List of documents in case of an insurance event

The insurance payment is made on the basis of a written application from the recipient of the payment, an identity document and supporting documents.

The list of documents that must be provided is given in the Rules (Policy Conditions) of insurance, on the basis of which your insurance contract was concluded or in the insurance contract (policy).

«Permanent total loss of working capacity», «Disability» as a result of illness:

• Certified copy of the Certificate from the branch of the Bureau of Medical and Social Expertise on assignment of a disability group.
• Certificate of examination (Branch of the Bureau of Medical and Social Expertise). A 4-page document certified by this medical institution.
• A copy of the Referral to the Medical and Social Expertise (form 088/u-06) (a document issued by a hospital, clinic, oncology dispensary or other medical institution certified by this medical institution) and a return coupon to it.
• A copy of the outpatient card or an extract from the outpatient card at the place of residence (certified by this medical institution).
• A copy of the return coupon from the Bureau of Medical and Social Expertise, which is sent to the medical institution that referred the insured person for examination and assignment of a disability group to him.
• A copy of the inpatient card or an extract from the inpatient card (medical history) (certified by this medical institution) institution).

• A certificate from a medical institution or a copy certified by this medical institution, indicating the diagnosis for which the disability was established.
• A copy of the rehabilitation program for the disabled person (indicating which medical institution referred the insured person for examination to assign a disability group).
• A copy of the outpatient card or an extract from the outpatient card (certified by this medical institution).

In case of realization of the risk of "Permanent total loss of working capacity", "Disability" as a result of an accident.

• Copy of the Certificate from the branch of the Bureau of Medical and Social Expertise (assignment of a disability group).
• Extract from the Certificate of examination (Branch of the Bureau of Medical and Social Expertise). A 4-page document certified by this medical institution.
• Copy of the Referral to the Medical and Social Expertise (document issued by a hospital or clinic, certified by this medical institution).
• Copy of the outpatient card or extract from the outpatient card (certified by this educational institution).
• Copy of the inpatient card or Extract from the inpatient card (medical history) (certified by this medical institution).

• Copy of the Certificate of accident at work (Form-N1), certified by the institution or enterprise where the accident occurred.
• Original or copy of the certificate (certified by the LU) on the content of alcohol, narcotic, or toxic substances at the time of the insured event.
• Copy of the accompanying sheet/coupon of the emergency medical service, which indicates the state (alcohol, narcotic, or toxic substances) of the insured at the time of the insured event.
• Copy of the resolution on initiation/refusal to initiate a criminal case from the investigative bodies (OVD, Prosecutor's Office, Investigative Department, and other law enforcement agencies) certified by this institution.
• Copy of the court decision, certified by this institution.

«Death» as a result of illness

• A copy of the death certificate, certified by a notary, or the original from which a copy is made by an employee of the claims department and certified by an employee of the claims department.
• A copy of the death certificate and/or a copy of the medical death certificate indicating the cause of death.
• A copy of the postmortem summary from the hospital (certified by this medical institution).
• A copy of the outpatient card or an extract from the outpatient card at the place of residence (certified by this educational institution).
• A copy of the hospital card or an extract from the hospital card (history illness).

• If the insured died at home, on the street, in a country house, in the metro or other public places (NOT in a hospital), the following are required:
• A copy of the Autopsy Report (certified by this medical institution):
1. A forensic medical examination report (external description of the body, injuries).
2. A forensic chemical examination report (internal description of the corpse with blood tests, organ fragments for alcohol, narcotic and toxic substances).
• Copy of the resolution on initiation/refusal to initiate a criminal case from the investigative bodies (OVD, Prosecutor's Office, Investigative Department and other law enforcement agencies) certified by this institution.
• Copy of the outpatient card or an extract from the outpatient card (certified by this medical institution) from the place of work (VHI insurance).
• Certificate of the right to inheritance by law (if the Beneficiary is not appointed)

“Death” as a result of an accident

• Copy of the death certificate, notarized or the original from which a copy is made by an employee of the claims department and certified by an employee of the claims department.
• Copy of the Death Certificate and/or copy of the medical death certificate indicating the cause of death.
• Copy of the resolution on initiation/refusal to initiate a criminal case from the investigative bodies (OVD, Prosecutor's Office, Investigative Department and other law enforcement agencies) certified by this institution.
• Copy of the Autopsy Report (certified by this medical institution):
1. Forensic medical examination report (external description of the body, injuries).
2. Forensic chemical examination report (internal description of the corpse with examination of organ fragments for alcohol, narcotic and toxic substances).

