Leisure time group insurance for combined members in case of an accident
Leisure time accident insurance
Membership of the YTK Association includes leisure time accident insurance valid throughout the world. The insurance covers those members of the YTK Association with a permanent residence in Finland and who have paid their membership fees. As of 1 January 2018, the leisure time accident insurance is the Group accident insurance issued by Pohjola Insurance.
Please note that the leisure time accident insurance is not travel insurance and only covers expenses resulting from an accident (not, for example, falling ill while travelling, cancellation of a trip etc.). We advise you to take out separate travel insurance for your trip.
The insurance covers the following without a deductible
- accidents, which are sudden events that occur against the will of the insured due to external reasons, and that cause bodily injury to the insured
- medical treatment expenses for an accident up to the amount of EUR 8,000 (per accident)
- handicap benefit as a lump-sum compensation up to the amount of EUR 30,000
- death benefit of EUR 10,000
The insurance does not cover
Competitive sports or the related training. Competitive sports refer to competitions or matches arranged by a sports association or club, training arranged according to a training programme, and other training typical of the sport regardless of the level of competitiveness or the age of the insured person. Non-competitive or over-35 leagues organised by a sports association or club are not considered competitive sports.
Note! Leisure time accident insurance taken out by the Association for its members does not include the daily allowance referred to in section 5.2 of the insurance terms and conditions.
Insurance terms and conditions
The above description is not a full account on the content of the leisure time group accident insurance. A detailed description of the insurance can be found in the insurance terms and conditions.
The terms valid as of 1 January 2018 can be found here.
The terms valid as of 1 January 2020 can be found here.
In case of an accident
- Contact Pohjola Health Advisor at 0100 5225. You can also reach us on the Pohjola Hospital app. For detailed instructions, visit the Pohjola Hospital website. Instructions are also available on Pohjola Claim Help. In an emergency, you can also seek treatment at the nearest hospital or clinic that provides emergency care.
- Pohjola Health Advisor can give instructions for minor health problems and, if necessary, book an appointment for you at the nearest Pohjola Hospital or with a Pohjola Insurance partner. If you can present proof of your YTK Association membership at the appointment, the medical bill can be sent directly to Pohjola Insurance. You can prove your membership with a smartphone by logging on to the OMA+ and presenting your YTK Association membership certificate.
- If you require a payment commitment for a more expensive examination or treatment, you will be directed for treatment to a Pohjola Hospital or other Pohjola Insurance partner physician. If the cost of the recommended treatment or examination for an injury resulting from an accident is over EUR 1,500, its compensability should be verified with Pohjola Insurance in advance.
Claiming for indemnity after treatment
If the claim was not initiated via the Pohjola Health Advisor service or you did not present proof of your YTK Association membership at the appointment, do as follows:
Claim any reimbursements you are entitled to under the Health Insurance Act from Kela before filing a claim with Pohjola Insurance. Reimbursement for travel expenses (such as trips to examinations and treatment by personal car or taxi) should also be claimed from Kela.
In the loss report on the tab Policyholder’s details, select Other policyholder. In the Policyholder field, type YTK Association and in the Contract code field, the policy code listed in the OMA+ service. The insurance company will check the validity of your combined membership from the YTK Association.
- Keep all receipts related to the accident for six months.
The necessary appendices will be specified after the loss report is submitted to claims settlement. The insurance company will notify you should it require the receipts related to the accident.
Accidents occurring abroad
In case of a serious accident occurring abroad, contact the emergency service of your travel insurance company. However, if you intend to claim compensation from the Association’s leisure time accident insurance, pay for the expenses yourself and submit a claim as instructed above.
Group accident insurance does not cover the interruption of a trip, repatriation, or lost travel days, excursions or services.
Further information on the coverable expenses and exclusions of Pohjola Group accident insurance can be found in the insurance terms and conditions, or from service number 010 253 1333, Mon-Fri 8-18
You can find instructions at vahinkoapu.pohjola.fi/en