3. isiku vastus

Kuupäev: 23. jaanuar 2026 Austatud riigihangete läbivaatamise komisjon, Lloyd’s Insurance Company S.A. (PAT 5404) on saanud 16. jaanuari 2026. aasta kirja (edaspidi „vaidlustuskiri”) ja 19. jaanuari 2026. aasta kirja, mis on lisatud käesolevale kirjale vastavalt lisadena A ja B. Käesolevas vastuses viitame osapooltele järgmiselt: • Lloyd’s Insurance Company S.A. (PAT 5404): „LIC (PAT 5404)”, või „meie”, „meie” jne. • Narva Haigla Sihtasutus: „hankija” • AB „Lietuvos draudimas” Eesti filiaal: „vastaspool” Riigihankele „SA Narva Haigla II kohustuslik vastutuskindlustus”, mille riigihanke viitenumber on 303593, viidatakse kui „pakkumisele”. Pärast vaidlustuskirja läbivaatamist leiame, et LIC (PAT 5404) peab vastama järgmistele punktidele: (a) meie vastavus pakkumise nõuetele seoses kindlustusperioodi, pikendatud aruandlusperioodi ja õigusaktide nõuetega; (b) vastustaja väide, et meie pakkumine sisaldab „lisatingimust” ja on tingimuslik; (c) vastase väide, et me ei ole esitanud pakkumise väärtust; ja (d) meie Eesti kontaktpunkti andmed. Kõiki neid punkte käsitletakse allpool. Samuti käsitletakse vastase esitatud vaidlustuskirja lisade 2–4 asjakohasust ning dokumentide avalikustamist vastavalt punktides 5 ja 6. Eelistame kirjalikku menetlust. 1. Pakkumise nõuete täitmine Meie arvates vastab meie pakkumine täielikult hankedokumentides („RHAD“) sätestatud nõuetele. Olulisemad nõuded on järgmised: Lloyd’s Insurance Company S.A., insurance company regulated by the NBB and the FSMA under n°3094, Registered Office: Bastion Tower (14 th floor), Marsveldplein/Place du Champ de Mars 5, 1050 Brussels, Brussels Register of Companies VAT BE0682.594.839, tel: +32.(0)2.227.39.39, email: [email protected] Classification: Confidential RHAD punktis 2.1 „Riigihanke eseme kirjeldus” on sätestatud, et „Riigihanke eesmärk on sõlmida hankeleping, mille alusel ostetakse tervishoiuteenuse osutajale kohustuslik vastutuskindlustus teenuseks „ ” üheks aastaks. Nõuete esitamise ja kindlustuskaitse pikendatud periood on veel 3 aastat”. RHAD punktis 5.2.1 „Vastavustingimused” on sätestatud, et „pakkuja esitab pakkumuse kirjelduse viisil, mis võimaldab hankijal kontrollida selle vastavust kõikidele tehnilistes spetsifikatsioonides loetletud tingimustele. Pakkuja esitab pakutava kindlustusteenuse tingimused, mis peavad vastama vähemalt lisa 1 tehnilistes spetsifikatsioonides sätestatud nõuetele”. RHADi 1. lisa pealkirja „Kindlustuskaitse” all on sätestatud, et „SA Narva haigla kui tervishoiuteenuse osutaja jaoks ostetakse vastutuskindlustusteenus, mis tuleneb tervishoiuteenuse osutaja kohustusliku vastutuskindlustuse seadusest (TOKVS) ja mis jõustub 01.11.2024. Teenuse maht ja ulatus peavad vastama eespool nimetatud seadusest tulenevatele tingimustele ja miinimummääradele.” RHADi 1. lisa pealkirja „Kindlustusperiood” all on märgitud: „30.11.2025–29.11.2026 või arvutatakse lepingu sõlmimisest alates. Nõuete esitamise ja kindlustuskaitse pikendatud periood kestab veel 3 aastat, kuni 29.11.2029”. Seega on pakkumistingimused järgmised: a) Hankija soovib osta kindlustuspoliisi, mille kehtivusaeg on 1 aasta ja pikendatud teatamisperiood („ERP”) vähemalt 3 aastat, kusjuures ERP on selgesõnaliselt lubatud ja nõutav; ning b) Pakutava kindlustuse tingimused peavad vastama kohustusliku vastutuskindlustuse seaduse („kohustuslik seadus”) nõuetele. Seoses eespool punktiga a) pakkus LIC (PAT 5404) pakkumises kindlustuspoliisi kehtivusajaga 1 aasta ja ERP-ga 10 aastat. Seega vastab meie pakkumine eespool kirjeldatud RHAD-i nõuetele. Punkti b) käsitletakse allpool punktis 1.1. 1.1 Kohustusliku seaduse ja LOA nõuete täitmine Kohustusliku seaduse asjakohased sätted on esitatud allpool. Page 2 of 10 Classification: Confidential Kohustusliku seaduse paragrahvis 4(2) on sätestatud, et „tervishoiuteenuse osutaja peab tagama, et tegevusloa kehtivuse ajal ja tervishoiuteenuste osutamise ajal on tema tegevus kaetud vastutuskindlustuslepingu kindlustuskaitse, kui seadusega ei ole sätestatud teisiti”. Kohustusliku seaduse § 10 lõikes 1 on kindlustusjuhtum määratletud „tervishoiuteenuse osutaja kohustuse rikkumisena, kui 1) tervishoiuteenuste osutamine on põhjustanud patsiendi kehavigastuse, tervise kahjustuse või surma; 2) tervishoiuteenuse osutaja vastutab tekitatud kahju eest LOA alusel; ja 3) kahju on tekkinud kohustusliku seaduse paragrahvis 10 lõikes 2 sätestatud asjaolude tagajärjel. Kohustusliku seaduse § 21 lõikes 1 on sätestatud, et „õigustatud isik peab kindlustusandjale kindlustusjuhtumist teatama kirjalikult nelja nädala jooksul alates kindlustusjuhtumi teadasaamisest. Kui õigustatud isik ei saa tervislikel või muudel mõjuvatel põhjustel teatamiskohustust täita, pikendatakse tähtaega vastava ajavahemiku võrra.” Kohustusliku seaduse paragrahvi 21 lõike 2 kohaselt „kui tervishoiuteenuse osutaja on saanud teate kindlustusjuhtumi kohta, edastab ta selle teabe viivitamatult kindlustusandjale. Tervishoiuteenuse osutaja peab kindlustusandjat teavitama õigustatud isiku poolt tema vastu esitatud nõudest või hagist ühe nädala jooksul alates kuupäevast, mil tervishoiuteenuse osutaja sai teada nõude esitamisest”. Kohustusliku seaduse paragrahvis 26 on sätestatud nõuete aegumistähtaeg, mis on „kolm aastat alates hetkest, mil isik sai teada tervishoiuteenuse osutaja kohustuse rikkumisest ja kahju tekkimisest, kuid mitte rohkem kui kümme aastat pärast kindlustusjuhtumi toimumist”. Kohustusliku seaduse § 2 lõikes 2 on sätestatud, et võlaõigusseadust („LOA”) kohaldatakse „vastutuskindlustusele, võttes arvesse” kohustusliku seaduse erisusi. LOA paragrahvis 510 on sätestatud, et „vastutuskindlustuse puhul täidab kindlustusandja kindlustusvõtja asemel kohustuse hüvitada kahju, mille kindlustusvõtja on kindlustusperioodi jooksul kindlustusjuhtumi tagajärjel kolmandale isikule (kahjukannatanule) tekitanud, ning katta õigusabi kulud”. a) Nõuete esitamise põhimõttel põhinevad kindlustuspoliisid vs juhtumi põhimõttel põhinevad kindlustuspoliisid Page 3 of 10 Classification: Confidential Kohustuslik seadus ei sätesta, et kindlustuspoliis peab olema sündmuspõhine. Selle asemel nõutakse, et kindlustuspoliis kataks kindlustusjuhtumi, mis toimub kindlustusperioodi kehtivuse ajal (st sõltumata sellest, millal nõue esitatakse, tingimusel et kahjukannatanul on õigus esitada nõue aegumistähtaja jooksul). LOA nõuab kindlustusandjalt hüvitist kahju eest, mille kindlustatu on tekitanud kannatanud kolmandale isikule kindlustusjuhtumi tagajärjel, mis on toimunud kindlustusperioodi kehtivuse ajal, ning õigusabi kulude katmist. Paragrahvi 510 eesmärk on tagada kindlustusperioodi jooksul toimunud kindlustusjuhtumitest tuleneva vastutuse katmine, mitte määrata kindlaks teatamismehhanismi. Seega ei keela LOA otseselt nõuete esitamise poliise ega sätesta teatamismehhanismi. Lisaks kinnitas Tallinna ringkonnakohus otsuses TlnRnKo 13.01.2019, 2-17-18744 lk 9, 12 selgesõnaliselt, et vastutuskindlustuslepingutes võib kokku leppida ka selles, et kindlustuskaitse rakendub kindlustatud isiku vastu esitatud nõude alusel, sõltumata sellest, millal kindlustatud isik kahju tekitas. LIC (PAT 5404) poliis toimib nõuete esitamise alusel. Asjakohane kindlustusklausel on järgmine: „Kindlustusandja kohustub käesoleva punkti tingimuste kohaselt hüvitama kindlustatud isikule tema tsiviilvastutusest tuleneva kahju, makstes hüvitist (sh nõude esitaja kulud ja kulutused) seoses nõudega, mille õigustatud isik esitab esmakordselt kindlustatud isikule ja millest teatatakse kindlustusandjale kindlustusperioodi või pikendatud teatamisperioodi jooksul kindlustusjuhtumite teatamise ja nõuete käsitlemise korra kohaselt, mis tuleneb ainult järgmistest asjaoludest [...].” Seega, kui kindlustusjuhtum toimub kindlustusperioodi kehtivuse ajal või pärast mis tahes tagasiulatuvat kuupäeva, hüvitame me õigustatud isikule kahju. See on täielikult kooskõlas LOA paragrahvis 510 sätestatud nõuetega. Lisaks peegeldab meie sõnastuses esitatud „kindlustusjuhtumi” määratlus kohustuslikus seaduses esitatud määratlust. Nõue tuleb esitada kindlustusperioodi jooksul või pikendatud teatamisperioodi jooksul. Nagu eespool märgitud, ei ole LOA-s sätestatud, kuidas peab olema struktureeritud kindlustusjuhtumi toimumise aja ja nõude esitamise vaheline suhe; see on jäetud poolte lepingulise otsustada. Kokkuvõttes ei sätesta kohustuslik seadus ega LOA selgesõnaliselt, et kohustuslik vastutuskindlustus peab olema sõlmitud juhtumi toimumise alusel, mistõttu vastaspool on eespool nimetatud sätteid valesti tõlgendanud. Page 4 of 10 Classification: Confidential  b) Pikendatud aruandlusperiood Nagu eespool märgitud, sätestab kohustuslik seadus ainult nõuete aegumistähtaja, kuid ei keela pikendatud aruandlusperioodi. Kuigi meie poliis on struktureeritud nõuete esitamise alusel, tähendab tagasiulatuv kuupäev ja pikendatud aruandlusperiood, et sellel on sama mõju kui juhtumi alusel sõlmitud poliisil. Tagasiulatuv kuupäev tagab, et kindlustuskaitse hõlmab ka enne kehtiva poliisi jõustumist (kuni kokkulepitud tagasiulatuva kuupäevani) toimunud sündmusi, tingimusel et nõue esitatakse poliisi kehtivusaja jooksul või ERP-perioodil. ERP võimaldab nõudeid esitada pärast poliisi kehtivusaja lõppu, tingimusel et kindlustusjuhtum toimus poliisi kehtivusaja jooksul (või tagasiulatuvalt kehtivuskuupäeval või pärast seda) ja ERP on ostetud. ERP kehtib kuni 10 aastat, mis on kooskõlas kohustusliku seaduse kohase aegumistähtajaga. LIC (PAT 5404) poliis sisaldab ka mehhanismi, mis tagab seaduse järgimise juhul, kui kindlustatu lõpetab tegevuse või naaseb tagasi juhtumipõhise poliisi juurde. Enne ülemaailmselt laialdaselt kasutatava nõuete esitamise poliisi tutvustamist Eesti turule kohtus LIC (PAT 5404) sotsiaalministeeriumi esindajatega, et arutada nõuete esitamise poliisi kasutuselevõttu, võttes arvesse vajadust tagada õigustatud isikutele võimalus esitada nõue kahju hüvitamiseks, mis on tekkinud kuni kümme aastat pärast juhtumi toimumist. Sotsiaalministeeriumi esindajad ei esitanud vastuväiteid. LIC (PAT 5404) avalikustas ka poliisi sõnastuse ja selgitas poliisi toimimist Eesti Finantsinspektsioonile, kes nõudis väikeseid muudatusi, mis viidi kohe ellu, kuid muidu ei esitanud vastuväiteid. Lõpuks säilitab kannatanu LOA paragrahvi 521 lõike 5 kohaselt õiguse poliisi täitmisele nõuda isegi juhul, kui tervishoiuteenuse osutaja ei ole ERP-d omandanud. Sellisel juhul jääb kindlustusandja vastutavaks kannatanule hüvitise maksmise eest vastavalt LOA paragrahvi 521 lõikele 5 ja võib taotleda hüvitist tervishoiuteenuse osutajalt. 