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2021 ◽  
Vol specjalny (XXI) ◽  
pp. 677-687
Author(s):  
Wioletta Witoszko

A one-off for family members in the event of the death of an insured person as a result of an accident at work or occupational disease shall be of an insurance nature. It is granted in the event of the death of an insured person who was covered by accident insurance. The benefit is paid by ZUS on the basis of a decision. It is paid from the accident fund, where the premiums paid for accident insurance are collected. In addition, the amount of the premium depends on the degree of risk of accident. The conditions for one-off compensation and its amount were structured in a schematic manner, since it was not necessary to determine the nature and size of the damage. Such rules for determining one-off compensation lead to simplification and scheme for compensation for damage. These features of compensation mean that the damage can be repaired in a limited manner. Accident compensation does little to meet the characteristics of civil law compensation. The extent to which the compensatory function of compensating for damage is to be carried out will depend on the type of damage and its extent, as well as on whether family members will be entitled to other accident benefits.


Author(s):  
Zoran Miladinović ◽  

Insurance of life in favor of third parties is more important than the insurance of life in case of death. Moreover, in some rights this type of insurance can be contracted only in the event of the death of the insured person. There are no such restrictions in our insurance law, which means that the same can be agreed in case the isured person reaches a certain age. With this type of insurance, the insured event can be realized on the person of the insurance policyholders or on some other person. The insured person can therefore be the insurance contractor himself and it can also be another person. Considering that in this type of insurance, upon the occurrence of the insured event, the payment of the insured amount is always made to a certain third party beneficiary and that the insurance contract mentions several persons with different legal status, the insurance contract must clearly define the issues such as clear determination of the beneficiary insurance, what happens if the insurance beneficiary dies before the insured person, or the contractor assures, whether it is necessary for the insurance beneficiary to give his consent to be paid compensation, whether and until when the insurance policyholder can revoke the benefit he has contracted for a third party-beneficiary of the insured, etc. All these issues are mainly regulated by legal provisions, but of particular importance are General Conditions of life insurance of life insurance companies, as the above issues are clearly defined on the basis of experiences that have proven to be open in practice.


2021 ◽  
pp. 19-39
Author(s):  
Zoran Miladinović ◽  

Life insurance is the field of insurance which covers all those types of insurance where the occurrence of the insured accident is connected to a certain event in the life of the insured person. There are two basic types of life insurance: life insurance in case of death of the insured person and annuity insurance in case the insured person lives longer, t.i beyond the insured life term. Life insurance is the insurance where the insurer for a certain insurance premium assumes the obligation to pay to the insured person or the other beneficiary designated by the insured person a certain sum of money in case of his death or annuity installments in case he lives longer then the agreed life term. Although originally, life insurance was forbidden and was considered to be an unethical legal activity, today life insurance is accepted in legislations and in practice worldwide and it has been proven as a very beneficial and justified institute. This type of service is offered by insurance companies with an investment aspect which allows life insurance to keep its traditional function (protection from various risks – death, disability, life longer than the agreed insurance term), but also to have a wider, macroeconomic function in the form of savings and investment. This service has not been widely accepted in the Republic of Serbia although it is regulated by both the Law on insurance and the Law of contract and torts. In the 1990s it almost ceased to exist, while nowadays it started to revive, but with far less cases than in EU countries and other countries of developed world.


2021 ◽  
Author(s):  
◽  
Stephen Grant Bourne

<p>A claims made policy protects an insured person or business in relation to claims made against that person or business during the policy period, regardless of when the cause of loss occurred, and regardless of when the claim is notified to the insurer (subject always to the terms of cover and the relevant law). The trigger event for a claim against the insurer is the receipt of the claim or demand by the insured. However, issues can arise when the insured has knowledge of circumstances that may lead to a claim, but the claim itself is delayed, a situation sometimes addressed by way of a contractual 'notice of circumstances' provision coupled with a deeming provision. The proposition in this dissertation is that New Zealand should have a statutory deeming regime affecting claims made insurance policies, similar to that contained within section 40 of Australia’s Insurance Contracts Act 1984 (Cth). However, to properly consider that proposition, it is necessary to review the context within which section 40 arose, its practical effect in that context, and the perceived issues that might be addressed in New Zealand by way of a statutory deeming regime. In particular, it is necessary to acknowledge the juxtaposition of sections 40 and 54 of the Insurance Contracts Act (Cth), and the implications of section 9 of New Zealand's Insurance Law Reform Act 1977.</p>


