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Samenvatting persoons- en arbeidsongevallenverzekeringen
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Samenvatting van het vak persoons- en arbeidsongevallenverzekeringen gegeven in het tweede jaar Immobiliën en verzekeringen.
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Samenvatting Persoons- enOngevallenverzekeringen
Inhoud
1 Inleiding – Inleiding der verzekeringen ........................................................................................1
2 De lichamelijke ongevallenverzekering ........................................................................................3
2.1 Intro ....................................................................................................................................3
2.2 Vereisten .............................................................................................................................3
2.3 Soorten ...............................................................................................................................4
2.4 Begrip ongeval .....................................................................................................................4
2.4.1 Vereiste componenten.................................................................................................4
2.4.2 Uitbreidingen...............................................................................................................4
2.4.3 Uitsluitingen ................................................................................................................5
2.5 Voorwaarden.......................................................................................................................5
2.5.1 Voorafgaande voorwaarden.........................................................................................5
2.5.2 Voorwaarden en -verplichtingen tijdens de duur van de overeenkomst .......................5
2.6 Prestaties ............................................................................................................................5
2.6.1 Bij overlijden ................................................................................................................5
2.6.2 Bij invaliditeit ...............................................................................................................6
2.6.3 Medische kosten ..........................................................................................................6
2.6.4 Kosten voor opzoeking en repatriëring.........................................................................7
2.7 Aanvullende lichamelijke ongevallenverzekering .................................................................7
2.7.1 Excedentaire arbeidsongevallenverzekering.................................................................7
2.7.2 AVRO: Aanvullende Verzekering tegen Risico Overlijden door Ongeval ........................7
3 Verzekering gewaarborgd inkomen .............................................................................................7
3.1 Voor wie? ............................................................................................................................8
3.2 Soorten: ..............................................................................................................................9
3.3 Modaliteiten........................................................................................................................9
3.3.1 Voorafgaande voorwaarden.........................................................................................9
3.3.2 Wachttijd .....................................................................................................................9
3.3.3 Carenztijd .................................................................................................................. 10
3.3.4 Einde ......................................................................................................................... 10
3.4 Prestaties .......................................................................................................................... 10
3.4.1 Rente ......................................................................................................................... 10
3.4.2 Vrijstelling van premie ............................................................................................... 10
, 3.5 Premies ............................................................................................................................. 11
3.6 Uitsluitingen ...................................................................................................................... 11
3.7 De collectieve verzekering gewaarborgd inkomen ............................................................. 12
3.7.1 Ratione personae of voor wie?................................................................................... 12
3.7.2 Ratione materiae ....................................................................................................... 12
3.7.3 Modaliteiten .............................................................................................................. 13
3.7.4 Prestaties................................................................................................................... 13
3.7.5 Premies...................................................................................................................... 13
3.8 Aanvullende verzekering tegen het invaliditeitsrisico: AVRI ............................................... 13
3.8.1 Voor wie? .................................................................................................................. 13
3.8.2 Modaliteiten .............................................................................................................. 13
3.8.3 Prestaties................................................................................................................... 14
3.9 Omzetverzekering ............................................................................................................. 14
4 Verzekering gezondheidszorg .................................................................................................... 15
4.1 Hospitalisatieverzekering ................................................................................................... 15
4.1.1 Inleiding de Belgische ziekenhuiswereld..................................................................... 15
4.1.2 Nut en toepassing ...................................................................................................... 18
4.1.3 Soorten hospitalisatieverzekering .............................................................................. 19
4.1.4 Voor wie? .................................................................................................................. 20
4.1.5 Modaliteiten .............................................................................................................. 21
4.1.6 Prestaties................................................................................................................... 22
4.1.7 Risico-uitsluitingen..................................................................................................... 23
4.1.8 Waarborguitsluitingen ............................................................................................... 24
4.1.9 De collectieve of groepshospitalisatieverzekering ...................................................... 24
4.2 Verzekering ambulante zorgen .......................................................................................... 25
4.2.1 Toepassing ................................................................................................................. 25
4.2.2 Soorten ...................................................................................................................... 26
