Insurance risks:
Liability arising from the use (operation) of ground vehicles (including rail transport), other than that defined by the Law of Ukraine "On Mandatory Insurance of Civil Liability of Owners of Ground Vehicles."
Insurance risks can be:
A. Fire (fire), besides arson, the smoke that accompanies it, including the release of soot, explosions (including gas explosions), lightning strikes.
B. Natural phenomena (natural meteorological phenomena): strong winds including tornadoes, hurricanes, storms, typhoons, squalls, gales; snow avalanches, landslides, rockfalls, debris flows; landslides; high water levels (floods, inundations), hail, large hailstones, very heavy rain (downpour), prolonged rain; very heavy snowfall, intense wet snow accumulation, snow cover pressure, severe icing, very severe frost; intense ice drift.
C. Ground subsidence, rising groundwater levels.
D. Earthquake.
D. The impact of water or other liquids (from plumbing, sewage, heating systems, neighbouring premises, fire extinguishing systems, including their false activation)
E. Collision with ground vehicles
Ye. Falling aircraft, their parts, debris or cargo; spillage of aircraft fuel
Zh. Unlawful actions by third parties, namely: theft, robbery, vandalism, armed gang assault, arson; intentional damage/destruction of property (including explosion)
Z. Falling trees and other foreign objects (glass, slate, structures or their debris, advertising signs, etc.)
I. Other insurance risks specified in the insurance contract (terrorist act, breakage of glass surfaces (glass elements of the building (including internal glass partitions, door panes, glass doors), mirrors, stained glass) for any reason, including as a result of their accidental breaking (breaking); impact of electric current: short circuit, sudden increase in current or voltage fluctuations in the electricity network, including overloads in the electricity network that led to the failure of the insured property)
I. Military / war risks - direct and/or indirect impact of missiles, unmanned aerial vehicles of any type and/or their debris, air defence systems, missile defence systems, aerial combat munitions excluding firearms, nuclear weapons, mines (of any type), grenades, with appropriate documentary confirmation from competent authorities.
In the area of liability insurance, the insured risks include all sudden unforeseen events that occur during the policyholder's business activities and lead to liability for damage caused to a person or their property, except for the exclusions and limitations stipulated in the contract.
up to 100,000,000.00 UAH for one object, including:
for the "Express-Domivka" package - up to 200,000.00 UAH.
for the "Home Protection" package - up to 200,000.00 UAH.
for the "Solar Energy" package - up to 500,000.00 UAH.
for the "Universal Housing" package - up to 2,500,000.00 UAH.
Insurance rate: from 0.001% to 20% for one object.
The insurance premium is calculated by multiplying the insurance rate by the insured amount.
The insurance agreement establishes an unconditional excess ranging from 0% to 30%.
The territory of the contract is established in the insurance contract and may include:
Ukraine, except for the temporarily occupied territories of Ukraine; territories where hostilities are (were) taking place; territories where state authorities temporarily do not exercise their powers or are located along the line of contact; territories that, according to the legislation of Ukraine, are under occupation, temporary occupation, encirclement, blockade, and are the territory of combat, military actions, or military conflicts.
The duration of the insurance contract is established by mutual agreement of the parties and is specified in the insurance contract. Unless otherwise provided in the insurance contract, the contract comes into effect at 00:00 hours on the date specified in the insurance contract as the start date of the contract's validity, but not earlier than 00:00 hours on the day following the day of receipt or payment (if stipulated in the contract) of the insurance premium or its first instalment (in the case of payment of the insurance premium in instalments) to the Insurer's account in the amount and within the timeframe specified in the insurance contract.
The contract is valid until 24:00 hours on the date specified in the contract as the end date of its validity, unless other circumstances provided in the contract have led to the premature termination of its validity.
The insurance contract may stipulate that insurance cover (the Insurer's responsibility) commences on the third to seventh day (the specific period is stated in the contract) from the day following the payment of the insurance premium.
The term of the contract is not divided into insurance periods.
The insurer may refuse the insurance payout or reduce its amount if the policyholder:
The insurance product is not an addition to other goods, works or services that are not insurance. In connection with the conclusion of the contract, there is no need to obtain additional or ancillary services from the insurer and/or third parties related to receiving the financial service under the contract.
Not provided
Before concluding an insurance contract, the policyholder is obliged to inform the Insurer of the information regarding the insured object and circumstances that are of significant importance for assessing the insurance risk (determining the likelihood and probability of an insurance event occurring and the size of potential losses), including:
1) type of activity of the insurer; preferred method of payment of the insurance premium; preferred term of insurance; desired insurance risks; territory of the insurance contract;
2) information about existing insurance contracts concluded regarding the insured object;
3) information about the existence of a lawful insurance interest in relation to the insured object, including the presence of such interest in the beneficiary (if such a person is specified in the insurance contract);
4) the presence of risk factors (the presence of flammable and explosive substances in the building, the use of open fire (fireplace), the presence of a sauna, the presence of a large aquarium, the presence of combustible waste (rubbish), the use of open fire on the premises or in the house, the use of gas and electric welding, conducting construction or renovation work on the site);
5) other important information about the insured objects (for example, any losses in the last 5 years, which hazardous objects are nearby at a distance of 50-100m, existing property damage on the date of the contract conclusion).
For class 8 and class 9 (depending on the category of property to be insured):
6) type of property to be insured; value of the property at the specified address, method of determining the value for each insured item; list of household goods, if they are to be insured;
7) type of real estate to be insured (residential, non-residential real estate, structures, integrated property complex, agricultural buildings), area of the premises;
8) short description of the real estate which is the object of insurance and/or where the insured property is located: age of the property; year of last renovation and type of renovation; number of storeys of the building and floor location of the flat;
9) type, condition and characteristics of the fence, if it is to be insured;
10) type and condition of heating systems; condition of engineering systems (gas, water, heat supply);
11) material of residential property structures (foundation, roof, floors, walls, internal partitions, windows, doors);
12) material of farm building structures, if they are subject to insurance (foundation, roof, walls, floors);
13) type and condition of finishing, if it is insured under the contract (internal doors, wall coverings, ceiling, floor, facade of the building, internal engineering equipment);
14) information about the land plot if it is insured under the contract (area of the plot, location, purpose, what objects are located on it, what is around its perimeter, whether it is leased and to whom);
15) the presence of security measures on the premises: functional fire alarms, sound fire hydrants, operational fire extinguishers, effective security alarms, building or area security, additional security means (grills on windows, impact-resistant glass, reinforced doors, dogs, video monitoring, motion detectors, intercom and/or keypad locks on entrance doors, concierge, area fencing, entrance through barriers, etc.);
16) the presence of natural factors that increase the degree of risk (increased seismic danger, groundwater, flood risks, landslides, etc.);
17) type of solar power station (ground-mounted, rooftop) - when insuring it.According to class 13 (if liability is subject to insurance):
18) a brief description of the property where the policyholder resides (age of the property, year of last renovation and type of renovation, number of floors in the building and floor of the apartment);
19) objects located in the vicinity;
20) type and condition of heating systems; condition of engineering systems (gas, water, heating supply);
21) availability of security measures on the premises (operational fire alarms, functional fire extinguishers, video surveillance etc).
The consumer/client, to make an informed decision about entering into an insurance contract, must familiarise themselves with the following before entering into such a contract:
1. Exceptions to insurance cases and grounds for refusing to make insurance payments.
Under the insurance contract, the Insurer does not compensate for losses that occur in the event of:
1) cases other than those specified in the insurance contract as insured;
2) war, invasion, acts of hostility or military actions (whether war is declared or not) and the consequences of military actions, mines, torpedoes, bombs and other warfare instruments, civil war, strike or civil unrest;
3) alienation of the insured property as a result of confiscation or requisition by any legally established authority; destruction or damage to insured property by order of military or civil authorities;
4) unlawful actions or inactions of state authorities and local self-government bodies, including as a result of the issuance of unlawful documents and orders;
5) coup, military or popular uprising, rebellion, revolution, civil unrest on a scale or with a number of participants that can be equated to an uprising, usurpation of power;
6) terrorist act. This exclusion also applies to damages, losses, expenses of any origin arising from or occurring in connection with a takeover, prevention, containment, or any other action related to a terrorist act;
7) state of war, state of emergency, state of siege or any event or cause leading to the introduction or maintenance of a state of war or state of siege or resulting in a change of government or head of state;
8) any actions aimed at overthrowing or influencing the government, local government bodies or any part thereof by means of force, through intimidation, use of violence or threats of its use;
9) looting, criminal offences, theft, burglary, malicious damage, vandalism or any similar activities, if they occur in connection with any action specified in paragraphs 2-8.
