The year 2014 was marked by another innovation for insurers and policyholders. The changes affected compulsory car insurance. A rule has appeared in the legislation that allows a citizen who has suffered damage, both material and health, to compensate for his losses directly, i.e., to use the so-called DCP (direct compensation for losses).

To do this, it is enough to contact your insurer, and not the insurance company of the culprit, as the law previously required. Thus, the time allotted for payment of compensation is significantly reduced.

How to properly take advantage of this opportunity and receive compensation from your insurer? To obtain a PPV, you need to contact your insurance company with a written application, of course. You should not delay, since any delay in filing an application reduces your chances of receiving compensation.

The document has the following structure and contains:

  • Name of the insurer. It is clear that we are talking about the organization to which the application is being submitted. The name must be accurate; if you don’t remember something, take the data in the contract or policy;
  • Full name of the policyholder, his address;
  • If your representative acts on your behalf (submits an application signed by you, receives a payment), then his full details (full name, address);
  • Full description of the incident. It is necessary to indicate when it happened, i.e. place, date, time, what exactly was damaged (property, people). Be sure to list all the circumstances of the past. The picture must be complete. Remember that PVU is paid only if the damage was caused by vehicles;
  • Next, you need to indicate all the data that relates to the guilty party: information about the car, the driver responsible for the incident;
  • Information about the victim, his property;
  • Identification, study, assessment of damage. This refers to the procedure for inspecting a vehicle;
  • Marks (at the conclusion of the document after the applicant’s signature) about when and by whom the application was accepted (date, time, recipient’s signature).

After the application is submitted and accepted, you need to receive an act (acceptance certificate) or a receipt for receipt of documents from the insurer’s representative.

It should contain the following points:

  • List of documents accepted by the insurer;
  • Details of the victim. They will be needed when receiving payments;
  • Marks indicating that documents have been accepted for consideration;
  • Additional Information. This item is completed by a representative of the insurer, if necessary.

Important! The application and other documents attached to it must be reliable and contain only accurate and truthful information. Marks in documents are not allowed. All fields are filled out without distortion, corrections, and legibly. Otherwise, compensation may be denied.

Documents for an application to the insurance company for compensation of losses under compulsory motor liability insurance

The application for compensation for damage incurred is accompanied by the following documents, which are its integral part.

The package of documents must include:

  • notification of an accident. The form of this document is issued by the insurer when drawing up a contract and receiving a motor vehicle policy. It is filled out by both parties to the accident. The document describes the accident, all its aspects, lists the damage received as a result of the incident;
  • If traffic police officers were present at the scene of the accident and conducted an investigation into the incident, then a certificate from the State Traffic Inspectorate (F-748) is also attached to the application. This certificate duplicates the notice, since it sets out all the circumstances of the collision;
  • Copies of vehicle registration certificate, PTS. That is, those documents that indicate the victim’s ownership of the damaged car;
  • Copies of the passport (other document proving the identity of the victim), driver’s license. If his representative acts on behalf of the victim, then a power of attorney is provided in his name (notarized), allowing him to act in the interests of the policyholder;
  • If the accident involved a car that is owned by any legal entity, the package of documents also includes a waybill received by the driver at the dispatch center of this legal entity. The sheet must indicate the route prescribed for vehicles.

In the event that traffic police officers were also present at the scene of the accident, materials from the traffic police department, copies of protocols drawn up by employees, and decisions on the case will also be required. The entire package of documents is submitted to the insurer.

Where to submit an application for compensation for damages under compulsory motor liability insurance

A package of prepared documents is submitted to the insurer with whom the victim has an agreement within the established time frame (either by law or specified in the current contract). If an application for payment is submitted after the end of the established period, the insurer has the right to refuse compensation. Unless, of course, the violation of the deadline is agreed upon with him.

After the application is accepted, the insurer inspects and assesses the damage incurred. Then he makes a decision: to pay compensation or refuse payment. Duration – 15 days and no more.

The insurer has the right to compensate for its losses at the expense of the company responsible for the accident. This process is called subrogation. This will not affect the victim's compensation in any way.

Important! You will not be able to receive compensation twice. It is unacceptable to receive compensation from both your insurer and the insurer of the person responsible for the accident.

In essence, this is fraud and law enforcement agencies will consider such an act as a criminal offense with all the ensuing consequences (criminal prosecution, and possible trial).