2. Täiendavad tingimused ja tingimuslikud pakkumised RHADi abikõlblikkuse nõuete punktis „Pakkumuse esitamine” on sätestatud, et „pakkumus peab vastama hankedokumentides sätestatud tingimustele ega tohi sisaldada nõutavatest tingimustest lisatingimusi ega olla mingil viisil eksitav. Pakkuja esitab pakkumuse kirjelduse viisil, mis võimaldab hankijal kontrollida selle vastavust kõikidele tehnilistes Page 5 of 10 Classification: Confidential spetsifikatsioonides loetletud tingimustele. Pakkumise esitaja peab esitama pakutava kindlustusteenuse tingimused, mis peavad vastama vähemalt lisa 1 tehnilistes spetsifikatsioonides sätestatud nõuetele.” Nagu eespool punktis 1 märgitud, nõudis RHAD vähemalt 3-aastast ERP-d. LIC (PAT 5404) on pakkunud 10-aastast ERP-d. ERP ei ole seega „täiendav tingimus”, kuna see oli osa algsetest pakkumistingimustest. Lisaks ei kujuta ERP endast tingimuslikku pakkumist allpool esitatud põhjustel. Tsiviilseadustiku üldosa seaduse (GPCCA) paragrahvis 102 on sätestatud, et „(1) Tingimuslik tehing on tehing, mis sõlmitakse peatava või tühistava tingimusega. (2) Tehing sõlmitakse peatava tingimusega, kui tehinguga määratletud õiguslike tagajärgede tekkimine sõltub ebakindlast sündmusest (peatav tingimus). (3) Tehing sõlmitakse tühistamistingimusega, kui tehinguga määratletud õiguslike tagajärgede lõppemine sõltub ebakindlast sündmusest (tühistamistingimus).” Kindlustus- ja lepinguõiguses vaadeldakse ERP-d täpsemalt ja õigemini kui lepingulist võimalust või tingimust kindlustuskaitse laiendamiseks (tingimusel, et makstakse lisapreemia), mitte kui tingimuslikku pakkumist abstraktses GPCCA mõttes ja pakkumise ja vastuvõtmise doktriinilises mõttes. Seda kirjeldab kõige paremini lepinguline optsioon või tingimuslik õigus (mis on osa kindlustuslepingu tingimustest), mitte aktsepteerimist nõudev „pakkumine” (st iseseisev). Lisaks tooks paragrahvi 102 range tõlgendamine kaasa absurdsed tulemused, kuna kõik kindlustuspoliisid sisaldavad vastutuse tingimusi, mis tähendab, et lepingulised õigused sõltuvad tulevastest sündmustest või tegevustest, nagu kindlustusmakse, omavastutuse ja teate maksmine. Näiteks § 102 range sõnastuse kohaselt (st pakkumine on tingimuslik, kui pakkuja deklareerib, et ta on seotud ainult siis, kui täidetud on kindlaksmääratud tingimus) klassifitseeritaks poliisi omavastutus tingimusliku pakkumisena, kuna kindlustusandja nõustub hüvitama kahju alles pärast omavastutuse maksmist (st pakkumine ei täitu enne omavastutuse maksmist). See ei ole kahtlemata seaduse eesmärk ja tegelikult on „omavastutus” kohustusliku seaduse alusel selgesõnaliselt lubatud (vt paragrahvid 12(2) ja 22(1)). Page 6 of 10 Classification: Confidential On selge, et GPCCA paragrahvi 102 ei ole mõeldud sõna-sõnalt tõlgendamiseks ja nagu eespool kirjeldatud, ei ole ERP tingimuslik pakkumine, vaid pigem kindlustuslepingu tingimus, ning pakkumise nõudeid ei ole rikutud. 3. Pakkumise väärtuse esitamise nõuded RHADi abikõlblikkuse nõuete punktis „Pakkumise maksumus” on sätestatud, et „kindlustusmakse (teenuse kogumaksumus, sealhulgas kõik kindlustusteenuse müügiga seotud kulud) esitatakse aastase maksena. Kindlustusvõtja maksab teenuse eest igakuise arve alusel”. LIC (PAT 5404) on esitanud hankijale aastase kindlustusmakse ja lõpliku koguhinna (sh ERP) saab arvutada hankijale esitatud valemi alusel. Kui kindlustuspoliis uuendatakse pidevalt või hankija ostab teise nõuete esitamise alusel kehtiva kindlustuspoliisi (meilt või teiselt kindlustusandjalt), ei ole ERP-d vaja. Kuna ERP ei ole muutunud maksmisele kuuluvaks, ei ole vaja seda lepingu alguses maksmiseks esitada. 4. Eesti kontakt RHADi abikõlblikkuse nõuete punktis „Nõuete käsitlemine eesti keeles ja Eestis asuvas kontaktpunktis” on sätestatud, et „Kindlustusandjal peab olema nõuete käsitlemise osakond või esindus või koostööpartner, kelle poole tervishoiuteenuse osutaja ja õigustatud isik saavad pöörduda eesti keeles ja Eestis asuvas kontaktpunktis. Pakkumise esitaja peab esitama asjakohase kinnituse. Kui kasutatakse koostööpartnerit, tuleb esitada ka koostööpartneri kirjalik kinnitus tema osalemise kohta hankija nõuete käsitlemise protsessis. LIC (PAT 5404) tegeleb piiriülese kindlustustegevusega ja on volitatud osalema pakkumisel vastavalt kindlustustegevuse seaduse (edaspidi „kindlustusseadus”) 2. peatüki 3. jao lõike 36 punktile 1. Enne pakkumuse esitamist oli LIC (PAT 5404) (ja on jätkuvalt) NBB poolt väljastatud kehtiva kindlustusandja tegevusloaga ning tal on õigus osutada tsiviilvastutuskindlustuse teenuseid. LIC (PAT 5404) on seotud mitme osapoolega, sealhulgas Northern1 International Insurance Brokers OÜ („Northern1”), Denis Europe OÜ („Denis Europe”) ja Crawford & Company Adjusters (UK) Limited („Crawford”). Need suhted on allpool täielikult kirjeldatud, kuid LIC (PAT 5404) kinnitab, et me ei ole kahjunõuete käsitlemist allhanke korras teinud. 4.1 Suhted Northern1-ga Pakkumise nõuete täitmiseks on LIC (PAT 5404) määranud Eestis kontaktisikuks Northern1 esindaja Signe Soonbergi. Page 7 of 10 Classification: Confidential Kontaktisiku ülesanne pakkumise raames piirdub rangelt suhtlemise hõlbustamisega ja tagamisega, et hankija (kes on kindlustusvõtja) ja nõude esitaja („õigustatud isikud”) saaksid suhelda eesti keeles. Northern1-l ei ole mingit volitust hinnata riske, sõlmida kindlustuslepinguid ega käsitleda ja hüvitada nõudeid LIC (PAT 5404) nimel. Northern1 ei sõlmi kindlustuslepinguid LIC (PAT 5404) nimel ja meie arvel. Northern1 tagab, et kindlustusvõtjad ja õigustatud isikud saavad mugavalt juurdepääsu teabele ja LIC (PAT 5404) nõuete esitamise korrale, mis on kättesaadav ühes kohas veebisaidil www.medmal.ee. Northern1 tegutseb sõltumatu kindlustusmaaklerina ainult kindlustusvõtjate huvides ja on kantud kindlustusmaaklerina Eesti Finantsinspektsiooni poolt peetavasse kindlustusvahendajate registrisse (vt järgmist linki: Northern1 International Insurance Brokers OÜ | Finantsinspektsioon). Kordame, et Northern1 ei tegutse LIC (PAT 5404) agendina ega kahjunõuete menetlejana ühegi kehtiva määratluse alusel. 4.2 Suhted Denis Europe ja Crawfordiga LIC (PAT 5404) on seotud Denis Europe ja Crawfordiga. Denis Europe'il ei ole õigust tegutseda LIC (PAT 5404) nimel ja tegutseb rangelt esimese teate kontaktpunktina järgmiste ülesannetega: • Võtta vastu nõudeid (esitatud veebisaidiwww.medmal.ee/kahjuteated kaudu või nende registrijärgses asukohas Eestis), • Kinnitada nõude kättesaamist õigustatud isikule e-kirjaga eesti, vene või inglise keeles, • vastata telefonikõnedele eesti või inglise keeles (numbril + 372 602 8559), • vastuvõtmine ja vastamine e-kirjadele eesti, vene või inglise keeles ([email protected]), • Vastuvõtma kirjalikke nõudeid eesti, vene või inglise keeles posti teel (aadressil Sakala 7-2, Tallinn, Harjumaa), • Kindlustusandja taotlusel ja vajaduse korral koordineerida koostööd kohalike õigus- ja meditsiiniekspertidega. Page 8 of 10 Classification: Confidential LIC (PAT 5404) on määranud Crawford'i LIC (PAT5404) juhendamisel volitatud kahjunõuete haldajaks, kelle ülesanded hõlmavad kahjunõuete käsitlemist ja kahjunõuete rahuldamise kinnitamist LIC (PAT 5404) volituste alusel. 5. Vastase dokumentide asjakohasus Vastulause kirjas esitas vastulause esitaja teatavad dokumendid, mis on esitatud lisades 2– 4. Me ei näe mõtet lisada lisa 2 – EHL teade liikmetele, milles lihtsalt märgitakse, et LIC (PAT 5404) pakutav kindlustus on nõuete esitamise alusel. See ei ole käesoleva pakkumise puhul asjakohane. Punktis 3.4.3 väitis vastulause esitaja, et LIC (PAT 5404) on teistes pakkumistes tagasi lükatud (otsused on esitatud lisades 3 ja 4) ning seetõttu ei vasta meie pakkumine käesoleva pakkumise tingimustele. Meie arvates on see teave asjakohatu. Iga pakkumist tuleks hinnata eraldi ning asjaolu, et me otsustasime mitte vaidlustada hankijate otsuseid vastulause esitaja viidatud pakkumistes, ei tähenda, et me nõustume nende põhjendustega ega ka seda, et otsused on õiged. LIC (PAT 5404) võitis hiljuti pakkumise (riigihankeleping nr 301064), mille vastulause esitaja samuti vaidlustas, kuid vastulause esitaja ei olnud selles esialgses vaidlustuses edukas. LIC (PAT5404) sisenes Eesti turule ülemaailmselt tunnustatud meditsiinilise väärkäitumise lahendusega monopolistlikus ja veel arenevas kindlustuskeskkond , eesmärgiga edendada ausat konkurentsi ja tutvustada rahvusvaheliselt tunnustatud parimaid tavasid. Kuigi toode on Eesti turul uus kategooria, vastab see täielikult kõigile kohaldatavatele Eesti õigusaktide nõuetele. Meditsiinilise väärkäitumise vastutuskindlustuse segment on Eestis veel arengu algstaadiumis ja vajaks jätkuvat turu harimist ja küpsemist. 