10) embezzlement during natural disasters, technological catastrophes, civil unrest and other emergencies not related to war;
11) the exceptions noted in paragraphs 2-8 also exclude losses, expenses of any kind, directly or indirectly caused, resulting from or in connection with any actions taken to control, prevent, terminate or in any way related to paragraphs 2-8;
In any claim, legal action, proceeding or any court proceedings to enforce a claim under the contract for damages or injury according to paragraphs 2-8, the burden of proof that such damages or injury are not covered by this exclusion is placed on the policyholder;
12) the occurrence of an event that has the characteristics of an insurance case (as well as the damage that has occurred) in the territories of the administrative districts of Ukraine, within which there are settlements where state authorities do not temporarily exercise their powers or are located along the line of conflict, according to the Resolution of the Cabinet of Ministers of Ukraine dated 7 November 2014 No. 1085 with all amendments and additions; in the temporarily occupied territories of Ukraine defined by legislative acts of Ukraine, including in the understanding of the law of Ukraine "On ensuring the rights and freedoms of citizens and the legal regime in the temporarily occupied territory of Ukraine", as well as in the territories where combat operations are (were) being conducted (within the duration of hostilities) or temporarily occupied by the Russian Federation, according to the Resolution of the Cabinet of Ministers of Ukraine dated 06.12.2022 No. 1364, According to the order of the Ministry for Reintegration of the Temporarily Occupied Territories of Ukraine dated 22.12.2023 No. 309 and the damages that occurred in areas located closer than 50 (fifty) kilometres from such territories, on the date of the event that has signs of an insured event (if stated in the contract); in any other areas that, according to the legislation of Ukraine, are under occupation, temporary occupation, surrounded, blockaded, are areas of combat operations, military actions, anti-terrorist operations, military conflicts;
13) actions of nuclear energy in any form, use of fissile materials, ionising actions and radiation;
14) deliberate or criminal actions of the insured (residents of their house/apartment or persons whose liability is insured) or third parties aimed at causing an insured event;
15) collapse of buildings or parts thereof, if the collapse is not caused by an insured event, including but not limited to, due to the freezing and thawing of the ground, river and coastal soil erosion, soil desiccation, any human activity, design or construction errors; defects in building materials, ageing, dilapidation of the structure, partial destruction or damage due to long-term use;
16) violation by the insured (persons whose liability is insured) of the established laws or other regulatory acts, rules and norms of fire safety, safety engineering or instructions for the use of gas, electric heating and heating appliances, use of household appliances or other property for purposes not intended; requirements and measures of fire safety, sanitary norms, violation of which is the cause of the occurrence of an insured event;
17) violation by the insured or members of the insured's family of the rules for storing flammable or combustible liquids and explosives, rules for smoking in premises, rules for the operation of gas equipment, if such violations have caused loss or damage to the insured property and/or have increased the amount of damage, provided that this exclusion does not apply to actions of the insured's minor children or children of persons living with them;
18) gross negligence of the policyholder, persons living with them, tenants, violations of laws, regulations, instructions and other normative documents concerning the preservation, operation and maintenance of the insured property;
19) actions of the policyholder (or persons whose liability is insured) who were under the influence of narcotic, toxic or alcoholic substances;
20) unauthorized re-planning of buildings, premises, structures, installation and use of equipment (including water supply, sewerage, heating systems and fire suppression systems) that is not certified in Ukraine, and/or installed by persons who do not have the appropriate permits for such installation;
21) the carrying out of building and installation or repair work on the territory covered by the contract, if there is a causal link between the damage and such work (however, if stated in the insurance contract, excluding minor building and repair work that does not change the load-bearing capacity of the foundation, load-bearing walls (supports, columns, beams), ceilings, stairs, balconies, loggias, roofs, its covering, and the total cost of which does not exceed 50,000.00 (fifty thousand) UAH);
22) carrying out maintenance, welding (hot) work;
23) soil subsidence, collapses that occurred as a result of earthworks or any other human activity; other ground movement for new buildings and structures (new buildings and structures are those that were commissioned less than two years before the discovery of damage due to subsidence and other ground movement), except for ground movement that occurred as a result of an earthquake; 24) cessation of electricity supply from the energy supply network;
25) the failure of the insured to eliminate circumstances significantly increasing the degree of risk within the agreed time with the Insurer, of which the Insurer had notified the insured in writing; 26) unlawful actions of third parties if the law enforcement agencies have closed the criminal proceedings due to the absence of an established event of criminal wrongdoing or the absence of the elements of a criminal offence in the actions;
27) disconnection or cessation of heating, electricity, water, and gas supply by the insured's suppliers, freezing of engineering and communication networks and systems;
28) leakage of liquid due to the application of physical force by a person (overturning containers with water and others), as well as liquids used for cleaning, washing or laundering;
29) use of residential or commercial buildings or insured property for unintended purposes;
30) dilapidation of buildings or errors in their design/construction or design/installation of their utilities or use of materials and components with defects;
31) actions of pests and animals (including birds, rodents, insects, parasites, etc.), mould, mildew, fungi, spores or microorganisms;
32) continuously active operating factors, reactions occurring due to the natural qualities of the insured property, gradual effects of any conditions, including: wear and tear of the insured property, gradual loss of its natural qualities and useful properties, or deterioration of qualities due to prolonged use or cessation of use;
33) condensation, drying out, corrosion, rusting, erosion, fermentation, decay, spoilage, decomposition, dryness, desiccation, noise, weight loss;
34) errors in design, planning, specifications, deficiencies and mistakes in construction, installation, poor quality of work, production defects or defects (shortcomings) of materials;
35) damages caused to buildings (structures) that are under construction and/or installation, restoration, not put into operation or not in use, and property located in such buildings;
36) damage, destruction, ruin of buildings or premises in buildings that were constructed in violation of building norms and rules, or buildings whose technical condition requires major repairs, as well as property located in such buildings or premises, including, in accordance with current legislation;
37) damage caused by fire that cannot spread on its own; damage in the event of the influence of useful (working) fire or heat necessary for smelting, welding, thermal treatment, firing, cooking, smoking, drying and other similar purposes, outside installations using fire or heat;
38) damage in the event of heating or burning by burning coals that have fallen from fireplaces, stoves, etc., cigarettes or cigars, blowtorches and similar objects, or heating caused by the sudden escape of fire from a place specifically designated for it, except in cases of fire outbreaks;
39) sinking, cracking, compression, expansion or swelling of the surface of roads and pavements, foundations, walls, load-bearing structures or ceilings of buildings and structures;
40) floods, inundations, rise in water levels in places and areas where such natural disasters have been recorded in the past five years;
41) the movement of stone blocks, layers of rock or masses of soil, if this movement was caused by earthworks or excavation, blasting works or the extraction of gaseous, liquid or solid substances from the earth's crust;
42) actions of a layer of snow that was formed by humans;
43) the outflow of liquid as a result of the application of physical force by a person (overturning water tanks, etc.), as well as liquid used for cleaning, washing or washing.
The following are not compensated under insurance risks of class 8 and class 9:
1) damages caused by a natural phenomenon (an extreme meteorological event), upon declaring the territory of the contract as a disaster zone until the contract is concluded;
2) damages caused by fire and explosion to property in which fire is intentionally created and/or which is intended for its spread, maintenance, and transmission. However, if the fire occurs outside such property, or if fire exceeds the intended limits within such property, the incurred damage shall be compensated;
3) damages in the case of non-compliance or violation by the insured of storage, operation, and maintenance instructions for the insured property, as well as the use of this property for unintended purposes, if this leads to the occurrence of an insured event or an increase in the extent of damage;
4) damages in the event of rainwater, snow, mud and/or other liquids entering through open windows, doors, roofs or other openings, whether caused deliberately or due to age, dilapidation, improper maintenance or construction/manufacturing defects, unless such openings were caused by the occurrence of an insured event;
5) damages resulting from soil subsidence, collapse that occurred due to excavation works or any other human activity; subsidence and other soil movement for new buildings and structures (new is defined as buildings and structures that were put into operation less than two years before the discovery of damages due to subsidence and other soil movement), except for soil movement caused by an earthquake;
6) losses due to the effects of humidity (mould, fungus), water vapour, condensation on insured property, not caused by an insured event;
7) losses due to wear and tear, rot, corrosion or other natural properties of the insured property or the consequences of the use of the insured property; excessive humidity inside the premises, building, structure;
8) losses in case of the effects of electric current, including due to indirect action of atmospheric electricity (indirect effect of lightning), on various electrical appliances, causing fire or not, resulting from voltage surges, insulation failure, short circuits, other accidents and malfunctions of electrical equipment, provided that this did not cause the occurrence of further fire;
9) losses in case of malfunctions of electrical equipment that caused failures or breakdowns of insured electrical or electronic devices, appliances, wiring, etc., except in cases where they caused the outbreak and subsequent spread of fire or explosion to other insured property or if the influence of electric current was caused by fire (provided that such devices were not damaged or destroyed as a result of fire); electrical sparking, melting due to malfunctions in insured electrical devices, appliances, wiring and similar equipment, except in cases where such phenomena caused the outbreak and subsequent spread of fire to other insured property;
10) losses in the event of insufficiency, instability, disconnection or cessation of electricity, water, gas supply or supply of any other services, as well as heating, except in cases of damage to pipes due to freezing;
11) losses in the event of a physical explosion (a physical explosion is understood as the rupture of boilers (turbines, tanks, etc.) due to centrifugal force, liquid pressure or a defect in the material of the container), provided that if the contract stipulates insurance against the risk of "explosion", losses resulting from the loss or damage of insured property (excluding the boilers, turbines, tanks, etc. themselves) caused by a physical explosion are subject to compensation;
12) damage, destruction or theft of insured property located in an un-fenced and/or not fully fenced yard of the house;
13) damage or theft of insured property located outdoors and/or on unsecured or open balconies, loggias, terraces or in the yard of the house; precious stones and metals not stored in safes (if they are covered by insurance protection under the insurance contract);
14) damage to insured property by animals, worms, rodents or insects;
15) theft or misappropriation of insured property during or immediately after the occurrence of an insured event, other than wrongful acts of third parties, if the insured did not provide adequate protection for the property against further misappropriation as soon as they became aware of the occurrence of the insured event; 16) theft without signs of forced entry (including without signs of break-in); theft in collusion with the insured; disappearance of insured property under unexplained circumstances; fraud; other wrongful acts of third parties resulting in no physical damage to the insured property;
17) conducting assembly, disassembly, installation, setting up, carrying out commissioning, testing and other works with property. Insurance protection during these works applies to property that is in working condition (such property is considered to be in working condition if the installation and setup have been fully completed, after passing commissioning, testing and other works and the acceptance act has been drawn up), while damages caused to the property during assembly, disassembly, installation, setting up, commissioning, testing and other works are not covered;
18) self-ignition, heating, explosion or ignition of dust (including grain dust), fermentation, decay, corrosion or other natural properties of the insured property;
19) damages in case of impact on the insured property by fire or heat (without the occurrence of a fire) for the purpose of processing, reprocessing or for other reasons;
20) processing property by explosion or pressure (without the occurrence of fire) for production or other purposes (explosion welding, synthesis of substances during an explosion, applying coatings by shock wave, moving by explosion, strengthening materials by explosion, explosions in combustion chambers of various types of engines, etc.);
21) use of explosives (dynamite, TNT and other chemical compounds) or mixtures of substances capable of rapid exothermic reactions that release large amounts of heat and gases, specifically intended for conducting explosions in one form or another;
22) use of damaged property in operation after the onset of an insured event without proper repair, or if the repair of such property was carried out without the Insurer's consent;
23) breakage of glass during its installation/dismantling, except in cases where this risk is insured under the insurance contract. Costs for restoring artistic painting/drawings on glass are also not reimbursed;
24) damages caused to electronic equipment and other property as a result of indirect atmospheric electricity (indirect lightning strike), unless this has led to the occurrence of a subsequent fire;
25) damages for which other parties are liable under supply contracts, guarantees, contracts for work and repair, etc.;
26) damages in the case of defects in the insured property, its damage or shortcomings that existed before the start of the contract term and of which the insured or their representatives were aware or should have been aware, regardless of whether the Insurer was aware of these defects and shortcomings; costs for eliminating functional defects, provided that these defects are not related to damage from the destruction or damage to the insured property as a result of an insured event;
27) losses in the event of mechanical and any other internal breakage (for household property);
28) damages caused by cracks, defects, and other manufacturing flaws, as well as breakage of glass during its installation/demolition;
29) damage to the insured property from graphics, drawings, inscriptions, and other similar damages;
30) damage only to the window structure (frames, sashes, glass, fittings, beads, and seals), if there are no other damages to the structural elements of the apartment; 31) damage to window glass and frame as a result of sound/explosion/shock waves;
32) damage caused to works of art (paintings, sculptures, etc.), antiques, collections of postage stamps, coins, manuscripts, plans, drawings, accounting and business books, slides and photographs, models, samples, information on technical media, including computer programs, software, databases, landscape design, greenhouses, property used for production and commercial purposes;
33) losses caused to insured property if it is located on the roofs of wooden, dilapidated, emergency buildings, and losses caused to insured property by wooden, dilapidated, emergency buildings located within the scope of the agreement;
34) damages to insured property if it is located in the area of dacha houses and/or residential buildings that are visited less frequently than once every 30 calendar days;
35) damages to insured property caused by a vehicle if the policyholder (beneficiary) and/or their relatives (persons related by blood regardless of degree of kinship) were behind the wheel of such a vehicle, and/or the vehicle belonged to the policyholder (beneficiary) or their relatives;
36) damages caused to solar power plants with a total capacity exceeding that stipulated in the insurance contract for such insured property;
37) reduction in the productivity of the solar power station;
38) technical failure that led to the destruction, damage of the hydroelectric station, dam, weir.