2021 ◽  
Author(s):  
◽  
Stephen Grant Bourne

<p>A claims made policy protects an insured person or business in relation to claims made against that person or business during the policy period, regardless of when the cause of loss occurred, and regardless of when the claim is notified to the insurer (subject always to the terms of cover and the relevant law). The trigger event for a claim against the insurer is the receipt of the claim or demand by the insured. However, issues can arise when the insured has knowledge of circumstances that may lead to a claim, but the claim itself is delayed, a situation sometimes addressed by way of a contractual 'notice of circumstances' provision coupled with a deeming provision. The proposition in this dissertation is that New Zealand should have a statutory deeming regime affecting claims made insurance policies, similar to that contained within section 40 of Australia’s Insurance Contracts Act 1984 (Cth). However, to properly consider that proposition, it is necessary to review the context within which section 40 arose, its practical effect in that context, and the perceived issues that might be addressed in New Zealand by way of a statutory deeming regime. In particular, it is necessary to acknowledge the juxtaposition of sections 40 and 54 of the Insurance Contracts Act (Cth), and the implications of section 9 of New Zealand's Insurance Law Reform Act 1977.</p>


2021 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong

Abstract Background: Urban and rural residents’ basic medical insurance (URRBMI) is an institutional arrangement for rural residents and unemployed urban residents in China. The serious illness medical insurance system (SIMIS) was established to provide additional medical cover. There are two ways in which medical expenses are covered. One is based on large expenses and provides proportional compensation for the individual’s own expenses after the URRBMI payment; the other is to pay for the treatment of some serious diseases after the URRBMI payment. At present, the SIMIS payment method in China is based on large expenses, and only a few areas, such as Shanghai, pay according to the treatment of serious diseases. This study aims to simulate and analyse the effect of the two payment methods on SIMIS in Shanghai. Methods: We developed a micro-simulation model to predict the number and characteristics of SIMIS participants among urban and rural residents in Shanghai and to simulate the process of medical treatment, medical consumption, and medical insurance payments for each insured person from 2020 to 2025. We then summarised and analysed the payment compensation effect, and compared it with Shanghai’s current policies.Results: Under the current financing standard, the payment of SIMIS according to high expenses is not sustainable and the compensation is insufficient and cannot effectively prevent or alleviate poverty.Conclusions: The policy of designing SIMIS according to national guidelines does not meet the development needs of Shanghai. Shanghai should take the current policy of paying compensation according to the treatment of serious illness as the policy basis, consider the security needs of patients with large medical expenses outside the scope of protection, and adjust policies appropriately to prevent poverty caused by illness.


Author(s):  
Erich Koch

On the one hand, the complex, constantly evolving system of German Agricultural Social Insurance guarantees each individual insured person comprehensive protection under social insurance law comparable to that for the general population. On the other hand, the state supports not only farms but agriculture as an economic sector as a whole with a reliable and massive financial contribution. The history, tasks, responsibilities, benefits, financing and organisational structure will be presented as well as prevention, special programmes and international relations. In doing so, all four branches of the German Agricultural Social Insurance System are dealt with by means of the descriptive method.


