Travel insurance abroad

The Insurer shall not pay or indemnify for the cost of diagnostics, treatment and services related to such diseases and events:
medical care and treatment that are not related to the need to provide emergency or urgent medical care to the Insured Person;
treatment of chronic or congenital diseases (anomalies), deformities and chromosomal disorders and defects, complications, exacerbations of these diseases that are not life-threatening or consequences that existed in the Insured person at the time of concluding the Contract and required treatment, except when there is an acute threat to the life of the Insured person or there is a need for targeted measures to eliminate acute pain
neoplasms, diseases of the endocrine system, diabetes mellitus;
nervous diseases (except for neuritis), mental diseases, incl.ч. diagnostics and determination of the cause of epileptic seizures; treatment of psychosomatic disorders, as well as related traumatic injuries;
oncological diseases, cirrhosis, chronic renal failure, systemic connective tissue diseases, autoimmune diseases;
treatment of diseases known at the time of conclusion and/or commencement of the Insurance Contract, regardless of whether the treatment was carried out or not, except in cases where medical care was necessary in connection with emergency medical care or saving the life of the Insured / Insured person. The existence of such disease must be proved by the Insurer;
venereal diseases, sexually transmitted diseases, immunodeficiency, AIDS;
diseases of blood and hematopoietic organs;
epidemic and pandemic diseases except COVID-19;
. acute and chronic radiation sickness;
Scheduled consultations and examinations during pregnancy, regardless of the gestational age;
consultations, examinations and treatment related to pregnancy complications after the 29th week of pregnancy, obstetric care for persons with a gestation period of more than 29 weeks, childbirth;
medical services related to abortion of the Insured Person, except for emergency induced termination of pregnancy for medical reasons;
diagnostics and treatment of male/female infertility, menopause, depleted ovarian syndrome, menstrual disorders, premenstrual syndrome, hormonal disorders (hyperprolactinemia, hyperandrogenism, etc.), erectile and sexual dysfunction, artificial insemination, and pregnancy prevention costs;
any health disorders, complications or death due to failure to follow the doctor’s recommendations, side effects of medicines that were not prescribed by a doctor, as well as side effects of food additives;
diseases or consequences (complications) of viral hepatitis and tuberculosis;
diseases and disorders of the hearing organs, except for acute hearing diseases for medical reasons;
diseases, injuries, inflammation of the eyes, eyelids, lacrimal apparatus, except for cases related to emergency care that threatens the life of the Insured person;
fungal and dermatological diseases, allergic dermatitis of any origin, sunburns except for the first and second degree, other skin changes caused by ultraviolet radiation;
diseases that occurred before the start of the insurance period and/or in the territory of permanent residence, which led to medical or additional expenses during the trip, as well as diseases that occurred after the Insured person returns from the trip;
further treatment abroad of the Insured person if he/she refuses medical evacuation to the place of permanent residence. The Parties agree that a telephone recording of a conversation or correspondence and exchange of messages in messengers with the Insured person or his/her relatives made to the Assistance Company or the Insurer regarding refusal of medical evacuation shall be considered as a written refusal and may be used by the Insurer as evidence in case of disputes;
medical examination that is not a result of acute pain, sudden illness or injury, provision of services that are not reasonably necessary or medically urgent or are not part of the treatment prescribed by a doctor, as well as provision of special services such as a separate room, telephone, TV, etc;
services and treatment that can be postponed until the return from the trip, including surgical operations that can be replaced by a course of conservative treatment before the end of the trip, etc;
Surgical (operative) interventions related to benign and malignant tumors (carcinoma, lipoma, other according to the International Classification of Diseases ICD-10);
performing manipulations and surgeries on the heart and blood vessels, including angiography, angioplasty, bypass surgery, stenting, installation of an artificial pacemaker, etc;
diagnostic services: consultations, laboratory tests and other measures not prescribed by the doctor and the assisting company as necessary to establish a diagnosis for further treatment;
preventive vaccinations, medical examinations and laboratory tests not related to the insured event;
all types of plastic and cosmetic surgeries and procedures, all types of prosthetics (including teeth and eyes), organ transplants;
dental treatment, except for acute pain relief;
medical services provided by a legal entity or individual who does not have a license or a person who is not entitled to practice medicine;
physiotherapeutic treatment, treatment with non-traditional methods, treatment that is considered experimental or investigational;
purchase or repair of auxiliary aids (such as pacemakers, glasses, contact lenses, hearing aids, inhalers, prostheses, crutches, wheelchairs, measuring devices, etc.) purchase of general health products, hygiene products, baby food;
artificial insemination, infertility treatment, pregnancy prevention measures;
treatment of alcoholism, drug addiction, etc., including treatment of withdrawal symptoms;
medical evacuation, repatriation or burial abroad organized without written consent of the Insurer;
expenses when the trip was made with the intention of receiving treatment;
Self-medication, as well as treatment by spouses, parents, or children;
eliminating the consequences of self-medication;
the need for individualized care, patronage and security;
medical examination for preventive purposes;
continuation of treatment of the Insured person after his/her return to the place of permanent residence, expenses covered by social, health insurance and other provision;
therapeutic recreation, rehabilitation, sanatorium and health resort treatment, as well as spa treatments; diagnostic services, consultations, laboratory tests and other measures not prescribed by the doctor and the assisting company as necessary to establish a diagnosis for further treatment;
diseases that result from a mental reaction to military events, internal disturbances, terrorist attacks, air crashes or fears related to such events;
age-related degenerative and dystrophic processes, except for the acute stage;
replacement therapy, except in acute conditions;
expenses stipulated by the Contract shall not be indemnified if they are incurred by the Insured (the Insured person) without prior approval of the Insurer, except in emergency cases when approval of the Insurer is impossible due to the risk to life and health of the Insured person;
expenses for insured events occurred during professional sports, active recreation, performance of work in the absence of a corresponding mark in the Individual part of the Contract for this Insured person (ES, AR, W, DW,
expenses in case of failure to notify/timely notification of the Insurer of occurrence of an event having signs of an insured event shall not be indemnified;
expenses related to attack of predatory or poisonous animals or insects that occurred in natural water bodies (rivers, seas, oceans, etc.) or during tourist walks in their habitat outside the place of temporary residence of the Insured person shall not be indemnified;
any expenses shall not be indemnified if the Insured / Insured person is entitled to free medical care.