The introduction of a PWU helps reduce the time for reviewing, assessing damage, and receiving payments in case of a minor accident.

If the documents are drawn up correctly, payment can be received within 3 to 8 days. This period largely depends on what rules are established by the victim’s insurer.

The PWI implies that in the event of a road traffic accident, the injured party has the right to apply for compensation for damage to the organization with which the insurance contract was concluded. Before changes were made to the legislative framework, it was necessary to contact the company responsible for the incident. In order for something like this to happen, conditions must exist that presuppose. In addition, you must apply for a PES and follow the application procedure.

In what cases is a document drawn up?

To compensate for losses incurred under the PES program, When registering an accident, the following conditions must be met:

It does not matter who the applicant is listed in the policy, the insured or the owner. Subject to the conditions outlined above, he has the right to submit an application to his company and receive compensation directly.

How to fill out: detailed step-by-step instructions

The approved application forms contain standard columns; differences may only be in visual design. They are issued at the insurer's office upon application by the client. The document is filled out as follows:

The form and an example of how to fill it out correctly are given below:

What do you need to include?

The completed appeal must be accompanied by a package of relevant:

Everything is transferred according to the acceptance certificate, which serves as confirmation of the fact that the victim actually contacted the insurer. The act indicates the entire list of collected documents, certificates and copies.

Where to submit?

By contact the office of the victim's insurer. In this case, the insurance company has the right to demand an inspection of the vehicle to determine the amount of losses. Independent experts are often involved in the inspection and are carried out on the basis of their conclusions.

The company of the driver who caused the accident will not accept this document, since this is not its responsibility. But in a situation where the victim’s insurance organization has lost its license or has been declared bankrupt, it is permissible to contact the culprit’s insurer. In such cases, you can demand payment under the PES directly from the RSA. For such situations, a special fund has been created, which provides for payments according to a clearly regulated procedure.

After accepting the application, the victim’s insurance company compensates the losses to its client, and then turns to the insurer of the person responsible for the accident to receive compensation. Even if a dispute arises between insurance organizations and the case goes to court, their relationship will not affect the victim in any way.

Deadlines and fees

According to Federal Law No. 40, which regulates compulsory motor liability insurance and the relationship between the insurer and the policyholder, 5 working days are allotted for filing an application for a PPV from the date of the accident, otherwise the driver will lose the right to claim such compensation. But if there are valid reasons for the delay, the filing deadline can be extended. In addition, the time of application also affects the amount of payment, so it is better for the policyholder not to delay if he does not want the amount of compensation to be less than it should be.

The victim's insurer notifies the culprit's insurance company within 7 days. A decision on the application must be made before the expiration of 20 days from the date of acceptance. During this time, company employees assess the damage and conduct an examination. As a result, the insurance company is obliged to compensate for losses or refuse the client, clearly justifying its position.

If refused, the driver has 30 days to appeal the decision of his insurer in court. The money is usually transferred to a current account, but you can also receive it in cash at the insurance company’s cash desk. The entire procedure has clear regulations, each document is defined at the legislative level.

As for payment, there are no state fees for filing such an application. Expenses can only be incurred if you go to court in case of refusal of the insurance company to fulfill its obligations towards the client or to issue a power of attorney, if the applicant is not the policyholder.

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When contacting the office of the insurance company, you should remember that a correctly drawn up application and proper registration of an accident are the main documents that guarantee the receipt of a PPV in the necessary form. If problems arise with filling out, the company manager is obliged to provide detailed information about the rules for drawing up the document. Since many firms try to avoid payments by sending the client to the company at fault, it is better to consult with a lawyer in advance to know the nuances of the legislative framework on this issue.

Video on the topic

You can learn more about how to apply for a PPV from this video:

Information

Until August 2, 2014, the party injured in an accident could apply to the insurer for compensation for losses in two ways:

  • Contacting the insurer of the person responsible for the accident. The victim in this case needed to find the office of the culprit’s insurance company, then contact the company’s employees and resolve the situation;
  • Applying to your insurer for a direct loss claim (DCL), which was only possible in cases where two cars were involved in an accident and no one was injured in the accident.

This approach to compensation for losses led to the fact that insurers tried by hook or by crook to refer the victim to another insurance company. Very often, insurance company employees deliberately made it difficult to submit the necessary papers so that the driver would refuse to pay.

