The Rules On Claims And The Calculation Procedure For A Person To Material Losses

Original Language Title: Noteikumi par apdrošināšanas atlīdzības apmēru un aprēķināšanas kārtību par personai nodarītajiem materiālajiem zaudējumiem

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Read the untranslated law here: https://www.vestnesis.lv/ta/id/98105

 
Cabinet of Ministers Regulations No 1009 Riga 2004 December 14 (Mon. No 72 1. §) rules on insurance claims and the calculation procedure for a person to material losses Issued under the motor liability insurance Act, compulsory 19. the third paragraph of article i. General questions 1. determines the ground vehicle owners civil liability compulsory insurance the amount of remuneration and the procedure for calculation of road traffic accident person material losses associated with the treatment of the victim temporary incapacity for work, capacity, loss or death.
2. the terms used in the rules: 2.1 a beneficiary – a person with insurance claims;
2.2. material damage of supporting documents – receipt and/or business of formal receipts (original) with the properties of the payer received medical and therapeutic services, purchased medical products (medical preparations, medicines and vitamins);
2.3. the claims of recurring charges-charges which are the parties involved in a road traffic accident or loss of capacity due to death the insurer or the insurer of the vehicle out of the Office.
II. calculation of claims required documents 3. Insurer or insurers of vehicles Office examine the claims of the applicant's written submissions about road traffic accident person material losses associated with the treatment of the victim, temporary incapacity, loss of capacity or death if it within a period of three years from the occurrence of the insurance event.
4. in order to receive insurance compensation for the victim's treatment, the application shall be accompanied by the following: 4.1. extracts from the hospital and/or outpatient treatment services, patient medical card issued by the medical establishment, which in a road traffic accident victim conveyed or referring the same after a road traffic accident;
4.2. extracts from the hospital and/or outpatient treatment services, patient medical card issued by the medical establishment, which in a road traffic accident the injured party continued treatment after a road traffic accident injuries;
4.3. documents certifying the road accident injuries according to material losses;
4.4. documents justifying reasonable travel expenses incurred in attending treatment services.
5. in order to receive insurance compensation for temporary incapacity of the victim, the application shall be accompanied by: (A) disability page 5.1 and disability (B) a copy of the page (if the reimbursement requests the victim's employer, requires only A copy of the page);
5.2. the statement of the employer under the labour law of average earnings before the accident;
5.3. employer's statement on the victim of a calculated and paid in cash;
5.4. The State social insurance agency a statement of the victim sickness benefits paid amount (if the reimbursement requests the same injured party);
5.5. The State social insurance agency a statement of the parties involved in a road traffic accident insurance contribution amount for the last six months before the accident;
5.6. assurances on the victim paid the money (if reward requires a victim's employer).
6. in order to receive insurance compensation for the injured party's loss of capacity, in addition to the application of these rules in the document referred to in paragraph 5 shall be added: the health and capacity of 6.1 inspection of State Commission issued the medical disability certificate copy (showing original) or notarized copy;
6.2. the national social security agency certificate or a copy of the decision of the victim/granted disability pension paid or the amount of the capacity loss due to accidents at work;
6.3. employer's statement on salary (if the injured party continues to work);
6.4. The State social insurance agency a statement of the parties involved in a road traffic accident insurance amount (if the injured party continues to work);
6.5. a statement of the benefits received from State and local government budget;
6.6. a certificate of higher education institutions, in which the injured person learned to road traffic accident to full time courses (if the injured person required to pay tuition fees);
6.7. inquiries from educational institutions, in which the injured person continue to learn after a road traffic accident in part-time study program (if the injured person required to pay tuition fees);
6.8. documents certifying the payment of the tuition fees this rule 6.6 and 6.7 in referred to education (if the injured person required to pay tuition fees);
6.9. a copy of the document (the presentation of the original) and the application for selected educational and training programmes, as well as the documents justifying the chosen new professions, which is consistent with current health condition (if requesting reimbursement of incurred expenses associated with the new learning of the profession).
7. for claims for damages due to the victim's death (burial expenses), the application shall be accompanied by the following: 7.1 a road accident killed the person a copy of the death certificate, showing the original;
7.2. documents (such as a voucher for funeral services, grave responsibility certificate, excerpt from the graves archive books), which certifies the fact of death;
7.3. the documents justifying the fact of iztērēto reasonable expenses for the burial of the victim (claims submitted to the applicant who requested a consideration greater than the minimum monthly salary of eight).
8. for claims for damages due to the death of the victim (for survivors), the application shall be accompanied by the following: 8.1 road accident deaths in persons – survivor – a copy of the death certificate (showing original);
8.2. relationship of the supporting document copy (showing original) or notarized copy;

