On the Approval of the Content and Form of the Compulsory Insurance Contract for Occupational Disability or Death Resulting from Industrial Accidents and Occupational Diseases — CBAR — AZ

AZERBAIJAN REPUBLIC CENTRAL BANK BOARD OF DIRECTORS DECISION No. 23/3 Baku, August 31, 2021

On the Approval of the Content and Form of the Compulsory Insurance Contract for Occupational Disability or Death Resulting from Industrial Accidents and Occupational Diseases

Based on Article 11.3 of the Law of the Azerbaijan Republic "On Compulsory Insurance for Occupational Disability or Death Resulting from Industrial Accidents and Occupational Diseases" and Article 22.0.17 of the Law of the Azerbaijan Republic "On the Central Bank of the Azerbaijan Republic", the Board of Directors of the Central Bank of the Azerbaijan Republic DECIDES:

The content and form of the "Compulsory Insurance Contract for Occupational Disability or Death Resulting from Industrial Accidents and Occupational Diseases" are approved (attached).
The Legal Department (R.Malikova) is tasked with ensuring that this Decision is submitted to the Ministry of Justice of the Azerbaijan Republic for inclusion in the State Register of Legal Acts within 3 days.

Chairman of the Central Bank Elman Rustamov

"Approved"
Central Bank of the Azerbaijan Republic
Decision No. 23/3
August 31, 2021

Compulsory Insurance Contract for Occupational Disability or Death Resulting from Industrial Accidents and Occupational Diseases

On one side, hereinafter referred to in the text of this contract as the "insurer" ________ ___________________________________________ insurer's name (open joint-stock company) _____________________________________________________________ insurer's authorized executive officer's position, first name, last name, patronymic in the person of, on the other side, hereinafter referred to in the text of this contract as the "policyholder" _____________________________________________________________ if a legal entity, name including organizational-legal form; if an individual, first name, last name, patronymic in the person of (hereinafter referred to in the text of this contract as the "parties"), in accordance with Article 3.1 of the Law of the Azerbaijan Republic "On Compulsory Insurance for Occupational Disability or Death Resulting from Industrial Accidents and Occupational Diseases" (hereinafter referred to in the text of this contract as the "Law"), conclude the following contract:

Subject of the Contract
The policyholder, in accordance with Article 13 of the Law, pays the relevant insurance premium calculated based on the applicable insurance tariffs determined in accordance with Article 13 of the Law and agreed upon in this contract. In return, the insurer undertakes to pay insurance benefits in accordance with Article 18 of the Law for occupational disability or death resulting from industrial accidents and occupational diseases affecting the life and health of physical persons specified in the Annex attached to this contract and forming an integral part thereof (hereinafter referred to in the text of this contract as the "contract annex" or "policyholders").
Insured Persons
2.1. The policyholder insures any one, part, or several of the categories specified in Article 3.1 of the Law for whom this contract is concluded, as indicated in the contract annex:

2.2. The contract annex (attached) is prepared for each contract year, and all changes regarding insured persons during the contract year are formalized as additions and amendments to the contract annex.

