According to the most inexpensive insurance, the insurance company will pay for: calling an ambulance doctor, establishing a diagnosis, hospitalization, treatment in a clinic, medicines prescribed by a doctor, dressing and fixing means (in case of a fracture), transportation, sometimes an emergency flight to home.
The insurance company provides these services not independently, but with the help of special service centers (assistance companies). Each insurance policy contains the telephone number of the dispatching service center, where there are Russian-speaking operators.
Russian insurance companies usually work with Elvia, Europ Assistance, Mondial, AXA, Inter Partner Assistance, Express assist, Global Voyager Assistance, etc.
Specialists organize medical care for tourists in a particular country, send them for emergency treatment, and conduct cash payments between doctors and the insurance company. Some insurance companies do not have such a partner abroad, and they are trying to resolve all assistance issues from Russia.
It is cheaper, but much less efficient.
Standard insurance, as a rule, gives the tour operator along with a ticket, and most often it is included in the tour price. This is convenient: you do not need to spend time on the choice of the insurance company and registration, to understand the nuances of the insurance program. But the list of insurance claims in the standard program is minimal, and there are a large number of exclusions from insurance coverage when the company refuses to pay.
You can get a wider range of insurance services by purchasing insurance from a tour operator and “getting” the necessary services from an insurance company. You can refuse the insurance included in the permit, and insure yourself. Under Russian law, the tour operator has no right to impose insurance services on you.
It is only necessary to transfer information about the new insurance to the tour operator before applying for a visa. You will choose an insurance company whose reliability is certain, and an individual approach will allow you to insure yourself taking into account the interests and peculiarities of your family.
For example, specifically include in the insurance coverage some risks (consequences of acclimatization, food poisoning, etc.).
Insurance usually costs from 0.5 to 2−3 dollars per person per day. The cost of insurance (the size of the insurance premium) is influenced by the following factors:
The age of the child. Most insurance companies refuse to insure children up to 1 year old (some up to 3 years old), explaining that by too much liability (in other words, unprofitable). For children 1-3 years old, insurance may cost two to three times more than for adults.
Children older than three years are insured at an adult price. Most insurance company experts explain: the high cost of insurance for children is quite justified.
After all, children are at high risk, that is, the probability of an insured event and the severity of the consequences for them is much higher than that of adults.
Health status. The more chronic diseases a child has, the higher the cost of insurance.
The amount of the sum insured (the amount of insurance coverage), i.e. the amount to which the insurance company reimburses the expenses incurred. The smaller the amount of insurance coverage, the lower the cost of insurance and the less money will be spent on treatment.
The country in which you are going to rest. The farther away from Russia the country of destination, the more expensive the insurance. So, for Bulgaria, the Czech Republic, the Baltic countries, Turkey, Egypt, insurance with an insurance coverage (the amount of the insured amount) of $ 15,000 is required.
These countries are close by, and treatment is relatively inexpensive there. But the Schengen countries require insurance coverage of $ 30,000, because here, for example, evacuation on a regular flight costs about $ 10,000 and about $ 25,000 – on a special ambulance plane.
Canada, USA, Australia, Japan, South Africa require coverage already from $ 50,000. Of these, $ 30,000 is supposed to be used for medicine, and the reserve – for transportation.
For those who want to rest in exotic countries, the insurance amount must also be at least $ 50,000.
Types of recreation: excursion (movement abroad by bus or other transport), active recreation (sports) or passive (stay in one place). If you plan to spend time with your child actively, you will need special sports insurance. The insured amount in this case will be higher, because the treatment of injuries received during sports activities is expensive, often urgent medical evacuation by helicopters is required.
Tell about your plans to specialists of the insurance company. Otherwise, you will treat your child’s sprain, sprains, fractures, bruises at your own expense.
Pay attention to the franchise. This is an amount in the range of $ 50−100, which is not refundable by the insurance company and which should always be in your possession.
The purpose of the franchise is to interest the customer to take more precautions.
Be sure to include in the insurance policy all countries that are going to visit, as well as transfer points. If you forget to specify any country or your plans suddenly change during the trip, the insurance policy will not be extended to this territory. Find out if insurance coverage is split by type of medical service.
For example, out of the total amount of $ 30,000, $ 20,000 is allocated for transportation, $ 8,000 for medicine, and so on, and redistribution is not allowed.