Medical expenses of the Insured shall not be subject to insurance indemnity in the following cases:
the trip was made by the Insured despite medical contraindications for its implementation;
medical services were received by another person not insured under the Contract;
the Insured refused the prescribed examination, treatment, medical transportation.
The Insurer shall not indemnify for fines, penalties, forfeitures, interest for late payments and other indirect losses, lost profits incurred by the Insured.
In the case of baggage insurance, events arising as a result are not recognized as insured events:
exposure of baggage to normal temperature, normal atmospheric humidity, natural qualities of baggage (normal wear and tear of baggage and the maximum difference in determining the net weight), corrosion, rot, natural wear and tear, internal damage, loss, rust, mold, etc;)
internal properties or defects of the insured baggage;
illegal actions of third parties that have not been confirmed by law enforcement agencies;
transfer of baggage for transportation in a damaged condition;
damage to luggage by worms, rodents, insects;
shortage of baggage with the integrity of packaging and seals, as well as depreciation of baggage due to its contamination with the integrity of packaging and seals and the serviceability of security equipment;
inconsistency of technical condition of suitcases/bags for safe transportation, loading, unloading or storage of baggage;
inconsistency of baggage packaging with technical conditions and standards;
transportation of baggage by carriers that do not have a license/permit for transportation;
confiscation of baggage by customs authorities or other representatives of official authorities of the country of temporary stay;
violation by the Insured/Insured person of baggage transportation rules, in particular inclusion of baggage in the registered
The Insurer shall not indemnify for service charges, charitable contributions to a medical institution, moral damages and damages caused as a result of professional errors of doctors or other persons who provided assistance to the Insured/Insured person.
Grounds for Insurer’s refusal to pay insurance indemnity shall be:
intentional actions or omissions of the Insured (the Insured person) aimed at occurrence of insured event, except for actions taken in a state of necessary self-defense (without exceeding its limits) or to protect property, life, health, honor, dignity and business reputation. Qualification of the Insured person’s actions shall be established in accordance with the current legislation of Ukraine;
violation by the Insured person of the rules of conduct, safety or order in the territory/place of temporary stay; violation of the legislation of the country of temporary stay;
submission by the Insured, the Insured person or the person in whose favor the insurance payment is to be made, of deliberately false information about the subject of insurance, location of the Insured (the Insured person) as of the date of conclusion of the contract Proof of providing information about the location of the Insured (the Insured person) as of the date of concluding the Agreement shall be the relevant border crossing stamps in the passport or airline tickets, railway or bus tickets or other documentary evidence in case the Insured person crosses the borders of countries where no stamps are placed;
creating obstacles for the Insurer in determining the circumstances, nature and amount of losses;
untimely notification of the Insurer of the Insured Event without valid reasons, failure to approve or violation of the terms of approval of independently incurred diagnostic or treatment costs, as well as untimely submission/non-submission (not in full) of documents to the Insurer, a written claim for insurance payment (insurance indemnity) and other documents attached to the claim in accordance with this Contract or requested by the Insurer
failure of the Insured (the Insured person) to fulfill his/her obligations under the Contract;
Failure to comply with the Insurer’s/Insurer’s instructions in the process of settlement of an insured event/occurrence of an insured event;
receipt by the Insured (the Insured person) of full compensation for losses from the person responsible for causing them;
consumption of alcohol, prohibited drugs, toxic substances;
documented by a medical institution consumption of alcohol in doses exceeding 1 ppm,
insurance of persons under the age of 1 year (inclusive) from 60 years (inclusive) without additional payment;
commission of an intentional crime by the Insured, the Insured person or the Beneficiary that led to the insured event;
refusal of the Insured/Insured person to undergo repeated diagnostics, receive consultations at the Insurer’s request;
purchase by the Insured/Insured person of the Policy for a period shorter than the duration of the trip, except when the Insured/Insured person extends the period of stay abroad or has entered into the Insurance contract while already outside the country of permanent residence on the terms and conditions stipulated by the Contract;
the event occurring to the Insured/Insured person is not an insured event;
the event occurred before the insurance coverage started or outside the insurance coverage period;
The Policyholder/Insured has failed to pay insurance premiums or provided false information about their payment;
the insured event occurred due to damage caused to the Insured/Insured person by his/her own actions, the consequences of which the Insured/Insured foresaw but frivolously expected that they would not occur or did not foresee, although he/she should have foreseen and had the opportunity to do so;
occurrence of the insured event due to rendering assistance, rescue of third parties;
dental prosthetics (crowns, stump inlays, etc.), orthodontics;
receipt by the Insured/Insured person of legal (legal) assistance, assistance of an interpreter without prior agreement with the Insurer;
if the Insured/Insured person is a citizen of the aggressor state, terrorist state in accordance with the local legislation of the Insurer.