At the same time, some drivers could also abuse the position. For example, applications were often submitted to two insurers at once.

To exclude such actions and create a system of insurance payments under compulsory motor liability insurance, a document was created by law on non-alternative direct compensation for losses. In other words, the injured party can only apply for an insurance premium to its insurer. In turn, the insurer cannot refuse to consider the case.

Direct compensation for losses implies that the party injured in a traffic accident can apply for an insurance premium to its insurer with whom the MTPL agreement was signed.

Despite the fact that the legislation clarified such points and removed the two-sidedness of the situation, the negative side of the new rules is that the POL was limited to certain circumstances that must occur during a vehicle accident. If at least one of the items listed below is not included in the insured event, then your insurer will not be able to use the PES.

Direct Indemnity Terms of Use

You can apply for payment from your insurer if you comply with the following:

  1. Two cars were involved in the accident, and each driver has a valid MTPL policy.
  2. Only cars were damaged in the accident. There was no harm to people's health or lives.
  3. There is no mutual fault of the drivers (there is one culprit and one victim).
  4. The insurance company has a valid license to issue MTPL policies.

The driver will not be able to obtain a PDP under the MTPL agreement if:

  • The insurer of the person responsible for the traffic accident has already received a claim regarding this insured event;
  • Participants in a traffic accident decided to use a simplified system for registering an accident without police officers, but the documents about the accident were filled out incorrectly;
  • The applicant demands that the insurance company compensate for his moral damages or benefits that were lost due to the traffic accident;
  • The accident occurred with the participation of a training vehicle, during an official racing competition, etc.;
  • During the accident, damage was caused to securities, cash, art objects, antiques, etc.;
  • The fact of a traffic violation that caused the accident is the cause of legal proceedings;
  • In other cases, which are specified in the agreement of members of the Russian Insurance Association.

Direct compensation for losses is quite easy to learn. The driver must submit a set of correctly completed papers, after which he will be sent for examination. If the documents are completed correctly and a positive decision is received from the insurer of the person responsible for the accident, the funds will be transferred to the driver’s account, which must be indicated in the application. Everything else that follows (proceedings between insurers, disputes, courts, etc.) no longer relates to the party injured in the accident.

It should be taken into account that many insurance companies try to minimize the amount of direct compensation for losses. In addition, if the amount of the insurance premium is significant, then the insurer of the victim will by all means send the driver to the insurance company of the culprit.

It should be noted that:

  1. It is often impossible to resolve all direct compensation issues simply because the documents submitted by the injured party are incorrect or incomplete, allowing the insurance company to claim that it received false information about the accident. Because of this, you will not be able to settle the incident with your insurer under the PPV.
  2. The latest amendments to the law say that the injured party can apply to their insurance company for an insurance premium under compulsory motor liability insurance for direct compensation of losses, regardless of whether the driver is listed in the policyholder's policy or not. In the past, it was very common for insurance companies to refuse any payout under a PPV if the insured and the owner of the vehicle on the policy did not match.
  3. Motorists should also take into account that only one form of certificate from the traffic police complies with the rules of compulsory motor insurance, which is provided to the insurer along with other papers to obtain a PPV. This is Form 748, which is approved by the relevant order of the Russian Ministry of Internal Affairs.
  4. If the accident did not cause harm to human health, the amount of damage caused to the vehicle does not exceed 50,000 rubles, two cars were involved in the accident, both drivers have valid MTPL policies, and the circumstances of the incident do not cause disputes among the participants in the accident, then direct compensation for damage under compulsory motor liability insurance is issued without the participation of the police.

As you know, MTPL insurance is mandatory and gives an advantage in case of an accident only to the injured party. In case of an accident, the injured party will be able to receive compensation for the damage caused. To receive payments, you must fulfill all the conditions specified in the insurance, otherwise you will not be able to receive money.

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How insurance works

When purchasing a car in one way or another, you need to apply for compulsory motor liability insurance at any bank of the driver’s choice. If the driver’s favorite bank does not provide such insurance, you need to choose another suitable bank.

When applying for compulsory motor liability insurance, the power of the car is taken into account and the cost of insurance is determined. At the same time, the maximum amount of payment that can be paid to the driver is determined.