Author(s):  
M. N. Stepanova

The article presents the rationale for the importance of financial competence in compulsory social insurance for insured persons. It highlights the features of the formation and manifestation of financial competence. The author came to the conclusion that the financial competence of the insured person is expressed in the ability to use the opportunities for insurance coverage so that they meet the imperative social guarantees and the interests of the household. The insured must be able to use other methods of managing social risks. Special attention is paid to the formation of financial knowledge in the field of social insurance. The main role in preparing the population for insurance relations is played by non-formal and informal education. However, citizens are passive. The state, policyholders and insurers are not interested in comprehensive training of insured persons. Financial literacy programs include pension insurance. They do not take into account other types of social insurance. The availability of financial and legal knowledge on social insurance can influence the preservation of the financial well-being of citizens. It ensures the achievement of state social goals. Therefore, the question is raised about the need to include in the strategy of improving the financial literacy of the population of the Russian Federation.


2021 ◽  
Author(s):  
Zoran Miladinović ◽  

Accident insurance, together with life insurance are two basic types of individual insurance traditionally covered by insurance law. In this kind of insurance, the insurer for a certain insurance premium, assumes the obligation to pay the insured sum to the insured individual or other beneficiary if, during the insurance contract, the insured person or other beneficiary sustains injury or even death as a result of the accident covered by the insurance contract, as well as to reimburse the costs of medical treatment and income loss as a result of temporary work disability, if foreseen by the contract. The basic rule in accident insurance is that, in case of the accident covered by the contract, the insured person will receive the insured sum agreed in the contract, and not the reimbursement of the incurred expenses or losses. Only in rare cases this type of insurance has the elements of property insurance – only in cases when the insured is entitled, in addition to the insured sum, to reimbursement of medical expenses and income loss. Today, the insurance of the individuals against accidents is widely used. It is a specific type of services offered by insurance companies. From the original accident insurance contracts signed on voluntary bases, we have come long way to have a large number of mandatory accident insurances, which is mostly the result of the growing number of occupations with the risk of accidents. It is obvious that beneficiaries of this type of insurance have realized that for a relatively small amount of premium, they will receive protection if they suffer from unexpected accidents that may result in physical injuries, even fatalities.


2021 ◽  
Vol 29 (2) ◽  
pp. 44
Author(s):  
Alusianto Hamonangan ◽  
Ria Sintha Devi ◽  
Melky Saro Bulyan Zebua

Life insurance is an insurance, whereby an insurer binds himself to an insured person, by receiving a premium, to provide reimbursement due to a death event. Study and analyze the heirs whose names do not recommend as beneficiaries in a life insurance policy to which the heirs have responded as heirs. Indication of wishes to the insured party's wishes submitted in the SPAJ and agreed upon in an agreement document called an Insurance Policy. In this study raised the title Legal Protection Against Inheritance Who Is Not Designated in Life Insurance Policy (Study District Court Decision Number: 10 / Pdt.G / 2015 / PN Lbp). The formulation of the problem in this research, first how are the beneficiaries in life insurance after the insured dies (District Court Decision Number: 10 / Pdt.G / 2015 / PN Lbp)? Second, how are the legal efforts of the heirs appointed to get the right to money? life insurance coverage as inheritance (District Court Decision Number: 10 / Pdt.G / 2015 / PN Lbp)?, three, how is the legal protection in the decision that decides the inheritance rights to life insurance coverage money (District Court Decision Number: 10 / Pdt.G / 2015 / PN Lbp)?. This type of research is a normative legal approach method, the nature of this research is descriptive in accordance with the problem and research objectives.The results of the study investigated the consideration that the judge's consideration in making the decision number: 10 / Pdt.G / 2015.PN Lbp, based on several considerations, the judge examined arguments, letters, certificates and decided that the sum insured was an inheritance that the panel of judges ordered and passed guided by arguments, evidence and evidence submitted in the trial. The judge's decision obtains a stipulation regarding the legal heir for the party who wins the case, obtains legal certainty regarding the status of inheritance ownership in the form of compensation from life insurance. As a recipient of life insurance funds, they have an administration because the heirs are actually the heirs regulated in the Civil Code and determined by a judge's decision. The judge's decision obtains a stipulation regarding the legal heir for the winning party in the case, obtains legal certainty regarding the status of inheritance ownership in the form of compensation from life insurance to the legal heir.


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