Standard insurance product “E-liki”

Insurance Risk:

1. an acute illness of the Insured Person;
2. exacerbation of a chronic illness of the Insured Person;
3. a health disorder of the Insured Person as a result of an accident.

An insured event under the contract means that the Insured Person receives, at a pharmaceutical establishment (pharmacy), medicinal products (specifically, generic drugs and medical devices) prescribed by the Insured Person’s family doctor in connection with the occurrence of insurance risks, within the diagnoses and medicines covered by:

• the list of diagnoses according to international classifications of primary health care and/or diseases for which medicines covered by the E-liki insurance product are prescribed;
• the list of international nonproprietary names of medicinal products included in the coverage of the E-liki insurance product.

The following persons cannot be insured:

• persons declared legally incapable according to the law;
• persons suffering from severe diseases of the nervous system (brain tumor, spinal cord and vertebral column tumor, nervous system lesions caused by malignant neoplasms, brain death, spinal or spinal cord trauma, acute cerebrovascular accident (stroke), acute necrotic encephalitis), or malignant neoplasms;
• persons with mental illnesses;
• HIV-infected persons.

When concluding an insurance contract for 6 months, the insurance sum is UAH 10,000; when extending the contract for 12 months, the insurance sum is UAH 20,000.

Insurance rate — from 3.6% to 12% of the insured sum.
Monthly insurance premium — from UAH 60 to UAH 200.
6-month insurance premium — from UAH 360 to UAH 1,200.
12-month insurance premium — from UAH 720 to UAH 2,400.

The insurance rate and premium depend on the age of the Insured Person.

An unconditional deductible of 20% applies to the cost of medicines prescribed to the Insured Person by their family doctor at each appointment, according to the Protocols of the Ministry of Health of Ukraine, within the list and scope defined in Appendix No. 1 to the General Terms of the “E-liki” insurance product.

Territory of the contract — Ukraine.

The contract does not apply to temporarily occupied territories of Ukraine; areas where state authorities of Ukraine temporarily do not exercise their powers; settlements located along the line of contact; or active combat zones where military (combat) actions are taking place on the date of an event that has the characteristics of an insured event.

The term of the insurance contract is 6 months, with the possibility of extension (renewal) for 12 months.

The contract term is divided into insurance periods lasting 1 (one) month.

The insurance contract takes effect at 00 hours 00 minutes on the start date specified in the contract, but not earlier than the day following payment of the insurance premium in the amount defined by the contract to the Insurer’s account.

The contract remains in force until 24:00 (Kyiv time) on the date indicated in the contract as the end of its validity period, unless other circumstances lead to its early termination.

The contract is automatically extended (renewed) for 12 months, and each subsequent extension is for 12 months under the same conditions, unless either party notifies of its intention to terminate it.

Insurance coverage during each insurance period is valid provided the insurance premium for that period is paid according to the contract.

The contract terminates, and insurance coverage cannot be reinstated, if regular insurance payments fail to be received or are received incompletely to the Insurer’s account for six (6) consecutive months.

The product provides for a waiting period for an insured event — a period of 14 (fourteen) days from the effective date of the insurance contract (or from the date of payment of an overdue premium for a period of insurance if the previous three periods were unpaid), during which insurance coverage under the contract is not in effect.

Failure of the Policyholder (the Insured Person) to fulfill the obligations defined in the insurance contract may be grounds for the Insurer to refuse payment of the insurance benefit.

The Insurer has the right to refuse an insurance payment if the Insured Person fails to perform the actions provided for in the insurance contract in the event of an incident that has the characteristics of an insured event.

Events occurring during the insurance period for which the insurance premium was not paid within the time limits specified in the contract are not recognized as insured events.

The contract is not an addition to any other goods, works, or services that are not insurance-related. There is no need to obtain any additional or related services from the Insurer and/or third parties in connection with receiving the financial service under the Contract.

Discounts and promotional offers are not available and do not apply.

When concluding an insurance contract, the Policyholder must provide the Insurer with information regarding the existence of an insurable interest concerning the insured object, as well as all circumstances known to them that are material for the assessment of the insurance risk according to the prescribed list. The Policyholder must also notify the Insurer of any changes to such circumstances within 5 (five) working days after they occur during the validity of the contract.

The list of information the Policyholder must provide to the Insurer (or insurance agent) before concluding the contract, which is material for the Insurer’s decision on concluding the contract and/or determining the amount of the insurance premium under the contract, includes:
- surname, first name, and (if applicable) patronymic of the Insured Person;
- place of residence / stay of the Insured Person;
- date of birth of the Insured Person;
- taxpayer identification number;
- number (and, if available, series) of the passport of a citizen of Ukraine (or another identity document permitted by Ukrainian law for legal transactions), date of issue, issuing authority, and information about the place of residence or stay;
- confirmation that the Insured Person has no conditions or diseases that would make them ineligible for insurance. The absence of such circumstances and illnesses is confirmed by the Policyholder through signing the Contract;
- information about existing insurance contracts concluded in respect of the insured object.

This insurance product requires the consumer to review the relevant information in advance in order to make an informed decision regarding the conclusion of the insurance contract.

Before concluding the contract, the consumer must review the information on exclusions from insurance coverage and reasons for refusal of insurance payments, limits of the insurer’s liability for specific insured objects, insurance risks and/or insured events, as well as the procedure for calculating and conditions for making insurance payments contained in the General Terms of the insurance product "E-liki" (the public part of the insurance contract), available at: https://uniqa.ua/storage/public-offer/partner-reports/1109_UMOVY_E-LIKI.pdf