• Copy of driver's license in case of an accident, if the insured was driving a vehicle.
• Copy of the court decision, certified by this institution.
• Certificate of right of inheritance by law (if the Beneficiary is not appointed).

«Permanent total loss of working capacity», «Disability» as a result of an accident:

• Copy of the Certificate from the branch of the Bureau of Medical and Social examination (assignment of disability group).
• Extract from the Certificate of examination (Branch of the Bureau of Medical and Social Expertise). A 4-page document certified by this medical institution.
• Copy of the Referral to the Medical and Social Expertise (document issued by a hospital or clinic, certified by this medical institution).
• Copy of the outpatient card or an extract from the outpatient card (certified by this educational institution).
• Copy of the hospital card or an extract from the hospital card (medical history) (certified by this medical institution).

• Copy of the Industrial Accident Report (Form-N1), certified by the institution or enterprise where the accident occurred.
• Original or copy of the certificate (certified by the LU) on the content of alcohol, narcotic, or toxic substances at the time of the insured event.
• Copy of the accompanying sheet/coupon of the SMP, which indicates the state (alcohol, narcotic, or toxic substances) of the insured at the time of the insured event.
• Copy of the resolution on initiation/refusal to initiate a criminal case from the investigative bodies (OVD, Prosecutor's Office, Investigative Department, and other law enforcement agencies) certified by this institution.
• Copy of the court decision, certified by this institution.

“Death” as a result of an accident or illness in the territory of another state

• Death Certificate translated into Russian, certified by a notary.
• Death Certificate translated into Russian, certified by a notary.
• Medical documents and documents from the police translated into Russian, certified by a notary.
• Copy of the document confirming repatriation (transportation of the body to the territory of registration and residence of the insured person, i.e. the Russian Federation).
• If the autopsy was performed in the territory of another state, then the autopsy data translated into Russian, certified by a notary, are required. notarized.
• If the autopsy was performed on the territory of the Russian Federation, a copy of the autopsy from the forensic medical examination (certified by this institution) is required.

«Injury (Temporary loss of working capacity as a result of an accident)»

Bodily injury of the insured, payment according to Table No. 1 (extended) or Table No. 5.

The amount of insurance payment for sick leave, which is from 0.2% of the insured amount (specified in the Agreement), for each day of temporary disability, starting from the day of disability specified in the agreement and not more than 90 days.

• A copy of the sick leave certificate(s) with all the seals of the LU, certified by the HR department at the place of work. In the event that the amount of insurance payment is calculated based on sick leave certificates.
• The original or a copy of a detailed extract from an outpatient card indicating the circumstances, date of injury, and diagnosis (certified by this institution).
• The original or a copy of a certificate from a trauma center (certified by this institution) indicating the date of injury and first aid provided.
• The original or a copy of a detailed extract from a hospital card (medical history), certified by this institution.
• A copy of the accompanying sheet/coupon from the emergency medical service, which indicates the state (alcohol, narcotics or toxic substances) of the insured at the time of the insured event, if the insured was delivered to a medical facility by an emergency medical service.
• A conclusion of an X-ray and/or ultrasound examination, computed tomography and/or magnetic resonance imaging, depending on the nature of the injury, confirming the diagnosis
• The original conclusion of a neurologist and an encephalogram with a conclusion (in case of concussion, contusion and crushing of the brain.
• A copy of the Act on an accident at work (Form-N1) certified by the institution or enterprise where the accident occurred.
• A copy of the resolution on initiation/refusal to initiate a criminal case from investigative bodies (OVD, Prosecutor's Office, Investigative Department and other law enforcement agencies) certified by this institution, if the injury is of a criminal nature.
• A copy of the court decision (certified by this institution) if a criminal case was opened by law enforcement agencies case.

