50% of the total insurance premium. If the insurance contract stipulates payment of the insurance premium in installments, then the contract may provide for a sanction for non-payment in deadlines next insurance premium.

The insurance contract comes into force on the next day after payment of the insurance premium. The day of payment of the insurance premium by bank transfer is considered the day the insurance premium is received in the insurer's bank account.

The insurance contract is drawn up on a special insurance policy form, which is handed to the policyholder upon receipt of the insurance premium in cash or within 5 days after its payment by bank transfer.

Upon the occurrence of an insured event, the insurer is obliged to pay the insurance coverage within 5 working days from the date of receipt of all necessary documents in accordance with the terms of the insurance contract. Compensations can be made both to the insurer himself, the beneficiary, and in the event of the death of the insured person (beneficiary) - to his heirs. Federal Law of November 29, 2007 N 286-FZ “On Mutual Insurance” (Collection of Legislation of the Russian Federation, December 3, 2007, N 49, Art. 6047)

The insured who is legal entity, has no right to receive the insured amount or part thereof.

The insurance contract is terminated in the event of:

1) expiration of the insurance period stipulated by the insurance contract;

2) fulfillment by the insurer of its obligations in in full;

3) agreements of the parties;

4) liquidation of the insurer as a legal entity in the manner established by the legislation of the Russian Federation;

5) failure by the policyholder to pay the insurance premium (part thereof) within the time period established by the contract;

6) liquidation of the insurer in the manner established by the legislation of the Russian Federation;

7) in other cases, provided for by law RF.

Under a terminated insurance contract concluded for a period of more than one year, the policyholder has the right to receive part of the insurance premium (less expenses incurred by the insurer under this insurance contract) for each full unexpired year of insurance.

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from accidents in a person acting on the basis, hereinafter referred to as " Insurer", on the one hand, and in the person acting on the basis of, hereinafter referred to as " Policyholder", on the other hand, hereinafter referred to as the "Parties", have entered into this agreement, hereinafter " Agreement”, about the following:
  1. The insurer undertakes, within the limits of the insured amount, which is rubles for each employee, to pay to the person in whose favor the contract was concluded:
    • in case of loss of ability to work – a benefit in the amount of average daily earnings for each day of disability, starting from the day, but not more than% of the insured amount;
    • upon the onset of disability - lump sum allowance in the following amounts of the insured amount: I disability group - 100%, II - 50%, III - 25%;
  2. In the event of the death of the person in whose favor the contract was concluded, the recipient of the insured amount is.
  3. Payments are made within the period from the date the Insurer receives information confirming the fact of the accident and the occurrence of the consequences specified in clause 1 of this contract for the insured person in this regard.
  4. The insurer has the right to reduce the amount of payment by% if an accident occurs as a result of the action (inaction) of the insured person who is intoxicated, or as a result of his committing intentional illegal actions.
  5. The policyholder undertakes:
    • pay the Insurer an insurance payment in the amount of rubles;
    • immediately inform the Insurer about the circumstances upon the occurrence of which payments are made under this agreement;
  6. Duration of the contract: from “”2019 to “”2019.
  7. This agreement may be extended for new term by notifying the Insurer about this no later than one month before the expiration of the current contract and payment of the insurance payment.
  8. Other terms of the agreement: .

LEGAL ADDRESSES AND BANK DETAILS OF THE PARTIES

Insurer Legal address: Postal address: INN: KPP: Bank: Payment/account: Correspondent/account:

AGREEMENT No. __ N01 _________

Moscow "__" ______ 2013

Deadline for payment of insurance premium

Amount of insurance premium, rub.

until "__"_______ 2013

until "__"_______ 2013

2.6. The insurance premium (insurance premium) is considered paid from the moment it is received into the Insurer's bank account in the amount and within the time limits provided for in clause 2.5 of this Agreement.

2.7. If the insurance premium (the next installment) is not received to the Insurer's current account in full and within the period specified in the Agreement, the Agreement is terminated from the date of the Insured's obligation to pay the next insurance premium. The Insurer's obligation to pay insurance compensation does not arise.

3. DURATION OF THE AGREEMENT

3.1. This Agreement is valid from 00:00. "__"_______ 2013 and 24:00 “__”_______ 2014 (12 months).

3.2. The insurance contract comes into force from the moment of payment of the insurance premium (first insurance premium) in accordance with clause 2.5 of this Agreement.

3.3. The insurance contract is terminated in the following cases:

a) expiration of its validity period;

b) fulfillment by the Insurer of its obligations to the Policyholder under the contract in full;

c) failure to pay the insurance premium by the Policyholder.

d) liquidation of the Insured, who is a legal entity, except for cases provided for by the current Legislation;

e) death of the Insured in the cases provided for in clause 3.8 of the Rules;

f) liquidation of the Insurer in the manner established by the current legislative acts Russian Federation;

g) the court makes a decision to recognize the insurance contract as invalid;

h) in other cases provided for by legislative acts of the Russian Federation.

3.4. The insurance contract is terminated before the expiration of the period for which it was concluded, if after its entry into force the possibility of the occurrence of the insured event has ceased, and the existence of the insured risk has ceased due to circumstances other than the insured event.

c) suspend the fulfillment of its obligations under the insurance contract by notifying the Policyholder, in the event of failure by the Policyholder to comply with the terms of the insurance contract and the Rules.

d) independently determine the causes and circumstances of the insured event, if necessary, request information related to the insured event from law enforcement agencies, medical institutions, other institutions and organizations that have information about the circumstances of the insured event;

e) demand from the Insured a written description or explanation of the circumstances of the insured event.

e) postpone insurance payment in the event of a criminal case being initiated against the Policyholder, the Insured or the Beneficiary upon the occurrence of an event until the relevant decision is made by the competent authorities and full information and supporting documents about it are received;

g) refuse insurance payment if the Policyholder (Insured, Beneficiary) informed the Insurer of knowingly false or false information about facts influencing the determination of the degree of risk when concluding the Agreement, or the occurrence of an insured event provided for in the Agreement;

h) defer insurance payment for events that occurred during the period until the next insurance premium is paid, if payment of the insurance premium is not made in the amount and within the time frame provided for in the Agreement until payment in full.