After purchasing a car, the driver is given time to insure the car. After this period, driving without this type of insurance is a violation and the driver is subject to a fine depending on the time spent driving without insurance. The same story applies when the previous insurance expires.

The insurance comes into force after an accident and the fulfillment of the circumstances specified in the contract. After which the injured driver can receive payment under compulsory motor liability insurance through the insurance company at the insurance company’s bank.

Circumstances under which insurance is paid

The circumstances specified in the contract must be fulfilled one hundred percent, otherwise it will not be possible to receive payment. There may be a catch here, but with careful insurance planning this can easily be avoided.

Mandatory conditions for payment under compulsory motor liability insurance:

  • The accident occurred between two cars. If one or two of these cars has a trailer, then it is still considered one vehicle. In this case, if one or more than two cars are involved in an accident, insurance under MTPL is not valid.
  • Damage was caused only to vehicles. If drivers or third parties were injured in an accident, or damage was caused to city property, then the insurance is again not valid.
  • The culprit of the accident was mutually recognized. If it is not possible to reach an agreement, then it is worth calling on the traffic police officers who will find out the guilt of one or another participant in the accident. If there is mutual fault on both sides, direct payments are not valid.
  • Each participant has active MTPL insurance at the time of the accident. Otherwise, there is no way to receive insurance compensation. You can check the availability or originality of the policy on site via the Internet. This information from each insurance company is not secret and is easily found using Internet search engines. It is also advisable to check it before starting to compile all documents.

Even if these conditions are met, direct payment for insurance under compulsory motor liability insurance cannot be obtained under such circumstances as:

  • Failure to fulfill at least one point of the conditions established by law (Article 14.1 of the Law “On Compulsory Motor Liability Insurance”).
  • When drawing up a Euro protocol, which is a mandatory document for determining payment, if you do not call the traffic police officers, mistakes were made or there were disagreements in the protocols of the two parties.
  • The accident occurred while a person was competing or learning to drive. Under these conditions, direct payment is not possible. The nuance is that competitions must be official, but driving lessons may not be so.
  • The insurance company from which you want to receive direct payment was notified later than the deadline specified in the insurance.
  • If the culprit has not been found, that is, the decision of the State Traffic Safety Inspectorate is now in court to resolve this issue, then direct payment is not possible.

Video: Features

Filling out an application for direct compensation for MTPL losses

An application for direct compensation for SAGO losses can be drawn up without the participation of the State Traffic Safety Inspectorate. This option is carried out by writing a European protocol on the part of both participants in the accident.

This application must contain the following information::

  • The name of the insurance company to which the claim will be filed. The data is taken from the company's insurance policy;
  • Last name First name Middle name and address of the victim who is the owner of the insurance policy for which direct payment will be made;
  • If the payment is received by a trustee, then the data of the trustee must be present;
  • Information relevant to the accident:
  • Place, time and date of the traffic accident, circumstances of the accident, and so on. It should be remembered that for direct payment, damage must be caused only to the cars of 2 participants;
  • Information about the car and driver responsible for the accident
  • Information about the injured party and his property;
  • The procedure for inspecting the car to identify the cost of damage;
  • Marks on submission and acceptance of the application.

When preparing this application, you must provide only reliable information. When filling out the protocol, you must write legibly and clearly for reading. These facts may also serve to deny direct reimbursement.

A sample application for direct compensation for losses under compulsory motor liability insurance can be downloaded.

Documentation

Like any application, an application for direct compensation for losses under compulsory motor liability insurance must be supported by additional documents that are attached to the application and confirm what is written in it.

The required documents for such an application are:

  • Notification from an accident. The form of this document is provided to drivers when applying for MTPL insurance. It indicates the circumstances of the accident, the damage caused and must be confirmed by both drivers. Otherwise, such a document is not valid.
  • If State Traffic Inspectorate employees are involved in an accident, you will need a certificate from them in form 748. There, as well as in the notification of an accident, the main parameters of this accident are indicated on the part of the State Traffic Inspectorate employees.
  • Copies of documents confirming the ownership of the vehicle by the indicated persons. If you are using a car that is not your own, you must have a power of attorney from the owner. Also technical passports of cars.
  • Copies of documents proving the driver’s identity and ability to drive. That is, a passport and a driver's license.
  • If this vehicle belongs to a legal entity, then a copy of the waybill issued to the driver by the dispatcher is attached.

