On the recovery of insurance payments to reimburse additional expenses caused by damage to the employee's health (one-time insurance payments).
In accordance with the wording of article 19 of Law No. 30, as of February 7, 2005, in order to receive insurance payments to reimburse additional expenses caused by damage to health, an employee had to submit documents confirming the costs incurred. Law No. 234-IV amended this provision (entered into force on August 9, 2010), according to which the amount of insurance payment began to depend on the degree of UPT (from 5 to 29% – 500 MCI, etc.). Payment was made only upon provision of a document confirming the establishment of the degree of UPT to the injured employee. Since the introduction of this rule, employees have been contacting insurance companies to collect insurance payments without confirming the costs incurred. The practice in the republic was ambiguous. Some courts (East Kazakhstan region, Almaty city) collected from insurance companies amounts from 500 to 2,000 MCI for all employees, regardless of the terms of the contract concluded between the policyholder and the insurer. Other courts (in the Karaganda region) refused. In 2016, the Supreme Court established a uniform practice.
In refusing to satisfy the claims of the plaintiffs, whose insured event occurred during the period of the contract concluded before the above changes were made, the board proceeded from the fact that the terms of the contracts, the amount of additional costs caused by damage to the employee's health and determined by the insurer on the basis of documents confirming the costs submitted by the employee or the person who incurred these costs, corresponded to paragraph 2 of Article 19 of the Law as amended at the time of their conclusion. It does not follow from Law No. 234-IV that it applies to relations arising from previously concluded contracts. Law No. 311-V again changed the procedure for making one-time insurance payments. Their reimbursement is carried out by the insurer on the basis of documents confirming these expenses. In addition, there is a limit to the insurance benefit depending on the degree of UPT.
Attention!
Law and Law Law Law draws your attention to the fact that this document is basic and does not always meet the requirements of a particular situation. Our lawyers are ready to assist you in legal advice, drawing up any legal document suitable for your situation.
For more information, please contact a Lawyer / Attorney by phone: +7 (708) 971-78-58; +7 (700) 978 5755, +7 (700) 978 5085.
Attorney at Law Almaty Lawyer Legal Services Legal Advice Civil Criminal Administrative Cases Disputes Protection Arbitration Law Firm Kazakhstan Law Office Court Cases