“Partial permanent disability” as a result of an accident

Insurance payment is made according to Table No. 3 (short).

• Original or copy of detailed extract from outpatient card indicating circumstances, date of injury, and diagnosis (certified by this institution).
• Original or copy of certificate from trauma center (certified by this institution) indicating date of injury and first aid provided.
• Original or copy of detailed extract from hospital card (medical history), certified by this institution.
• Copy of accompanying sheet/coupon of emergency medical service, indicating in what condition (alcohol, drugs or toxic substances) the insured was at the time of the insured event, if the insured was delivered by emergency medical service to a medical institution.
• X-rays with description for fractures of any localization.
• Original neurologist's report and encephalogram with a conclusion (in case of concussion, contusion and crushing of the brain.
• Copy of the Industrial Accident Report (Form-N1) certified by the institution or enterprise where the accident occurred.

"Partial permanent disability" as a result of an accident

• A completed application for insurance payment indicating the bank details for transferring the insurance payment.
• Copies of all sick leaves, certified by the HR department.
• Extract from the history illness/certificate from the casualty department with a diagnosis.
• X-rays with a description, results of laboratory and biochemical studies confirming the fact of an accident or illness.
• Medical report on the results of the Insured's blood test on the presence/absence of alcohol, narcotic or toxic substances in the blood on the date of opening of the sick leave.
• Neurologist's report, encephalogram with a conclusion (mandatory in case of closed craniocerebral injury - concussion, bruise, crushing of the brain).
• Act on an insured event at work (form H1), if the realization of the insurance risk is associated with an accident during the performance of official duties by the Insured.
• A copy of the resolution on the initiation/refusal of a criminal case or other documents from the relevant internal affairs agency, if the death of the Insured or its circumstances are recorded by the internal affairs agency in accordance with applicable law.
• If temporary disability occurred as a result of illness, then an official medical document on the health status of the Insured.

«Diagnosing the Insured’s Health»

• A copy of the hospital card or an extract from the hospital card (medical history) (certified by this medical institution).
• A copy of the outpatient card or an extract from the outpatient card (certified by this educational institution).
• Documents that are the result of machine processing:
• electrocardiograms, radiographs, CT scan results and other documents/images that are the result of machine processing, name and date of birth must be made in a way that does not allow any changes, i.e. must form a single whole with the document/image without the possibility of changing them.
• Any available medical documents confirming the established diagnosis.

«Death as a result of SOB»

• A copy of the death certificate certified by a notary or a copy of the original certified by an employee of the claims department.
• A copy of the Death Certificate and/or a copy of the medical death certificate indicating the cause of death.
• Copy of outpatient card from the clinic or extract from the outpatient card (certified by this educational institution).
• Copy of postmortem summary from the hospital (certified by this medical institution).

• Copy of the Autopsy Report (certified by this medical institution):
1. Forensic medical examination report (external description of the body, injuries).
2. Forensic chemical examination report (internal description of the body with examination of organ fragments for alcohol, narcotic and toxic substances).
• Copy of the resolution on initiation/refusal to initiate a criminal case from investigative bodies (OVD, Prosecutor's Office, Investigative Department and other law enforcement agencies) certified by this institution.
• Copy of outpatient card or extract from outpatient card under VHI insurance (if any).

«Hospitalization»

• Copy of inpatient card or Extract from inpatient card (medical history), certified by this medical institution.
• Copy of outpatient card from polyclinic or extract from outpatient card (certified by this educational institution).

«Surgical operation"

• A copy of the hospital card or an extract from the hospital card (medical history), certified by this medical institution.
• A copy of the outpatient card from the clinic or an extract from the outpatient card (certified by this educational institution).