Thus, the Institute of OSS from industrial accidents and professional diseases Provides except compensatory payments A number of insurance services related to the mechanisms for the prevention of accidents, curriculum Preparation of personnel to safe work, as well as with the provision of medical and rehabilitation assistance to the injured in production.

Insured persons (employees), insured and insurer are subjects of non-accident relations on accidents on accidents on industrial accidents and occupational diseases.

The most important functions of insurance against industrial accidents and occupational diseases are:

- the function of compensation for the material damage of employee income from damage to their health and the loss of working capacity;
- financial activities of the Insurer for Accumulation and Management of Financial Resources;
- organization of comprehensive social protection of victims by compensation payments, the provision of medical and rehabilitation assistance;
- the implementation of assessments and analysis of the reasons for the competence of professional risk due to industrial accidents and occupational diseases;
- making proactive measures to reduce the likelihood and reduce the severity of the consequences of professional risks.

Insured, in case of damage to its health and ability to work, compensates for the loss wages and reimbursement medical helpAnd also organizes medical, professional and social rehabilitation programs aimed at the maximum possible restoration of working capacity and providing the possibility of professional retraining and a device for work. Thus, the insurer, represented by its specialists, organizes the complex social protection of victims by compensation payments, the provision of medical and rehabilitation assistance.

Another feature of the insurer is the identification and analysis of typical mass professional risks of industrial injuries and professional morbidity. To this end, the Insurer specialists have a staff of highly professional technical inspectors and medical workerswhich conduct systematic checks for risk factors in workplaces and in production. These employees have the right to issue orders to employers in order to eliminate violations of security rules in the operation of machinery and equipment and work organization.

Evaluation, identification and prevention of risky situations in the best possible way to be organized in the specialization of technical inspectors and medical workers on the same type of industries and production industries, the use of modern diagnostic devices, methods and procedures, the possibilities of research centers and laboratories to identify constructive disadvantages of equipment and risk factors existing in technological processes.

The insurer's control function includes in its arsenal of funds:

- Penalties for employers and employees for gross violations of safe activities;
- Punishment of guilty people with the help of a full or partial refusal to them in insurance protection.

The extreme measure to policyholders (employers) for violations of the rules of safe activities in production is to establish increased insurance premiums that financially burdens them and requires a change in their attitude to safe activities.

The most serious instrument of influence on individual employers allowing coarse and, often, intentional actions, as a result of which accidents occur in production, this is refusing to refund costs of accidents with the help of insurance mechanisms. The imposition of expenses for damage to employees, if the cause of an accident was rude negligence by the employer, emphasizes an irreconcilable position to malicious violators safe labor activity.

Another direction of the preventive activity of the Insurer in the field of assessment and minimizing professional risks is the formation of anti-grade enterprises in the staff. For this purpose, insurer specialists are widely educated in enterprises for clarifying employers and employees physical, chemical, biological and psychological nature of professional threats. It is believed that employers and employees will correctly perceive the requirements of safe work and respond to potential hazards through not only administrative and repressive measures, and on the basis of the understanding of the nature of the manifestation of risks, the formation of motivational installations and internal culture of safe behavior at work.

Insured persons by this kind social insurance The citizens of the Russian Federation as well foreign citizens and stateless persons, unless otherwise provided by federal law or international Agreement of the Russian Federation.

Ridgel VII Holding Visory І Flammable control over Orsdi Pratsy

Ridge VIII Vіdpovіdalnіst for the defendant of the legislative about Okhane Pratsy

Law "On Social Insurance"

Provisions "On Investigation of Accidents at Production"

I. Rosselіduvannya Ta Oblіk Nechadny Vipadkiv Zagalnі

3. For the results of Roslіduvannya to take on the oblast і we wake up the act for the form of H-1 Torzor at the Breas:

61. Komіsiya Z Roslіduvanny Zobov "Yasana:

3. Rosselіduvannya Tu oblak Avar

Article 5. Basic Insurance Principles for Accident

The main principles of insurance From an accident are:

state parity representatives of insured persons and employers in managing accident insurance;

timely and complete damage to the insurer;

obligatory insurance against accidents of persons who Work on the terms of employment contract (contract) and other grounds provided for by legislation on labor, as well as voluntaryness of such insurance for persons who provide themselves with independently, and citizens - business entities;

providing state guarantees implementing insured citizens of their rights;

obligatory payment of insurance premiums by the insured;

the formation and consumption of insurance funds on a joint basis;

differentiation of the insurance factor taking into account conditions and condition of occupational safety, industrial injuries and professional morbidity at each enterprise;

economic interest in subjects of insurance in improving the conditions and safety of labor;

target use of accident insurance facilities.

Article 6. Subjects and Accident Insurance Objects

Account Insurance Subjects are insured citizens, and in some cases members of their families and other persons, insurers and insurer.

Insured is an individual, in the interests which insurance is carried out (hereinafter - the employee).

Insured by employersAnd in some cases - insured persons.

Insurer - Social Insurance Fund From accidents at the production and occupational diseases of Ukraine (hereinafter referred to as the Foundation for Social Insurance against Accidents).

Object insurance against unfortunate The case is the life of the insured, his health and ability to work.

