The Employees' Group Life Assurance

Information about the insurance
The central labour market organizations have agreed on the provision of group life insurance coverage for employees.

The liability to take out insurance applies to all employers whose binding collective agreement, or in whose field a valid general national collective agreement, contains provisions on group life insurance.

Claims are processed by the Employees´ Group Life Assurance Pool

Postal address:

Finnish Workers' Compensation Center (TVK)
PO Box 275
FI-00121 Helsingfors
Finland

Telephone: +358 409 222 900 (customer service) 
Telefax: +358 404 504 246
www.trhv.fi

Member companies of the Employees´ Group Life Assurance Pool

  • Aktia Life Insurance Company Ltd
  • Insurance Company Life-Alandia Ltd
  • SB Life Insurance Company Ltd
  • Fennia Life Insurance Company Ltd
  • Kaleva Mutual Insurance Company
  • LocalTapiola Mutual Life Insurance Company
  • Mandatum Life Insurance Company Ltd
  • OP Life Assurance Company Ltd

Employees´Group Life Assurance, 2016

1 Scope of the insurance
 
1.1 A death benefit as provided in these terms and conditions is paid upon the death of an insured employee.

2 The insured
2.1. Coverage extends to an employee when

1) his employment has lasted for at least one month and his earnings from this employment are at least the earnings referred to in section 141 of the Finnish Employees' Pensions Act multiplied by the figure six (6); or

2) his earnings during the six months preceding the termination of his most recent employment are at least the earnings referred to in section 141 of the Finnish Employees' Pensions Act multiplied by the figure eighteen (18).

2.2. An employee is covered by the insurance when his employment or civil service relationship terminates during the insurance period or the policy terminates for a reason other than notice given by the policyholder.

Coverage ceases when:

1) three years have passed since the end of the employee's employment or civil service relationship;

2) five years have passed since the employee's employment or civil service ended due to retirement on full disability pension;

3) the employee is covered under an equivalent security system by virtue of subsequent employment or civil service relationship or farming;

4) the employee, upon termination of employment or civil service relationship or the policy, is covered by an equivalent security system by virtue of parallel employment or civil service relationship or farming;

5) the employee starts to receive old-age pension; or

6) the employee turns 68 and has no employment relationship as referred to in clause 2.1.

2.3. An employee retains coverage when on statutory family leave.

If the employment or civil service relationship ends on the same date for which wages or salary was most recently paid, the employment or civil service relationship is deemed to have ended on that date. Should the employment or civil service relationship continue longer, the days of annual holiday and days reducing working time accrued to the employee are added to the date for which wages or salary for hours worked or sick pay was last paid when determining the date on which the employment or civil service relationship ends.

Old-age pension refers to pension constituting the ultimate decision on retirement due to old age.

2.4. However, an employee is not covered by the insurance if he is covered under another security system equivalent to this policy by virtue of parallel employment or civil service relationship or farming and if his earnings from that employment or civil service relationship or farming exceed his earnings from the employment or civil service relationship entitling him to coverage under this policy, or if that employment or civil service relationship or farming has ended after the ending date of the employment or civil service relationship most recently covered by this policy. Earnings means earnings obtained from an employment or civil service relationship or from farming during a period of one month immediately preceding the termination of that employment or civil service relationship or farming. The income confirmed for him under the provisions of the Farmers' Pensions Act is considered the earnings of a farmer.

2.5. Employees are covered only by virtue of one employment or civil service relationship.

3 Policyholder
3.1. An employer whose employees have been insured under these terms and conditions is a policyholder.

4 Insurer
4.1. The insurance companies mentioned in the policy are the insurer jointly and severally.

5 Beneficiaries
5.1. The following beneficiaries are entitled to the death benefit:

1) the spouse of the insured;

2) the partner in a registered partnership; and

3) the children of the insured aged under 22.

5.2. Spouse means the person with whom the insured upon death

1) was married; or

2) permanently cohabited in marriage-like circumstances and with whom the insured had or had had a mutual child or with whom the insured had in place an agreement on mutual maintenance confirmed by the authorities.

The spouse referred to above in item 1) is not entitled to the death benefit if the insured at the time of death cohabited in the manner referred to above and a petition to dissolve the marriage was pending. The common-law spouse referred to above in item 2) is not entitled to the death benefit if the insured was married at the time of death and no petition to dissolve the marriage was pending.

5.3. Child of the insured means

1) a biological child of the insured;

2) an adopted child of the insured;

3) a child of the spouse whose custodian the said spouse is;

4) a child born out of wedlock for whom the insured's maintenance liability has been confirmed by decision of a court of law or by agreement; and

5) a child for whom the insured has provided maintenance in his own home or otherwise.

