Article 9. The rights and obligations of the insurer of the Law on Compulsory Insurance of an Employee against accidents in the Performance of his Labor (Official) Duties

Home / RLA / Article 9. The rights and obligations of the insurer of the Law on Compulsory Insurance of an Employee against accidents in the Performance of his Labor (Official) Duties

1. The Insurer has the right to:

1) participate in the investigation of insurance claims;

2) be present at the examination of the employee by the territorial subdivision of the authorized body;

2-1) check the information for compliance with the classification of economic activities into occupational risk classes according to the staffing table or other information provided by the policyholder and (or) requested by the insurer;

3) verify information on insured events and, if necessary, send requests to the relevant authorized bodies;

4) to carry out surveys of the policyholder's facilities to assess the insurance risk;

5) to refuse insurance payment in cases stipulated by the Civil Code of the Republic of Kazakhstan, the Social Code of the Republic of Kazakhstan and this Law;

6) to give recommendations on the prevention of insurance claims;

7) involve an independent expert to assess the insurance risk;

8) a reverse claim against the person who caused the harm.

2. The Insurer is obliged to:

1) (deleted - No. 244 dated May 7, 2007);

2) to acquaint the policyholder with the terms of the employee's compulsory accident insurance contract and explain his rights and obligations arising from the employee's compulsory accident insurance contract;

3) upon the occurrence of an insured event, make an insurance payment and reimbursement of funeral expenses in accordance with this Law and the employee's compulsory accident insurance contract.;

3-1) upon notification of an insured event (an event considered as an insured event) that occurred during the period of insurance coverage under the employee's compulsory accident insurance contract, immediately register it and submit information on this insured event (an event considered as an insured event) to the organization for the formation and maintenance of a database in in accordance with the regulatory legal act of the authorized body for regulation, control and supervision of the financial market and financial organizations;

3-2) if the conditions stipulated in paragraph 1 of Article 195-1 of the Social Code of the Republic of Kazakhstan arise, make monthly insurance payments under the pre-retirement annuity agreement in accordance with the concluded pre-retirement annuity agreement and this Law;

4) to ensure the confidentiality of information about the policyholder and beneficiary obtained as a result of their activities;

5) in the event of a decision to refuse insurance payment, send to the beneficiary, within seven working days from the date of receipt of the application and all documents provided for in paragraph 2 of Article 20 of this Law, a reasoned justification in writing for the reasons for the refusal and a notification of the right of the policyholder (beneficiary) to contact the insurance ombudsman to resolve disputes, taking into account the specifics of legislation Republic of Kazakhstan;

5-1) upon receipt of an application from the policyholder (beneficiary), consider the claims of the policyholder (beneficiary) and provide a written response indicating the further procedure for resolving the dispute within five working days.;

5-2) upon receipt of an application from the policyholder (beneficiary) to the Insurance Ombudsman, forward this application, as well as the documents attached to it, to the Insurance Ombudsman within three working days from the date of receipt;

6) reimburse the policyholder for the expenses incurred by him to reduce losses in the event of an insured event;

7) excluded by the Law of the Republic of Kazakhstan dated 12/30/2009 No. 234-IV (effective from 08/9/2010);

8) excluded by the Law of the Republic of Kazakhstan dated 05/07/2007 No. 244;

9) in case of late payment of insurance payments provided for in paragraph 1 of Article 19 of this Law, pay the beneficiary a penalty in the amount of 1.5 percent of the unpaid amount for each day of delay.

10) reimburse the policyholder for the costs of preventive measures in the amount of no more than six percent of the insurance premium calculated on the expiration date of the insurance contract;

11) reimburse the policyholder and (or) the beneficiary for the costs incurred for rehabilitation measures in the amount of no more than six percent of the insurance premium calculated on the expiration date of the insurance contract;

12) reimburse the beneficiary for the costs of sanatorium treatment in an amount not exceeding one hundred times the monthly calculation index established for the relevant financial year by the law on the republican budget.

An insurer licensed to carry out insurance activities in the life insurance industry under the annuity insurance class is obliged to conclude an annuity agreement in favor of an employee or a person entitled to compensation for damage caused by the death of an employee in the cases provided for by this Law, within the limits of the insured amount established by the employee's compulsory accident insurance contract..

An insurer licensed to carry out insurance activities in the life insurance industry under the annuity insurance class is required to conclude a pre-retirement annuity agreement in favor of an employee eligible to receive insurance payments under a pre-retirement annuity agreement, in accordance with Article 23-1 of this Law.

The Insurer is obliged to notify the beneficiary (his legal representative) of the annuity agreement concluded in his favor within twenty working days after the date of conclusion of the annuity agreement.

3. The contract of compulsory insurance of an employee against accidents may provide for other rights and obligations of the insurer that do not contradict the legislative acts of the Republic of Kazakhstan.

The Law of the Republic of Kazakhstan dated February 7, 2005 No. 30.

This Law regulates public relations arising in the field of compulsory employee accident insurance and establishes the legal, economic and organizational basis for its implementation.

President

Republic of Kazakhstan

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