Events that occurred as a result are not recognized as insured events:
civil unrest, strikes or state of emergency, ionizing radiation; use of nuclear, chemical or biological weapons;
committing suicide or attempted suicide by the Insured (except for cases when the Insured was brought to such a state by illegal actions of third parties, which must be proved by the Insured or the Insured person);
committing or attempting to commit by the Insured person illegal actions that are in direct causal connection with the insured event, as established by the competent authorities;
failure of the Insured to comply with official recommendations of the Ministry of Foreign Affairs of Ukraine, website: www.http://mfa.gov.ua/, and the Insurer regarding travel to war zones, terrorist attacks, natural disasters, epidemics or pandemics, except when such travel is provided for in the insurance terms and conditions in writing as a separate annex to the contract;
travel of the Insured or another person designated in the insurance contract as the Insured to a country or area designated by the Insurer as a war zone, unless such travel is provided for in the terms and conditions of the insurance contract, which are documented in a separate annex.
active participation in war (declared or undeclared), civil war, military operations, service in the armed forces and military formations;
exposure of the Insured to unjustified risk, deliberate danger (except for life saving);
accident while traveling on a non-tourist route in the mountains, at sea, in the jungle or other remote areas, as well as in case of existing prohibitions by local authorities on movement in the mountains, at sea, etc.
participation in betting, offenses or fights (except in cases of self-defense);
driving by the Insured/Insured person by means of land/water/air transport without a valid driver’s license or the appropriate category, as well as transferring the control of the vehicle by the Insured/Insured person to a person who is in a state of alcoholic, narcotic or toxic intoxication, does not have a valid driver’s license or the appropriate category;
performing any work under an employment agreement (contract) or performing work and/or rendering services under any civil law contract, including using tools, loading/unloading vehicles, etc. if the Insurance Policy does not contain a “W” or “DW” mark.
The insurance coverage and obligations to pay claims or services are possible to the extent and as long as it does not contradict economic, trade or financial sanctions or embargoes imposed by the United Nations, the United States of America, the United Kingdom of Great Britain and Northern Ireland, Switzerland in relation to: the Russian Federation, the Republic of Belarus, the Islamic Republic of Iran, Cuba, Syria, Afghanistan, the Democratic People’s Republic of Congo, Iraq, the Democratic Republic of Korea, Liberia, Lebanon, Somalia, Sudan, Sierra Leone, Côte d’Ivoire.
The insurance contract may provide for additional or other exclusions from insurance payments than those specified in these General Terms and Conditions, which are agreed with the Insured and do not contradict the law.
The grounds for denial of insurance indemnity (payment) shall be
intentional actions of the Insured or the person in whose favor the insurance contract is concluded, aimed at occurrence of the insured event, except for actions taken in a state of emergency or necessary defense, or cases determined by law or international customs; commission by the Insured or the person in whose favor the insurance contract is concluded of an intentional criminal offense that led to the occurrence of the insured event;
submission by the Insured of false information about the object of insurance, circumstances essential for assessment of the insurance risk, or the fact of occurrence of the insured event;
receipt by the Insured of full compensation for losses from the person who caused them. If the loss is partially reimbursed, the insurance payment shall be made after deduction of the amount received from the said person as compensation for losses;
late notification by the Insured (person specified in the insurance contract or legislation) of the insured event without good reason or failure to fulfill other obligations specified in the insurance contract or legislation, if this resulted in the Insurer’s inability to establish the fact, causes and circumstances of the insured event or the amount of damage (losses) caused
existence of circumstances that are exceptions to insured events and insurance limitations provided for in the insurance contract;
existence of other grounds established by law or the insurance contract.
The Insurer’s decision to make or refuse to make an insurance payment may be appealed by the Insured in court.