Insurance companies often distinguish between outdoor activities and extreme ones. If the first category can include, for example, cycling, then the second - downhill skiing or diving. The cost of insurance for extreme vacations is much higher than the standard one. AiF.ru learned from Maxim Starodubtsev, chairman of the board of the public organization for the protection of the rights of consumers of medical services, Maksim Starodubtsev, which aspects of the insurance contract are important to pay attention to, and what to do if the insurance company refuses to provide compensation.
As Maksim Starodubtsev explains, there is no general list where the types of extreme and active recreation would be indicated, therefore each insurance company has its own list. Some companies share insurance for outdoor activities (this may include, for example, aerobics, running or cycling), for dangerous sports (say, kayaking, mountain hiking, skiing, etc.), for extreme recreation (say, rafting ) and for participation in sports competitions. Therefore, when choosing insurance, it is important to carefully read the contract and clarify whether your particular sport is included in the amount of insurance coverage.
“If a person is going to engage in, for example, diving, then this should be clearly stated in the contract. When concluding an insurance contract, you need to ask clarifying questions and find out whether it includes, say, regular diving or deep-sea diving, ”advises Starodubtsev. He adds that each insurance has its own terms and conditions, there is a comprehensive insurance and is broken down according to certain parameters.
“It is necessary to look and choose professionally in each case, assessing your risks. You need to understand: if you take standard insurance, but at the same time you get a serious injury, then for treatment you will need a large enough amount of money. And it is better to foresee this moment in the contract in advance, ”the expert adds.
In this case, a person can go to court. According to Maxim Starodubtsev, the more documents we manage to collect, the better. These can be receipts for medications and treatment, medical records.
“As a rule, all the circumstances of the injury are described in the medical history or extracts from it. Western clinics know that people are insured and they will need this information, medical institutions often immediately prepare extracts. As a last resort, papers can be requested later, but this is quite difficult and dreary. Therefore, a person needs to immediately stock up on documents, keep receipts, ”the expert advises.
These are usually health problems caused by drugs or alcohol. Although some insurance companies can include the option "Alcoholic intoxication" in the policy, it still does not cover the treatment of injuries that have arisen if a person, for example, got drunk behind the wheel. Insurance also does not apply for sunburn or allergies. Dental problems are a separate story. As a rule, insurance covers only emergency dental care for acute toothache, and all other problems do not. The standard policy does not cover health problems arising from pregnancy, or in the event of hostilities or terrorist attacks. An exacerbation of chronic diseases can be recognized as an uninsured event.
In addition, any insured citizen must, upon the occurrence of an insured event, first of all call the service center, which is indicated in the policy. He tells him the last name, first name, policy number and the nature of the assistance required, after which the insurance company recommends to him a specific hospital with which the company has a contract. If the victim goes to the first clinic that comes across, the insurer may refuse to reimburse the costs. The exception is cases that require emergency medical attention.
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