6. Dokumentide avalikustamine LIC (PAT 5404) ei pea vajalikuks ega asjakohaseks jagada vastaspoolega kogu pakkumist, kuna see sisaldab väga tundlikku äriteavet. Leiame, et oleme vastanud kõigile vastulause esitaja vastulause kirjas tõstatatud küsimustele. Page 9 of 10 Classification: Confidential LIC (PAT 5404) on esitanud kindlustusklausi eespool punktis 1 ja lisanud IPID-i koopia, mis on lisatud lisas C. IPID sisaldab kogu olulist teavet, mida vastulause esitaja võib vajada, ja poliisi sõnastus ei anna sellele täiendavat teavet. Oleme valmis jagama poliisi sõnastust riigihangete läbivaatamise komiteega, kuid ainult juhul, kui sõnastust ei jagata vastulause esitaja või tema esindajatega. Saadame selle eraldi turvatud failina. Kui riigihangete läbivaatamiskomitee soovib näha Denis Europe'iga sõlmitud äritingimuste lepingut, saame ka selle esitada, kuid ka see on konfidentsiaalne ja seda ei tohi jagada vastaspoolega ega tema esindajatega. Ootame riigihangete komitee lisaküsimusi. Parimate tervitustega, David Jackson CUO & Member of the Management Committee LIC (PAT 5404) Page 10 of 10 Classification: Confidential  LISA A APPLICATIONS: 1 To revoke the decisions of the NARVA HOSPITAL Foundation of 06.01.2026 on declaring Lloyd's Insurance Company S.A. PAT 5404 compliant and declaring its tender successful. 2 On the basis of the phased nature of the decisions, the decisions on the non-elimination and qualification of Lloyd's Insurance Company S.A. PAT 5404 are also annulled. 3 Request from the contracting authority and disclose to the opponent the offer of Lloyd's Insurance Company S.A. PAT 5404, including the terms and conditions of the insurance service submitted by Lloyd's Insurance Company S.A. PAT (incl. leaflets, policy/certificate form, standard terms and conditions used by the insurer). 2 | 11 1 To order the NARVA HOSPITAL Foundation to pay the state fee and legal expenses paid on the appeal in favour of the Estonian branch of the opponent AB "Lietuvos draudimas" in accordance with the list submitted. 2 Review the appeal in a written procedure. 1 FACTS ON WHICH THE CHALLENGE IS BASED 1.1 On 03.12.2025, the Contracting Authority started the public procurement "Mandatory Liability Insurance of SA Narva Haigla II" (reference number 303593) to be carried out as an open procurement procedure. 1.2 The criterion for evaluating the tenders was the value of the tender on the principle of "least is the best" (with a weight of 100). 1.3 By the deadline of 18.12.2025, the tender was submitted by the Estonian branch of AB "Lietuvos draudimas" (hereinafter the Opponent) and Lloyd's Insurance Company S.A. PAT 5404 (hereinafter referred to as the Third Party). 1.4 On 06.01.2026, the Contracting Authority announced that it had adopted decisions by which: 1.4.1 declared the tenders submitted by the Opponent and the Third Party to be compliant 1.4.2 declared the Third Party's tender and 1.4.3 qualified and did not eliminate the Third Party. 1.5 The notice (decision) forwarded by the contracting authority on 06.01.2026 was worded as follows: "The contracting authority has declared both tenders to be compliant with its decision (with regard to the tenderer AB "Lietuvos draudimas" Estonian branch, the contracting authority has noted in its decision that in essence it is a tender that does not correspond to the estimated value of the public procurement, because the contracting authority would not be able to conclude the tender with the offered price (significantly exceeds the estimated value of the contracting authority and thus the financial resources) in the event of success of the tender. the procurement contract). The tender of Lloyd's Insurance Company S.A. PAT 5404 (basis: lowest price not exceeding the estimated value of the public contract) has been awarded and the tenderer Lloyd's Insurance Company S.A. PAT 5404 does not qualify for exclusion and satisfies the selection criteria laid down.' Failed to make available appropriate reasoned decisions (outcome documents). 1.6 As the opponent became aware of the infringement of his or her rights on 06.01.2026, having examined the above-mentioned notice (decision) of the Contracting Authority in the eRHR, the challenge has been filed within the deadline (subsection 189 (1) of the PPrA). 1.7 The Opponent shall apply for the annulment of the above-mentioned decisions of the Contracting Authority to the extent that the tender of the Third Party was declared compliant and successful, as the contested decisions are unlawful in the respective respects. Based on the phased nature of the decisions, the decision on the qualification and non-exclusion of the successful tenderer should also be annulled. The opponent justifies the illegality of the decisions as follows: 2 PROCEDURAL IRREGULARITIES OF THE CONTRACTING AUTHORITY 2.1 The opponent shall first note that the Contracting Authority has materially violated the obligations (procedural requirements) set out in the PPrA in making and publishing decisions. The opponent asks the protest committee to verify the legality of the contested decisions also on the basis of procedural violations committed by the contracting authority. 2.1.1 The contracting authority has violated the requirements of § 104(8) of the PPrA. It is important to note that § 104(8) of the PPrA prescribes that the contracting authority may not make all decisions (decision made on the basis of the procurement passport, decision declaring tenders compliant, decision declaring the tender to be successful, and decision not to exclude and qualify the successful tenderer) together, but the decision not to eliminate and qualify the successful tenderer must be made separately after the decision to declare the successful tenderer. The contracting authority has violated the relevant prohibition. 3 | 11 2.1.2 The contracting authority has violated the requirements of § 47(4)3) of the PPrA and § 3(1) of the PPrA. The procedure for making and publishing the decisions of the contracting authority is essentially deficient because it creates a conflict with the principles of transparency and equal treatment (§ 3(1) of the PPrA). - Firstly, despite repeated inquiries from the Opponent, the Contracting Authority did not publish the required outcome documents on the decisions it had made, i.e. decisions with reasoning. In addition, the contracting authority justified declaring the third party successful with the lowest price that does not exceed the estimated value, but did not forward the data characterising the successful tender prescribed by law, as required by § 47(4)3) of the PPrA. After repeated inquiries from the opponent, the contracting authority submitted the outcome documents (reasoned decisions) and information about the costs of the tenders to the opponent only on the last day of the deadline for contesting the decisions (16.01.2026), thereby intensively infringed the rights of the opponent to information and the protection of the contracting authority's decisions (contestation). - Secondly , the Contracting Authority expressly declared the Opponent's tender to be compliant, but stated in the reasoning of the notice of 06.01.2026 that it would not be able to award the public contract for this tender. The result document forwarded on 16.01.2026 also highlights the decision that the Opponent's tender has been declared compliant, but the reasoning states that the Contracting Authority considers the tender to be substantially non-compliant with the estimated value (because the Contracting Authority has no financial resources). Thus, the contracting authority's decision and its reasoning are contradictory, which infringes the principle of transparency, all the more so since the amount of the value of the tender cannot be the basis for the non-compliance of the tender. As the contracting authority has expressly declared the tender of the Opponent to be in conformity in the operative part of the decision, the Opponent does not contest the decision made in respect of itself. However, the activities of the contracting authority violate the principle of transparency under § 3(1) of the PPrA and the requirement of § 47(4)3) of the PPrA, the purpose of which is to ensure a clear and comprehensible decision for tenderers and the opportunity to review the lawfulness of the activities of the contracting authority. 3 DECLARATION OF CONFORMITY OF A THIRD PARTY'S TENDER IS UNLAWFUL 3.1 Terms and Conditions of Insurance Services that are part of a third party offer. The Contestant has reasonable grounds to believe that the Third Party has submitted the terms and conditions of the insurance service (policy form/insurance certificate, leaflets, standard terms and conditions) as part of the tender, the content of which is either the same or substantially similar to the terms and conditions of the insurance service used by the Third Party in other procurements (Annex 1). If this is the case, then such a tender does not comply with the requirements set out in the procurement documents and the law and therefore cannot be declared compliant. 