5.4. The beneficiary clause may not be changed.

6 Death benefit
6.1. Death benefit is paid by virtue of one employment or civil service relationship only.

6.2. Death benefit consists of the basic benefit, child increments and accidental death benefit, the magnitude of which depends on the year of death of the insured in accordance with Annex A.

6.3. The basic benefit is paid whenever the insured has left beneficiaries mentioned in clause 5.

6.4. A child increment is added to the basic benefit for each child beneficiary left by the insured.

6.5. Upon the accidental death of the insured, an accidental death benefit is added to the basic benefit inclusive of child increments. An accident is defined as an unexpected and external event causing bodily injury and occurring against the will of the insured.

7 Division of death benefit
7.1. The death benefit is paid to the beneficiaries mentioned in clause 5.

7.2. The basic benefit inclusive of accidental death benefit if any is paid to the spouse of the insured and the child increments inclusive of accidental death benefit if any are paid to each child.

7.3. If the only beneficiaries are children as mentioned in clause 5.1 the death benefit is divided equally between the children.

7.4. The right to death benefit cannot be pledged or assigned to another.

8 Claim for death benefit
8.1. A claim application on the approved form shall be made to the insurer in order to claim the death benefit. Extracts from the population register concerning the insured and the beneficiaries and indicating the name and dates of birth and death of the insured and the names and dates of birth of the beneficiaries shall be appended to the claim application.

8.2. For payment of the accidental death benefit, the insurer shall be provided with a death certificate issued by a physician and indicating that the death was accidental. At the request of the insurer, a police investigation report shall also be provided.

8.3. In respect of the spouse other than marital spouse as mentioned in clause 5.2, a certificate of domicile or other equivalent certificate proving cohabitation shall be submitted to the insurer. When necessary, the insurer shall also be provided with the agreement on mutual maintenance confirmed by the authorities and a written account in proof that a petition to dissolve the marriage is pending.

8.4. In respect of children as mentioned in clause 5.3 the insurer shall be provided with an account indicating that prerequisites to being deemed a child appearing in the said clause and not apparent from the exctract from the population register are met.

8.5. The policyholder is obliged upon request to supply the claimant or insurer with such information concerning the employment of the insured as is necessary to process a claim.

9 Payment of death benefit
9.1. The insurer shall pay the death benefit or the uncontested portion thereof with all due expediency and no later than within one month of taking receipt of the accounts and information referred to in clauses 8.1 - 8.5 proving the right of the beneficiary to the death benefit or the uncontested portion thereof. The insurer shall notify of rejection of claim within the same time.

9.2. If payment is delayed, the insurer shall pay on it annual penalty interest determined according to the grounds employed under the Finnish Interest Act for calculating penalty interest on delayed insurance payment.

10 Application for insurance and entry into force
10.1. The insurance application shall be made to the insurance company with which the employer has insured his employees under the Finnish Employment Accidents Insurance Act. The company with which the employer has a valid statutory accident insurance policy is referred to as the managing company.

10.2. The insurer's liability commences on the date on which the managing company or its agent takes receipt of the insurance application unless another date of commencement of liability has been agreed.

11 Validity and expiration of policy
11.1. The policy is concluded for one calendar year or until the end of the current and the following calendar year and remains in force for one year at a time unless otherwise noted in the policy.

11.2. If the policyholder is found to be without means when the premium is collected through execution or if the policyholder's whereabouts are unknown even to the execution authorities, or if the policyholder disputes its payment obligation in writing when notified of enforcement measures by the insurer, the policy expires at the end of the current insurance period without separate notice.

11.3. When a statutory accident insurance policy is transferred to another insurance company, management of this policy transfers to the new company as well without separate application.

11.4. The policy may also be terminated by notice given by the policyholder. Notice shall be given one month prior to the end of the insurance period.

11.5. A fixed-term policy remains in effect on the same conditions as statutory accident insurance.

12 Insurance premium and payment thereof

12.1. The insurance premium is determined annually according to the grounds confirmed by the Board of the Employees' Group Life Insurance Pool. Changes in the premium take effect as from the first of January of each calendar year. An advance premium is collected for the period between two due dates, i.e. the insurance period. The final premium is determined on the basis of the payroll declaration for statutory accident insurance. Should the final premium exceed the advance premium paid, the policyholder shall pay the difference; should the final premium be lower, the managing company refunds the excess.

