YOUR ACTIONS IN THE EVENT OF AN INSURANCE EVENT (Health insurance in the event of an illness under the "COVID-19" program)
1. Informing the insurance company about the occurrence of an insured event:
About the occurrence of the event, the Insured Person must notify the Insurance Company "PRESTIGE" (hereinafter - the Insurer) within 5 working days from the moment when he had the opportunity to do so, by any means that allows to objectively record the fact of notification ( including by phone (044) 38-39-145 or by e-mail info@prestige-ic.com.ua). Depending on the circumstances (consequences) of the case, the Beneficiary or the Insured's heirs can provide this information instead of the Insured.
2. In order to make an insurance payment, the Insurer must be provided with the following documents:
- statement about the occurrence of an insurance event and receipt of an insurance payment;
- a copy of the insurance contract;
- a copy of the passport and TIN (natural person - the recipient of the insurance payment);
- laboratory test results: positive test/analysis for the coronavirus disease COVID-19;
- an extract from the medical card of an inpatient (in the case of inpatient treatment) or a copy of an extract from the medical history (discharge epicrisis);
- a copy of the certificate of incapacity for work (for employees);
- in case of death of the Insured person: Death certificate; a medical certificate (paramedic's certificate) about death or a certificate from a medical institution about the cause of death; materials of the competent authorities regarding the investigation of the causes of death; a document certifying the right to inheritance of the person who applied for the insurance payment, except for the cases when the amount of the insurance payment is received by the Beneficiary specified in the Agreement;
- documents on the basis of which will enable the Insurer to draw a conclusion about the amount of damage caused as a result of damage to the health of the Insured person, namely: a bill from a medical institution (with a detailed description of the estimate of the services provided), financial documents (checks, invoices, etc.) confirming the amount of expenses incurred during treatment, founding documents of the medical institution that provided services and other documents at the justified request of the Insurer regarding the fact, circumstances, reasons for the occurrence of the insured event and the amount of damage to health.
3. The document of the medical institution confirming the occurrence of an insured event must include:
- the name and location of the medical facility, its phone number;
- Surname, first name, patronymic of the Insured person, date of birth;
- home address and phone number of the Insured Person;
- the date of the Insured Person's application to a medical institution;
- diagnosis, list of types of medical care provided to the Insured Person by the medical institution;
- terms of treatment;
- the document of the medical institution is sealed with the signature of the responsible person and certified by the seal of the medical institution.
If the Insured Person receives medical services in an institution with which Prestige Insurance Company does not cooperate, it is necessary to provide copies of the license and registration certificate;
If medical services/expendable medical materials are provided by an individual as a private entrepreneur, it is mandatory to provide copies of the license, state registration certificate.
Other documents at the request of the Insurer, which are essential for confirming the insured eve
IMPORTANTLY! The insurance payment is made only in relation to cases that are insured, and only for services provided for by the insurance program and provided in a medical facility that is provided for in the terms of the insurance contract or agreed with the Insurer.
4. Terms of insurance payment:
- after receiving all the necessary documents specified in clause 2 of this notice, within 14 (fourteen) working days, the "PRESTIGE" Insurance Company issues an insurance act on insurance payment;
- insurance payment is made within 10 (ten) working days from the date of decision on insurance payment (signing of the Insurance Act).
5. Original documents should be provided/sent:
At the address:
1. "PRESTIGE" insurance company, 03145, Kyiv, str. Vasyl Stus, 35-37, office 101
or
2. Transcarpathian Directorate of the Prestige Insurance Company, 88000, Uzhgorod, str. Shvabska, 21b
You can find out information about the status of your case:
By phone +380 (44) 38-39-145