Article 7. Employer

An employer in accordance with this law is considered to be a legal (enterprise, institution, organization) or an individual, which within the limits of labor relations uses the labor of individuals.

Article 8. Persons subject to mandatory accident insurance

Compulsory insurance OT Accidents are subject to:

1) persons who work on the terms of employment contract (contract) or on other grounds provided for in labor legislation;

2) students and students of educational institutions, clinical orders, graduate students, doctoral students attracted to any time work before or after classes; during classes when they acquire professional skills; During the period of production practices (internship), the performance of works in enterprises;

3) Persons which are contained in correctional, medical and labor, educational-Trudovaya establishments and are involved in labor activities in these institutions or other enterprises on special treaties.

Article 9. Insurance of the embryo and newborn

Causing harm to the embryo as a result of injury at the production or professional disease of a woman during her pregnancy, in connection with which the child was born with disabilities, equal to the accident, which happened to the insured. Such a child in accordance with medical examination is considered insured and up to 18 years or until the end of study, but no more than 23 years old have been assisted by the Social Insurance Fund from Accidents.

Article 10. Employee Insurance Procedure

For insurance against accident in production, there is no harmony or an employee's statement. Insurance is carried out in an impersonal form. All the persons listed in Article 8 of this Law are considered insured since the entry into force of this law, regardless of the actual implementation of their obligations regarding the payment of insurance premiums.

All insured are members of the Social Insurance Fund from Accidents.

Article 11. Voluntary insurance From an accident

Voluntarily From an accident may insure:

1) persons who provide themselves with independently - A lawyer, notarial, creative and other activities related to obtaining income directly from this activity are engaged, members farm, personal peasant farming, if they are not hired employees;

2) citizens - entities of business activities.

3) priests, chickens

Article 12. Accident Insurance Certificate

Persons to be insured against accident is issued a certificate of publicly binding state social insurance, which is one for all types of insurance.

Article 13. Insurance Risk and Insurance Case

Insurance risk - circumstances, as a result of which an insured event may happen.

The insured event is an accident at work or a professional disease, which entailed the insured professionally predetermined physical or mental injury under the circumstances noted in Article 14 of this Law, with the onset of which the authorities of the insured personality arise to obtain material support and / or social services.

The professional disease is an insured event also in the case of its establishment or detection during the period when the victim was not in labor relations with the enterprise on which he fell ill.

Violation of labor protection rules insured, which entailed an accident or a professional disease, does not exempt the insurer from fulfilling commitments to the affected.

The basis for payment for the affected costs of medical care, medical, professional and social rehabilitation, as well as insurance payments is an act of investigating an accident or an act of investigating a professional disease (poisoning) on \u200b\u200bestablished forms.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted by http://allbest.ru.

Introduction

insurance Unhappy damage payment

Insurance as sphere financial activities originated from separation public labor And it developed as the human value of his life, health and property awareness.

In the conservation of a market economy, insurance belongs to the number of the fastest growing industries economic activity. Market economy, and above all the non-state sector national economy, makes demand for different kinds insurance because private propertyUnlike state-owned, needs a comprehensive insurance protection. She has no financial guarantee for its back of the state and wants to protect themselves from the consequences of possible risks.

Insurance belongs to the number of the oldest and sustainable forms of ensuring the economic life, which goes back in the distant history. Insurance is carried out on the basis of property or personal insuranceconcluded by a citizen or legal entity (insured) with an insurance organization (insurer). In essence, insurance is the creation of trust funds moneyintended to protect the property interests of the population in private and economic life from natural disasters and other emergency events random by their nature accompanied by damages.

In society, insurance plays the role of a mechanism that redistributing financial resources (Insurance Fund) from all members of the Society to those who need financial assistance as a result of insured cases that occurred with them. In contrast to social insurance, where most or all citizens are insured, redistribution occurs only between members of a particular insurance fund that paid insurance premiums into it.

Accident Insurance is the most traditional type of personal insurance for insurance practices. The main purpose of insurance against accidents is compensation for damage caused by the health and life of the insured as a result of an accident.

Accident Insurance is a traditional view of life insurance, the content of which in lately It has changed due to the inclusion of additional insurance coverage in the form of insurance of deadly diseases, therefore, the full modern name of this species is insurance against accidents and diseases. The main purpose of insurance against accidents is compensation for damage caused by the health and life of the insured as a result of an accident or the occurrence of the disease.

1. Subject S.fucked and insurance coverage

1.1 Accident Insurance History

Insurance against accidents over the years of market reforms has undergone significant changes. They are associated with the introduction of mandatory types of accident insurance for certain categories and groups of the population, the development of collective forms of insurance of employees of enterprises and organizations, the emergence and rapid distribution of such new for the domestic practice of the type of insurance, as insurance of citizens traveling abroad.

In the classification of types of insurance activities given by the Rustkhnadzor in terms of licensing insurance activities in the territory of the Russian Federation, traditional accident insurance is replaced by insurance against accidents and diseases and is defined as "a collection of personal insurance types, providing for the obligations of the insurer for insurance payments in a fixed amount, or in The size of partial or complete compensation of additional expenses of the insured caused by the offensive insurance case" As practice shows, in most cases insurers limit their responsibility only by accident, leaving the risk of diseases in the competence of medical insurance and life insurance.