3.2 The tender of a third party does not meet the requirements of Annex 1 "Technical Specification" of the RHAD 3.2.1 Condition of conformity. The RHAD "Conditions of Compliance" section "Submission of a tender" stipulates, among other things, the following requirement: /.../ The tenderer submits the tender description in a way that allows the contracting authority to verify its compliance with all the conditions listed in the technical specifications. The tenderer shall submit the terms and conditions of the insurance service offered, which shall at least comply with the requirements set out in the technical specifications of Annex 1. Annex 1 "Technical Specification" of the RHAD stipulates: Purchase of the liability insurance service arising from the Health Care Provider Compulsory Liability Insurance Act (TOKVS) for SA Narva Hospital as a health care service provider, which enters into force on 01.11.2024. The volume and scope of the service must comply with the conditions and minimum rates arising from the above-mentioned Act. 3.2.2 Content of the requirements arising from the condition of conformity. Thus, the conditions of compliance in conjunction with Annex 1 "Technical Specification" of the RHAD prescribe that the terms and conditions of the insurance service (volume and scope of the service) submitted by the provider comply with the requirements set out in the PPPD. Pursuant to § 10 of the PPA, an insured event is a breach of the obligation of a health care service provider, which consists of the cases specified in clauses 1-3 of the same subsection. Subsection 2 (2) of the Law of Obligations Act (LOA) provides that the relevant provisions of the Law of Obligations Act (LOA) are applied to liability insurance. Thus, the liability insurance provisions of the Law of Obligations Act are also part of the regulation of liability insurance in the Law of Obligations Act. § 510 of the Law of Obligations Act, which regulates liability insurance, stipulates that in the case of liability insurance, the insurer must perform the obligation to compensate for damage caused by 4 | 11 the policyholder has caused damage to a third party (injured person) as a result of an insured event that occurred during the validity of the insurance, and bear the costs incurred for legal assistance. Thus, the principle of compensation for occurrence-based damage, known in the practice of insurance services, arises from the above provisions – the damage is subject to compensation if the insured event occurred during the validity of the insurance. At the same time, it must be taken into account that the limitation period for claims filed against a health care service provider is up to 10 years from the occurrence of the insured event pursuant to § 26 of the Topsies. Unlike the principle of compensation for damage based on the time of filing of the claim (i.e. claims made), the principle of compensation for occurrence-based damage arising from §§ 10 and 2(2) of the LOA (in conjunction with § 510 of the LOA) ensures that if the insured event has occurred during the insurance period, then regardless of whether the claim is also filed during the insurance period, the insurer has the obligation to compensate for the damage. The terms and conditions of the third party insurance service do not correspond to the above, because the terms and conditions of the third party insurance service are insurance terms and conditions on the principle of claims made, which do not guarantee compensation for damage caused as a result of an insured event that occurred during the validity of the insurance pursuant to §§ 10 and § 2(2) of the LOA (in conjunction with § 510 of the LOA). 3.2.3 The offer of a third party is non-compliant because it does not guarantee compensation for damage caused by an insured event that occurred during the validity of the insurance. The terms and conditions of third-party insurance services are claims made terms and conditions, according to which the terms and conditions guarantee compensation for damage only if the claim has been reported during the insurance period or an extended notice period, and not compensation for damage caused as a result of an insured event that occurred during the insurance period, regardless of the time of filing the claim. The opponent explains it as follows: Terms and Conditions of Third-Party Insurance Services - On a daily basis, the Third Party is engaged in the marketing of so-called medical error insurance through Northern1 International Insurance Brokers OÜ and a website https://medmal.ee/ has been created for the marketing of Third Party Medical Error Insurance. It introduces the medical error insurance cover service offered by Lloyds and it is likely that Northern1 International Insurance Brokers OÜ (in the person of Signe Soonberg) has mediated the submission of a third party tender in this procurement as well, using the Medmal logo. The website describes the medical errors insurance cover offered by a third party as claim-based insurance cover, highlighting that in the case of claim-based insurance cover, it is important that the policy is valid at the time of filing the claim and that if the claim is filed after the insurance period, the cover is only possible if there is a continuous claim-based policy or an extended notice period or "tail", which in Estonia must reach up to 10 years (see Annex 5). - The Opponent points out that of the explanations provided in the information document "On Important Notice to the Insured Person" (see Annex 1, page 1), which is part of the insurance terms and conditions used by a third party, 5 | 11 It is also unequivocally clear that a third-party policy is 'claims made', i.e. a policy covers claims against the insured and notified to the insurer during the insurance period or an extended notice period (see Section 8). As the Opponent has noted, the Third Party has presumably submitted the same or similar insurance terms and conditions in this procurement. Also, although the Third Party advertises the medical errors insurance offered by Medmal on its website as insurance in accordance with Estonian legislation, it appears from the notice (warning) sent by the Estonian Dental Association to its members that the medical errors insurance mediated by Northern1 is claim-based, not case-specific (Annex 2 – EHL notice to members). Non-compliance of third-party insurance services - Taking into account the above circumstances, the insurance service of a Third Party Offer is an insurance cover operating on the principle of compensation made by claims, which presupposes the submission of a claim during the insurance period or an extended notice period. To put it simply: if the insured event has occurred during the insurance period, but the insurer has not been notified of the claim during the insurance period or the extended notification period, the insurer is not obliged to compensate for damage, i.e. contrary to the provisions of the Third Party Insurance Act, compensation for damage is not guaranteed. - Example 1: The insurance period is valid from 01.01.2026 to 31.01.2026. The doctor causes health damage to the patient in the course of providing health care services (e.g. surgery) on 15.12.2026. The patient files a claim against the medical institution (policyholder) on 01.01.2027 and the policyholder notifies the insurer of the claim on the same day. As the insurance period has ended, the insurer is not obliged to compensate for damage under the terms and conditions of compensation for claimed damage. In order for the insurer to have the obligation to indemnify the aforementioned damage, the policyholder must have entered into a contract with the insurer for an additional insurance period covering 01.01.2027 or have separately agreed on an extended notification period (and pay an additional fee, see clause 3.3.4), which covers the notification of claims even after the end of the insurance period (in this case, as at 01.01.2027). - Example 2: The insurance period is valid from 01.01.2026 to 31.01.2026. The doctor causes a health injury to the patient in the course of providing health care services (e.g. surgery) on 15.12.2026. The patient submits a claim for compensation for damage against the medical institution on 01.12.2036, i.e. almost 10 years later. The medical institution informs the insurer at the same time. As the insurance period has ended, the insurer is not obliged to compensate for damage under the terms and conditions of compensation for claims made. In order for the insurer to have the obligation to compensate for the above-mentioned damage, the policyholder must have entered into a contract with the insurer for an additional insurance period covering 01.12.2036 or have separately agreed on an extended notice period (and pay an additional fee, see clause 3.3.4), which covers the notification of claims even after the end of the insurance period (in this case, as at 01.12.2036). - Thus, the terms and conditions of the Third Party Insurance Service are not in conformity with the requirements of §§ 10 and § 2(2) of the PPA (in conjunction with § 510 of the Law of Obligations Act), according to which compensation for damage must be ensured if the insured event has occurred during the insurance period. As a result of the above, the Third Party's tender does not comply with the requirements set out in the "Technical Specification" in addition to RHAD 1. Alternatively, if in the opinion of the protest committee, the tender of the third party still meets the above requirements for some reason (which the opponent does not agree with), the tender of the third party is also conditional in any case, as it prescribes additional conditions for compensation for damage, which are not prescribed in the source documents of the procurement with reference to the regulation of the PPC (see section 3.3.3). 