What accident insurance covers
Personal accident insurance (in Russian, NS) pays out money if a sudden external event harms your health: a fall, a road accident, a burn, an animal bite, an injury in training. Unlike DMS (voluntary medical insurance), an accident policy does not pay a clinic for treatment; it pays money to the insured person or their family, to be used as they see fit: rehabilitation, lost income, medicines.
The main risks:
- Injury — fractures, dislocations, burns, wounds; paid according to a table of benefits.
- Hospital stay due to an accident — a fixed amount per day in hospital.
- Temporary disability — a payment for days on sick leave.
- Disability of group I, II or III — a percentage of the sum insured.
- Death from an accident — a payout to the beneficiaries.
Many programmes let you add illness risks, tick bites and sports.
Who needs it
An accident policy is useful for people with an active lifestyle, parents of schoolchildren and young athletes, drivers, manual workers and anyone without a financial cushion for a long recovery. Children's policies are often bought for the school year, sports policies for competitions: many event organisers require accident insurance.
For trips abroad an accident policy does not replace travel insurance: abroad, what matters is paying for treatment, not receiving money after you return.
Laws and regulation
Personal accident insurance is a voluntary type of cover; the contract is concluded under Chapter 48 of the Russian Civil Code and the insurer's policy wording. There is also compulsory insurance for certain groups (for example, transport passengers under Federal Law No. 67-FZ, or employees against workplace accidents through the Social Fund), but it does not replace a personal policy. Under Bank of Russia Directive No. 3854-U a voluntary accident policy can be cancelled within 14 calendar days if there have been no insured events.
What drives the price
- the sum insured and set of risks;
- occupation: office work is cheaper than working at height or with machinery;
- sports, especially professional or extreme;
- term and hours of cover: around the clock or only at certain times;
- age of the insured person;
- number of people insured: family plans are usually better value.
You can get an estimate with the calculator.
How to set the sum insured
Accident payouts are calculated from the sum insured: for death and group I disability the whole sum or most of it is usually paid, for injuries a percentage according to the table. So the sum should be large enough for the payout to really help.
- For an adult with dependants, base it on several years of family income and loan obligations.
- For a child or athlete, covering rehabilitation and recovery after injury matters more.
- If the policy is needed only to enter a competition, check the minimum sum the organiser requires.
How to choose a plan and insurer
- Decide what you want to protect against: injury, disability, lost income, death.
- Look at the benefits table: how much is paid for a broken arm, concussion, surgery.
- Check whether your sport is covered and on what terms.
- Look at the exclusions: alcohol or drug intoxication, driving without a licence, conditions known before purchase.
- Compare companies in the directory of insurers.
How to claim
- Get medical help and make sure the injury is recorded: an emergency room certificate, discharge summary, X-rays.
- Notify the insurer within the time set in the policy wording.
- Collect documents: claim form, passport, medical records with the diagnosis and date, and if needed a sick-leave certificate or a disability certificate from the medical and social expert commission (MSE).
- File the claim online or at an office and receive the payout within the time set by the wording.
Detailed instructions are in the Insurance claim section.
Common mistakes
- Not seeing a doctor straight away. Without medical records on the day of the injury, it is hard to prove an accident.
- Not declaring sports. An injury in training without a sports option may be excluded.
- Confusing accident cover with DMS. An accident policy pays money; it does not arrange treatment.
- Too small a sum insured. Payouts are a percentage of the sum, so with a small sum the compensation is token.
For long-term family protection see also life insurance and critical illness insurance.