The main purpose of insurance against accidents is compensation for damage caused by the health and life of the insured as a result of an accident.

Insurance against accidents leads its beginning from the 19th century. Its appearance is largely due to the emergence and development of railway transport. However, the idea of \u200b\u200binsurance against accidents was known much earlier. The Sea Right of Wisby 1541 demanded that the owner of the ship insured the life of his captain from accidents. In the Netherlands, in 1665, there was a fee for the loss of different members of the body for hired troops. In the 18th century in Germany, unions of mutual assistance in case of fractures were created. In the 19th century, this type of insurance began to develop in England, where a railway message appeared before other countries.

In the development of insurance against accidents in Russia, working legislation played a major role. Under pressure from the labor movement and reception of European states by law of June 2, 1903. The rules on the remuneration of victims of the victims due to accidents and employees, as a result of accidents, and equal members of their families, in the enterprises of the factory-factory, mining and mining industries. This document introduced the obligation of the employer to compensate for the harm caused by the employee as a result of an accident at work, in the form of temporary disability benefits (50% of earnings), compensation for medical expenses, the appointment of a pension for disability and pensions on the occasion of the loss of the breadwinner, as well as the payment of fixed benefits on Break.

In 1912, as part of a whole package of documents that introduced mandatory insurance of employees, a more perfect document-law was adopted and an application for insurance of workers from accidents. Compulsory accident insurance was distributed to all workers employed at factory and mining enterprises, shipping and on rail transport Private and some others.

In addition to compulsory insurance, they developed widely in pre-revolutionary Russia and voluntary forms of accident insurance. They were engaged like large joint-stock companiesand the society of mutual insurance.

IN soviet time Mandatory insurance against industrial accidents was introduced into the social insurance system, and its implementation is entrusted with a specially created state Fund Social insurance, which before the early 1990s. managed trade unions.

Voluntary insurance against accidents was conducted by the State Region. This type of insurance was the most popular in the field of personal insurance.

During the period of market reforms of the 1990s. The scope of application of accidents from accidents was much expanded: it provides insured and members of their families with comprehensive protection against economic consequences The offensive of disability or death that occurred as a result of unforeseen and random events.

Insurance practices from accidents shows that it can be carried out in various forms, while maintaining a single socio-economic content. Currently, accident insurance in the Russian Federation may be mandatory, carried out by the law, or voluntary on commercial basis.

1.2 Accident concept

Insurance is carried out on the basis of a personal insurance contract concluded by a citizen or legal entity.

Under the accident is understood as a sudden, external, unforeseen effect on the human body, the result of which is the harm of the health of the insured.

"Suddenness" means that the accident must be relatively short-term event (this does not apply to its consequence, i.e. damage to the health of the victim).

If a person has been subjected to harmful effects for a long time ambientThese impacts cannot be classified as an accident.

Similarly, undermining health due to excessive loads for a long time, for example, during sports, it is impossible to be considered as an accident.

Sunbathing in the sun, resting fell asleep and got strong burns.

There is no sign of suddenness, since the exposure to the sun on the human body was gradual.

The skier hit the tree, fell and injured.

Bunch of tree should be classified as a sudden action.

The concept of surprise also includes elements of unexpected, unforeseen and inevitable. This means that in certain cases, a relatively long time event can be viewed as a sudden.

For example, as an accident should be classified the death of the insured, which comes from a long-term inhalation of poisonous gases from a faulty furnace, if he could not see the leakage of gas, which has neither color, no smell, or did not have time to do anything, as he lost consciousness.

External impact.

Classified as an accident affecting a person can be mechanical, chemical, thermal and electric. Organic and functional changes occurring in the human body throughout its life are internal impacts, such as stroke or infarction, and do not belong to this category of events. As an external impact, human actions can also be considered.

The impact on the human body

Under the influence, classified as an accident, insurance is understood as the phenomenon of nature, for example fire, ice, and the actions of the people themselves who harm their health.

Continuous nature

The impact on the human body in insurance is considered as an accident only under the condition that as a result of its head of the insured unforeseen, harm was harmful. Suicide, as well as causing insured itself, injuries are not included in the insurance coverage.

It should be emphasized that a sign of unforeseen is not to an event, but to harm affected by the health of the insured person as a result of its offensive. How intimidated should be harmful to the health applied as a result of self-defense or when trying to save human life. The events that occurred as a result of the gross negligence of the insured person as a result of his offensive.

How intimidated should be harmful to the health applied as a result of self-defense or when trying to save human life.

The events that occurred as a result of the coarse negligence of the insured person are also recognized as an insured event if the insurer cannot prove that the harm of health was deliberately applied.

Damage to the health of the insured

The external impact on the human body is an accident if the immediate result of this event is to damage the health of the insured in the sense of the violation of the anatomical and physiological integrity of the body. Therefore, property damage resulting from external influence on the insured, for example, damage to the prosthetic limbs, dentures or points is not refundable for this type of insurance. For pay insurance compensation It does not matter what kind of harm was applied to the health of the insured. The term "harm to health" is not limited to direct corporal injuries. It is enough if, as a result of the external influence of the insured, a mental injury was applied, which can be expressed in nervous excitement, shock, omensitivity etc.

