INSURANCE PAYMENT TERMS. 11.1. Total amount of insurance payments in case of one or more insurance events under the Contract shall not exceed the insured amount/limits established by the Contract in accordance with the selected insurance conditions.
11.2. Medical assistance and services shall be provided in accordance with the Treatment guidelines of the Ministry of Public Health of Ukraine, effective at the time of their provision, in medical establishments as referred by the Insurer.
11.3. In case of occurrence of insured event specified in clause 5.1.. of Contract the Insurer shall indemnify for expenses regarding: 11.3.1.emergency (ambulance) pre-hospital care provided by the ambulance crew /of public stations or private clinics (1* th class clinics according to Insurer's classification) emergency (ambulance) medical care provided at Health Care Centre (examination and consultation provided by medical staff, emergency laboratory tests, cost of stay at Health Care Centre, purchase of medicines).
INSURANCE PAYMENT TERMS. 11.1. Total amount of insurance payments in case of one or more insurance events under the Contract shall not exceed the insured amount/limit specified in the Insurance Program chosen.
11.2. Medical assistance and services shall be provided in accordance with the Treatment guidelines of the Ministry of Public Health, effective at the time of their provision, in medical establishments as referred by the Insurer.
11.3. The list of medical establishments of each service class is listed on the Insurer's website at xxxxx://xxx.xxxxxxxxxx.xx/Xxxx_XXX.xxx and is updated by the Insurer constantly depending on the price and service policy of medical establishments. When choosing the medical establishment that will provide medical assistance to the Insured person, the Insurer shall be guided by the list of medical establishment on the above link as of the date of the insurance event.
11.4. The list of documents required for making insurance payments shall be determined:
11.4.1. in the case of organization and payment for medical care and services by the Insurer - contracts of the Insurer with medical establishment;
11.4.2. in case of compensation of funds spent by the Insured person - according to the list indicated on the Insurer's website at xxxxx://xxx.xxxxxxxxxx.xx/XxxxXxXxxxxxxxx- ForPaymentDMS_FF.pdf in this case, the collection of necessary documents shall be the responsibility of the Insured person). Further, if the insured person calls on 0 800 500 209 (around the clock, free of charge), the Insurer shall advise the Insured person on such a list of documents.
11.5. In case of submission of documents by the Insured person independently in accordance with the Contract - all documents necessary for making a decision on insurance compensation payment shall be provided by the Insured person not later than 30 (thirty) calendar days from the date of the treatment end.
11.6. The term for making a decision on payment/refusal to pay the insurance indemnity is 10 (ten) working days from the date of receipt of all necessary documents in accordance with this Contract. The Insurer, during the specified period, shall:
11.6.1. make a decision on payment and draw up an insurance act determining the amount of insurance payment or
11.6.2. приймає обґрунтоване рішення про відмову у страховій виплаті, про що письмово повідомляє Xxxxxxxxxxxxxx/Застрахованого протягом 10 (десяти) робочих днів з дати прийняття такого рішення.
11.7. У разі прийняття рішення про виплату страхового в...