An accident. What to do?

1.The following documents shall be submitted to the Insurer to determine the amount and make a decision on insurance indemnity:
1.1. a copy of the Insurance contract (Policy) or the original at the Insurer's request (only for individual insurance contracts);
1.2. a written application in the prescribed form for receipt of insurance indemnity with a detailed description of the circumstances of the insured event and indicating the method of receipt of insurance indemnity (through the Insurer's cash desk or by transferring to a bank account with bank details);
1.3. a copy of the document certifying the person receiving the insurance indemnity;
1.4. a copy of the certificate of assignment of an identification code to the person receiving the insurance payment;
1.5. if the recipient of the insurance payment is a legal entity, the following documents of such legal entity shall be submitted: certificate of state registration (copy); certificate of assignment of an identification code according to the Unified State Register of Enterprises and Organizations of Ukraine (copy); document confirming the authority of the head or representative of such legal entity (extract from the Charter, order, power of attorney, etc.).

2.The following documents shall be submitted to the Insurer to determine the amount and make a decision on payment of insurance indemnity in case of an insured event related to the Insured person's death

2.1. documents specified in sub-clauses. 1.1. -1. 5. of this List;
2.2. original death certificate of the Insured person or its copy certified by a notary or issuing authority;
2.3. a copy of the medical certificate of death of the Insured person in the form established by the Ministry of Health of Ukraine;
2.4. a copy of the Occupational Accident Report (Form H1) or the Official Investigation Report, duly drawn up (if the accident occurred while the Insured Person was performing his/her official duties);
2.5. the original document (Certificate, Resolution) issued by the relevant body of the Ministry of Internal Affairs, Ministry of Emergencies, Prosecutor's Office, or a copy of the document certified by the seal of the Ministry of Internal Affairs, Ministry of Emergencies, Prosecutor's Office (if necessary, namely: Road accidents, airplane crashes, fires, illegal actions, etc;)
2.6. a certificate from a medical institution confirming the presence or absence of alcohol, drug or toxic intoxication of the Insured at the time of the Insured Event (if any);
2.7. a copy of the court decision/order to close the criminal proceedings or an extract of the information entered into the Unified Register of Pre-trial Investigations on the completion of the pre-trial investigation;
2.8. the original certificate of inheritance or a notarized copy thereof, which includes the insurance payment (in cases where the Beneficiary is not determined on the date of the insured event, as well as in cases of death, the court declaring the Beneficiary dead after the insured event).

3.The following documents shall be submitted to the Insurer to determine the amount and make a decision on payment of insurance indemnity in case of an insured event related to the occurrence of a survival event
3.1. the documents listed in clauses 1.1. to 1.5. of this list;
3.2. the Insured shall confirm the fact of survival until the expiry of the Insurance contract or reaching the retirement age or the age specified in the Insurance contract (personally appear to the Insurer or allow the Insurer's representative to certify this).

4.In order to determine the amount and make a decision on payment of insurance indemnity upon occurrence of an insured event related to assignment of disability group to the Insured person, the following documents shall be submitted to the Insurer
4.1. the documents specified in paras. 1.1. - 1.5. and in subparagraphs 2.4. - 2.6. of this list;
4.2. the original of the MSEC certificate of disability group determination or its copy certified by a notary or the issuing authority; for a minor Insured Person - the original of the Medical Care Committee certificate of disability determination or its copy certified by a notary or the issuing authority;
4.3. a copy of the individual rehabilitation program for a disabled person (disabled child) in the form established by the Cabinet of Ministers of Ukraine;
4.4. a copy of an extract from the Insured person's medical history and/or a copy of an extract from the medical record and/or other medical certificates explaining the diagnosis;
4.5. In case of fractures and dislocations (subluxations) of bones, ruptures of joints (including syndesmosis), X-ray confirmation of the said injuries is a prerequisite for the application of the relevant articles of the Table.
 

5.The following documents shall be submitted to the Insurer to determine the amount and make a decision on payment of insurance indemnity in case of an insured event related to long-term disability
5.1. the documents listed in paras. 1.1. - 1.5. and in subpara. 2.4. - 2.6. of this list;
5.2. a copy of the extract from the Insured person's medical history and/or a copy of the extract from the medical record and/or other medical certificates explaining the diagnosis;
5.3. copies of closed sick leave certificates certified by the HR department with a seal at the Insured person's place of work.
5.4. In case of fractures and dislocations (subluxations) of bones, ruptures of joints (including syndesmosis), X-ray confirmation of the said injuries is a prerequisite for application of the relevant articles of the Table.
 

6.The insurance agreement may also provide for other (additional) documents to be submitted for the purpose of receiving the insurance payment.
 

7.All certificates and extracts from medical institutions must contain a diagnosis, as well as signatures of officials of the medical institution, the seal and stamp of the medical institution.
 

8.All documents submitted with the application for insurance payment shall contain the name and date of birth of the Insured Person, namely:
● on electrocardiograms, X-ray images, examination results, computed tomography scans and other documents/images resulting from machine processing, the name and date of birth must be scanned, i.e. must be a single whole with the document/image without the possibility of their correction.
● on other documents: medical certificates, extracts, reports, etc., the name and date of birth must be indicated in a way that makes it impossible to correct them.
 

9.All documents provided for in this section and submitted to the Insurer in connection with insurance payments shall be drawn up in Ukrainian or Russian. If the documents submitted to the Insurer are issued in a foreign country, they must be duly legalized, including an apostille (if applicable) and/or a notarized translation. In case of submission of documents that cannot be read due to peculiarities of handwriting of a doctor or employee of a competent authority, as well as due to violation of integrity of the document (torn, crumpled, erased, etc.), the Insurer shall have the right to postpone the decision on payment until the documents of proper quality are submitted.
 

10.If it is not possible to establish the fact of occurrence or absence of an insured event based on the submitted documents, the Insurer shall have the right to request additional documents from the Insured, the Insured person, the Beneficiary, law enforcement agencies, medical institutions, banks and other enterprises and organizations that have information about the circumstances of the insured event.
 

11.If not all documents are provided to the Insurer to determine the amount and make a decision on insurance payment, the Insurer shall be entitled to make a decision on insurance payment on the basis of the provided documents, provided that such documents are sufficient to establish the fact of the insured event and the amount of insurance payment.
 

12.In case of doubts as to the authenticity and/or reliability, as well as sufficiency of documents submitted by the Insured (the Insured person) in connection with the occurrence of an event having signs of an insured event or to confirm the state of disability, including when assigning a disability group, The Insurer shall have the right to refer the Insured for repeated laboratory and instrumental examinations (including ultrasound, X-ray and other radiation diagnostics), repeated medical examinations performed by doctors of various specialties. The said examinations and medical examinations shall be performed by doctors appointed by the Insurer in the places designated by the Insurer and at the Insurer's expense.