It is important to emphasize that in order to recognize the event by an insurance case, it is necessary to have a causal relationship between an accident, damage to the health of the insured and the damage to be insurance compensation. The burden of proof is entrusted with the law on the insured.

An accident is also considered to be events in which due to physical overvoltage of the insured person occurs the departments of the spine or joints of the limbs or a stretch or muscle break, tendons, ligaments or articular bags.

Thus, an accident is recognized as not only harm caused by the health of the insured as a result of a sudden external influence, but also due to excessive physical exertion. At the same time, there are in mind the conscious actions of the most insured, leading to the excessive tension of the forces, which, in turn, harms its health in the form of dislocation, stretching and breaking.

Damage to intervertebral discs and meniscus relating to age-related changes in the body, but manifested after severe exercise, are excluded from insurance coverage. This is explained by the fact that from an anatomical point of view, intervertebral discs and meniscus are cartilage, not tendons, ligaments, muscles or articular bags. Thus, the specified expansion of the insurance coverage applies only to typical injuries resulting from sports.

Exception from insurance coverage

In the composition of exceptions, two groups are allocated: certain events and certain types of damage.

Exceptions from insurance coverage make up the following events, which in all signs, although they are an accident, but on the consequences of which the insurance coverage does not apply.

Accidents that occurred as a result of mental disorders or disturbances of consciousness, including those caused by alcoholic or narcotic intoxication of the insured person, as well as strokes, epileptic seizures or convulsions that propagate on the whole body. Insurance guarantees are preserved, however, if these disorders or seizures were caused by an event included in the insurance coverage under the contract.

Accidents in which the insured as a result of the commission or attempt to commit them to unlawful actions.

Military actions, civil wars and other internal riots, if the insured accepted or civil war caught the insured face unexpectedly abroad, the insurance protection for this type of insurance within seven days is distributed.

Accidents that occurred with the insured when controlling lethal devices, including sports, or at the time of being in them as a crew member (in case of professional activity insured). These risks can be included in the insurance coverage at the conclusion of special insurance contracts through the Hermann Society of aeronautics. In addition, at present, some insurers are already offering the appropriate additional insurance coverage within voluntary insurance against accidents.

Racing Competitions on motor vehicles. Insurance coverage does not apply not only to the driver, but also on other people who are in the vehicle cabin involved in racing.

Accidents caused by atomic energy. An exception is not only damage caused by nuclear radiation, but also accidents as a result of explosions, a sharp change in pressure, due to the coming panic, etc.

Of the insurance coverage, the harm caused by the health of the insured as a result of the following events:

The insurance coverage eliminates the defeat caused by all kinds of ionizing rays. If the cause of the disease is radiation therapy, the insurance protection is maintained, provided that this therapy was assigned to treat the effects of an accident insured for the relevant contract. Persons, by the nature of their activities, exposed to increased radiation irradiation may insure the risk of a professional illness by including relevant reservations to the accident insurance contract or by concluding special insurance contracts.

Conducting therapeutic measures and surgical interference if they were not caused by the need to treat the effects of an accident.

For individual professions related to increased risk of infectious diseases, such as doctors, medium medical personnel, it is possible to include these risks into insurance coverage in cases where the causative agents of the disease in the insured organism occurred through skin damage or by injection.

Infectious diseases.

Insurance coverage is maintained, however, if the causative agent of the infectious disease has fallen into the body of the insured person as a result of injuries or injuries obtained due to an accident included in the insurance coverage under this Agreement. Minor damage to the skin and mucous membrane, through which the causative agents of the disease could get into the body of the insured immediately or after a certain time, are not considered injuries as a result of an accident.

Infectious diseases are the nature of the disease. That is why they are excluded from insurance coverage under accident insurance agreements. The responsibility of the insurer is maintained only in cases where at the beginning of the chain of causal relationships there is an insurance accident and the causative agent of the disease falls into the body of the insured person as a result of the defeat caused by this accident. AIDS disease and its consequences also constitute exceptions to the insurance coverage, if infection occurred through small lesions of the skin or mucous membrane.

Poisoning due to the adoption of solid or liquid substances through the throat.

It should be emphasized that it is the ingress of poisoning substances into the body through a throat is a basic condition for excluding the insurance coverage. If the insured inhales the poisoning substance or receives it in the form of an injection, then the insurance coating is preserved.

Obtaining a poisoning substance through a throat means also that the insured itself is undertaking actions through which it enters the body. It does not matter whether he acted voluntarily or forced, consciously or being in ignorance. If the poisoning substance fell into the body of the insured through the actions of third parties, the responsibility of the insurer remains.

The exclusion from the insurance cover is provided by the hernia of the white line of the abdomen and inguinal hernias, except when they arose as a result of violent external influence on the insured.

Insurance coverage does not apply to intervertebral disks, as well as bleeding internal organsUnless they were caused by an insurance accident.

An exception to the insurance coating is also nervous disorders, which are a mental reaction of the insured for certain events.

Some companies insure accidents that occurred as a result of the violation of the consciousness of the insured due to alcohol intoxication. When controlling the vehicle, however, the maximum boundary of the blood alcohol content should not exceed 1.3%

A number of insurers also offers insurance for the so-called passive risk of hostilities.

