General reasons of compensation denial:
1. Getting full reimbursement for the Insured's losses by the person that inflicted them.
2. Failure to inform the Insurer in time about the insurance accident without valid excuses or impending the Insurer's investigation of the circumstances, nature and amount of damage.
3. The amount and the procedure of medical and other services were not agreed with the assistance company or the Insurer without valid excuses.
4. Failure to provide the Insurer in time with the documents required for insurance compensation.
5. Failure to inform the corresponding services about the luggage loss or damage.
6. Force majeure (impact of nuclear power, natural disaster, war, any military operations, state of emergency declared by the government, revolution, conspiracy, rebellion, riots, strikes, acts of terrorism, etc.).
Exclusions in medical expenses and accident insuranceInsurance company does not provide coverage of the following cases:
1. Suicide attempt and suicide except for the cases when the Insured has been driven to suicide or suicide attempt caused by the illegal actions of the third parties.
2. Intoxication with alcohol or any other substances, consumed with intention or in the state of intoxication (by different spirits, spirituous substances, solvents, acids), consumption of drugs or toxic substances without doctor's prescriptions.
3. The Insured is uunder the alcohol, drug or toxic influence.
4. Participation of the Insured in illegal actions.
5. Venereal diseases, AIDS, alcoholism, drug addiction, toxic substances abuse, mental disorders, system diseases, especially dangerous infections (smallpox, plague, cholera, anthrax).
6. Diseases which began before the insurance coverage came into force except events when the emergency medical assistance is connected with acute pain.
7. Intensifying or complications of diseases, which occurred before the conclusion of the Insurance Agreement, regardless of the fact weather the medical treatment was performed or not. In this event the Insurer indemnifies urgent medical aid expenses required to prevent an immediate threat to life or expenses related to the acute pain relief.
8. Driving a vehicle without driving license, and giving a vehicle to the third person having no driving license or being in the state of intoxication.
9. Any chronic and infectious diseases except botulism and tetanus (only in case of accident insurance).
10. Cases which are not provided by this Insurance Agreement.
Accident insurance also excludes:
1. Treatment and other expenses in state and social medical institutions in the country of staying, if the Insured has the right of free medical care in accordance with the law of this country.
2. Medical services rendered in the event of sunburn or heat stroke if the Insured was sunbathing or air-bathing except cases requiring urgent medical services to save Insured's life.
3. Medical services related to the chronic diseases treatment, congenital anomalies, deformations and chromosomal abnormalities.
4. Medical services related to the treatment of neoplasms, endocrine system diseases, diabetes, tuberculosis.
5. Medical services related to the treatment of nervous disorders (except neuritis), mental disorders and related to them traumas.
6. Medical services related to the treatment of diseases of blood and blood-forming organs.
7. Medical services related to the treatment of fungal and dermatological diseases, allergic dermatitis.
8. Surgeries performed upon reasons which occurred before the Insurance Agreement came into force.
9. Surgeries or treatments of experimental or research nature.
10. Plastic and reconstructive surgeries except cases when such surgeries are performed to restore vital functions as the consequence of traumas.
11. Medical services connected with the Insured's termination of pregnancy (except for forced termination of pregnancy for medical prescriptions).
12. Obstetrical care for puerperal women after 28th week of pregnancy.
13. Medical intervention aimed at pregnancy assistance or prevention, including treatment, procedures and medicine.
14. Obesity treatment or weight loss.
15. Transplantation of organs or tissue.
16. Medical services related to the surgeries on the heart and blood vessels, including angioplasty, bypass and stenting surgery.
17. Providing service of preventive treatment, including vaccination and medical examinations.
18. Self-treatment, receiving medical services, which were provided by the person without appropriate education or license.
19. Purchasing medicine independently and receiving medical services without doctor's prescriptions.
20. Treatment and diagnostic procedures by nontraditional methods (phytotherapy, iridology, homeopathy, reflexology, manual therapy, etc.).
21. Sanatorium-resort treatment, rehabilitation, teaching and physical therapy.
22. Staying at inpatient treatment with the aim to get custodial or rehabilitation care.
23. Providing additional comfort in medical institutions, namely – a humidifier, a conditioner, barber or cosmetologist services, etc.