Class 13 risks are not compensated:
1) losses arising from the use and storage of flammable substances and explosive devices (excluding the use of household gas); poisonous, chemical or biologically active substances; fireworks displays on the territory of the contract;
2) expenses of the insured and a third party related to the insured event, if the insured has refused the Insurer's offer to settle the insured event out of court;
3) legal expenses of the insured and a third party related to the insured event;
4) damage caused to third parties by pets kept by the insured; claims related to the behaviour of animals owned by the insured or persons whose liability is insured under the contract;
5) claims of family members of the policyholder residing with him, and/or tenants of the insured property for compensation for harm caused to them by the actions of the policyholder;
6) claims for compensation for harm caused to the life, health and/or property of victims of third parties, resulting from the impact of asbestos dust, asbestos (or materials of any kind containing asbestos, or losses related to them), including the sale, export and transportation of asbestos fibres or materials containing asbestos, diethylstilbestrol (DES), dioxin, urea formaldehyde;
7) damages arising from the contamination of third parties by the policyholder (persons whose liability is insured under the contract) with any disease, as well as in cases of harm caused by such disease, in connection with the infliction of psychological trauma, depression, mental or psychological disorders, shock, racial, sexual or religious discrimination, defamation, violation of honour, dignity, business reputation, unlawful detention;
8) damage caused to third parties by the provision of any professional service; claims related to the provision by the policyholder, or persons whose liability is insured under the contract, of any industrial or service-related activity, as well as any paid activity or activity for monetary compensation;
9) damage caused to third parties by the leakage, spillage, eruption, dispersal, spread, escape or discharge of pollutants; assessment, inspection, control, purification, treatment, decontamination or neutralisation of pollutants or management of these processes;
10) damage caused to third parties in the event of the use of property (equipment) with defects known in advance to the insurer;
11) claims for compensation for damages related to: illegal actions or inactions of state authorities and local government bodies, including as a result of the issuance of unlawful documents and orders;
12) requirements for compensation for damage to property owned by the insured, leased by the insured, encumbered (mortgaged), or transferred by them for rental, lease or encumbrance (mortgage); movable property, including goods and material values that are stored with the insured under a contract or on another basis; property (its part) that should be restored, repaired or replaced due to the fact that the insured's services in its use were carried out in violation of the relevant rules, instructions, etc.; land, buildings and/or other structures, caused by vibration, subsidence or soil displacement, explosion, removal or weakening of support, as well as any damage arising in connection with such loss;
13) damage caused to third parties in the event of the policyholder expanding their own limits of liability or assuming the liability of another person;
14) damage caused to the policyholder themselves or to persons residing in the insured apartment;
15) claims made by persons (to each other) whose liability is insured by the contract, or by any other party that is directly or indirectly owned, controlled or managed by the policyholder, including claims by the policyholder against tenants and tenants against the policyholder;
16) requirements related to the operation or use of vehicles, aircraft, marine or river vessels, yachts, boats and other similar means by the policyholder or persons whose liability is insured;
17) claims made on the basis of a contract, agreement or arrangement (including an employment agreement);
18) damages in the event of the action of sound/explosive/shock waves, including damage to glass, infra- and ultrasound, vibration, the effect of electromagnetic fields, electrical and electromagnetic interference;
19) damages related to the negative impact of harmful factors on air, soil or water quality; liability resulting from the burial or preservation of waste;
20) damages related to the production, sale, or use of any pyrotechnic devices, including the organisation of fireworks displays, explosive devices, firearms, toxic substances, production waste, gases, and other hazardous materials (except for the use of domestic gas for internal household needs);
21) claims related to the use of firearms by the insured and/or by persons whose liability is covered under the contract;
22) claims related to the compensation for damages caused to third-party property rented, leased, pledged, borrowed, or stored by the insured or by persons whose liability is covered under the contract, as a result of using that property;
23) losses, damage, liability or expenses incurred as a result of or related to the use of the internet, the impact of a computer virus, unauthorized interference with an electronic network, actual or anticipated failure or malfunction of any computer or electronic device, or component, or system, or software or embedded program; as well as losses incurred due to the loss, damage, reduction or alteration of the functionality or operability of a computer system, technology, software, data, information bases, microchips, integrated networks or similar devices in computer and non-computer equipment;
24) damage (harm) caused as a result of ownership, use or disposal of property by other persons not specified as individuals whose liability is insured in the contract;
25) losses to persons who were dependents of the injured third party due to the loss of the breadwinner (their death);
26) losses (damage) from claims (lawsuits) by third parties against the policyholder, of which the policyholder informed the Insurer during the term of the contract, if such claims (lawsuits) are not related to the event that occurred during and in the place of the contract's operation, and of which the policyholder informed the Insurer in accordance with the terms of the contract;
27) losses (damage) inflicted on the insured property by the lessee of this property (the lessee's liability to the lessor);
28) claims for compensation for damage caused to injured third parties before the date the contract came into effect or after the expiration of its term.
Not reimbursable under the insurance contract:
1) damages caused by environmental pollution (ecological damage) and harm caused to the environment;
2) any indirect losses, lost profits (unreceived (lost) income, including interest, penalties), property maintenance costs, moral damages, rent, payment of fines, penalties, forfeit and other sanctions imposed on the insured in connection with an insured event;
3) damages occurring during the absence of the insured (representative of the insured) in the insured premises or leaving the insured premises unattended for a period exceeding that specified in the contract (but not less than 30 (thirty) calendar days);
4) losses that occurred before the contract came into effect, but were discovered after it had begun, of which the insured was aware or should have been aware at the time of entering into the contract;
5) losses that occurred outside the territory of the contract;
6) losses caused to land, water and air transport;
7) losses caused to stocks (goods), vehicles and special equipment during loading, unloading, transportation, transfer, or movement under their own power;
8) losses caused to communication lines, engineering systems that are not legally owned by the insured;
9) any losses, direct or indirect, related to or resulting from any disease (including infectious, contagious) and/or related to measures taken due to the spread of such disease, regardless of the nature of its spread (including that which characterises epidemics and pandemics);
10) electronic (computer) risks, including data loss, corruption or distortion of data or system errors in IT, computer viruses, data processing operations, any failures of computer hardware and software, embedded chips;
11) any losses incurred by the insured or third parties as a result of the loss of electronic data;
12) claims caused by circumstances which the insured knew or ought to have known about, but did not take all reasonable measures to prevent the insured event from occurring.
Insurance protection does not extend (except in cases where the insurance contract provides for the provision of insurance protection for such property) to:
The grounds for the Insurer's refusal to make insurance payments are:
1) deliberate actions of the policyholder or the person for whose benefit the insurance contract is concluded, aimed at the occurrence of an insurance event, except for actions taken in a state of extreme necessity or necessary self-defence, or cases defined by law or international customs;
2) the commission by the policyholder or the person for whose benefit the insurance contract is concluded of a deliberate criminal offence that resulted in the occurrence of the insurance event;
3) the policyholder providing false information about the insured object, circumstances of significant importance for assessing the insurance risk, or about the fact of the occurrence of the insurance event;
4) the policyholder receiving full compensation for damages from the person who caused them. If the damage is compensated partially, the insurance payment is made after deducting the amount received from that person as compensation for damages;
5) untimely notification by the policyholder (the person specified in the insurance contract or legislation) about the occurrence of an insured event without valid reasons, or failure to fulfil other obligations defined by the insurance contract or legislation, if this has led to the insurer's inability to establish the fact, causes, and circumstances of the occurrence of the insured event or the amount of damage (losses) caused, or creating obstacles for the Insurer in determining the circumstances, nature, and extent of the losses;
6) failure by the policyholder to fulfil their obligations under the contract;
7) the presence of circumstances that are exceptions to insurance cases and limitations of insurance provided for in the insurance contract;
8) receiving full compensation for damages from the policyholder by a third party, another insurer, if such payments were not agreed in writing with the insurer, or from another person responsible for their occurrence;
9) actions by the policyholder or an injured third party (persons who are related to them in a certain degree of kinship or employment relations) aimed at increasing the damage or unjustifiably increasing the amount of damages or insurance payment;
10) violation by the insured (or their representatives) of the legally established rules and standards of safety or other similar norms (including safety techniques, fire safety requirements in domestic conditions, sanitary standards), if the insured event occurred as a result of such violation, as well as violation of the conditions for storage, connection, installation or operation of the insured movable property established by the requirements of the technical documentation of its manufacturer (instruction (manual) for use (operation) etc.;
11) absence of an insurable interest of the insured (beneficiary) in receiving an insurance payment - in the part of property insurance;
12) refusal of the insured (beneficiary) to exercise the right to claim against the person responsible for the damage, or when exercising this right has become impossible due to the fault of the insured (beneficiary) - in the part of property insurance;
13) failure to submit within 1 (one) year from the occurrence of the insured event the documents required by the insurance contract that are necessary for making a decision on the insurance payout, or the provision of documents that contain false information regarding the duration, causes, circumstances of the insured event and the amount of damage caused;
14) the presence of other grounds established by law.