3.3 The offer of a third party is non-compliant because it is conditional 3.3.1 Condition of conformity. The RHAD "Conditions of Compliance" section "Submission of a tender" stipulates the following requirement: The tender must comply with the conditions set out in the tender specifications and must not contain additional conditions in addition to those required or be misleading in any way. Provider 6 | 11 submit the tender specifications in such a way as to enable the contracting authority to verify its compliance with all the conditions listed in the tender specifications. The tenderer shall submit the terms and conditions of the insurance service offered, which shall at least comply with the requirements set out in the technical specifications of Annex 1. The insurance premium must be submitted as an annual payment. The policyholder pays for the service on the basis of a monthly invoice. The tenderer must be ready to issue the insurance policy no later than 3 working days before the start of the insurance period 3.3.2 Legal definition of a conditional offer. Pursuant to § 102 of the GPCCA, a transaction is conditional if it has been concluded with a condition that suspends or amends it. Pursuant to § 110(3) of the PPrA, a conditional tender means that the tender sets out requirements (conditions) different from the RHAD or the tenderer makes the performance of its obligations dependent on a circumstance that arises in the future, i.e. the tenderer does not adopt all the conditions set out in the RHAD in the form prescribed by the contracting authority. A third-party tender meets that definition. 3.3.3 The offer of a third party is conditional as it provides for additional conditions for compensation for damage. As the opponent has pointed out above, the terms and conditions of the third party claims made insurance service do not guarantee unconditional compensation for damage in accordance with the requirements of the "Technical Conditions" and the terms and conditions of §§ 10 and § 2 (2) of the LOA (in conjunction with § 510 of the LOA). If the Review Committee finds that the Third Party Insurance Terms and Conditions are not in conflict with the above requirements, the Third Party's offer (insurance service terms and conditions) is still conditional on the above circumstances. - The terms and conditions of the third-party insurance service do not take over the conditions set by the contracting authority in the same form, but set additional conditions for compensation for damage, which are not provided for in the TOVS. Namely, as pointed out in clause 3.2.3, according to the terms and conditions of the Third Party Insurance Service, compensation for damage caused by an insured event during the insurance period is not guaranteed, as the condition for compensation for damage by the Third Party is notification of the claim during the insurance period or an extended notification period. Thus, in order for the policyholder (the Contracting Authority) to receive insurance cover for indemnification of damages caused by insured events that occurred during the insurance period (i.e. 12 months) on the basis of the insurance contract entered into in the procurement for the period of statutory liability (which is 10 years according to § 26 of the TOKA), the Contracting Authority must additionally enter into insurance contracts with the Third Party for the entire relevant period or agree with the Third Party on an extended notification period covering 10 years. Without the fulfilment of the above additional conditions, the 10-year liability period under the PPP is not guaranteed. - §§ 10 and 2(2) of the LOA (incl. in conjunction with § 510 of the LOA) do not prescribe that in order to compensate for damage caused by an insured event that occurred during the insurance period, the policyholder must also enter into an insurance contract for additional period(s) or enter into an agreement with the insurer for an extended notice period (valid for 10 years as of the insured event). Thus, the Third Party has presented additional conditions in its tender and has not transposed the procurement conditions in the form set by the contracting authority. 3.3.4 The offer of a third party is conditional, as it does not guarantee insurance cover to the extent of the liability period stipulated in the PPP without the payment of an additional fee. As the Opponent has explained above, the insurance cover provided by a third party operates on the principle of claims made, i.e. the prerequisite for compensation for damage is notification of the claim during the insurance period or during an extended notice period. The opponent has also pointed out above that in order for the indemnity period not to be limited compared to the 10-year liability period provided for in the PPP, the Third Party Insurance Terms and Conditions provide for either the obligation to conclude an additional insurance contract for the entire respective 10-year period (for which an additional fee must be paid) or the conclusion of an agreement for an extended notification period, for which the contracting authority (as policyholder) must pay an additional fee for the extended notification period. Thus, an offer that makes the validity of the liability period arising from § 26 of the PPP (i.e. 10 years from the occurrence of the insured event) conditional on the payment of an additional fee is restrictive and conditional. - The marketing materials of the third party medical errors insurance explain: it is important that the policy is valid at the time of filing the claim and that if the claim is filed after the insurance period, the cover is only possible if there is an ongoing claim-based policy or is 7 | 11 extended notification period or "tail", which in Estonia must reach up to 10 years. It is also pointed out that in the case of an on-demand policy, an agreed part of one annual payment must be paid (for an extended notification period) (see Annex 5).1 1 Website for the marketing of third-party services: https://medmal.ee/noudepohineleping/ In summary, ensuring the statutory liability period requires the payment of an additional fee by the policyholder (contracting authority). - It is clear that the continuing claim-based policies (i.e. insurance policies for new insurance periods), the conclusion of which is required by the terms and conditions of the Third Party Insurance Service in order to ensure the entire liability period under § 26 of the Insurance Act, are new insurance contracts, the conclusion of which entails both the relevant procedure and an additional fee for the policyholder. At the same time, according to the terms and conditions of the insurance service, the conclusion of subsequent policies for up to 10 years (i.e. 10 policies) must be ensured. Thus, the condition for concluding an additional policy and paying a fee for it does not meet the requirements of the PPP. - The extended notification period also requires the payment of an additional fee, which is not prescribed by the conditions set by the contracting authority. The Opponent points out that the "Important Notice to the Insured Person" (see Annex 1, page 1), which is part of the insurance terms and conditions used by a third party, indicates that the extended insurance period is not valid automatically, but only if an additional fee is paid for the extended insurance period (clause 8) (see Annex 1, Mandatory Liability Insurance of Health Care Service Providers version 1.1-2025, clause 8.2). The policy certificate form, in turn, indicates: Additional fee for the extended notification period (payment procedure see Section 8): XX% of the annual insurance premium (Annex 1, page 2). As the Opponent has noted, the Third Party has presumably submitted the same or similar insurance terms and conditions in this procurement. Thus, in order to ensure the minimum conditions pursuant to § 26 of the PPA, i.e. a liability period of 10 years, the contracting authority must pay an additional fee to the third party. Interim conclusion. The tender of a third party is conditional due to the principle of compensation based on the time of submission of the claim, because the submitted tender is not sufficient to ensure the statutory protection of mandatory patient insurance – in order to achieve this, the contracting authority must either enter into a new contract(s) or agree on an extended notification period (which would cover 10 years from the occurrence of the insured event). The Contracting Authority shall also pay an additional fee to the Third Party in order to conclude additional insurance contract(s) or to obtain an extended notification period. Such an additional condition means that the tender does not contain a final and unconditional obligation to provide the service in accordance with the requirements set out in the procurement documents and the law, but the performance of the obligation depends on a circumstance that arises in the future (conclusion of a new contract or extension of the notice period, as well as the payment of an additional fee for the previous ones). Pursuant to § 110(3) of the PPrA, this corresponds to the characteristics of a conditional tender and must be rejected on the basis of § 114(2) of the PPrA. 3.4 The tender of a third party is non-compliant because it does not meet the requirement to submit the value of the tender 3.4.1 Condition of conformity. The RHAD "Conditions of Compliance" section "Cost of the offer" states the following requirement: The premium (the total cost of the service, including all costs related to the sale of the insurance service) is presented as an annual payment. The policyholder pays for the service on the basis of a monthly invoice. 