8.3. the child's birth certificate copy (showing original) or notarized copy, if the dependant is a child under the age of eight years and regular payments can be allocated to operational well widow (widower);
8.4. a copy of the marriage certificate (showing original) or notarized copy, if consideration requires the widow (widower);
8.5. a certificate of secondary education or higher education institutions, if the dependant is a child, and at a time when the household death occurred, he studied secondary education institution or has been higher education full time student and is not older than 24 years;
8.6. the health and integrity of the expertise of the National Commission of physician issued a copy of the certificate of disability, the presentation of the original or notarized copy, if the dependant is the disabilities (people with disabilities);
8.7. the national social security agency for a road accident deaths in persons the amount of contributions for the last six months before the accident;
8.8. The State social insurance agency's certificate or a copy of the decision of road accident deaths dependants of the person granted a survivor's pension, social security benefits or rewards for survivors due to accidents at work;
5.5. statement of benefits received from State and local budgets.
III. modalities for the calculation of claims 9. Insurance claims for traffic accident person material losses is calculated by the day when encountered the right to it.
10. insurance reimbursement for road traffic accident person material losses calculated, within certain limits of liability of the insurer of the person to cover the damage.
11. insurance compensation for road accident victim treatment shall be calculated on the basis of the submission of supporting documents.
12. the material of the supporting documents for the insurer or insurers Bureau checked and compared with the statements from the hospital and/or outpatient hospital's patient's medical record.
13. the material of the supporting documents that contain expenditure is reimbursed, kept by the insurer or the insurer of the Vehicle in the Office. Documents that do not certify road accident injuries gained, the insurer or the insurer of the Vehicle at the request of the applicant, the Office shall send or give to the applicant.
14. expenditure on elevated service and traditional treatment methods (such as acupuncture, biophysical techniques, aromatherapy, homeopathy, magnetic pulse, bioresonance therapy and bioenergetics) reimburses the advance written agreement with the insurer or the insurer of the vehicle.
15. insurance compensation for road accident victim's permanent incapacity is calculated on the basis of this provision, paragraph 5 documents.
16. Claims of the road accident victim's loss of capacity is calculated on the basis of this provision, paragraph 6, of the documents submitted. The regular claims payments for one year is calculated based on the period for which it is calculated and paid by the State (disability) pension or compensation for the loss of capacity due to accidents at work. If you change the State (disability) pension or compensation for the loss of capacity due to accidents at work or about changing the level of earned income received, claims adjustment according to the aforementioned changes within one month of the rules referred to in paragraph 27 and the renewed application of these rules in the document referred to in paragraph 5.
17. Insurance claims for losses due to road traffic accident victim's death is calculated on the basis of this provision, paragraph 7 and 8 of the said documents.
18. no part of the income received, which was owed for each dependant, the victim's life, is calculated by dividing the deaths of persons received income by the number of dependants will be increased by one.
19. the income received is determined as follows: 19.1. person-not workers received average earnings, which according to the labour law, excluding taxes, calculated on all employers, with which the said person has been working relationships;
19.2. the self-employed person does not receive income, calculated on the previous 12 months, the amount of labour income divided by the number of months and excluding taxes;
19.3. non-working pensioners-to determine the pension;
19.4. worker pensioner – this rule 19.1, 19.2 and 19.3. referred to income (income accumulating);
19.5. non-working person-the minimum national wage, excluding taxes.
20. for each dependant in calculating the regular claims payment amount each month along with the national pension or social security benefits should not be less than the national minimum level of maintenance that every parent has an obligation to ensure the child.
21. If you change the minimum amount of maintenance, insurance claims adjustment according to the above changes.
22. If you change the State pension or social security benefits, insurance claims adjustment according to the aforementioned changes within one month of the rules referred to in paragraph 27 of the restored application and these terms, and 8.8 8.9. document referred to in the receipt.
23. A change in the number of dependants, insurance claims, other dependants will not be translated, except in certain civil law the legal origin of the child.
24. the regular claims payments are made once a month, if not otherwise agreed between the beneficiary and the insurer or the insurer of the vehicle.
25. The insurance reimbursement for road traffic accident person material losses connected with the victim's treatment, temporary disability, incapacity or death, loss of pay, as long as there are circumstances giving entitlement to insurance claims.

26. the beneficiaries of the fault of the unduly paid claims for regular payment amounts may be deducted up to that amount for full deletion. If the regular claims payments stopped before all the debt and that a beneficiary the amounts unduly received shall not be refunded the amount voluntarily, shall recover in court.
27. regular payment of insurance indemnity the beneficiary of every 12 months from the date of the previous application retrieves the application for payment of the insurance indemnity for the continuation of regular cost. The updated application submitted during the month following the previous 12-month period, adding that rule 6 and 8 of the documents referred to in point.
28. If a beneficiary of this provision in paragraph 27 deadline without justification does not update the application for payment of the insurance indemnity for the continuation of regular, the insurer or the insurer of the vehicle up to the Office to submit a new application to stop the regular claims payments and three working days, send a written notification to the beneficiary.
IV. final question 29. Rules apply to those insurance cases that occurred after the entry into force of these regulations.
Prime Minister a. Halloween Finance Minister o. Spurdziņš Editorial Note: rules shall enter into force on 18 December 2004.