2. Limits of the Insurer's liability for a specific insurance object, insurance risk and/or insurance event. They are determined within the limits of the insured amount. For certain active insurance packages within the insurance product "Insurance of individuals' property", the liability limits are specified in item 2.9. of the General Terms of the insurance product "Insurance of individuals' property", approved by the Order of the Chairman of the Board dated 14.06.2024 No. 78, which can be found at the link https://universalna.com/documents/offers/R1-private_property_insurance.pdf
3. Procedure for calculating and conditions for making insurance payments.
To receive an insurance payment, the policyholder or beneficiary must notify the Insurer, and then submit a written application for the insurance payment along with documents that confirm the occurrence of the insured event, as specified in the contract.
The Insurer is obliged to establish the fact, causes and circumstances of such an event and make a decision regarding the recognition or non-recognition of the event as an insured event, considering the conditions of the insurance contract, and determine the amount of the loss. The procedure for determining the amount of the insurance payment and the deadline for its implementation are outlined in the insurance contract. The insurance payment cannot exceed the amount of direct loss incurred by the policyholder, and/or another person specified in the insurance contract.
In the case of property insurance, the amount of damage and the appropriate insurance payout are calculated within the limits of the insured sum / limits / sub-limits of liability established in the insurance contract. In the case of liability insurance, the insurance payout is made in the amount of the damage caused to third parties, after deducting the deductible, but not exceeding the insured sum or limits of liability established in the insurance contract.
The insurer makes a decision regarding the insurance payout or denial of the insurance payout within the term specified in the contract, but no longer than 15 (fifteen) working days after receiving the last required document confirming the occurrence of the insured event and the amount of damage, and prepares an insurance act - in the case of making a decision on the insurance payout.
The insurer is obliged to make the insurance payout within the term specified in the contract, but no later than 10 (ten) working days from the date of the decision on the insurance payout.
Regarding the denial of an insurance payout or the postponement of a decision on payout/denial of an insurance payout, the Insurer must notify the insured (beneficiary) in writing within the period specified in the contract, but no later than 10 (ten) working days from the moment of making such a decision, providing the rationale for the decision made or justifying the reasons for the denial.
The Insurer has the right, if there are reasons for doubt about the validity (legality) of the insurance payout, to postpone the decision on payout or denial of the insurance payout until confirmation or refutation of these reasons is received from the relevant competent authorities, for the period specified in the contract, but no longer than 180 (one hundred and eighty) calendar days.
In the event of the case being recognised as an insured event, the insurer will make the insurance payout:
- in the part concerning property insurance - to the insured (to another person designated in the insurance contract or by law) in accordance with the terms of the insurance contract or legislation;
- in terms of liability insurance - at the request of the policyholder to the injured third party (in case of their death – to the heir) or to the policyholder, if the latter has compensated the damage to the third party according to the court decision, after providing the Insurer with all necessary documents confirming such payment. Full information on the procedure for calculating and the conditions for making insurance payments is specified in the General terms of the insurance product 'PROPERTY INSURANCE FOR INDIVIDUALS', which can be found at the link. https://universalna.com/documents/offers/R1-private_property_insurance.pdf
The insurance company makes payments according to the terms of the contract in the event of an accident, including death, establishment of disability, loss of ability to work, or the insured person sustaining traumatic injuries and/or functional health disorders.
The object of insurance is the life, health, and ability to work of the insured person.
The insurance risks are:
1. Accident (accidents include: traumatic injuries to the body (injuries, including from firearms), wounds, contusions, anaphylactic shock, accidental inhalation of foreign bodies, drowning, lightning strikes or electric shocks, burns, frostbite, overheating, hypothermia, animal bites, poisonous insects, snakes, etc., accidental poisoning by gases, household or industrial chemicals, medications, substandard food products (excluding infectious diseases), diseases such as rabies, tetanus, botulism, malaria, and encephalitis transmitted by tick bites.
The following individuals cannot be insured:
1. Aged over 85 years;
2. Recognised as legally incompetent in accordance with established procedure;
3. Those registered with narcological or psychoneurological dispensaries;
4. Persons with first group disabilities, children with disabilities, HIV-infected individuals;
Individuals directly participating in combat operations, armed conflicts, military actions, and those for whom facts of service in the armed forces of Ukraine and/or other specially designated paramilitary formations and units, in the armed forces of the aggressor state (the Russian Federation), Republic of Belarus have been established.
from 1,000 to 50,000,000 UAH.
from 0.006 to 10% of the insured amount.
Not applicable
The territory of application of the agreement is "Ukraine" or "the whole world", except for:
- temporarily occupied territories of Ukraine, as defined by the normative legal acts of Ukraine, including in the understanding of the law of Ukraine 'On ensuring the rights and freedoms of citizens and the legal regime in the temporarily occupied territory of Ukraine', as well as in territories where hostilities are taking place (or have taken place) (within the duration of hostilities) or temporarily occupied by the Russian Federation, in accordance with the resolution of the Cabinet of Ministers of Ukraine dated 06.12.2022 No. 1364, Order of the Ministry for the Reintegration of Temporarily Occupied Territories of Ukraine dated 22.12.2022 No. 309; territories where, at the time of the occurrence of an event that has the characteristics of an insured event, there are settlements within which state authorities are temporarily not exercising their powers or are located on the line of contact, in accordance with the Order of the Cabinet of Ministers of Ukraine dated 07.11.2014 No. 1085 with all amendments and additions;territories that, in accordance with the legislation of Ukraine, are under occupation, temporary occupation, encirclement, blocking, are territories where combat operations, military actions, military conflicts are taking place, as well as territories located closer than 50 km to the line of contact.
- territories outside Ukraine in areas of military operations of any nature, regardless of official recognition of war under the norms of law, territories for which the Ministry of Foreign Affairs of Ukraine has recommended refraining from travel until the insured person crosses the border, territories of the Russian Federation, Republic of Belarus. The term of the contract cannot exceed 1 (one) year.
Unless otherwise specified in the insurance contract, the insurance contract shall come into effect at 00:00 hours on the day specified in the contract as the start date, but not earlier than the day following the payment of the insurance premium or its first installment (if the contract provides for the payment of the insurance premium in instalments), and shall terminate at 24:00 hours on the date specified in the insurance contract as the expiry date of the insurance contract.
Insurance cover is effective throughout the duration of the insurance contract, unless otherwise stipulated in the insurance contract.
The waiting period is the period that begins on the date this Agreement commences and lasts for a certain duration. The insurer does not make insurance payments for incidents that occur during this period. The waiting period is 5 calendar days from the date the contract comes into effect. The waiting period does not apply to group insurance and when extending the contract for the following year, unless otherwise stipulated in the insurance contract.
Untimely notification by the insured of the occurrence of an insured event without valid reasons, or failure to fulfil other obligations defined in the insurance contract or legislation, if this has led to the impossibility for the insurer to establish the fact, causes and circumstances of the occurrence of the insured event or the amount of damage (losses) is grounds for refusing to make an insurance payment.
In the event of non-payment or incomplete payment of the insurance premium for the current insurance period, the insurance cover under the contract does not apply, and insurance payments for events that occurred during the unpaid insurance period are not made by the Insurer. Insurance cover is restored from 00 hours 00 minutes on the day following the day of receipt of the insurance premium for the insurance period, the duration of which is specified in the contract, in full amount to the Insurer's account, and is valid until the end of the insurance period. The contract ceases to be in effect and insurance cover cannot be restored in the event that regular insurance payments do not arrive or are received in incomplete amounts in the Insurer's account within 10 (ten) working days or 6 (six) months consecutively. (depending on the specified conditions in the Insurance Contract)
The insurance product is not an addition to other goods, works or services that are not insurance. In connection with the conclusion of the contract, there is no need to obtain additional or ancillary services from the insurer and/or third parties related to receiving the financial service under the contract.
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The policyholder, before entering into an insurance contract, is obliged to inform the Insurer or the insurance intermediary about any known circumstances that are of material importance for assessing the insurance risk (determining the probability and likelihood of an insurance event occurring and the extent of potential losses), and/or to provide any other information that is of material importance for the Insurer's decision to enter into the insurance contract, including:
1) Regarding the presence of an insurable interest, and/or the amount of the insurance premium under the insurance contract;
2) Surname, first name and (if available) patronymic, date of birth, number (and if available - series) of the passport of a citizen of Ukraine (or other document confirming identity and legally usable in Ukraine for concluding transactions), issue date and the authority that issued it, information about the place of residence or place of stay, registration number of the taxpayer's account card, number (and if available - series) of the passport of a citizen of Ukraine, which has a note about refusing to accept the registration number of the taxpayer's account card, or the passport number with a note about refusing to accept the registration number of the taxpayer's account card in an electronic contactless medium, unique record number in the Unified State Demographic Register (if available);
3) Insurance coverage and insurance premium for each insured person;
4) Information for identifying the beneficiary (if specified):
- name or surname, first name, patronymic (if available), date of birth of the beneficiary or
- any other information in accordance with Ukrainian legislation and/or regarding the identification of the beneficiary to the extent sufficient for identifying the beneficiary in the event of an insured event and clearly determining their right to receive the insurance payout;
5) circumstances that are significant for assessing the insurance risk (determining the probability and likelihood of an insurance event occurring and the extent of possible losses):
- whether the insured person belongs to a risk group according to Appendix 1 to these insurance regulations;
- whether a disability group has been established for the insured person;
- whether the insured has been declared legally incapacitated in the established manner;
- whether the insured person is registered with narcological or psycho-neurological dispensaries;
- whether the person is directly participating in combat actions, armed conflicts, military operations, individuals with confirmed ties to the armed forces of Ukraine and/or other specially designated military units and divisions, or in the armed forces of a state - aggressor (Russian Federation), Republic of Belarus;
6) information on the existence of an insurance interest in relation to the insured object on a legal basis or on the basis of other legal relations, including the existence of such interest for the beneficiary (if such person is specified in the insurance contract).