3.4.2 Non-compliance of a third party's tender with regard to the total value. According to the circumstances highlighted in clause 3.3.4 and the insurance terms and conditions of the third party, in order to ensure the period of compensation for damage provided for in the PPC, the contracting authority must enter into a new (additional) paid insurance contract or pay an additional additional fee for the extended notice period, which is why the price indicated in the tender does not reflect the total cost necessary to ensure mandatory protection arising from law. The amount of the premium may be significant (e.g. 100% of the annual insurance premium), which means that the total cost of the tender will be significantly higher than the initial offer. The tender of a third party does not comply with the requirement set out in the tender documents to submit a final price reflecting the actual value. 8 | 11 Consequently, the tender is non-compliant because it does not guarantee statutory protection without additional operations and payments, and does not meet the requirement of the RHAD "Conditions of Compliance" to submit the final value of the tender, and it is also a conditional tender. The tender must be rejected on the basis of § 114(2) of the PPrA. 3.4.3 The tender of a third party has also been rejected as non-compliant in other procurements with the same content. A third-party tender has just been rejected in several other procurements with the same content, as the third party's insurance terms and conditions prescribe the principle of claims made and are therefore in conflict with what is required by the PPP. The Viljandi Hospital Foundation rejected the tender of a third party in the procurement "Mandatory liability insurance of a health care service provider" (procurement reference number: 301260), as the insurance premium does not guarantee the unconditional and proper fulfilment of the TOKVS (Annex 3). When rejecting the offer, it was justified that the content of the offer was a policy based on the "submission of a claim", i.e. that the insurance cover applies to claims and insured events submitted during the insurance period or extended notice period that have arisen during the insurance period or on a retroactive date and after the tenderer pays a premium of 100% of the annual premium for the application of the extended notice period. Thus, the insurance premium according to the offer will increase twice. The tender of a third party was also rejected by the public limited company Põlva Haigla for similar reasons (Annex 4). Thus, the above also confirms that the insurance terms and conditions of a third party are based on the principle of the time of submission of the claim, set additional conditions by the tenderer and thus impermissibly deviate from the claims for compensation for damage provided for in the PPC. Interim conclusion. A third-party tender does not meet the requirement set out in the RHAD "Conditions of Compliance" to submit a final price reflecting the actual value. The insurance premium indicated in the tender does not cover all the costs necessary to ensure the mandatory protection arising from the law, since in order to achieve this, the contracting authority must pay an additional fee either for the conclusion of an additional insurance contract or for an extended notice period. The amount of the additional fee may be significant (e.g. 100% of the annual payment), which means that the total cost of the tender will be significantly higher than the initial tender. Such a situation violates the requirement set out in the procurement documents to submit the final total cost of the service and makes the tender conditional within the meaning of § 110(3) of the PPrA. The tender must be rejected on the basis of § 114(2) of the PPrA. 3.5 The offer of a third party is non-compliant because it does not meet the requirements of claims handling and the contact point 3.5.1 Condition of Compliance. The RHAD "Conditions of Compliance" section "Claims Handling in Estonian and at a Contact Point in Estonia" stipulates the following requirement: The insurer must have a claims handling department or its representative office or cooperation partner to whom the health care service provider and the entitled person can turn in Estonian and at the contact point located in Estonia. The tenderer shall provide the relevant confirmation. If a cooperation partner is used, the cooperation partner's written confirmation of their involvement in the contracting authority's claims handling process must also be submitted. 3.5.2 The limits of the contact point's activities and the risk of a branch claim. The activities of the Contact Point must be limited to forwarding information and ensuring the possibility of contacting the Contact Point in Estonian in Estonia.2 2 Patient insurance. Annotated edition. Juura, 2024, § 6, comm. 2.1: Acontract with an insurer operating across the border can be entered into through an insurance broker (subsection 174 (1) of the Insurance Act), but a foreign insurer may not have an insurance agent in Estonia (subsection 174 (2) of the Insurance Act). /.../ In order for the activities of the contact point not to be regarded as insurance activities, it must be ensured that the activity remains strictly the activity of the contact point, which is to ensure that the health care service provider and the entitled person have the opportunity to turn to the foreign insurer in Estonian and at a contact point in Estonia. /.../ If a person representing a foreign insurer in the performance of the obligation of a contact point has been given the right to act on behalf of the insurer in handling or compensating for damage caused to the injured party, the question may arise whether such activity should be considered a permanent activity, i.e. the establishment of a branch (subsection 36 (2) of the Insurer Act). If a contact point representative has been authorised to act as an insurer's 9 | 11 In the name of the Insurance Act, it may be regarded as a permanent insurance activity which, pursuant to subsection 36 (2) of the Insurance Act, requires the establishment of a branch. 3.5.3 A representative of a third party acts as an insurance agent on a permanent basis. As the opponent has explained above, Lloyds' daily activities are carried out in the distribution of medical errors insurance through Northern1. Northern1 has also acted on behalf of a Third Party in the exchange of information in this procurement. For the marketing of third-party medical error insurance, a website https://medmal.ee/ has been created, which is managed by Northern1 and introduces the medical error insurance cover service offered by Lloyds. The information published on the website shows that Northern1 acts in the interests of Lloyds as a foreign insurer, providing the services of only one insurer (Annex 5 – website information). Thus, Northern1 advertises on its website "Internationally recognised insurance cover for medical errors from Lloyd's on the European insurance market" and invites you to enter into an insurance contract specifically with Lloyds through it (see Annex 5). Thus, although Northern1 is officially registered as an insurance broker, Northern1 is de facto acting as an insurance agent within the meaning of § 174(2) of the KindlTS by representing Lloyds. Namely, an insurance agent acts for and in the interests of the insurer (subsection 174 (2) of the Insurance Act), unlike an insurance broker who acts for and in the interests of the policyholder (subsection 174 (1) of the Insurance Act). However, acting as an insurance agent on a permanent basis is not permitted under § 36(2) of the Insurance Act and the establishment of a branch is required. Lloyds has not established a branch, which is why its activities without establishing a branch do not comply with the requirements of § 36(2) of the KindlTS. 