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Claims and Indemnification |
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What to do upon the occurrence of an insured event
Now follow general requirements which are applicable to the main types of insurance.
Detailed instructions have been set out in the conditions of the relevant service. You may also ask for assistance from ERGO’s representatives.
In the case of property insurance:
- Do your best to avoid further loss or damage.
- Report the event to a competent body – police, fire department, etc.
- Notify ERGO’s representative office as soon as reasonably practicable.
- File a written claim with the insurance company, on the basis of which the claim will be handled and settled.
In the case of a traffic accident:
- If people were injured in consequence of a traffic accident, please administer first aid to the injured or call an ambulance.
- If the parties to a traffic accident fail to reach an agreement as to the party at fault, the police must be called.
- Traffic accident must be definitely documented by filling in the relevant form (traffic accident advice). Make sure that the party at fault will confirm his or her responsibility for the damage caused. If the other party to the accident fails to produce an insurance policy, write it down as well.
- To report traffic damage, turn to the insurance company of the party at fault or the Motor Third Party Liability Insurance Fund as soon as possible.
In the case of travel insurance:
- Turn to the nearest doctor for medical care.
- If necessary, contact or ask the doctor to contact the Claims Centre at the phone number indicated at the back of the policy (insurance card). State your name, location, contact phone and policy number and describe the causes of your call.
- In the case of travel interruption insurance please contact your travel agent/transportation company/hotel for changing your trip schedule. After that contact ERGO Insurance Company.
- Upon the occurrence of a luggage insurance case please report immediately to the representative of the company that provided the service to you, or to the police and after that contact ERGO Insurance Company.
- Complete the claim form and deliver it along with the original documents substantiating the occurrence of an insured event to the nearest ERGO office as soon as possible.
Claims Department abroad:
EUROALARM Assistance Prague s.r.o.
Kozi 5, 110 00 Praha 1
Czech Republic
Tel +420 221 860 616
Faks +420 221 860 600
E-post help@euro-alarm.cz
www.euro-alarm.cz
In case of life insurance:
- The insurer indemnifies for any loss or damage according to the provisions of the insurance contract. Therefore, it is very important that you carefully study the insurance conditions before signing the insurance contract.
- Inform the insurance company either personally or through a third party or parties of the occurrence of an insured event as soon as possible. The insurance advisor will assist you in filling in the claim advice and inform you of the documents that are required for the disbursement of the insurance benefit.
- If the occurrence of an insured event was occasioned by the activity of a third party or the event occurred at work, the occurrence must be recorded by the police or employer.
- If the insured event has occurred abroad, you must obtain all documents substantiating the insured event, including documents substantiating referral to a doctor and treatment administered. If necessary, the insurer may request that the documents be translated on the account of the beneficiary.
In the case of health insurance:
- Upon contracting an illness, refer to your family physician and in the event of an accident to the nearest emergency room or hospital.
- If you need specialist advice, you should first consult your family physician about the specialist advisors. You can benefit more from specialist advice if you have had a preliminary examination carried out by your family physician.
- You may also contact directly any medical institution or doctor with whom ERGO has signed a relevant contract, without your family physician’s referral (you received relevant information with your insurance policy). You need not pay the visit fee.
- Take your health insurance card with you every time you visit a doctor or medical institution. Be prepared for the doctor to check the validity of your insurance coverage.
The insurance coverage is valid if you have effected premium payments when due. Medical services are normally paid for directly to the doctor or medical institution on the basis of the bills issued by them. You only need to pay for dental care.
If for some reason you have paid for the medical services yourself or if you claim compensation for transportation costs, please file a relevant claim advice with ERGO Elukindlustus within three days. Fill in the Claim Form and enclose the following documents to it:
- Insurance policy
- Copy of an identification document
- Original bill for medical services along with the receipt substantiating payment
- In the case of an illness or accident, a doctor’s excerpt from the case history or medical file
- Original bill for medical transportation along with a doctor’s confirmation that the transportation was necessary for emergency healthcare.
The insurance benefit is disbursed within two weeks from the submission of all required documents.
We believe that our cooperation will be successful, if the foregoing rules of procedure are followed.
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