The consumer/client, to make an informed decision about entering into an insurance contract, must familiarise themselves with the following before entering into such a contract:
1. Exceptions to insurance cases and grounds for refusal of insurance payments.
Events that occurred in the case of the following are not recognised as insurance claims:
- the performance by the Insured Person of any type of hazardous work (circus performers, acrobats, wild animal trainers, horse riders, stunt performers, individuals working underground, divers (unless otherwise specified in the contract);
- engaging in professional or amateur sports, participating in competitions, training sessions and/or demonstrations by professional athletes (unless otherwise specified in the contract);
- injury to the Insured Person while participating in sporting events (unless otherwise specified in the contract);
- suicide or attempted suicide by the Insured Person;
- actions of the Insured person/Policyholder/Beneficiary when committing or attempting to commit illegal acts that are directly causally related to the insured event, as established by competent authorities;
- exposing the Insured person to unjustified risk, conscious danger (except for saving another person's life);
- consumption of alcohol, narcotic, toxic substances by the Insured person, as well as poisoning by surrogate alcohol, medications without a doctor's prescription, being in a state of alcohol (presence of ethanol in blood and/or urine regardless of concentration), narcotic, or toxic intoxication at the time of the accident;
- diseases of the Insured person, other than those specified in the Insurance Contract; - self-treatment;
management by the Insured person of any vehicle if they do not have the right to manage this vehicle or do not have the appropriate category of driver’s licence or transferring management to another person who does not have the aforementioned rights and/or was under the influence of alcohol, drugs, toxic intoxication or poisoning;
- flights by the Insured person on aircraft and their management, except in the case of flying as a passenger on a civil aviation aircraft piloted by a professional pilot, or management of the aircraft by the Insurer/Insured person who is a professional;
- intentional infliction of bodily harm by the Insured person;
- exposure to radioactive radiation, nuclear explosions, radiation, radioactive, chemical, biological or toxic contamination or infection, use of explosives;
- an accident that occurred to the Insurer/Insured person in places of deprivation of liberty;
- accidents and illnesses that occurred outside the scope of the Agreement and before/after the Agreement's validity, as confirmed by a medical institution's conclusion;
- events that occurred during the waiting period;
- if death and disability as a result of an accident occurred more than 12 (twelve) months after the date of the accident;
- military actions, military measures of any kind, use of weapons, military equipment and instruments of war, actions of military forces and/or special formations (units) of any state, any kind of non-state armed forces or armed formations, actions of militants, armed groups, their individual members (regardless of whether a state of war has been declared or martial law has been imposed), unless otherwise specified in the agreement;
- actions of the Armed Forces of Ukraine, special forces and/or other specially designated paramilitary formations and units, conducting activities to ensure national security and defence, repelling and deterring armed aggression, carrying out national resistance tasks, unless otherwise specified in the contract.
- with the Insured Person, who is recognised under law as missing, during the validity of the Insurance Contract even if further information is received regarding their bodily harm/injury and/or their death is established later.
- with the Insured Person, recognised in court as deceased (or for whom the fact of death has been established in court).
- in the event of political actions carried out under the orders of military or civilian authorities and political organisations;
- mass disturbances, acts of civil disobedience, civil war, strikes, lockouts, riots, uprisings, coups or attempts thereof, insurrections or revolutions, terrorist acts and their consequences, sabotage, actions by armed insurgents, as well as actions by authorities aimed at suppressing them;
- transfer, forced appropriation or seizure of property in situations of war or emergency, confiscation, arrest, nationalisation, destruction or damage of property under the orders of military or civilian authorities acting legally or de facto;
- looting, theft, robbery, banditry or any other actual appropriation of property in places of sabotage, uprisings, other spontaneous and organised actions, war zones, military operations (regardless of the fact of a declaration of war or the imposition of martial law);
- the occurrence of an event that has the characteristics of an insured event in the territory specified in the exclusions;
- persons under 1 year old and over 75 years old (unless otherwise specified in the contract).
- Illness of the Insured person, including sudden and occupational illnesses, does not qualify as an insured event and constitutes grounds for refusal of insurance payment.
Persons who are registered with narcological, psychoneurological dispensaries at the time of signing the Insurance Agreement are not considered Insured under this contract. Persons who are legally declared incapacitated, persons with disabilities of the first group, children with disabilities, HIV-infected individuals.
The contract does not apply to Insured persons who participate directly in combat actions, armed conflict, military operations, persons who are established to be in the armed forces of Ukraine and/or other specially designated paramilitary formations and units, in the armed forces of the aggressor state (the Russian Federation), the Republic of Belarus.
The grounds for the Insurer's refusal to make insurance payments are:/p>
- Deliberate actions by the policyholder or the person in whose favour the insurance contract is concluded, aimed at the occurrence of an insured event, except for actions taken in a state of extreme necessity or necessary defence, or cases specified by law or international customs;
- Committing a deliberate criminal offence by the policyholder or a person for whom the insurance contract is made, which led to the occurrence of an insured event;
- The policyholder submitting false information about the insurance object, circumstances that are essential for assessing the insurance risk, or about the fact of the occurrence of an insured event; - Failure to promptly notify by the policyholder (the person identified in the insurance contract or by law) about the occurrence of an insured event without valid reasons or failure to fulfil other obligations specified in the insurance contract or by law, if it led to the inability of the insurer to establish the fact, cause, and circumstances of the occurrence of the insured event or the extent of the damage (losses);
- The presence of circumstances that are exceptions to the insured events and limitations of insurance as provided in the insurance contract;
- Failure to comply with the deadlines for reporting the accident, which may later be qualified as an insured event, to the relevant healthcare institution; - Failure of the Policyholder (Insured person) to fulfil their obligations under the Contract; - Failure to provide all necessary documents required for obtaining the insurance payment as stipulated in the insurance contract;
- Creating obstacles for the Insurer in determining the circumstances, nature, and extent of damage inflicted on the life and health of the Insured person;
- Non-compliance with the doctor’s appointments, leading to a deterioration in the health of the Insured person and/or the occurrence of an event that has the characteristics of an insurance case;
- The Insured person's refusal to undergo examination by the Insurer’s appointed doctor after the occurrence of the insurance event;
- The Insured person's belonging to the category of individuals who:
1. are registered at narcological and psychoneurological dispensaries;
2. recognised as incapacitated in the established manner, persons with disabilities of the first category, children with disabilities, HIV-infected;
3. participate directly in combat operations, armed conflict, military actions, individuals for whom there are established facts of being in the armed forces of Ukraine and/or other specially designated paramilitary formations and units, in the armed forces of the aggressor state (Russian Federation), republic of Belarus;
- Presence of other grounds established by the legislation of Ukraine;
2. The limits of liability of the Insurer for a specific insurance object, insurance risk and/or insurance event.
In the event of an insured event, regarding accident insurance, the Insurer will make an insurance payment.:
- in the event of the death of the Insured due to an accident - to the Beneficiary or heir in the amount of 100% of the insurance sum specified in the contract (unless otherwise stated in the contract);
- in the event of the Insured being assigned a disability group due to an accident - to the Insured in the following amounts:
- for the assignment of Group I disability – 100% of the insurance sum specified in the contract (unless otherwise stated in the contract);
- for the assignment of Group II disability – 80% of the insurance sum specified in the contract (unless otherwise stated in the contract);
- in the case of establishing a Group III disability - 60% of the insured amount specified in the contract (unless otherwise specified in the contract);
- in the case of establishing a primary disability of any group for the Insured Person under 18 years - 100% of the insured amount specified in the contract (unless otherwise specified in the contract).
- in the event of temporary incapacity for work of the Insured Person due to an accident - the Insured Person shall receive an amount determined in accordance with the contract, but not more than 50% of the insured amount specified in the contract (unless otherwise specified in the contract);
- in the event of traumatic injuries to the Insured person's body as a result of an accident, regardless of the degree of their incapacity for work, - the Insured person will receive a one-time payment in accordance with the table of insurance payouts. - If both types of insurance cases are simultaneously specified in the agreement: temporary incapacity for work and traumatic injuries to the Insured person's body as a result of an accident, the insurance payout will be made for one of these cases, at the choice of the Policyholder/Insured person, which the Policyholder/Insured person specifies when filling out the application for the insurance payout (unless otherwise stated in the agreement).
3. Procedures for calculating and conditions for making insurance payouts.
The insurance payout is carried out by the Insurer in accordance with the insurance contract based on the policyholder's application and the Insurer's decision to recognise the event as an insured case and to make the insurance payout (insurance certificate).
The Insurer makes a decision regarding the insurance payout/ denial of the insurance payout/ postponement of the decision on the insurance payout or denial of the insurance payout within 10 (ten) working days from the date of receipt of all the necessary documents specified in this Agreement, and in case of a decision to make a payout, prepares the insurance certificate.
The insurance payout is made by the Insurer within 10 (ten) working days from the date of the decision to make the insurance payout (issuance of the insurance certificate) by the method specified by its recipient in the insurance payout application.
If there are grounds and doubts regarding the justification (legality) of the insurance payment, the Insurer may postpone the decision on the payment or refusal of the insurance payment until confirmation or refutation of these reasons by competent authorities is received, for a period not exceeding 90 (ninety) working days from the date of submission of all documents specified in the Agreement.