3.5.4 There is reason to believe that a representative of a third party is permanently engaged in insurance business, i.e. claims handling. Although it is stated on the website managed by Northern1, through which Northern1 mediates medical error insurance provided by a third party, that claims handling is carried out through Crawford and Denis Europe OÜ, it has not been known or confirmed that Lloyds actually has entered into a proper agreement in Estonia for outsourcing claims handling services. Considering that it is not possible to provide insurance services without claims handling, it is presumed that the contact person appointed by a third party is also authorised to carry out claims handling. In such a case, § 36(2) of the KindlTSA also requires that an insurer operating across borders may operate only through a branch, but a third party has not established a branch. Interim conclusion. The third-party tender does not meet the requirements of the claims handling and contact point set out in the RHAD "Compliance Conditions". The contracting authority's condition presupposes that the insurer has a contact point in Estonia where claims handling is carried out in Estonian, but the circumstances presented indicate that the contact person appointed by the third party actually acts permanently as an insurance agent and probably also with claims handling. Such activity pursuant to § 36(2) of the KindlTSA presupposes the establishment of a branch, which Lloyds has not done. In addition, there is no clear and verifiable assurance that claims handling is carried out properly through a cooperation partner located in Estonia. Thus, the tender does not ensure the provision of services in accordance with the requirements set out in the procurement documents and the law and must be rejected on the basis of § 114(2) of the PPrA. 3.5.5 Binding nature of the source documents of public procurement. The source documents of a public procurement (RHAD) are essentially a preliminary administrative act (see judgment of the Administrative Law Chamber of the Supreme Court 3-3-1-29-12, para. 16), which, if valid, is mandatory for everyone to comply with under § 60(2) of the Administrative Procedure Act. Consequently, the contracting authority cannot declare a tender which does not comply with the conditions laid down in the RHAD and such a decision is unlawful. 4 UNLAWFULNESS OF THE AWARD OF A THIRD PARTY'S TENDER 4.1 The unlawfulness of the decision declaring the tender to be compliant shall result in the unlawfulness of the decision declaring the Third Party's tender to be successful. Since the Third Party's decision is unlawful and must be annulled, the Third Party's Award Decision is also unlawful. Pursuant to § 117(1) of the PPrA, only a tender that has been declared compliant is subject to evaluation. Thus, based on the fact that the declaration of conformity of a third party's tender is unlawful and the third party is therefore unable to participate in the further procurement procedure (including the award of the contract), the declaration of the third party's tender must also be declared invalid. 10 | 11 5 PROCEEDING FROM THE PHASED NATURE OF THE DECISIONS, THE SUBSEQUENT DECISIONS OF THE CONTRACTING AUTHORITY MUST ALSO BE DECLARED INVALID 5.1 Due to the unlawfulness of the decision declaring it compliant, subsequent decisions must also be repealed in time. As the tender of the Third Party should not have been declared compliant and the Third Party cannot participate in the further procurement procedure, the subsequent decisions of the contracting authority (i.e. the decisions on the qualification and non-exclusion of the Third Party) are also unlawful due to the phased nature of the decisions. 6 REQUEST TO REQUEST DOCUMENTS FROM THE CONTRACTING AUTHORITY 6.1 The Contester requests the Contracting Authority to request from the Contracting Authority the tender submitted by the Third Party, including the terms and conditions of the insurance service submitted by the Third Party, including the information sheets, the policy/certificate form and the standard terms and conditions used by the Third Party. Requesting the relevant documents is necessary to ascertain the non-compliance of the Third Party's tender. 6.2 The Contracting Authority cannot rely on the protection of business secrets if the Third Party has not explicitly indicated which documents are business secrets when submitting the tender. Pursuant to § 35(1) of the PPrA, only information in respect of which the tenderer has applied for confidentiality can be considered a business secret. The compliance conditions set in the procurement also required the indication and justification of business secrets. We ask the PPAC to check whether the Third Party has made such a note in the tender and to what extent. If there is no notation, the documents must be requested. Moreover, in the opinion of the Opponent, the information requested, in particular the insurance terms and conditions, cannot be regarded as a business secret by its nature, as it is information that must be freely available to all victims (patients) and other entitled persons in the course of providing health care services in order to enable them to effectively protect their interests and, if necessary, to turn to the insurer with claims. 7 RIGHT OF APPEAL 7.1 It follows from § 185(1) of the PPrA that a tenderer has the right to contest the decision of the contracting authority if it finds that the violation of the PPrA by the contracting authority violates its rights or harms its interests. The practice of the court and the PPAC has confirmed that the only legal purpose of participation of persons in the procurement procedure is the economic interest in concluding the procurement contract. Thus, pursuant to § 185(1) and (6) of the PPrA, the legal right protected in the review procedure of a public procurement is the lawful possibility to enter into a public contract or to receive compensation for damage that arose due to the fact that the public contract was entered into with someone else (judgment of the Tallinn Administrative Court of 08.02.2012 in case no. 3-11-2945, judgment of the Tallinn Administrative Court of 14.02.2012 in case no. 3-11-2947). Contesting the source document of the procurement or the decision of the contracting authority must help the opponent to achieve the objective of participating in the procurement procedure – to enter into a public contract with the contracting authority (Tallinn Circuit Court judgment of 18.05.2012 in case no. 3-11-2403, PPAC judgment of 08.04.2014 no. 56 14/149838.) 7.2 The Opponent has the opportunity to enter into a public contract if the PPAC invalidates the contested decisions Declaring the tender of a third party to be compliant and successful, as according to the criteria for evaluating the tender, the Opponent submitted the tender that came in second place and thus the Opponent's tender must be declared successful. 8 PROCEDURAL ISSUES 8.1 Review of the appeal. The opponent wishes to review the appeal in written proceedings. 8.2 Annexes (Certificates). Proceeding from procedural economy, the opponent has not added to the review evidence that is available to the PPAC from the eRHR. 8.3 Forwarding of notices and documents. The opponent requests that all documents, notices, etc. related to this protest procedure be forwarded to the e-mail address of their authorised representative [email protected]. 11 | 11 8.4 State fee. It follows from the combined effect of § 186 of the PPrA and § 258(1)1) of the State Fees Act that a state fee in the amount of 1280 euros is payable on the filing of this challenge. The opponent has paid the state fee before filing the appeal. A printout of the payment order certifying the payment of the state fee is attached to the appeal (see Annex 6). Yours sincerely, /digitally signed/ Kaidi Reiljan-Sihvart Attorney-at-Law Contractual representative of AB "Lietuvos draudimas" Estonian branch ANNEXES: 1) Insurance terms and conditions used by third parties 2) EHL notice to members 3) Decision to reject the tender of a third party in the procurement of Viljandi Hospital 4) Decision to reject the tender of a third party in the procurement of Põlva Hospital 5) Screenshots of the website https://medmal.ee/ 6) Payment order for payment of the state fee.  