4.2.3 Voor wie? .................................................................................................................. 26
4.2.4 Modaliteiten .............................................................................................................. 26
4.2.5 Prestaties................................................................................................................... 26
4.2.6 De collectieve verzekering ambulante zorgen ............................................................ 27
4.3 Vergelijk hospitalisatieverzekering met ambulante zorgen................................................. 27
4.4 Bijlagen ............................................................................................................................. 27
5 Verzekering arbeidsongevallen.................................................................................................. 28
5.1 Historiek ............................................................................................................................ 28
5.2 Frequentie ......................................................................................................................... 28
,5.3 Toepassingsgebied ............................................................................................................ 28
5.3.1 Basisprincipe.............................................................................................................. 28
5.3.2 Uitbreiding................................................................................................................. 29
5.3.3 Bijzondere gevallen.................................................................................................... 29
5.3.4 Uitgesloten personen van de arbeidsongevallenwet .................................................. 29
5.3.5 Andere vergoedingsregelingen inzake arbeidsongevallen ........................................... 30
5.4 Het arbeidsongeval ............................................................................................................ 30
5.4.1 Elementen ................................................................................................................. 30
5.4.2 Bewijsvoering ............................................................................................................ 32
5.5 Arbeidsweg- ongeval ......................................................................................................... 33
5.6 Kenmerken arbeidsongevallenverzekering......................................................................... 34
5.6.1 Wettelijke verplichting ............................................................................................... 34
5.6.2 Dubbele rechtsverhouding ......................................................................................... 34
5.6.3 Aanvang polis............................................................................................................. 34
5.6.4 Duur polis .................................................................................................................. 34
5.6.5 Einde polis ................................................................................................................. 34
5.6.6 Financiering verzekering ............................................................................................ 34
5.6.7 Eenheid van verzekering ............................................................................................ 34
5.6.8 Keuze verzekeraar...................................................................................................... 35
5.6.9 Verzekeringsverplichtingen ........................................................................................ 35
5.6.10 Tarifering ................................................................................................................... 35
5.7 Prestaties .......................................................................................................................... 36
5.7.1 Basisloon ................................................................................................................... 36
5.7.2 Geneeskundige verzorging ......................................................................................... 37
5.7.3 Verplaatsingskosten ................................................................................................... 37
5.7.4 Tijdelijke arbeidsongeschiktheid ................................................................................ 37
5.7.5 Blijvende arbeidsongeschiktheid ................................................................................ 37
5.7.6 Dodelijke arbeidsongevallen ...................................................................................... 39
5.7.7 Conclusie schaderegeling van arbeidsongevallen verzekering .................................... 40
5.7.8 Aanvullende waarborgen ........................................................................................... 40
5.8 Procedure.......................................................................................................................... 40
5.8.1 Afsluiten van een arbeidsongevallenverzekering ........................................................ 40
5.8.2 Preventieve Ernstig arbeidsongeval............................................................................ 42
5.8.3 Preventie ongevallen ................................................................................................. 43
5.9 Fedris (Ex FAO en beroepsziekten samen).......................................................................... 43
5.9.1 Taken ......................................................................................................................... 43
, 5.10 Niet verzekering ................................................................................................................ 44
5.11 Verzekering huispersoneel................................................................................................. 44
5.11.1 Rationa Personae/Voor wie?...................................................................................... 44
5.11.2 Modaliteiten .............................................................................................................. 44
5.11.3 Prestaties................................................................................................................... 44
6 De zorgverzekering.................................................................................................................... 44
6.1 Wat is een zorgverzekering ................................................................................................ 44
6.2 Soorten zorgverzekering .................................................................................................... 44
6.3 De Vlaamse zorgverzekering .............................................................................................. 44
6.3.1 Verplichte aansluiting en bijdrage .............................................................................. 44
6.3.2 Wie kan een tussenkomst verkrijgen? ........................................................................ 45
6.3.3 Vanaf wanneer hebt u recht op een tenlasteneming? ................................................ 45
6.3.4 Bedrag van de uitkering ............................................................................................. 45
6.4 Privé zorgverzekering – DKV HOME CARE .......................................................................... 46
6.4.1 Uitkering .................................................................................................................... 46
6.4.2 Wachttijd ................................................................................................................... 46
6.4.3 Carenz ....................................................................................................................... 46
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