Beneficiaries
3.1. An insured person who has lost occupational capacity as a result of an insurance event is simultaneously the beneficiary entitled to receive the insurance benefit.
3.2. If the insured person dies as a result of an insurance event, the following persons are recognized as beneficiaries:
3.2.1. non-working persons who were under the care of or entitled to receive support from the insured person until the day of death;
3.2.2. children born after the insured person's death;
3.2.3. one of the parents, spouse (husband/wife), or other family members who care for children under 14 years of age, or children who have reached this age but require care due to health conditions as determined by medical authorities; grandchildren, brothers, and sisters of the insured person who were under their care;
3.2.4. persons who were under the care of the insured person and lost their working capacity within five years after the insured person's death.
3.3. For the purposes of clauses 3.2.1 and 3.2.4, non-working and persons who lost working capacity include:
3.3.1. children under 18 years of age;
3.3.2. children studying in full-time departments of educational institutions, up to the age of 23;
3.3.3. fathers, mothers, spouses, and children who have reached the pension age determined in accordance with Articles 7 and 8 of the Law "On Labor Pensions" or who are disabled;
3.4. If any person specified in clause 3.2 of this contract is absent, the family members of the insured person are considered beneficiaries.
Insurance Amount
The insurance amounts for each insured person under this contract, as well as the total insurance amount, are determined in the contract annex in accordance with the calculation method established by Article 14.4 of the Law.
Insurance Premium
5.1. The annual insurance premium calculated for each insured person, the method of payment, and the total amount of the insurance premium for the contract year are agreed upon as indicated in the contract annex, applying relevant insurance tariffs determined in accordance with Article 13 of the Law.
5.2. If a lump-sum payment of the insurance premium is agreed upon in the contract annex, the total amount is paid on the day the contract annex is approved.
5.3. If installment payment of the insurance premium is agreed upon, the first agreed portion (not less than 25% of the total insurance premium) is paid on the day the contract annex is approved, and the remaining portion is paid in two, three, or four installments as indicated in the contract annex.
5.4. The policyholder may determine installment payment dates based on either the "amount of insurance premium paid" method or the "payment date of insurance premium" method.
5.5. If installment payment dates are determined by the "amount of insurance premium paid" method, the payment date for each installment is calculated using the following formula:
Payment Date of Installment = MQ + (CÖDSH / ÜSH * GS) If installment payment dates are determined by the "payment date of insurance premium" method, the insurance premium payable for the next installment is calculated using the following formula:
Insurance Premium Payable per Installment = ÜSH * (NT - CT) / GS If any installment is paid in an amount exceeding the agreed amount, the insurance premium payable for the next installment decreases by the amount of the excess paid.
5.6. If changes occur in the list, category, occupational risk level of insured persons, or the policyholder's wage fund, within 15 working days from the date of such changes, the total insurance premium amount must be recalculated proportionally to the remaining time until the end of the contract year, and corresponding additions and amendments must be made to the contract. The resulting difference in the total insurance premium amount must be paid either as a lump sum or with the first agreed portion of the difference paid on the day the additions and amendments are made. In this case, the first portion of the insurance premium for the addition/amendment is calculated using the following formula:
First Portion of Insurance Premium for Resulting Difference = ((NT - ƏT) / QGS) * ƏSH Other portions of the resulting difference in the total insurance premium amount must be paid proportionally by the dates specified in the contract annex.
5.7. The conditional symbols used in the formulas of clauses 5.5 and 5.6 of this contract represent the following:
MQ - date of approval of the contract annex;
CÖDSH - total insurance premium payable for previous installment(s); GS - number of days in the contract year; ÜSH - calculated total insurance premium; NT - payment date for the next installment of the insurance premium; CT - current payment date for the insurance premium. ƏT - date of making the addition and amendment; QGS - number of days remaining until the end of the contract annex; ƏSH - total insurance premium for the addition and amendment.
5.8. If installment payment of the insurance premium is agreed upon, the payment dates for the insurance premium and any resulting difference in the total amount are determined once per contract year in accordance with clause 5.3 of this contract and apply to all additions and amendments to the contract annex for that period. If additions and amendments are made to the contract annex in accordance with clause 5.6 after the last payment date specified in the contract annex, the resulting difference in the total insurance premium amount must be paid as a lump sum on the day the additions and amendments are made.
5.9. If the total insurance premium amount decreases as a result of additions and amendments specified in clause 5.6, the resulting difference is refunded by the insurer within 5 working days at the policyholder's choice, or offset against future installment payments as specified in the contract annex.
Contract Term, Annex, Entry into Force, and Territorial Scope