LISA B NARVA HOSPITAL Foundation Our 19.01.2026 No. 12.2- 10/10 E-mail: [email protected] [email protected] Lloyd’s Insurance Company S.A. PAT 5404 e-post: [email protected] [email protected] Notice of filing an appeal We would like to inform you that on 16.01.2026, the Estonian branch of AB "Lietuvos draudimas" filed a protest against the decisions of the contracting authority in the public procurement of the NARVA HOSPITAL Foundation "SA Narva Haigla mandatory liability insurance II" (reference number 303593) to declare the tender of Lloyd's Insurance Company S.A. PAT 5404 compliant and successful and not to eliminate it and qualify it (appeal attached). Pursuant to § 192(5) of the Public Procurement Act (hereinafter the PPrA), the protest committee shall involve Lloyd's Insurance Company S.A. PAT 5404 as a third party in the review proceedings. Pursuant to § 194(5) and (6) of the PPrA, we ask the contracting authority and a third party to submit a written response to the Public Procurement Review Committee within three working days, i.e. by 22.01.2026 at the latest, and all documents necessary for adjudicating the challenge that are not available in the Public Procurement Register. If a participant in the proceedings wishes to present evidence that should be concealed from the other participant in the proceedings, an explicit reasoned request must be submitted to the protest committee and the documents with access restrictions must be distinguished (not to be added to the same digital container as the response or other annexes). Also, if the response to the challenge contains the business secrets of one of the participants in the proceedings, a non-confidential version of the response must be submitted for forwarding to the other participants in the proceedings. Please let us know whether the review of the appeal is requested at a public session or in written proceedings. Pursuant to § 194(4) of the PPrA, the NARVA HOSPITAL Foundation does not have the right to enter into a public contract in this public procurement procedure from the receipt of this notice until the receipt of the condition provided for in § 201 of the PPrA. Yours sincerely, (digitally signed) Angelika Timusk Member of the Public Procurement Review Committee Annex: Dispute with annexes Tartu mnt 85 / 10115 Tallinn / 611 3713 / [email protected] For your information: to the opponent's representative, attorney-at-law Kaidi Reiljan Sihvart e-post: [email protected] Mari-Ann Sinimaa 611 3713, [email protected] 2 (2)  LISA C Tervishoiuteenuse osutaja kohustuslik vastutuskindlustus Kindlustustoote teabedokument Äriühing: Lloyd’s Insurance Company S.A on Belgia piiratud vastutusega äriühing, mille registrijärgne asukoht on Bastion Tower, Marsveldplein 5, 1050 Brüssel, Belgia, ja mis on registreeritud Belgia ettevõtete registris Banque- Carrefour des Entreprises / Kruispuntbank van Ondernemingen numbri 682.594.839 RLE (Brüssel) all. Toode: Tervishoiuteenuse osutaja kohustuslik vastutuskindlustus.Versioon 1.1-2025 Käesolev dokument on kokkuvõte kindlustuspoliisiga ettenähtud põhilistest hüvitistest ja välistustest ning ei sisalda teie kindlustuslepingu kõiki tingimusi. Täielik lepinguline teave toote kohta on esitatud teie kindlustuspoliisi dokumentides. Kokkulepitud kindlustussummad, kohaldatavad kindlustuskaitse osad ning täiendavad tingimused on täpsustatud sertifikaadil. Mis liiki kindlustusega on tegemist? Poliis katab ravivigade nõuded, mis esitatakse tervishoiuteenuse osutaja vastu, kellel on kehtiv tegevusluba tervishoiuteenuste korraldamise seaduse alusel; kindlustuskaitset saab osta nii kindlustusperioodiks kui ka pikendatud teatamisperioodile. Mis on kindlustatud? Mis ei ole kindlustatud? Tervishoiuteenuse osutaja vastutuskindlustus välistab kindlustuskaitse ü Tervishoiuteenuse osutaja vastutuskindlustus: järgmise eest (see ei ole ammendav loetelu, palun lugege katab esitatud nõuded kindlustatud isiku vastu kindlustuslepingutingimusi (Punkt 6 lk 13), et saada täielik ülevaade kahju ja nõuete kulude eest, mille eest välistustest): kindluststud isik võib vastutada seoses mis tahes kehavigastuse, tervisekahjustuse või û sertifikaadis märgitud omavastutus; surma korral, mis on põhjustatud kindlustatud û asjaolud ja nõuded, mis on kindlustatud isikule teada enne käesoleva isiku hooletusest, hooletusest tulenevast veast kindlustuse alguskuupäeva, välja arvatud juhul, kui kindlustusandja on või hooletusest tulenevast tegevusetusest seda deklareerinud ja sellega nõustunud; kindlustatud isiku äritegevuse käigus või mis û nõuded, mis on põhjustatud mis tahes ametialase väärkäitumise tahes hea samariitlase akti raames. juhtumi, õnnetuse, hooletuse, hooletuse tõttu tehtud vea, hooletuse ü Õigusabikulud: kui kindlustuspoliisi sõnastuses tõttu tehtud tegevusetuse, rikkumise või kaotuse tõttu, mis on toimunud ei ole sätestatud teisiti, tasub kindlustusandja enne sertifikaadis märgitud tagasiulatuvat kuupäeva; õigusabikulud, mis lisanduvad û ebaausad ja pahatahtlikud teod; kindlustussummadele. û nõuded, mis on seotud seksuaalsete suhete, seksuaalse kontakti või Täiendavad kindlustuskatted: intiimsuse, seksuaalse ahistamise või seksuaalse ärakasutamisega või selliste püüdlustega; ü Dokumentide kadumine: mis tahes kindlustatud û kindlustatud isikute vahelised nõuded; isiku äritegevusest tulenevate dokumentide tahtmatu hävimine, kahjustumine või kadumine. û vastutus, mille kindlustatud isik võtab endale lepingu alusel, välja arvatud juhul, kui selline vastutus oleks olemas ka lepingu puudumisel; ü Konfidentsiaalsuse rikkumine: kindlustatud isiku û varasematele kindlustusandjatele teatatud nõuded/asjaolud; või tema töötaja poolt toime pandud tahtmatu patsiendiandmete konfidentsiaalsuse rikkumine. û trahvid, karistused, suurendatud või mitmekordne kahju, leppetrahvid, karistuslik kahju või muud hüvitise suurenemist põhjustavad tegurid; ü Laim ja solvang: kindlustatud isiku tegevus, mille û vastutus mis tahes nõude eest, mis on esitatud mis tahes käigus esitatakse tahtmatult vale kirjalik või jurisdiktsioonis või jurisdiktsiooni alusel väljaspool sertifikaadis suuline väide, mis kahjustab isiku või määratud nõude jurisdiktsiooni; organisatsiooni mainet. û vastutus kindlustusjuhtumi eest väljaspool sertifikaadis sätestatud ü Hea samariitlase akt: esmaabi andmine või territoriaalseid piire; andmata jätmine ja abi osutamine hädaolukorras või õnnetusjuhtumi korral, välja arvatud juhul, kui û kahjud, mis on seotud mis tahes küber- või andmetega seotud kindlustatud isik on ametialaselt seotud teise intsidendiga. isiku või üksusega. û IVF, geneetilise sõeluuringu või testimisega seotud kahju.  Kas kindlustuskaitsel on piiranguid? ! Me hüvitame kahjud ja nõuete kulud sertifikaadis kindlustussummana märgitud summade ulatuses vastavalt käesoleva kindlustusetingimustele ja välistustele. ! Kahjude ja nõuete kulud arvatakse maha omavastutusest. ! Teie poliisi suhtes võivad kehtida lisad (vt Kindlustuslepingutingimused) Kus kindlustuskaitse kehtib? • Kindlustatud isik on kindlustatud kahjude eest, mis tekivad sertifikaadis määratletud territoriaalsetes piirides. Millised on minu kohustused? • Kindlustusvõtja on kohustatud maksma kindlustusmakse kindlustusperioodi eest sertifikaadil märgitud summas. • Kindlustusvõtjal on kohustus tasuda pikendatud teatamisperioodi tasu siis, kui: a) kindlustusandja või kindlustusvõtja ei uuenda kehtivat poliisi uueks kindlustusperioodiks ja b) poliisi ei asendata samalaadse - nõude esitamise - poliisiga teise kindlustusandja poolt, välja arvatud juhul, kui kindlustatud isik on füüsilisest isikust ettevõtja (mitte juriidiline isik) ning kindlustatud isiku surm, pensionile jäämine või puue muudab tema töövõime alaliselt võimatuks. • Kindlustusvõtja peab kindlustusandjat teavitama kindlustuspoliisil märgitud kahjunõude teatamise aadressil igast kindlustusjuhtumist, nõudest või asjaolust, mis võib põhjustada nõude, kirjalikku taasesitamist võimaldavas vormis nelja (4) nädala jooksul alates kindlustusjuhtumist, kahjunõudest või asjaolust teadasaamisest ning 30 päeva jooksul alates mis tahes asjaolust, sündmusest või misiganes muutustest, mis oluliselt muudavad kindlustusavaldusel esitatud teavet. • Kindlustusvõtja ei tohi kindlustustingimusi avaldada teistele isikutele ilma kindlustusandja eelneva kirjaliku nõusolekuta. • Kindlustusvõtja teeb kindlustusandjaga koostööd kõigis uurimistoimingutes, sealhulgas seoses ettepaneku vormiga. • Kindlustusvõtja tohi ilma kindlustusandja kirjaliku nõusolekuta teha ega anda ühtegi tunnistust, pakkumist, lubadust, loobumist tagasinõudeõigusest, makset ega hüvitist. • Kindlustusvõtja kohustub rakendama mõistlikke ettevaatusabinõusid oma kulul, et vältida sündmust, mis võib käesoleva poliisi alusel põhjustada vastutust. • Kindlustatud isik peab tagama, et kogu kindlustusperioodi jooksul on kõik arstid registreeritud Terviseametis. Millal ja kuidas ma maksan kindlustusmakse? • Kindlustusmakse või selle osa tuleb tasuda sertifikaadil näidatud summas ja tähtajaks. Tavaliselt tasutakse makse pangaülekandega arve alusel. Millal kindlustuskaitse algab ja lõpeb? • Kindlustuskaitse algab ja lõppeb sertifikaadil märgitud algus-ja lõppkuupäeval või kindlustusmakse mitte tasumisel arvel esitatud tasumise tähtpäevaks, lõpeb kindlustuskaitse koheselt. Kindlustuskaitse võib lõppeda ka enne poliisil märgitud tähtaega, kui kindlustusleping lõppeb või lõpetatakse enne seda. Näiteks võib kindlustusandja lepingu lõpetada, kui kindlustusmakse jääb tasumata. Kuidas saan kindlustuslepingu lõpetada? Kuidas ma saan lepingu tühistada ? • Kindlustusvõtja ei saa kindlustuslepingut enne tähtaega lõpetada. Kindlustusvõtjal on õigus lõpetada kindlustusleping, teavitades kindlustusandjat (kindlustusmaakleri vahendusel) vähemalt 1 kuu Kindlustuslepingu enne käesoleva saab enne tähtaega lõpetada vaid poolte kokkuleppel erakorralistel kindlustusperioodi lõppu. asjaoludel. Näiteks kui kindlustatud ettevõte • Kindlustusandjal on õigus lõpetada kindlustusleping, teavitades kindlustusvõtjat (kindlustusmaakleri vahendusel) vähemalt 1 kuu lõpetab enne käesoleva oma tegevuse. kindlustusperioodi lõppu, kuid viivitamata, kui kindlustusmakse ei ole laekunud kindlustusmakse tasumise tähtpäevaks. Lepingu lõpetamiseks tuleb esitada sooviavaldus kindlustusandjale. • • • Kindlustuskaitse võib lõppeda ka enne poliisil märgitud tähtaega, kui kindlustusleping lõppeb või lõpetatakse enne seda. Näiteks võib kindlustusandja lepingu lõpetada, kui kindlustusmakse jääb tasumata.