When involving traffic police officers at the scene of an accident, the following documents are added to the above documents:

  • Protocol on administrative violation, which indicates the causes of the accident and the culprit.
  • A resolution on an administrative violation, which openly talks about this violation. That is, the articles that the driver violated and the fact of the violation are indicated.
  • Refusal to initiate a case. It is advisable to sign this document last. If the culprit of the accident admits his guilt and all the documents for direct payment have already been drawn up, then court proceedings will become unnecessary and for this purpose such a document is drawn up.

Where to submit

This application is submitted to the victim’s insurance company. This is what is stated in the insurance contract. After submitting documents for the period specified in the contract, the insurance company checks the data specified in the application, which may take several days. The involvement of the parties in the accident and who is to blame is checked. The amount of damage is determined.

Also, one of the available options for filing such a claim is submitting it to the insurance company of the culprit. Such an action will oblige the company that insured the culprit to pay, but there is a nuance - when submitting an application to the insurance company of the victim, the company itself has the right to recover the amount of payment from the insurance company of the culprit.

If you contact the culprit's insurance company directly, it is no longer possible to apply for direct compensation and you will have to follow a plan to completely sort out this situation.

Do motorists need insurance?

This type of insurance is mandatory for every car owner, but every rule has an exception.

It is accepted by law that disabled people of group 1, combatants or disabled war veterans who drive their own vehicles have the right to not have this type of insurance.

In such cases, direct reimbursement will not be possible.

Examples of companies

The MTPL insurance service is provided by many insurance companies. In general terms, the amount and cost of insurance is the same for the same car in different companies. The amount of insurance varies for different cars and is higher for more powerful cars.

Examples include the following insurance companies:

  • Ingosstrakh is one of the leaders in MTPL insurance. At the moment, it also provides the opportunity to obtain compulsory motor liability insurance via the Internet.
  • Rosgosstrakh is the leader in the Russian MTPL insurance market.
  • Insurance company Moskovia - has branches in Moscow, Moscow region, Bryansk region, Smolensk region, St. Petersburg, Kolomna, Kaluga, Sochi, Obninsk, Novy Urengoy, Ryazan, Tambov, Rostov-on-Don, Krasnodar, Crimea, Sevastopol and urban settlement Shakhovskaya.

Bank of Russia
dated September 19, 2014 N 431-P
"On the rules of compulsory insurance
civil liability
vehicle owners"

(form)