24. Dental prosthetics and orthodontia, periodontosis treatment, orthopedic implant surgery.
25. Selection and mending of medical devices (glasses, contact lenses, hearing aids, cochlear implants, prostheses, crutches, wheelchairs, etc.).
26. Purchasing and mending ancillary medical devices (cervical collar, bandage, prostheses, glasses, contact lenses, surgical hardware in osteosynthesis, including nails, screws, pins, plates, bolts, etc.).
27. Providing medical services in the events which occurred while traveling abroad which took place in spite of doctor's recommendations.
28. Providing medical services in case of medical repatriation denial, although medical repatriation decision was made by assistance company expert and agreed with treating physician.
29. Treatment which on medical prescriptions may be adjourned until the Insured returns to the country of permanent residence.
30. Events which occurred before the Insurance Agreement conclusion and/or the Insured's crossing the border or outside of the insurance cover.
31. Providing medical services connected with the Insured's active kinds of leisure or any kind of sport except of traveling for sport purposes (if in the Insurance Agreement section “Risk group” there is an “S” mark).
Expenses are not indemnified for the Insured's terminated return to the country of permanent residence in case of death of closest relatives (husband, wife, children, parents, sibling brother or sister), if death is a consequence of the disease, which led to his/her hospitalization during the Insured's travel abroad.
Expenses are not indemnified for legal assistance to the Insured, if it was provided without a prior agreement with assistance except cases of urgent need (imprisonment, arrest, etc.).
Exclusions in luggage insurance:
Following events are not considered to be insured if they were caused by the following:
1. In case luggage is effected by ambient temperature, hold's air, normal atmospheric humidity or luggage special properties or original qualities (natural loss of insured luggage (ordinary for this luggage and means of transportation natural weight or volume loss, luggage fray) and limit differences in net weight evaluation), corrosion, decay, natural fray, inner damage, loss, rust, mold, etc.).
2. Inner properties or defects of the insured luggage.
3. Illegal actions of third parties not confirmed by authorities.
4. Consigning luggage in damaged condition.
5. Damage caused by worms, rodents, insects.
6. Lack of luggage upon package and seal integrity and luggage devaluation as a consequence of its contamination upon package and seal integrity and cover protective in working order.
7. Luggage (bag etc.) technical condition discrepancy for safe transportation, loading, unloading or storage.
8. Luggage wrapping discrepancy for technical conditions and standards.
9. Luggage transportation by unqualified carriers.
10. Luggage confiscation by customs authorities or other authority representatives of the country of temporary residence.
11. Losses, lacks or any kind of damages of not declared luggage, those are things which the Insured did not include into customs declaration.
12. In the event of luggage loss or damage while being transported by qulified carriers the Insurer does not indemnify the cost of cash in any currency, shares, bonds, insurance policies, deposit books, cheques, credit cards and etc., manuscripts, drawings an other commercial, scientific or personal documentation, ingots of precious metals and gems; jewellery; pearls and any jewellery, animals, plants and seeds, stamps, coins, token money and notes, pictures, paintings, sculptures, other collections and works of art.
13. If upon accepting the luggage the Insured has not stated in written form about its lack to the carrier, it is considered that the Insured has received luggage in accordance to the Transporation Terms.
Exclusions in public liability insurance:The following cases are not indemnified:
1. Loss related to contract, economic and criminal liability of the Insured ahead of third parties and damages caused to the environment.
2. Harm and damage caused by the Insured with any kind of vehicle with motor.
3. Harm and damage caused to the Insured’s family members; penalties, fines or other financial penalties which do not have direct consequences to the caused harm of health or protperty demages of the third parties.
4. Excess sizes and sums of damages within the Law of Ukraine and/or countries of temporary residence of the Insured and within the indicated insurance amount of the Insurance Agreement.
5. Harm and damage which occured upon sport competition paticipation and during preparation to it.
6. Harm and damage related to industrial, occupational activity, manual labor or criminal activity of the Insured.
7. Harm and damage which occured in the connection with fact, situation, circumstances known to the Insured Person before the Insurance Agreement came into force or regarding to which the Insured had opportunity to forsee filing a suit.
8. Moral injury and harm caused to the image and reputation of the third parties.
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