Types of insurance guarantees

Voluntary insurance against accidents in case of death offers a wide range of insurance guarantees, which are included in the treaties under the Agreement of the Parties. By entering into an insurance contract, the insured is entitled to freely choose the type and amount of insurance coverage.

The most important guarantee provided by the Insured from Accidents is the guarantee of insurance payments in case of disability, which is necessarily included in the contract. The remaining types of guarantees are coordinated at the discretion of the parties in addition. Insurance payments for disability include:

Insurance payments in case of death

Daily cash benefit

Daily monetary allowance during the stay in the hospital

Monetary allowance during recovery, including payment of sanatorium treatment, space operations, etc.

1.3 Object and incident insurance subjects

Insurance against accidents guarantees protection in the form of payment of compensation upon an accident occur.

The object of insurance against accidents on Russian legislation is the property interests of the insured associated with disability or death due to an accident.

The main subjects of insurance relations are insurers and insurers. Under the personal insurance contract, one party (insurer) undertakes to the contract due to the contract (insurance premium) paid by the other party (by the Insurer), to pay at a time or paid a periodically due to the agreement (insurance amount) in case of harmfulness of the life or health of the most independent Citizen agreement (insured person).

Insurers recognize legal entities and capable individualswho have concluded insurance contracts with insurers or being insured by the law

Insurers are legal entities created in accordance with the legislation of the Russian Federation for insurance, reinsurance, mutual insurance and licenses in accordance with the procedure established by this Law.

Insurers are evaluating insurance risk, insurance premiums are obtained ( insurance contributions), form insurance reserves, assets invest, determine the amount of damages or damage, produce insurance payments, carry out other related obligations under the insurance contract.

1.4 Insurance cover

Accident Insurance offers four basic guarantees. However, in practice, insurers can use various combinations of these standard coatings or exclude some of them from private insurance conditions.

Accident Insurance Guarantees:

Basic warranties:

Insurance amount in case of death;

Insurance amount in case of disabilities;

Daily allowance for temporary disability;

Payment of medical expenses for treatment;

Additional warranties:

Pension on the loss of the breadwinner;

Disability pension;

Care allowance;

Payment of prosthetics and cosmetic surgery;

Payment of expenditures on sanatorium-resort treatment required for rehabilitation.

Warranty in case of death as a result of an accident implies the payment of the beneficiary specified in insurance contract, or heirs of the insured defined in private insurance monetary sum. At the request of the policyholder, capital can be paid in the form of rent (pensions).

There are two approaches for determining disability coefficients . In the first case, insurance companies based on their own statistical observations are developing tables that assess the loss of disability based on the complete loss or loss of the functionality of various organs, or use state tables used in determining damages from accidents at work.

Table 1. Calculation coefficients of disability in the complete loss or functional unfortunate parts of body parts and senses

Full loss or final functional unfortunate body part or sense organs	Disability ratio,%
One eye
Rumor one ear
Smean
Taste sensations
One hand in the shoulder joint
One hand above the elbow joint
One hand to the elbow statute
Brush one hand
One thumb brush hand
One index finger brush hand
One finger brush hand: medium, unnamed or little finger
One leg above the middle of the thigh
One leg before the middle of the hips
One leg to knee
One leg until the middle of the leg
One foot in the ankle joint
One thumb
One any other finger

If within one year since the accident as a result of it comes an irreversible deterioration in the physical or mental state of the insured (disability), then he is paid to the insurance indemnity in the form of a certain amount of money, the size of which depends on the degree of disability.

So broad definition of the concept of disability is not chosen by chance. On the one hand, it falls under it the deterioration of all the functions of the human body. On the other hand, such a definition, such a definition can be used in relation to the insured persons of all age groups regardless of the nature of their activities.

Disability must be installed by a doctor for three months after one year after the accident occurred, as the insurer is obliged to declare the insurer in the prescribed manner.

The guarantee in case of temporary disability ensures the insured reimbursement in the form of a daily allowance for the treatment and rehabilitation.

The provision of this warranty has significant features. First, the amount of benefits is established in proportion to the insurance amount specified in the Treaty for the risk of temporary disability. As the maximum limit of the allowance, the size of the average daily labor income of the insured is taken. Secondly, the warranty in case of temporary disability usually contains a franchise, expressed in the number of the first days of disability during which the allowance is not paid. The most common is a franchise lasting seven days. Thirdly, the guarantee in case of temporary disability has a limit on the duration of the benefit payment period. This period is negotiated in private insurance conditions and is traditionally 365 days.

A guarantee of payment for medical expenses necessary for the treatment of accident consequences provides for reimbursement of hospitalization costs, outpatient treatment, medicines, care.

As an option, the cost of prosthetics, cosmetic surgery and sanatorium treatment can be proposed. The amount of guarantees is determined as a percentage of the costs. According to the basic guarantees, payment can be set at a level of 100% of payment for medical expenses, according to an additional no more than 20-50%. Typically, the size of this guarantee depends on the degree of coverage of the costs of treatment at the expense of social insurance or social security.

In general, about insurance coverage during accident insurance, it is necessary to allocate two different approaches to the definition of specific amounts of insurance payments. The Insurance Company establishes the size of all guarantees in a percentage of one amount provided for in case of death or uses various insurance amounts to determine each warranty. Domestic insurers prefer to conduct all guarantees based on one insurance amount in case of death using various percentage norms. However, in any case, the total amount of insurance compensation payments for one or more insurance events that occurred during the insurance contract may not exceed the sum insured indicated in the contract or insurance amounts for each guarantee if several insurance amounts are specified in the contract.