6.1. The contract is concluded for an indefinite term.
6.2. The parties approve the contract annex for each subsequent contract year. At least 3 working days before the start of the next contract year, the policyholder must submit to the insurer information regarding the list, age, position, category, occupational risk level, and one-year wage fund of insured persons. After receiving the relevant information, the insurer submits the contract annex for the next contract year to the policyholder for signature.
6.3. The contract and its annex, as well as additions and amendments thereto, enter into force at 24:00 on the day of contract conclusion, annex approval, and making additions/amendments, respectively.
6.4. Insurance benefits provided under this contract cover industrial accidents or occupational diseases occurring in connection with the performance of work/services under employment or civil contracts by insured persons, both within and outside the territory of the Azerbaijan Republic.
Amendment and Termination of the Contract
7.1. In addition to cases specified in clause 5.6, additions and amendments may be made by mutual agreement of the parties.
7.2. If changes are made to insured persons' categories and occupational risk levels, the policyholder must notify the insurer within 10 working days from the date of such changes.
7.3. The contract is terminated in the following cases:
7.3.1. at the initiative of the policyholder, provided that the insurer is notified at least 30 days before the end of the contract year;
7.3.2. if a physical person policyholder dies, or a legal entity policyholder is liquidated or its activities are terminated (provided that rights and obligations cannot be transferred to another person);
7.3.3. regarding a specific insured person, if the employment or civil contract between the policyholder and that insured person is terminated;
7.3.4. in other cases provided by Article 919 of the Civil Code of the Azerbaijan Republic.
7.4. Termination of the contract does not exempt the insurer from its obligation to pay insurance benefits for insurance events that occurred during the period the contract was in force.
7.5. Upon termination of the insurance contract, the insurer sends a written notice to the policyholder in electronic form.
Insurance Risks
8.0. Insurance coverage is provided under this contract for the following risks:
8.0.1. sudden and sharp deterioration of health due to injury of body parts or tissues while performing work/services (industrial accident);
8.0.2. chronic or acute diseases of the insured person resulting from the impact of unfavorable and harmful production factors on the body (occupational disease).
Rights and Obligations of the Policyholder
9.1. The policyholder has the following rights under this contract:
9.1.1. participate in the investigation of industrial accidents occurring at work, in accordance with Article 7.1.2 of the Law;
9.1.2. personally or through a representative participate in the examination of the insured person, in accordance with Article 7.1.3 of the Law;
9.1.3. request clarification from the insurer regarding the terms of compulsory insurance and rights/obligations under this contract;
9.1.4. appeal to the Central Bank of the Azerbaijan Republic and the court against the insurer's decision to refuse insurance payment or reduce its amount;
9.1.5. exercise other rights provided by the Civil Code of the Azerbaijan Republic, the Law, the Labor Code of the Azerbaijan Republic, the Law "On Insurance Activity", and the Law "On Compulsory Insurance".
9.2. The policyholder has the following obligations under this contract:
9.2.1. pay the insurance premium to the insurer in the amount, manner, and time limits established by this contract;
9.2.2. notify the insurer within 10 working days from the date of changes in insured persons' categories and occupational risk levels;
9.2.3. implement measures to prevent insurance events and ensure safe working conditions;
9.2.4. ensure the investigation of insurance events, in accordance with Article 7.2.5 of the Law;
9.2.5. submit to the insurer documents within its control necessary for the calculation and payment of insurance premiums and determination of insurance benefits;
9.2.6. explain to insured persons their rights and obligations, as well as the terms and procedures of compulsory insurance;
9.2.7. promptly notify the insurer about reorganization, liquidation, or termination of activities;
9.2.8. maintain accurate accounting for the calculation and transfer of insurance premiums, ensure preservation of documents serving as grounds for insurance payments, and provide information to the insurer in accordance with this contract;
9.2.9. take measures to reduce losses arising from insurance events;
9.2.10. perform other obligations provided by the Civil Code of the Azerbaijan Republic, the Law, the Law "On Insurance Activity", and the Law "On Compulsory Insurance".
Rights and Obligations of the Insurer
10.1. The insurer has the following rights under this contract:
10.1.1. participate in the investigation of insurance events, in accordance with Article 9.1.1 of the Law;
10.1.2. participate in examinations conducted by authorized state bodies to determine the degree of loss of occupational capacity of the injured insured person, and if disagreeing with such examination results, challenge the decision administratively or in court, and request a new examination;
10.1.3. obtain and verify information regarding insurance events, and send inquiries to authorized state bodies;
10.1.4. request documents from policyholders, insured persons, and beneficiaries in accordance with Article 18.6 of the Law;
10.1.5. provide recommendations related to preventing insurance events;
10.1.6. refuse to make insurance payments in cases specified in clause 13 of this contract;
10.1.7. exercise other rights provided by the Civil Code of the Azerbaijan Republic, the Law, the Law "On Insurance Activity", and the Law "On Compulsory Insurance".