5.2. The insurer is obliged:

a) when concluding an insurance contract, familiarize the Policyholder with the Rules;

b) ensure confidentiality in relations with the Policyholder.

c) make payment of insurance compensation in accordance with the Insurance Rules.

5.3. The policyholder has the right:

a) demand from the Insurer the fulfillment of obligations under the insurance contract;

b) terminate the insurance contract early;

c) receive an Insurance Certificate (policy) - upon written request;

d) to receive from the Insurer information relating to its financial stability, which is not a commercial secret.

e) appoint Beneficiaries under the Agreement upon receipt of written orders from the Insured to appoint Beneficiaries.

5.4. The policyholder is obliged:

a) at the request of the Insurer, provide reliable information about the Insured Person, as well as about all circumstances known to him that are important for assessing the insurance risk;

b) pay the insurance premium in the amounts and terms specified in the insurance contract;

c) during the period of validity of the insurance contract, immediately notify the Insurer of significant changes that have become known to him in the circumstances communicated to the Insurer at the conclusion of the contract, if these changes may significantly affect the increase in the insurance risk;

In any case, the changes specified in the Agreement are considered significant.

d) comply with the terms of the Rules and the insurance contract;

e) obtain written consent from each Insured for the processing of their personal data by the Insurer (in accordance with Federal Law No. 000 of 01/01/2001) in the form in accordance with Appendix No. 3 to this Agreement, and also provide them to the Insurer;

f) in the event of the death of the Insured or damage to his health, within 30 days from the moment when he had the opportunity to report the incident, notify the Insurer in any way available to him, allowing him to objectively record the fact of the complaint.

If this requirement is not met, the Insurer has the right to refuse to pay the insurance amount unless it is proven that the Insurer learned about the incident in a timely manner, or that the Insurer’s lack of information about this could not affect its obligation to make the insurance payment.

5.5. The insured has the right:

a) receive from the Policyholder the Rules on the basis of which the insurance contract was concluded;

b) appoint a Beneficiary (replace him) during the period of validity of the insurance contract;

c) upon the occurrence of an insured event, demand performance by the Insurer accepted obligations under an agreement concluded in his favor.

5.6. The Insured is obliged to comply with the terms of the Rules and the Insurance Agreement.

5.7. Upon the occurrence of an insured event related to personal injury, the Insured is obliged to:

a) immediately consult a doctor and strictly follow the doctor’s recommendations in order to reduce the consequences of the insured event;

b) when the opportunity arises, inform anyone in an accessible way, allowing the Insurer or its representative to objectively record the fact of the incident being reported to the Insurer or its representative, but no later than 30 days from the date of the occurrence of the insured event;

c) provide, at the Insurer’s request, documentation of treatment related to the insured event, as well as provide the Insurer with the opportunity to review the medical documentation by releasing the attending physician from the obligation to maintain medical confidentiality.

d) within 45 days from the receipt of all necessary documents, submit an application for insurance payment;

e) undergo a medical examination upon request and under the conditions determined by the Insurer;

f) provide a written description or explanation of the circumstances of the insured event at the request of the Insurer.

5.8. The rights and obligations of the parties are fully defined in the Insurance Rules, on the basis of which this Agreement was concluded.

6. PROCEDURE FOR INSURANCE PAYMENT

6.1. The procedure for making insurance payments, the list of documents and the deadlines for their provision are defined in section 10 of the Rules, in accordance with scheme No. 2, clause 10.1.2 of the Rules.

7. ADDITIONAL CONDITIONS

7.1. There are no additional conditions under this Agreement.

8. LIMITATION OF ACTION AND PROCEDURE FOR CONSIDERATION OF DISPUTES

8.1. A claim for claims arising from this Agreement may be brought within the time limits provided for by the civil legislation of the Russian Federation.

8.2. Disputes between the Insurer and the Policyholder are resolved through negotiations between the parties, and if no agreement is reached, in court.

9. SPECIAL CONDITIONS

9.1. All changes and additions to this Agreement are considered valid if they are in writing and signed by both parties.

9.2. Relations between the parties that are not regulated in the text of this Agreement are governed by the Rules. If the terms of the Agreement contradict the provisions of the Rules, preference is given to the terms of the Agreement.

9.3. The policyholder has read the Rules and received one copy at the time of signing this agreement.

10.APPLICATIONS

10.1. The following documents are attached to the Agreement and are an integral part of it:

Application. Rules for insurance against accidents and illnesses (occupational diseases) dated 01.01.01. Insurer;

Application. Application for accident and illness insurance;

Application. List of Insured.

11. ADDRESSES AND BANK DETAILS OF THE PARTIES

Insurer:

OOO « INSURANCE COMPANY « ARSENAL»

Policyholder:

public corporation

«_________»

I have read and agree with the Insurance Rules.

Legal/factual address: Moscow, 2nd st. Sinichkina,

building 9 a, building 10

Bank details:

account 407.018.105.0000.8859.001

at CJSC "Nefteprombank"

c/s 301.018.108.0000.0000.272

Tel. +7 (4, t/f: +7 (4

E-mail: *****@***ru

Legal address: ___________

Fact. address: ___________

Bank details:

account account ___________ in CJSC "___________"

c/s ___________BIK ___________, TIN ___________, checkpoint ___________

Tel. __________, t/f: ___________

E-mail: _______________

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