Typical Insurance Insurance Rules Developed by the All-Russian Insurers Union, recommend to determine the amount of insurance payments as a percentage of the sum insured in this type of insured claims in accordance with the insurance payment table when paying the insured person of overall working capacity as a result of an accident on the basis of a hospital and preventive institution certificate , as a rule, without examining the insured person (Table.3). If the insured person has obtained damage to the soft tissues, organs of vision, hearing or the genitourinary system, it can be sent by the insurer to examine the specialist doctor to determine the consequences of such damage. According to the same rules due to the onset of temporary disability, in the amount of 0.2% of the sum insured in this type of insured event for every day of disability, starting from the 6th calendar day of disability, but not more than 90 days per year.

Table 2. Excerpts from the pay table with a loss of the insured face of overall working capacity as a result of an accident,% of the Insurance amount

	Character of damage or its consequences
	Concussion of the brain at which treatment is required for 10 days and more
	Brain injury
	Accommodation paralysis of one eye
	Damage to one eye, resulting in a complete loss of sight of one eye
	Damage to one or both eyes resulting in a complete loss of view
	Full deafness
	The breakpoint breakpoint, which has occurred as a result of injury, without a decrease in hearing
	Lung damage, resulting in:
	passenger failure
	removal of part, lung share
	light removal
	Fracture breasts
	Fracture of ribs:
	three ribs
	each next rib
	Fractures of jaws:
	upper jaws, zick bones
	lower jaw, dislocation of the lower jaw

2. Insurance types of accidents

2.1 Mandatory Insurance against Accidents in the Russian Federation

Mandatory insurance against accidents is one of the elements of a social insurance system and covers the risks of industrial injuries and occupational diseases. The scope of its action is limited by the consequences of accidents occurring in the workplace or during working hours (including the time of location towards work and from work). An essential feature of this type of insurance is that insurance premiums fully pays the employer. In Russia, compulsory insurance against accidents is governed by law "On compulsory social insurance against accidents at work and occupational diseases" dated July 24, 1998 No. 125-FZ (ed. Dated 07/17/1999) and by the subtitle acts to it.

Another direction of the organization of compulsory insurance against accidents that complements or compensating social insurance is the mandatory state insurance of the life and health of those categories of civil servants whose professional activities are related to the increased risk of an accident in the performance of their official duties. These include: judges, prosecutors, employees of the Ministry of Taxes and Claims, military personnel. Public personal insurance covers the risks identical to mandatory accident insurance: death and loss of ability to disappear due to injury, injury, injuries that have come when performing official duties. Compulsory insurance of civil servants is regulated by federal legislation. The third direction of mandatory insurance against accidents is the mandatory personal insurance of passengers transported by air, railway, water and road transport on long-distance and tourist routes.

Insurance against industrial accidents and occupational diseases

Be sure to insurance against accidents is one of the elements of social insurance and covers the risks of industrial injuries and occupational diseases. An essential feature of this type of compulsory insurance against accidents is that insurance premiums fully pays the employer. Compulsory insurance against industrial accidents is usually subject to all hired employees, students, children visiting preschool institutions, farmers and persons working in peasant farms.

Mandatory insurance against industrial accidents and occupational diseases provides for the provision of social protection of employees through:

Compensation for harm caused by the life and health of employees in the performance of responsibilities for the employment contract or in other cases established by law;

Increasing the interest of enterprises and organizations in reducing the level of professional risk;

Financing of preventive measures to reduce production injuries and occupational diseases.

The funds received for insurance against accidents can be used by the FSS for the needs of state social insurance as a whole, which is confirmed by federal laws on the fund's budget. Insurance premiums for compulsory social insurance against industrial accidents and tradeboles are paid by the insureders directly in the FSS. All employers are the insured:

Legally, the persons of any legal form for workers employed under labor contracts (contracts);

Individuals hiring other individuals on the employment contract (contract).

Insureders are required to register in the FSS executive bodies at their location. Insurance fee tariffs are approved annually by federal law for the next year. Insurance rates are established by the FSS on the basis of the rules for attributing sectors of the economy to the class of professional risk. The amounts of insurance premiums are listed by the Insured monthly on time set to obtain funds in banks to pay wages for the current month. Insured by established insurance payments to the insured, consisting of them in labor relations, insurance premiums are listed over a minus payouts.

The object of compulsory insurance against industrial accidents and occupational diseases is the property interests of individuals related to their loss of health, professional disability or their death due to an accident at work or a professional disease. Insured according to this type of insurance are:

All individuals performing work on the basis of an employment contract concluded with the employer;

Physical persons who have already received health damage due to an accident at work or professional care, confirmed in the prescribed manner, by the time federal Law on compulsory social insurance against accidents;

Individuals convicted of imprisonment and brought to work by the insured.

