Lump-sum accident insurance

2024 Author: Howard Calhoun | [email protected]. Last modified: 2023-12-17 10:16

Insurance against accidents (HC) is the third most popular type of insurance after OSAGO and Casco. It covers the risks associated with loss of working capacity, death of the driver/passengers. In the process of issuing the policy, the sum insured is set at the request of the insured. Depending on the terms of the contract, there are two ways to calculate it: by the seat system and by the lump-sum system. In the first case, the payment is determined based on the number of seats in the car, and in the second, a percentage of the sum insured is set.

The essence of the term

The concept of "lump sum" in German means the total amount of the purchase for a certain amount of goods. In franchising, the term refers to the cost of the right to market under a well-known brand name. A lump-sum insurance system is a specific system in which the amount of payment is provided for the entire vehicle: each person who was in it during an accident is recognized as insured and receives a certainshare of the total.

For whom?

Unfortunately, the number of accidents on Russian roads is increasing. If another driver is found guilty of the accident, then the insurance company (IC), which issued the OSAGO policy to him, is obliged to pay compensation. However, there are times when there is no one responsible for the accident. In such situations, you can receive compensation under insurance from the National Assembly in an accident. Within the framework of this agreement, two payment options are provided: lump-sum and seat insurance system.

Features

The lump-sum payment system is suitable for vehicles of legal entities, in the cabin of which there are passengers. For example, fixed-route taxi drivers should insure passengers at each seat they occupy. A limit is set for the victims as a percentage: 40% of the total amount for one person, no more than 35% for two. If there are more victims, then the payment is divided equally among all. At the same time, according to statistics, in an accident, the passenger sitting in the front seat is most at risk. The severity of his injuries is much higher than that of passengers in the back seats. This is despite the fact that the payments are shared by everyone.

An accident according to the lump-sum system is damage to life and he alth as a result of which the victim died, received a disability group, or was injured. In case of complete disability, the amount of the benefit depends on the assigned group and is calculated as a percentage of the sum insured per person:

• for 1 group - 90-100%;
• for group 2 – 70-80%;
• for group 3 - 50-60%.

In the event of the death of a passenger, a payment of 100% is made.

It should be noted that not all companies make payments in case of total disability. If such a clause is present in the contract, then the calculation of the amount under the lump-sum system can be carried out in two ways.

1. In % of the sum insured for each day of disability. At the same time, the maximum payout amount is set at 10-50% of the limit.
2. Depending on the extent of the injury. The Appendix to the Insurance Rules contains a table with a list of possible consequences of an accident. It sets the payout amount.

Restrictions

The lump-sum payment system provides for limits that depend on the number of persons:

• who were in the cabin at the time of the accident;
• accident casu alties;
• applicants for payment.

Limit per person is:

• 40-50% if there is only one victim;
• 35% if there are two victims;
• 30% if there are three victims;
• the sum insured is divided by the number of people if four or more people were injured as a result of an accident.

Important! When calculating the payment, the insured divides the total amount by the number of persons, regardless of the number of victims. For example, if only the driver was in the car at the time of the accident, the payment will be 2-2.5 times less than the total amount under the contract.

What else to look for

Before signing the insurance contract, you should study the rules and parameters of the product in detail. Different insurance companies differ in the following parameters.

1. List of events. It does not always correspond to the list of risks related to the vehicle. So, when applying for an accident policy, passengers can count on payment only in case of an accident.
2. Notice deadline. Sometimes victims are given more days to file a claim than in car damage cases.
3. Coverage area. Even if hull insurance is valid on the territory of foreign countries, HC insurance may not cover the risks of causing harm to the he alth of passengers outside the Russian Federation.
4. The insured rarely can independently choose the risks, apply the franchise. This "inflexibility" reduces the demand for this product. Nevertheless, the payments under the policy from the National Assembly do not depend on the compensation for the Casco. Human life and he alth are priceless. Therefore, reimbursement is always paid in full on all policies.

How to get paid out

After the occurrence of an insured event, you must notify the company. Within 5 days, a decision is made whether the case is insured. If questions arise, the company has the right to conduct its own investigation for 30 days. After a positive decision is made, the victim must be provided with the results of a medical examination. Payments are made according to the described limits. However, according to the law, the UK must pay compensation, even if all the certificates are not provided.

Where else is usedterm

There is a lump-sum wage system for seafarers. The amount consists of base salary and other benefits such as overtime compensation. The seafarer's employment contract clearly states the number of hours that he must work for remuneration, as well as all kinds of payments under the lump-sum system. If an hourly scheme is applied, then the rate must be at least 25% higher than the base rate. The same principle applies if overtime is paid on a lump-sum basis.