LAW OF OBLIGATION ACT, PART 4, CHAPTER 26

Chapter 26

ACCIDENT INSURANCE 

  • 548. Insurer’s obligation to compensate

In the case of accident insurance, the insurer shall, upon the occurrence of an accident, pay the amount specified in the contract as a lump sum payment or in instalments, compensate for patrimonial damage caused by the occurrence of the insured event or perform the contract in any other agreed manner.

  • 549. Application of life insurance and non-life insurance provisions

(1) If payment of an agreed amount of money rather than compensation for damage is prescribed as the insurer’s performance obligation, the policyholder shall have the right to appoint a beneficiary pursuant to the provisions of §§ 537 and 538 of this Act.

(2) The parties to the contract may agree upon the application of relevant provisions of non-life insurance insofar as such provisions do not contradict the nature of accident insurance.

  • 550. Persons covered by accident insurance

(1) If an accident involving a third party is insured against, it shall be presumed that the third party is the insured person.

(2) If a policyholder has taken out insurance against an accident involving a third party in order to insure the insured risk of the policyholder, the written consent of the third party is needed for the contract to be valid. If the third party is a person with restricted active legal capacity and the policyholder is his or her legal representative, the policyholder may represent the third party in the grant of consent only with the permission of the court of the residence of the third party.

[RT I 2009, 60, 395 – entry into force 01.07.2010]

  • 551. Intentional causing of accident

(1) If a policyholder has taken out insurance against an accident involving a third party in order to insure the insured risk of the policyholder, the insurer shall be released from its performance obligation if the accident is caused by an intentional unlawful act of the policyholder.

(2) If the beneficiary causes an accident by an intentional unlawful act, the beneficiary shall be deemed not to have been appointed.

  • 552. Deterioration of health of insured person

It is presumed that the health of the insured person deteriorated due to circumstances beyond his or her control.

  • 553. Notification obligation of beneficiary

If a beneficiary is entitled to performance of the obligation by the insurer, the beneficiary shall give notice of the insured event and provide information and submit evidence concerning the insured event.

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