The Insurer shall notify the beneficiary in writing of the refusal to make the insurance payment / decision to defer payment or refusal of the insurance payment within 5 (five) working days from the date of taking the relevant decision, with an explanation of the motivation for the decision to defer or justification of the reasons for refusal.
Full information on the calculation procedure and conditions for making insurance payments is specified in the General Conditions of the insurance product "ACCIDENT INSURANCE", which can be found at the link. https://universalna.com/documents/offers/R1-accident_insurance.pdf
Information document on the standard insurance product
https://universalna.com/documents/offers/ID-1411_31_12_24.pdf
Consequences of the accident:
The object of insurance is the life, health, and capacity to work of the Insured person.
Insurance is carried out for risks within the classes of insurance:
- risk within the class of insurance "accident insurance, including insurance for occupational injuries and diseases" of insurance class 1 "Accident insurance (including for occupational injuries and diseases)" (hereinafter referred to as class 1 or accident);
-the risk within the insurance class "health insurance" class 2 "Health Insurance (including medical insurance)" (hereinafter referred to as class 2 or illness). Insurance may be carried out under the following combination of classes:
1. class 1 (Packages "CHILD PROTECTION", "DRIVER PROTECTION", "PASSENGER PROTECTION", "DRIVER and/or PASSENGER PROTECTION");
2. class 1 and class 2 ("HEALTH PROTECTION").
Insurance is carried out under the risks within the insurance classes:
- the risk within the insurance class "accident insurance, including insurance for occupational injury and occupational disease" class 1 "Accident Insurance (including for occupational injury and occupational disease)" (hereinafter referred to as class 1 or accident);
- risk within the insurance class of "health insurance" class 2 "Health insurance (including medical insurance)" (hereinafter referred to as class 2 or illness).
Insurance can be carried out with the following combination of classes:
1. class 1 (Packages "CHILD PROTECTION", "DRIVER PROTECTION", "PASSENGER PROTECTION", "DRIVER and/or PASSENGER PROTECTION");
2. class 1 and class 2 ("HEALTH PROTECTION").
Insurance is carried out for risks within the classes of insurance:
- risk within the class of insurance 'insurance against accidents, including insurance for work-related injuries and occupational diseases' class of insurance 1 'Accident insurance (including for work-related injuries and occupational diseases)' (hereinafter referred to as class 1 or accident);
- risk within the class of insurance 'insurance for the case of illness' class of insurance 2 'Insurance for the case of illness (including health insurance)' (hereinafter referred to as class 2 or illnesses).
Insurance can be carried out under such a combination of classes:
1. Class 1 (Packages "CHILD PROTECTION", "DRIVER PROTECTION", "PASSENGER PROTECTION", "DRIVER and/or PASSENGER PROTECTION");
2. Class 1 and Class 2 ("HEALTH PROTECTION").
For the Packages "CHILD PROTECTION", "DRIVER PROTECTION", "PASSENGER PROTECTION", "DRIVER and/or PASSENGER PROTECTION", the insurance risk is:
Under class 1: an accident – a sudden, random, time-limited, unpredictable event that is independent of the will of the Insured person and/or another person defined in the Insurance Contract, that occurred as a result of external influence and caused harm to the life, health and/or ability to work of the Insured person.
The following are considered accidents under this Contract:
- For the packages "HEALTH PROTECTION" and "CHILD PROTECTION": traumatic injuries to the body (injuries, including from firearms), wounds, contusions, anaphylactic shock, accidental entry of foreign bodies into the respiratory tract, drowning, electric shock or lightning strikes, burns, frostbite, overheating, hypothermia, animal bites, stings from poisonous insects or snakes, etc., accidental poisoning from gases, household or industrial chemicals, drugs, and substandard food products (excluding infectious diseases), such diseases as rabies, tetanus, botulism, malaria, as well as tick-borne encephalitis;
- For the package "DRIVER PROTECTION": traumatic injuries (injuries), wounds, contusions, anaphylactic shock, accidental inhalation of a foreign body resulting from a road traffic accident (hereinafter referred to as RTC) that occurred while the Insured person was driving a vehicle involved in the RTC;
- For the packages "PASSENGER PROTECTION" and "DRIVER and/or PASSENGER PROTECTION": an accident that may occur as a result of a road traffic accident (hereinafter referred to as RTC) involving the Insured person while being in the vehicle as a passenger during the term and within the territory of the Agreement.
For the "HEALTH PROTECTION" package, the insured risks are:
Class 1: accident – a sudden, accidental, time-limited, unpredictable event that is independent of the will of the Insured person and/or another person defined in the Insurance Agreement, which occurred as a result of external influence and caused harm to the life, health and/or ability to work of the Insured person.
The following are considered accidents under this Agreement:
- bodily damage (injuries, including those from firearms), wounds, contusion, anaphylactic shock, accidental aspiration of foreign bodies into the respiratory tract, drowning, electrocution or lightning strikes, burns, frostbite, overheating, hypothermia, animal bites, stings from venomous insects, snakes, etc., accidental poisoning by gases, household or industrial chemicals, medicines, or substandard food products (excluding infectious diseases), such diseases as rabies, tetanus, botulism, malaria, as well as tick-borne encephalitis;
Class 2: a disease that first occurred in the Insured person during the term and within the territory of the Insurance Agreement.
- The following are recognised as illnesses under this insurance agreement: myocardial infarction, cerebrovascular disorder (stroke), malignant neoplasm.
Persons cannot be insured for the packages "HEALTH PROTECTION", "CHILD PROTECTION" and "DRIVER PROTECTION": 1. Aged over 80 years;
2. Recognised as legally incapacitated in accordance with the established procedure;
3. Those registered with narcological or psychoneurological dispensaries;
4. Persons with first group disabilities, children with disabilities, HIV-infected individuals;
For the Packages "CHILD PROTECTION", "DRIVER PROTECTION":
The amount of insurance is established in the insurance contract from 1,000 to 200,000 UAH:
The liability limit in case of an accident (class 1) from 1,000 to 200,000 UAH.
The sublimit for incidents (traumatic injuries to the Insured person's body as a result of the occurrence of the insured risk regardless of the degree of incapacity of the Insured person, determination of disability of the Insured person as a result of the occurrence of the insured risk, death of the Insured person due to the occurrence of the insured risk, temporary incapacity of the Insured person due to the occurrence of the insured risk) from 1,000 to 200,000 UAH.
The limit of liability for medical expenses incurred in the treatment of injuries and/or illnesses that are complications of injuries resulting from the occurrence of an insured risk ranges from 500 to 100,000 UAH. For the "CHILD PROTECTION" package, the limit for a single insurance case is 500 UAH.
For the "PASSENGER PROTECTION" and "DRIVER and/or PASSENGER PROTECTION" packages:
The amount of insurance is set in the insurance contract from 1,000 to 1,000,000 UAH:
The liability limit in the event of an accident (class 1) ranges from 1,000 to 1,000,000 UAH.
For the Package "HEALTH PROTECTION":
The amount of insurance coverage is determined in the insurance contract from 1,000 to 200,000 UAH:
The liability limit in the event of an accident (class 1) is from 1,000 to 200,000 UAH.
The sub-limit applies to cases (traumatic injuries to the insured person's body as a result of the occurrence of the insured risk regardless of the degree of disability of the insured person, establishment of disability for the insured person due to the occurrence of the insured risk, death of the insured person due to the occurrence of the insured risk, temporary disability of the insured person as a result of the occurrence of the insured risk) from 1,000 to 200,000 UAH.
The limit of indemnity for expenses on medication support in the treatment of injuries and/or diseases that are complications of injuries arising from the occurrence of an insured risk is from 500 to 100,000 UAH, with a limit of 500 UAH per insured event.
The limit of liability upon the occurrence of diseases (class 2) is from 1,000 to 200,000 UAH..
For the Packages «CHILD PROTECTION», «DRIVER PROTECTION», «PASSENGER PROTECTION», «DRIVER and/or PASSENGER PROTECTION» and «HEALTH PROTECTION» from 0.006% to 10%
Не передбачена.
The area of application of the contract is Ukraine and/or Europe, excluding:
- temporarily occupied territories of Ukraine as defined by legal regulations of Ukraine, including under the understanding of the Law of Ukraine "On Ensuring the Rights and Freedoms of Citizens and the Legal Regime in the Temporarily Occupied Territory of Ukraine", as well as territories where hostilities are (have been) taking place (within the duration of hostilities) or temporarily occupied by the Russian Federation, in accordance with the Resolution of the Cabinet of Ministers of Ukraine dated 06.12.2022 No. 1364, and the Order of the Ministry for the Reintegration of Temporary Occupied Territories of Ukraine dated 22.12.2022 No. 309; territories where, at the time of the occurrence of an event that may be considered an insured event, there are settlements where state authorities temporarily do not exercise their powers or are located along the line of conflict, in accordance with the Regulation of the Cabinet of Ministers of Ukraine dated 07.11.2014 No. 1085 with all amendments and supplements; territories that, in accordance with the legislation of Ukraine, are under occupation, temporary occupation, encirclement, blockade, and are territories where combat operations, military actions, and military conflicts take place.
The term of the contract is from 1 day to 1 (one) year inclusive.
The contract comes into effect from 00:00 hours on the start date of the contract, but not earlier than the payment of the insurance premium / first instalment of the insurance premium (if the contract provides for payment of the insurance premium in instalments) in the amount and within the timeframe specified in the insurance contract, to the Insurer's account (unless the contract provides otherwise) and is valid until 24:00 hours on the day specified in the Insurance Contract as the expiry date of the Contract. Insurance coverage under the Contract is valid throughout the term of the contract.
Untimely notification by the insured of the occurrence of an insured event without valid reasons, or failure to fulfil other obligations defined in the insurance contract or legislation, if this has led to the insurer's inability to determine the fact, causes and circumstances of the occurrence of the insured event or the amount of damage (loss) is grounds for refusal to make an insurance payout.