__________________________________________________________________________ (name of insurer) Application about insurance compensation or direct compensation for losses under a compulsory insurance contract civil liability of vehicle owners 1. Victim (beneficiary, representative of the beneficiary) (underline as appropriate) _____________________________________________________ (full name of the legal entity or surname, first name, patronymic of an individual) ___________________________________ _____________________________________ (date of birth of the individual) (TIN of the legal entity) ________________________________________________ _____________ ____________ (certificate of registration of the legal entity (series) (number) or identification document of an individual) Address ___________ _________________________________________ _____________ (index) (state, republic, territory, region) (district) _______________________ _______________________ _____ ________ __________ (settlement) (street) (house) (building ) (apartment) Telephone ________________________________________________________________ 2. Damaged property Owner _______________________________________________________________ (full name of the legal entity) _________________________________________________________________________ (last name, first name, patronymic of the individual) ___________________________________ _____________________________________ (date of birth of the individual) (TIN of the legal entity) _______________________________________________ _____________ ____________ Address ___________ ________________________________________ _________ (for (index) (state, republic, territory, region) (district) correspondence) _______________________ _______________________ _____ ________ __________ (settlement) (street) (house) (building) (apartment) Information about the damaged vehicle Make, model, category vehicle _________________________ Vehicle identification number __________________________ Year of manufacture of the vehicle _________________________________ Vehicle registration document ___________________________ (vehicle passport ________________________________________________________________________, vehicle registration certificate, self-propelled vehicle passport or similar document) ____________ ___________ _________________ (series) (number) (date of issue) ) State registration mark _____________________________________ Information about other damaged property Type of damaged property _______________________________________________ Type and details of the document confirming ownership of the damaged property: ________________________________________________________________________ Information about harm to life / health Person whose life / health was harmed ___________________________ (last name, first name, patronymic of the individual nature and degree of damage to health _________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Are there additional /-\ /-\ expenses for treatment, restoration of health: yes, no \-/ \-/ /-\ /-\ Is there any lost earnings ( income): | | yes, | | no \-/ \-/ Relationship to the deceased person (degree of relationship) ____________________________ 3. Information about the insured event Date and time of the insured event: __.__.20__,__:__ Address of the place where the insured event occurred: ____________________________ ________________________________________________________________________ The driver who drove the vehicle during the use of which the damage was caused: _________________________________________________________________________ (last name, first name, patronymic of the individual ) Circumstances of the insured event: _______________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ __________________________________________________________________________ ________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 4.1. I ask you to make insurance compensation / direct compensation for losses (underline as appropriate) under the contract of compulsory insurance of civil liability of vehicle owners, series _____ N ________, issued by the insurance company _______________, by: | | organizing and paying for the restoration repair of a damaged vehicle at a service station selected from the list proposed by the insurer: __________________________________________________________________________ at ________________________________________________________________________ About the date of delivery of the repaired vehicle, please inform me in the following way (by phone, mail, e-mail): __________________________________________________________________________ or / -\ | | and by paying the cost of restoration of the damaged \-/ vehicle of the service station: Full name _____________________________________________________ Address ___________________________________________________________________ Payment details: Recipient's bank: ____________________________________________________________ Recipient's account: __________________________________________________________ Correspondent account: _________________________________________________ BIC: _____________________________________________________________________ Taxpayer Identification Number: _____________________________________________________________________ Indication of the service station not from the one proposed by the insurer The list is possible only in relation to passenger cars owned by citizens and registered in the Russian Federation, and with the consent of the insurer in writing. 4.2. I request you to make an insurance payment in the amount determined in accordance with Federal Law No. 40-FZ of April 25, 2002 “On compulsory insurance of civil liability of vehicle owners”: /-\ | | cash; \-/ or /-\ transfer by bank transfer using the following details: \-/ Recipient's name: ________________________________________________ Recipient's bank: ________________________________________________________ Recipient's account: ________________________________________________________ Correspondent account: _________________________________________________ BIC: _________________________________________________________________________ INN: _________________________________________________________________________ Clause 4.2 is filled in when making an insurance payment in case of harm life or health of the victim, as well as in the presence of the conditions provided for in paragraph 16.1 of Article 12 of the Federal Law of April 25, 2002 N 40-FZ “On compulsory insurance of civil liability of vehicle owners.” 5. I am attaching the following documents to this application:
Document ***
(copy/certified copy/original - specify)		 Qty
sheets
Identity document
document certifying the authority of the representative
beneficiary
Bank details for transferring insurance payments
Consent of guardianship authorities
Certificate of traffic accident
Notification of a traffic accident
Protocol on administrative offense, decisions on
administrative offense case
Ruling on refusal to initiate administrative proceedings
offense
In case of damage to property
Documents confirming ownership of the damaged property
property or right to insurance payment
Conclusion of an independent examination (assessment)
Documents confirming payment for the services of an expert technician
(appraiser)
Documents confirming payment for evacuation services
damaged property
Documents confirming payment for storage services
damaged property
In case of harm to life/health
Documents issued and executed by a medical organization, with
indicating the nature of the injuries and injuries received by the victim,
diagnosis and period of incapacity
Conclusion of a forensic medical examination on the degree of loss
general or professional ability to work
A certificate confirming the fact of disability or
category "disabled child"
Certificate from the ambulance station about the services provided
medical assistance at the scene of a traffic accident
Certificate or other document about average monthly earnings
(income), scholarships, pensions, benefits
Application containing information about family members of the deceased
victim
Copy of death certificate
Birth certificate of the child(ren)
Certificate from educational organization
Conclusion (certificate from a medical organization, body
social security) about the need for outside care
Certificate from the social security authority (medical
organization, local government, employment service)
that one of the parents, spouse or other family member
the deceased does not work and is busy caring for his relatives
Marriage certificate
Documents confirming funeral expenses incurred
Extract from the medical history
Documents confirming payment for the services of a medical organization
Documents confirming payment for purchased medications
Other documents
Victim (beneficiary, representative of the beneficiary) ______________ (______________________) (signature) (full name) "____"______________ 20___ (date of filling out the application) Insurer (representative of the insurer) ______________ (______________________) (signature) (full name) "____"______________ 20___ (date of receipt of application)