Prawie 500 tys. osób z odszkodowaniami po wypadkach (2019). Jak działa NNW?

  • Ubezpieczenie NNW obejmuje przede wszystkim urazy doznane wskutek niespodziewanego wypadku – każdego roku ubezpieczyciele zajmują się tysiącami takich spraw.
  • W ramach ubezpieczenia można otrzymać świadczenie za doznany trwały uszczerbek na zdrowiu wskutek nieszczęśliwego wypadku.
  • Do podstawowego zakresu ochrony można dokupić dodatkowe klauzule, które pomogą wrócić do sprawności i odzyskać zdrowie, a także ułatwią funkcjonowanie po wypadku.

Aż 475 656 szkód z ubezpieczeń wypadkowych zlikwidowali ubezpieczyciele w 2019 r., wypłacając łącznie 358,64 mln zł – podaje Komisja Nadzoru Finansowego (KNF). Wśród ubezpieczeń wypadkowych ważne miejsce zajmują polisy następstw nieszczęśliwych wypadków (NNW).

– Ubezpieczenie NNW zapewnia wypłatę świadczenia, jeśli dojdzie do trwałego uszczerbku na zdrowiu wskutek nieszczęśliwego wypadku lub śmierci ubezpieczonego w jego następstwie. Po wypadku i zakończonym leczeniu zostaje ustalony procent trwałego uszczerbku, który jest jednocześnie wskazaniem do określenia wysokości świadczenia – mówi Andrzej Paduszyński, Dyrektor Departamentu Ubezpieczeń Indywidualnych w Compensa TU SA Vienna Insurance Group.

Oprócz tego ubezpieczenie NNW obejmuje inne elementy, o których nie zawsze pamiętamy.

Świadczenia dodatkowe

Ubezpieczenie NNW zapewnia nie tylko wypłatę z tytułu trwałego uszczerbku na zdrowiu wskutek nieszczęśliwego wypadku, ale też – po zakupie dodatkowych klauzul – inne świadczenia, np. zwrot kosztów prywatnego leczenia i rehabilitacji czy dostosowania wnętrza mieszkania lub domu mieszkalnego do potrzeb osoby niepełnosprawnej na skutek wypadku.

Rozszerzone działanie ubezpieczenia NNW obrazują dwa poniższe, prawdziwe przykłady szkód zgłoszonych w Compensie:

  1. Fotograf kupił polisę NNW z sumą ubezpieczenia za uszczerbek na zdrowiu w wysokości 50 tys. zł i dodatkowymi klauzulami, obejmującymi: zwrot kosztów leczenia, rehabilitację i poważne zachorowania – każda z sumą ubezpieczenia 10 tys. zł. Podczas sesji zdjęciowej w Tatrach złamał rękę i nogę. Po nieudanej operacji zdecydował się na prywatne leczenie. Otrzymał za to 9,5 tys. zł, a także pokrycie kosztów rehabilitacji w wysokości 7,5 tys. zł i świadczenie odpowiadające procentowi uszczerbku na zdrowiu.
  2. Zawodowy kierowca kupił polisę NNW z sumą ubezpieczenia 50 tys. zł za trwały uszczerbek na zdrowiu z opcją 5-krotnie podnoszącą świadczenie w razie trwałego uszczerbku i rozszerzenia: zwrot kosztów leczenia i rehabilitacji (po 10 tys. zł) oraz dostosowania wnętrza mieszkania lub domu mieszkalnego 50 tys. zł. Miał wypadek, który skutkował amputacją nóg. Z polisy otrzymał łącznie 296 tys. zł, w tym zwrot kosztów rehabilitacji oraz dostosowania mieszkania oraz świadczenie za uszczerbek na zdrowiu.

– Rozszerzenia mogą dotyczyć wielu różnych sytuacji. Jednym z przykładów jest zwrot wydatków na zabiegi plastyczne, jeśli po wypadku ich wykonanie jest konieczne. Jeżeli natomiast poszkodowany utraci zdolność do pracy w dotychczasowym zawodzie, dzięki zwrotowi kosztów przekwalifikowania osoby niepełnosprawnej, otrzyma środki na naukę nowych umiejętności – mówi Andrzej Paduszyński z Compensy.

Pomoc w razie choroby

Polisą NNW można również objąć poważne zachorowania (bez konieczności wypełniania ankiety medycznej). Niezależnie od tego, jaki skutek przyniesie zachorowanie, ubezpieczyciel zapłaci za sam fakt zdiagnozowanej u ubezpieczonego po raz pierwszy w okresie ubezpieczenia choroby (jeżeli jest wymieniona w warunkach umowy; może to dotyczyć także nowotworów). Związanym z chorobami elementem polisy NNW może być też tzw. dzienne świadczenie szpitalne, dzięki któremu hospitalizowana osoba otrzyma ustaloną kwotę za każdy dzień pobytu w szpitalu (nawet do 100 dni).

– Ubezpieczenie NNW można kupić bez względu na wiek oraz stan zdrowia, a świadczenia należą się w razie zdarzeń, do których doszło na całym świecie, zatem produkt jest uniwersalny – podkreśla Andrzej Paduszyński.

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