The insured event is recognized as confirmed by the established procedure of damage to health or death as a result of an accident at work or professional treatment. The accident at work is an event, because of which the insured received damage to health, leaving for a temporary or constant loss of professional disability or death that has come in the performance of duties under the employment contract both on the territory of the insured and abroad, while following work or compensation from the place of work on transport provided by the insured (or on personal transportused for service purposes under the contract or managing the employer). Accidents that occurred while following the place of service business trips and back, when working, the Watch-Expeditionary method during a distance recreation, while engaging an employee to participate in the elimination of the effects of emergency situations, in the implementation of the actions not included in the employment responsibilities of the employee, but carried out in The interests of the employer (to prevent accidents, damage) are also considered industrial.

The investigation and accounting of industrial accidents is carried out in accordance with the Regulation approved by the Decree of the Government of the Russian Federation of March 11, 1999. The employer is obliged to ensure a timely investigation and the execution of an accident at the production costs of an accident investigating an employer. The loss of professional disability is established by the institutions (Bureau) of medical and social expertise on the basis of the employer's appeal, insurer or independent appeal of the victim in the provision of an accident on the accident in production.

The day of the appointment of insurance payments is considered the day of establishing the fact of loss by the insured person of professional disability. In the event of an occurrence of a professional disease, the damage is considered either the date of identifying a professional disease, or the date of drawing up an act of investigating the professional disease, if the disease is not allowed to establish the moment possible. In order to investigate the insurance case, the Commission may establish wines of the insured in the occurrence of an insured event - coarse negligence, which contributed to the occurrence or an increase in harm caused.

If the death of the insured occurs as a result of the insured event, the right to receive certain insurance payments receive next faces: 1) disabled persons who were dependent on the deceased or the right of his death the right to receive the right of his death the right to receive content from him, on the following conditions:

Children before reaching the age of 18, and older students are 18 years old-until graduation educational institutions by full-time learning, but not more than 23 years;

Women who have reached the age of 55, and men who have reached the age of 60, - life;

Disabled - for disability; 2) the child of the deceased, born after his death; 3) One of the parents, spouse or another family member, regardless of the working capacity, which does not work and take care of the deceased children, grandchildren, brothers and sisters who have not achieved under medical and social conclusion in constant care; 4) Persons who were dependent on the deceased who became disabled for 5 years from the date of his death.

When damaged to life, health and professional working capacity of workers, they themselves or their loved ones are guaranteed:

Manual for temporary disability;

Insurance payments - positive, - "Movementary;

Payment for additional expenses on:

Additional medical care,

Strying care for victims, - Sanatorium-resort treatment,

Prosthetics and provision of necessary devices for labor activity and in everyday life,

Providing special vehicles and their contents

Professional training and retraining.

State life insurance and health of certain categories of civil servants

Communicable state insurance in the Russian Federation are subject to servicemen, employees of the Ministry of Internal Affairs, tax inspections, State fire service, prosecutors, investigators, judges and folk assessors, rescuers, deputies of the Legislative Assembly, employees of nuclear facilities, cosmonauts, health workers providing diagnosis and treatment of HIV infection, donors and some others.

Initially, public insurance was engaged in Rosgosstrakh. However, since 1993. There was a clear trend of the transition of insurers to other, commercial insurance companies, mainly a capety-type company, the founders of which are the policyholders themselves - the relevant ministries and departments are obliged to insure their employees. To implement compulsory public personal insurance of the insurance company, it is necessary to have a license to hold an appropriate type of insurance.

Recently, the issue of creating a state insurance company in the form of state-owned unitary enterprise. This is due to the fact that the mandatory state insurance of the life and health of civil servants is carried out at the expense of funds state budget And much of these funds goes into commercial insurance companies.

Public personal insurance covers the risks identical to mandatory social insurance against accidents: injury, injuries that have come in the performance of official duties. Insurance compensation is determined on the basis of an open salary or minimum size wage.

Pasal passenger insurance

The third direction of mandatory insurance against accidents is the mandatory personal insurance of passengers, transported air, railway, water and road transport on long-distance and tourist routes. Insurance covers the risk of death or injury and injuries as a result of a trip associated with a trip.

The maximum insurance amount payable in the event of the death of the passenger is established by the legislation in the amount of 120 minimum wages at the date of purchase of a travel document. In case of injury or injury, the amount of insurance compensation is calculated in proportion to the severity of injuries obtained as a result.

The insureders are the passengers themselves who pay the insurance fee on compulsory personal insurance when buying a travel ticket. However, the interests of the insurers in the design of this insurance operation were represented by a carrier transport organization that chooses insurance company And concludes an agreement with it on the implementation of this type of insurance. The only requirement to the insurance company is the availability of an appropriate license for compulsory passenger insurance. Passengers without the right to free travel are recognized as insured without paying the insurance premium.

Tariffs for compulsory personal insurance of passengers are approved by Rossekhnadzor and are consistent with the Ministries of Transport and RF reports. The main part of the tariff is the contributions to the fund of warning events, the funds are sent to the establishment of these ministries on the purpose of improving traffic safety (Table 1)

Table 3. Tariff structure on mandatory personal insurance of railway and long-distance car transport passengers

Compulsory personal insurance of passengers in the form in which it is carried out is a lot of complaints. First, the deduction of more than 90% of the insurance factor on the financing of the carrier's costs makes compulsory passenger insurance more similar to additional taxation of the population. Secondly, the transfer of the responsibility of the carrier for the life and health of the passenger on the passenger itself, a unworthy of a civilized society. In many countries, this issue is resolved by introducing the institution of mandatory liability of the carrier for the life and health of passengers, and in some cases, the mandatory insurance of the carrier's responsibility. The existing practice of compulsory passenger insurance in Russia contradicts its civil law. In paragraph 2 of Art. 935 ch. The 48 Civil Code of the Russian Federation indicates that the obligation to insure their life or health cannot be assigned to a citizen by law. In the interests of consumer protection, it would be legitimate to establish the responsibility of the carrier for the life and health of passengers.