10.2. The insurer has the following obligations under this contract:
10.2.1. monitor timely and full calculation and payment of insurance premiums;
10.2.2. ensure the provision of insurance benefits in accordance with the manner and time limits established by the Law;
10.2.3. if deciding to refuse an insurance payment, send a justified written notice to the policyholder, insured person, and beneficiary regarding the reasons for refusal;
10.2.4. perform other obligations provided by the Civil Code of the Azerbaijan Republic, the Law, the Law "On Insurance Activity", and the Law "On Compulsory Insurance".
Insurance Event
11.1. An insurance event is considered to be the loss of occupational capacity or death of an insured person due to sudden and sharp deterioration of health (injury of body parts/tissues) or chronic/acute diseases resulting from unfavorable/harmful production factors, occurring while performing work/services during the term of this contract.
11.2. The policyholder must notify the insurer within 3 working days from the date of the insurance event.
11.3. Examination to determine the degree of loss of occupational capacity of the injured insured person is conducted by an authorized state body upon request of the insured person, policyholder, or insurer, or based on a court decision.
11.4. An insurance event is determined based on:
11.4.1. an act prepared in the form established by the authorized state body regarding industrial accidents, or a court decision on the occurrence of an industrial accident;
11.4.2. a decision by the authorized state body confirming the degree of loss of occupational capacity due to industrial accident or occupational disease, or a death certificate.
Insurance Payment
12.1. An insurance payment is made to the insured person in the form of a monthly insurance benefit calculated in accordance with Article 17.1 of the Law, replacing lost monthly wages due to loss of occupational capacity resulting from an insurance event.
12.2. The monthly insurance benefit is paid starting from the day the authorized state body determines the degree of loss of the insured person's previous occupational capacity resulting from the insurance event.
12.3. If disability is assigned without specifying a subsequent examination period, the total monthly insurance benefit amounts are paid as a lump sum to the injured insured person in accordance with statutory procedures.
12.4. If the insured person dies as a result of an insurance event, the total monthly insurance benefit amounts are paid as a lump sum to other beneficiary(ies) in accordance with statutory procedures.
12.5. If the insured person receiving monthly insurance benefits for occupational disability dies directly due to the health impairment caused by that event, the total monthly insurance benefit amounts are paid as a lump sum to the beneficiary(ies) in accordance with statutory procedures.
12.6. If necessary, an additional insurance payment is made to cover costs for treatment, supplementary nutrition, medication, prosthetics, care by others, sanatorium-resort treatment, special transport vehicles, and retraining for another profession, provided such costs are not covered free of charge by law. Additional insurance payments are made from the date and for the period specified in the decision of the authorized state body.
12.7. Insurance payments are determined by the insurer based on the beneficiary's claim and documents listed in the official list of authorized state bodies. The insurer cannot require additional documents for making insurance payments.
12.8. Within 10 working days (or 2 working days if the insured person is deceased) from the date of submission of the insurance claim and relevant documents, the insurer makes a decision on whether to pay the insurance benefit and formally notifies the beneficiary.
12.9. If an insured person (or other beneficiary in case of death) submits the insurance claim more than three years after the right to receive payment arises, the insurance benefit is paid for the three years preceding the claim submission date. If such a claim is submitted within three years, the insurance benefit covers the entire period from the date the right arose.
Grounds for Refusal of Insurance Payment
13.0. The insurer refuses to make an insurance payment in the following cases:
13.0.1. if the insurance event resulted from intentional actions of the insured person directed at causing that event;
13.0.2. if the insurance event occurred while the insured person was performing work duties in a state of intoxication due to alcoholic beverages, narcotic, psychotropic, toxic, or other poisonous substances;
13.0.3. if other general grounds for refusal of insurance payment exist in accordance with Articles 935 of the Civil Code of the Azerbaijan Republic and 21 of the Law "On Compulsory Insurance".
Liability of Parties
The parties bear civil liability in accordance with established procedures for failure to comply with the terms of this contract.
Dispute Resolution
15.1. Disputes arising between the parties under this contract are first resolved through negotiations; if unsuccessful, they are resolved through courts in accordance with statutory procedures.
15.2. If the policyholder, insured persons, and/or beneficiaries consider their rights under this contract to be violated, they may appeal to the Central Bank of the Azerbaijan Republic by submitting a complaint to the following address:
_______________________________________________________________________ Address and telephone numbers indicated in the corresponding letter sent by the Central Bank of the Azerbaijan Republic for this purpose.
Addresses, Signatures, and Seals of Parties
INSURER

[Name of insurer]

[Address of insurer]

Authorized person's Full Name (A.S.A.)
Signature:____________________
M.Y.

POLICYHOLDER

[Name of policyholder]