In the event of non-payment or partial payment of the insurance premium for the next insurance period, the insurance coverage under the contract shall not be valid, and the insurer shall not make any insurance payments for events that occur during the unpaid insurance period. Insurance coverage is restored from 00:00 hours on the day following the day of receipt of the insurance payment for the insurance period, the term of which is specified in the contract, in full amount to the insurer's account, and shall be effective until the end of the insurance period. The contract shall cease to be valid and the insurance coverage cannot be restored in the case of non-receipt or receipt of partial recurring insurance payments to the insurer's account within 10 (ten) working days.
The insurance product is not an addition to other goods, works or services that are not insurance. In connection with the conclusion of the contract, there is no need to obtain additional or ancillary services from the insurer and/or third parties related to receiving the financial service under the contract.
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The policyholder, before entering into an insurance contract, is obliged to inform the Insurer or the insurance intermediary of any circumstances known to them that are of significant importance for assessing the insurance risk (determining the probability and likelihood of an insurance event occurring and the amount of potential losses), and/or to provide any other information that is of significant importance for the Insurer's decision on entering into the insurance contract, including:
1) About the existence of an insurable interest, and/or about the amount of the insurance premium under the insurance contract;
2) Surname, first name and (if available) patronymic, date of birth, number (and if available - series) of the passport of a citizen of Ukraine (or another document that certifies identity and may be used in accordance with Ukrainian legislation within the territory of Ukraine for transactions), date of issue and the authority that issued it, information about the place of residence or stay, registration number of the taxpayer account card, number (and if available - series) of the passport of a citizen of Ukraine in which a mark is made about the refusal to accept the registration number of the taxpayer account card, or the passport number with a record of refusal to accept the registration number of the taxpayer account card in an electronic contactless medium, unique record number in the Unified State Demographic Register (if available); 3) Insurance coverage and insurance premium for each insured person; 4) Information for the identification of the beneficiary (if determined):
- name or surname, first name, patronymic (if available), date of birth of the beneficiary or - other information in accordance with the legislation of Ukraine and/or regarding the identification of the beneficiary to the extent sufficient for identifying the beneficiary in the event of an insured event and unambiguous determination of their right to receive an insurance benefit;
5) circumstances that have significant importance for assessing the insurance risk (determining the probability and likelihood of an insured event occurring and the amount of potential losses):
- whether a disability group has been established for the insured person;
- whether the insured is recognised as incapacitated in accordance with established procedure;
- whether the insured person is registered with narcological and psychoneurological dispensaries;
- whether the insured person is HIV-positive;
6) information about the existence of a lawful insurance interest in relation to the object of insurance, including the existence of such interest for the beneficiary (if such a person is specified in the insurance contract).
The consumer/client, to make an informed decision about entering into an insurance contract, must familiarise themselves with the following before entering into such a contract:
1. Exceptions to insurance incidents and grounds for refusing insurance payments. For the packages "CHILD PROTECTION", "DRIVER PROTECTION", "PASSENGER PROTECTION", "DRIVER and/or PASSENGER PROTECTION" and "HEALTH PROTECTION":
The grounds for the Insurer's refusal to make insurance payments are:
- Deliberate actions of the policyholder or the person in favour of whom the insurance contract is concluded, the Driver of the vehicle aimed at causing the insurance incident, except for actions taken in a state of extreme necessity or necessary defence, or cases defined by law or international customs;
- The commission of a deliberate criminal offense by the policyholder or a person in favour of whom the insurance contract has been concluded, which has resulted in the occurrence of an insured event;
- The submission of false information by the policyholder regarding the insured object, circumstances that are of significant importance for assessing the insurance risk, or regarding the occurrence of the insured event;
- Untimely notification by the policyholder (the person designated in the insurance contract or by law) of the occurrence of an insured event without valid reasons or failure to fulfil other obligations specified in the insurance contract or by law, if this has resulted in the insurer's inability to establish the fact, cause and circumstances of the occurrence of the insured event or the amount of damage (losses);
- The presence of circumstances that are exceptions to the insured events and limitations of insurance provided for in the insurance contract;
- Non-fulfilment by the policyholder (insured person) of their obligations under the Contract;
- Non-fulfilment or violation of instructions from the Specialist Service of the Insurer (Insurer);
- The policyholder's refusal to undergo examination or expertise appointed by the Insurer to confirm the fact and circumstances of the occurrence of the insured event and the amount of expenses;
- Creating obstacles for the Insurer in determining the circumstances, nature, and extent of damage caused to the life and health of the insured person;
- The insured person's affiliation with persons who:
1. are registered with narcological and psychoneurological dispensaries;
2. recognised in the established order as incapacitated, persons with disabilities I, children with disabilities, HIV-infected
- The presence of other grounds established by the legislation of Ukraine.
Events that occurred in the case of the following are not recognised as insurance cases:
- the committing of suicide or attempted suicide by the Insured person;
- actions of the Insured person/Policyholder/Heirs when committing or attempting to commit illegal acts that are directly causally related to the insured event, as established by competent authorities (including criminal acts committed by the Policyholder or Insured person, disobedience to authorities (such as fleeing the scene, being pursued by police officers, etc.));
- exposing the Insured person to unjustified risk, conscious danger (except for saving the life of another person);
- consumption by the Insured person of alcohol, narcotic, toxic substances, as well as poisoning by surrogate alcohol (except in cases of violent application of these substances against the Policyholder (Insured person) by third parties), being in a state of alcohol, narcotic, toxic intoxication at the time of the insured event;
- accidents and illnesses that occurred prior to the conclusion of the Insurance Agreement and/or after the expiry of the Insurance Agreement, as well as for the "DRIVER PROTECTION" package not being the result of a road traffic accident, if it is not possible to establish a causal link between the road traffic accident and the insured event, as confirmed by the conclusion of a competent authority;
- the insured event occurred outside the territory of the Insurance Agreement;
- of war (declared or undeclared), combat or military actions (regardless of whether war was declared or not), performance of military service obligations, military invasions, acts of warfare, civil war, terrorist acts, anti-terrorist operations, joint forces operations, coups, revolutions, uprisings, riots, strikes, lockouts, civil (mass) unrest, military or unlawful seizure of power and/or temporary inability (full or partial) of the state (local) authorities to exercise their powers, arrests, etc. It is considered that all possible types of unlawful actions committed are an integral part of the aforementioned actions/events (exclusions) and are actually related to their occurrence;
- the occurrence of an event that has characteristics of an insured event in the temporarily occupied territory of Ukraine, as defined by the regulatory acts of Ukraine, including in the understanding of the Law of Ukraine "On Ensuring the Rights and Freedoms of Citizens and the Legal Regime in the Temporarily Occupied Territory of Ukraine", and the territory where hostilities are taking place (have taken place) (within the duration of hostilities) or temporarily occupied by the Russian Federation in accordance with the resolution of the Cabinet of Ministers of Ukraine dated 06.12.2022 № 1364, Order of the Ministry for Reintegration of the Temporarily Occupied Territories of Ukraine dated 22.12.2022 № 309; the territory within which at the time of the occurrence of the event that has the characteristics of an insured event, there are populated areas where the state authorities temporarily do not exercise their powers or are located on the line of contact, in accordance with the Order of the Cabinet of Ministers of Ukraine dated 07.11.2014 № 1085 with all amendments and supplements; the territory that, according to Ukrainian legislation
- actions of nuclear energy in any form, use of fissile materials, ionising radiation;
- self-treatment or treatment by a person without appropriate medical education and/or qualifications; intentional infliction of bodily harm by the Insured person on themselves;
- carrying out any form of dangerous work by the Insured person;
- engaging in professional sports and/or extreme sports (mountaineering, diving, etc.);
- confiscation, requisition, nationalisation, seizure of vehicles and other actions ordered by military or civil authority;
- explosion resulting from the transport, storage of explosive substances, munitions in a vehicle (hereinafter referred to as 'vehicle');
- conscious use of the Insured/Driver of the vehicle in a known emergency technical malfunction condition, particularly during tyre wear;
- use of the vehicle for purposes other than intended or in violation of the vehicle's technical operating conditions;
- operation of the vehicle by the Insured/Driver (Insured person) who is not authorised to operate and/or possess or manage this vehicle according to current legislation of Ukraine;
- operation of the vehicle by the Insured (Insured person) while in a state of illness, fatigue, or under the influence of medications that impair reaction speed and attention (according to the Road Traffic Rules), if there is a direct causal link between the state of the Insured (Insured person) and the occurrence of the insured event;
- operation of the vehicle under the influence of alcohol and/or with the presence of ethanol in the body or under the influence of narcotic or toxic substances;
- unlawful actions of third parties;
- violations by the Insured/Driver of the vehicle of road traffic rules, namely: exceeding the established speed limits by more than 50 km/h; passing on a prohibited traffic light signal or the gesture of a traffic controller; entering a railway crossing when the barrier is closed; moving into the oncoming traffic lane in places where this is prohibited; failure to comply with road signs that prohibit vehicle movement; reversing at intersections;
- while using the vehicle for educational, sports riding, as a taxi, or participating in competitions;
- treatment that is not related to the insured event or not caused by medical necessity.
Under this Agreement, no damage shall be paid:
- caused outside the scope specified in the Vehicle Insurance Agreement; - caused in the event of suicide, suicide attempt while operating or being in the vehicle;
- as a result of events that occurred before the conclusion or after the expiration of the Agreement;
- moral damage, lost profits.
For class 1, the Insurer does not reimburse costs for:
- medications not prescribed by a doctor, as well as medicines purchased outside the pharmacy network of Ukraine or not registered with the Ministry of Health of Ukraine;
- medical equipment, medical instruments (except for syringes and infusions, as well as disposable surgical instruments, materials and devices necessary for surgical intervention), care, hygiene, sanitation and cosmetic products;
- outpatient medical treatment lasting more than 60 days for a single insurance case; preventive and rehabilitation treatment;
- treatment by unconventional methods, including homeopathic remedies, dietary supplements.
The following are not considered insurance cases under Class 2:
- diseases specified in the Insurance Agreement that the Insured Person was aware of before entering into the Insurance Agreement;
- diseases other than those specified in the Insurance Agreement.