2.2 Voluntary Insurance against Accidents

Voluntary Insurance is carried out on the basis of an insurance contract and insurance rules defining general terms and Conditions and the order of its implementation.

Insurance rules are accepted and approved by the insurer or union of insurers independently in accordance with Civil Code Of the Russian Federation and this Law and contain provisions on subjects of insurance, about insurance facilities, insurance cases, on insurance risks, on the procedure for determining the sum insured, insurance tariff, insurance premium (insurance premiums), on the procedure for the conclusion, execution and termination of insurance contracts, On the rights and responsibilities of the parties, to determine the size of damages or damage, on the procedure for determining the insurance payment, on cases of refusal to insurance and other provisions.

Voluntary insurance against accidents has several organizational forms. First of all distinguish individual and collective insurance against accidents.

The individual insurance contract is an individual, and the contract is mainly applied to the insured and his family members.

Under the collective insurance contract, the insured is a legal entity, and the insured - individuals, in the life and health of which the insured is of material interest.

Accidental Accident Insurance

Collective insurance agreements are either employers in favor of their employees or various associations and societies in favor of their members. Contributions for collective insurance will significantly need than individually because additional risk leveling occurs within a certain group.

In the Russian Federation, collective insurance against accidents has its own specifics due to the peculiarities of the previously existing tax legislation that allowed the use of this form to care from income tax, income tax and contributions to extrabudgetary funds of social importance. Enterprises used insurance against accidents for additional cash payments, bypassing mandatory contributions established by law and taxes from the wage fund. Such a situation was possible thanks to the legal existence of insurance with the return of insurance premiums and preferential taxation of insurance premiums and insurance payments.

Currently, for insurance against accidents, there is a less profitable regime of taxation of insurance premiums and payments. Thanks to the tightening of the rules of taxation of insurance premiums, this type of insurance has become little attractive for use in order to ensure the "hidden" wage.

Individual accident insurance

Individual voluntary accident insurance exists in the following forms:

Complete accident insurance providing insurance guarantee for any period of both the private and professional life of a person during the action of the contract;

Partial insurance providing a guarantee only for a certain period of human life; The most common is insurance against accidents during the trip, travel, including abroad;

Additional insurance, i.e. use of insurance against accidents as component of various combined or batch policies; A guarantee of paying a double sum insured upon death as a result of an accident in life insurance; Warranty on accidents in the package policy of the head of the family, etc. Insurance against accidents is the most common addition of many insurance policies and the most profitable risk for insurers in the framework of personal insurance.

3. Insurance rates

Insurance rates for accident insurance are determined by methods used in constructing tariffs for risky insurance types. Insurance against accidents relates to damage insurance, therefore, at the heart of the Tariffment lies the principle of the distribution of insurance risk between all the insured. In the calculation of a net raising of insurance against accidents, the average loss rate of the sum insured in this type of insurance is laid.

Accident Insurance Tariffs, as a rule, depend on the floor and age of the insured. Insurance rates increase with an increase in the amount of the sum insured and the danger of the insured activities carried out, primarily professional. Insurance rates increase with an increase in the size of the sum insured and the degree of riskiness of professional and public duties of the insured. Insurers use their own scales for the conformity of tariffs and insurance amounts, as well as grouping professions depending on the potential danger.

Typical values \u200b\u200bof voluntary insurance of citizens from accidents contain the following recommendations for determining the sum insured and insurance premiums and the conditions for their payment. The insurance amount is determined by the insurer agreement with the insurer for each type of insurance claims separately and can be different or the same for the selected types of insured events. If the insured concludes an insurance contract for several persons, then the contract indicates the overall insurance amount for all insured and for each type of insurance claims. With the equality of individual insurance sums, the total insurance amount is determined by multiplying the sum insured set for one insured person, the number of persons named in the contract. If individual insurance amounts are different, then the total insurance amount under the contract is determined by adding insurance sums on each insured person.

Basic insurance rates are developed by the insurer on their own. In special cases, in determining the size of the insurance premium, the insurer is entitled to establish how to increase and lower coefficients to the basic insurance fare, determined depending on the individual characteristics of the risk. The insurance premium under insurance contracts concluded for a period of no more than one year is paid at the same time. When concluding a contract for a longer time, the premium is paid to installments, in two times, and the first insurance premium should be at least 50% of the entire insurance premium. The second part of the insurance premium must be paid no later than half the term of the contract. Insurance rate is set as an annual rate. When insuring for a period of less than a month insurance premium It is paid in the amount of 0.7% of the annual rate for each day of the insurance contract.

The insurance premium can be paid in different ways:

Non-cash transfer to the account of the insurer within five banking days from the date of signing the insurance contract, unless otherwise stated in the insurance contract;

...