12.2. The total pay used to determine the premium for statutory accident insurance is also used for calculating the insurance premium.

12.3. The insurance premium shall be paid to the managing company by the due date. In the event of delayed payment, the policyholder shall pay annual penalty interest determined on the same grounds as in statutory accident insurance.

12.4. The insurer shall be entitled to collect from the policyholder any insurance premium not paid by the due date, inclusive of delay penalty interest, by distraint without judgment or decision, and in accordance with the Taxes and Charges Enforcement Act.

13 Dissatisfaction with claim settlement decision
13.1. Appeals against the insurer's decisions shall be filed in Helsinki District Court. Subsequent to the death of the insured, the insurer's decision may also be appealed to the Finnish general court of first instance in the jurisdiction of which the beneficiary is or the insured most recently was domiciled. The case shall be brought within three (3) years of the party to the matter receiving written notification of the insurer's decision and this deadline, or of the recommendation of the advisory committee referred to in clause 13.2.

13.2. The policyholder or a beneficiary may also submit the insurer's decision for review by an advisory committee for group life assurance matters called the Delegation of Group Life Assurance, to obtain its opinion. Matters shall be submitted to the Delegation within one year of the party to the matter receiving written notification of the insurer's decision and this deadline.

14 Miscellaneous provisions
14.1. These terms and conditions of insurance apply to employment or civil service relationships ending on 1 January 2016 or thereafter. The terms and conditions of insurance in force earlier shall apply to employment and civil service relationships terminated in 1977-2015, however so that items 3) and 4) of clause 2.2 and clauses 2.4 and 6.2 of these terms and conditions apply also to employment and civil service relationships terminated during that time if the insured dies in 2016 or thereafter.

14.2. The insurer is entitled to modify the terms and conditions of insurance annually in the manner agreed by the key labour market organizations. Changes to the terms and conditions of insurance take effect as from the first day of January of each calendar year.

14.3. The insurer shall forward to the insured notification about changes to the insurance premium or other terms and conditions. The insurer may forward such notification also after the change has taken effect.

14.4. Upon modification of the terms and conditions of insurance the policyholder is entitled to terminate the policy within thirty (30) days of receiving notification of such changes from the insurer and in such cases the policy is deemed to expire on the date on which the changes take effect. The policyholder is not entitled to give notice on the policy for the sole reason of a change in the insurance premium.

Annex A

   
Basic benefits €
Age of the insured
at the time of death
 
 The insured died
in the year 2015
The insured died
in the year 2016
- 49 16 430 16 430
50 15 350 15 350
51 14 260 14 260
52 13 130 13 130
53 12 050 12 050
54 10 990 10 990
55  9 890 9 890
56 8 800  8 800
57 7 770 7 770
58 6 620 6 620
59 5 540 5 540
60 -  4 570 4 570
     
Child increment €
  7 400 7 400
     
Accidental death benefit
50 %of the sum total of the basic benefit and child increment.

 

Instructions for filling in claim application:

Beneficiaries
The insured's spouse and children under 22.

Enclosures to the application
A detailed extract from the population register on the insured shall be appended to the application. In the event of accidental death, a death certificate signed by a physician and giving a detailed account and the cause of death, or another report proving the accidental nature of the death such as a copy of the police investigation report, shall be appended to the application. Provisions on other enclosures to the application appear in clause 8 of these terms and conditions, which the claimant is advised to consult.

Signature
The claim application shall be signed by a beneficiary. Should the only claimants be children under the age of 18, the application is signed by the children's guardian, usually their custodian. Should the children have no statutory guardian, a copy of a court order appointing a guardian ad litem shall be appended to the application. The death benefit is paid to the beneficiary. Should the beneficiary be under the age of 18, payment is made to the guardian and the relevant local registry office is notified of the payment made.

Data on employment
The claimant shall contact the last employer of the deceased for information on employment and group life insurance. Should such information not be obtained, the claim application may nonetheless be submitted for processing. Processing of the claim is delayed by incomplete data.

Death benefit from employees´ group life assurance or equivalent benefit(e.g. financial support or insurance benefit under the Farmers' Pensions Act can only be obtained from one security system.

Claims are processed by the Employees' Group Life Assurance Pool

Postal address: PO Box 275, FI-00121 Helsinki, Finland

Tel. +358 409 222 900(customer service)
Fax +358 404 504 246
www.trhv.fi

Personal data concerning the insured and the claimants is processed in accordance with the Finnish Personal Data Act and the provisions of Finnish insurance legislation.

Compensation Claim, employer

Compensation Claim, beneficiary