Under this agreement, the following individuals are not considered Insured Persons:
- for the "CHILD PROTECTION" package, those under 3 years old and over 18 years old (unless otherwise specified in the Insurance Agreement);
- for the "HEALTH PROTECTION" package, those over 55 years old (unless otherwise specified in the Insurance Agreement);
- for the "DRIVER PROTECTION" package, those under 18 and over 75 years old (unless otherwise specified in the Insurance Agreement).
Under this agreement, those who are registered with narcological and psychoneurological dispensaries at the time of concluding the insurance contract are not considered Insured. Persons officially declared incapacitated, persons with disabilities of groups I, II, III, children with disabilities, and those living with HIV are also excluded.
The insurance contract may restrict and/or clarify (specify) the list of exclusions from insurance cases and limitations of coverage.
2. The limits of the Insurer's liability for specific insurance objects, insurance risks and/or insurance events (defined within the insurance sum).
For the Packages "CHILD PROTECTION", "DRIVER PROTECTION":
The liability limit in the event of an accident (class 1) ranges from 1,000 to 200,000 UAH.
The sub-limit for cases (traumatic injuries to the Insured person's body resulting from the occurrence of an insurance risk regardless of the degree of incapacity of the Insured person, the establishment of disability for the Insured person as a result of the occurrence of the insurance risk, the death of the Insured person as a result of the occurrence of the insurance risk, temporary incapacity of the Insured person as a result of the occurrence of the insurance risk) ranges from 1,000 to 200,000 UAH.
The limit of compensation for medicinal expenses in the case of treatment for injuries and/or diseases that are complications of injuries caused by the occurrence of an insured risk from 500 to 100,000 UAH. For the "CHILD PROTECTION" package, the limit for one insurance case is 500 UAH.
For the "PASSENGER PROTECTION", "DRIVER and/or PASSENGERS PROTECTION" packages:
The liability limit in the event of an accident (class 1) from 1,000 to 1,000,000 UAH.
For the "HEALTH PROTECTION" package:
The liability limit in the event of an accident (class 1) from 1,000 to 200,000 UAH.
Sub-limit of liability for cases (traumatic injuries to the Insured Person's body as a result of the occurrence of an insured risk, regardless of the degree of incapacity of the Insured Person, establishment of disability of the Insured Person due to the occurrence of an insured risk, death of the Insured Person as a result of the occurrence of an insured risk, temporary incapacity of the Insured Person as a result of the occurrence of an insured risk) from 1,000 to 200,000 UAH.
Sub-limit of liability for the case of expenses for medication support in the treatment of injuries and/or diseases that are complications of injuries caused by the occurrence of an insured risk from 500 to 100,000 UAH, limit per insurance case – 500 UAH.
Limit of liability in case of diseases (class 2) from 1,000 to 200,000 UAH.
3. The procedure for calculating and the conditions for making insurance payments.
In the event of an insured incident under class 1, the Insurer makes a payment:
- In the event of the death of the Insured person as a result of an accident - to the Beneficiary or heir in the amount of 100% of the liability limit specified in the Insurance Contract. For the "PASSENGER PROTECTION" and "DRIVER and/or PASSENGER PROTECTION" packages - 100% of the insured amount established for one seating place;
- In the event of the Insured person being awarded a disability group as a result of an accident - to the Insured person in the following amounts:
- when establishing a disability group for insured persons under 16 years old - 100% of the liability limit specified in the insurance contract;
- when establishing Group I disability - 100% of the liability limit specified in the insurance contract. For the ‘PASSENGER PROTECTION’ and ‘DRIVER and/or PASSENGER PROTECTION’ packages - 100% of the insured amount set for one seat;
- when establishing Group II disability - 80% of the liability limit specified in the insurance contract. For the ‘PASSENGER PROTECTION’ and ‘DRIVER and/or PASSENGER PROTECTION’ packages - 80% of the insured amount set for one seat;
- in the case of being assigned a disability group III - 60% of the liability limit specified in the Insurance Contract. For the 'PASSENGER PROTECTION' and 'DRIVER and/or PASSENGERS PROTECTION' packages - 60% of the insured sum established for one passenger seat;
- In the event of traumatic injuries to the Insured Person's body as a result of an accident, regardless of the degree of incapacity, the Insured Person will receive a one-time payment in accordance with the Table of Insurance Payments, which is Appendix No. 1 (hereinafter referred to as 'Table of Insurance Payments').
- in the case of temporary incapacity for work - at a rate of 0.2 percent of the insurance sum established for one seat, for each day of incapacity, but not more than 50 percent of the specified insurance sum established for one seat;
The insurance payment within one insurance incident is made by the Insurer based on the final consequences of the accident:
- in the event of disability being established after payments for temporary health disorder (with payment according to the payment table) within one insurance incident, the Insurer pays the difference between the amount paid for temporary health disorder and the amount that should be paid upon establishment of disability; - when the Insured Person is established with a more serious degree of disability, the Insurer pays the difference between the amount that should be paid upon establishment of a more serious degree of disability and the amount paid upon establishment of a less serious degree of disability;
- in the event of the death of the Insured Person, the Insurer pays the difference between the liability limit specified in the Agreement and the total amount of all insurance payments according to the terms of the insurance contract.
In the event of an insured event, "expenses for medication in the treatment of injuries and/or illnesses that are complications of injuries resulting from the occurrence of the insurance risk" of class 1, the Insurer makes an insurance payment:
- For the package "HEALTH PROTECTION" and "CHILD PROTECTION" in the amount of the expenses of the Insured person for medication and/or diagnostic services prescribed by a doctor, but not exceeding the liability limit set forth in the Insurance Agreement and a limit of 500 UAH for a single insurance case. In case the occurrence of the insured event is related to engaging in contact sports (free wrestling, Greco-Roman wrestling, judo, Cossack duel, hand-to-hand combat, traditional karate, kickboxing, boxing, judo, sambo wrestling, sumo, etc.) - compensation is provided at 50% of the limit for a single insurance case for medical expense insurance (coverage is provided no more than twice a year); - For the package "DRIVER PROTECTION" in the amount of the expenses of the Insured person for medication prescribed by a doctor, but not exceeding the liability limit set forth in the Insurance Agreement. In the event of an insured case in class 2, The insurer makes an insurance payment.:
- in the event of a diagnosis of the illness specified in the Insurance Agreement - the Insured Person shall be entitled to 100% of the insured amount as specified in the Insurance Agreement.
For the packages "DRIVER PROTECTION", "HEALTH PROTECTION" and "CHILD PROTECTION":
The insurer makes a decision regarding the insurance payment/refusal of the insurance payment/postponement of the decision on the insurance payment or refusal of the insurance payment within 10 (ten) working days from the date of receipt of all necessary documents provided in accordance with the terms of the Insurance Contract, and, in case a decision is made to pay out, draws up an insurance act.
The insurance payment is made by the insurer within 10 (ten) working days from the date of decision on making the insurance payment (drawing up the insurance act), by the method specified by its recipient in the insurance payment application.
In the presence of grounds for doubt regarding the justification (legality) of the insurance payment, the Insurer may postpone the decision on payment until confirmation or refutation of these grounds is received for a period not exceeding 90 (ninety) working days from the date of submission of all documents specified in the Insurance Agreement. The Insurer shall inform the recipient in writing about the refusal to make the insurance payment/the decision to defer payment or to refuse the insurance payment within 5 (five) working days from the date of the corresponding decision, providing the rationale for the decision made on deferral or the reasons for refusal.
For the packages 'PASSENGERS PROTECTION' and 'DRIVER and/or PASSENGERS PROTECTION':
The insurer, within 12 (twelve) calendar days from the moment of receiving the last of the required documents confirming the fact, reasons, and circumstances of the insurance case:
- makes a decision on the insurance payment and prepares an insurance act determining the amount of the insurance payment, or
- makes a reasoned decision to refuse the insurance payment, or
- in case of an objective necessity to carry out additional measures to establish the circumstances of the insurance case, postpones the deadline for making a decision on the insurance payment/refusal of the insurance payment until such circumstances are established, but for no more than 180 (one hundred and eighty) calendar days, after which it makes one of the above-mentioned decisions.
Regarding the refusal of an insurance payment or the postponement of a decision on the insurance payment/refusal, the Insurer shall notify the Insured in writing within 12 (twelve) calendar days, stating the reasons for the decision or the justification for the refusal. The insurance payment shall be made by the Insurer within 12 (twelve) calendar days from the date of the decision on the insurance payment, using the method specified by the recipient in the application for the insurance payment. The insurance payment under the Agreement shall be made regardless of the amount that the Insured person is entitled to receive from state social insurance and social security, and the amount that is to be paid to them as compensation for damages under such provision.
After the Insurer makes an insurance payment, the Agreement remains in force until the end of its term in the amount of the difference between the insurance sum as per the Agreement and the amount of the insurance payment made. The Policyholder has the right to restore the insurance sum to its initial amount by making the appropriate changes to the Agreement and paying an additional insurance premium.
If, after the insurance payment is made, circumstances arise that completely or partially deprive the Policyholder (Insured Person) of the right to receive it, the Policyholder (Insured Person) is obliged to return the insurance payment received to the Insurer within 12 (twelve) calendar days from the date of discovering such circumstances.
For all the above-mentioned packages:
The insurance payment is made by the Insurer in the national currency of Ukraine (hryvnia). The date of the insurance payment is considered to be the date the funds are debited from the Insurer's account. The fact of the Insurer making the insurance payment is confirmed by the respective payment document.
The amount of the insurance payment for each insured risk within the class of insurance cannot exceed the insured sum specified in the Insurance Agreement for this risk within the class of insurance and the limits of liability.
The Insurance Agreement, under which the insurance payment was made, remains in effect until the end of the term, while the insured sum established for the insured risk within the class of insurance is reduced by the amount of the insurance payment made by the Insurer for this risk within the class of insurance. The Insurer makes the insurance payment to the Policyholder/Insured Person/Beneficiary, in accordance with the terms of the Agreement.
Complete information on the calculation procedure and conditions for insurance payments is specified in the General Terms of the insurance product "PROTECTION", which can be found at the link https://universalna.com/documents/offers/R1-zakhyst.pdf
Information document on the standard insurance product
https://universalna.com/documents/offers/ID-13_31_12_24.pdf