Temporary disability due to a general illness

Claim Request Form Л3-53 – an original
Medical documents, associated with the treatment of an INFECTIOUS disease, included in the list of infectious diseases:
- Outpatient card of examinations conducted,
- Discharge summaries upon a hospital stay,
- interpretation of imaging test results,
- tests, etc.
All of the above mentioned medical documents - a copy
A School Certificate that the child has not attended school/kindergarten, if the non-attendance days (or part of them) are within the school year - an original with a signature and a stamp of the educational establishment/kindergarten
An official document, containing the bank account of one of the parents, if the Insuree does not have a bank account - a copy
A copy of the Birth Certificate of the insured child
A document certifying the right of guardianship over the insured child, if any
A copy of the insurance policy and a copy of the list of Insurees’ names

In case the sums will not be received by the eligible person:

Notarized power of attorney from the entitled person, if the sums will be received by another person. The power of attorney must contain a statement (text) that the eligible person has been notified that he is entitled to receive the sums in person.