See when the insurance contract takes effect. Usually, the insured’s crossing of the state border of the country of departure is taken as a point of reference (the mark of the border services in the passport). If you are traveling to the Czech Republic by bus, and the policy is valid only after crossing the border of the Czech Republic, then the entire road to the Czech Republic remains uncovered.
In this case, it is recommended to insure also in Russia.
Honestly tell the insurance company representatives all information about the child’s health (when filling in the application form – before entering into an insurance contract). If it turns out that the child has gone abroad with the sick or has a chronic illness that has worsened, the insurance company will refuse to refund the costs.
When concluding an insurance contract, it is important to take into account all the details and paint the insurance risks in detail: if what happened to the child does not fit into the specified set of risks, the insurance company will refuse to pay the expenses.
When an insured event occurs, the main thing for parents is not to be confused, but to strictly adhere to a clear procedure for action approved by the insurance company.
1) First of all, call one of the phones listed in the insurance. The insurance company will pay for the call (you will need to provide a confirming document invoice containing the following information: the date of the call, the phone number, the duration of the negotiations and the amount paid).
2) Inform the dispatcher:
- surname, name, patronymic of the insured child;
- insurance policy number;
- the circumstances of the incident and the nature of the assistance required;
- location and contact phone number for feedback.
3) Follow the instructions of the service center. Depending on the situation, the specialists will organize a consultation with a medical professional by phone, or they will inform you which medical institution and which doctor you should go to, or send it to you, or arrange hospitalization.
Pay nothing. You will only need to show the doctor an insurance policy – so that he will contact the service center. After the representatives of the insurance company verify the information transmitted by the doctor, the service center on behalf of the insurance company will transfer to the hospital the guarantee of payment of bills.
All expenses for services rendered through the service center will be covered by the insurance company.
True, some insurance companies allow payment of medical services directly to parents (this should be stated in the insurance contract). For example, in emergency cases, you can independently consult a doctor so that your child will receive first aid.
However, the insurance company will not be liable for the quality of the medical services provided.
In this case, it will be necessary to obtain from the doctor the documents confirming the treatment and the bills paid by you. Upon your return from abroad, you must notify the insurance company of the incident in writing and submit the following documents:
- an application for reimbursement of expenses related to the insured event, with a justification of the reasons for not applying to the insurance company or its representative (service center);
- insurance policy;
- original certificate of invoice from the medical institution (on company letterhead or with a corresponding stamp) with the patient’s name, diagnosis, date of seeking medical help, duration of treatment, list of services rendered, broken down by date and cost, total amount to be paid;
- originals issued by a doctor in connection with this disease prescriptions with pharmacy stamps and an indication of the cost of each medication purchased;
- referral of a doctor for laboratory research and laboratory account broken down by date, name and cost of services rendered;
- documents confirming the fact of payment for treatment, medicines and other services (payment stamp, receipt of money or confirmation of money transfer).
The list of cases that Russian companies consider to be non-insured (that is, when they occur, the insurance company will not cover the expenses incurred and you will have to pay them out of your pocket), is very long. As a rule, insurance companies do not cover expenses:
1) associated with the treatment of chronic diseases, which are usually exacerbated during the adaptation period (large insurance companies pay the costs in such a case only if medical assistance was related to saving the life of the insured, but this must be confirmed by an appropriate medical report);
2) to treat sunburn and other acute skin changes caused by exposure to ultraviolet radiation;
3) for the provision of dental care (some insurance companies pay for the cost of acute toothache in the amount of not more than 2 teeth for the entire period of insurance and for an amount equivalent to no more than $ 100 for each tooth);
4) for the relief and treatment of convulsive states, nervous and mental diseases, neuroses;
5) for the treatment of oncological diseases, HIV infection, as well as diseases resulting from it;
6) to conduct disinfection, vaccination, medical examinations, laboratory and diagnostic studies not related to a sudden illness or accident;
7) for preventive measures and general medical examinations;
8) related to the voluntary refusal of the insured to fulfill the doctor’s instructions received in connection with the application for an insured event;
9) resulting from natural disasters, epidemics, hostilities, riots, acts of terrorism.
In addition to the standard exemptions from insurance coverage, each insurance company has its own nuances. For example, there are companies that enter the following clause for sea vacationers: “The costs of injuries sustained on the water are not covered.”
This means: no swimming, much less water parks, scooters and yachts. Others write: “Insurance does not apply to injuries at sea.” But at the pool – this is an insurance case.
Many companies disclaim responsibility if the insured child is in trouble outside the hotel.