Frequently asked questions about life insurance and disability

 

In this post we collect some of the most frequently asked questions posed by those customers regarding life insurance and disability

 

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What is life insurance or disability?

Life insurance is a contract whereby, by paying a stipulated and within the limits established by law and the contract premium, the insurer undertakes to pay the beneficiary capital, income or other benefits agreed upon in case of death, survival or inability.

It is therefore a guarantee of future risks. So, when risks materialize and indeed happens insured, comes the obligation of the insured to pay the compensation agreed upon as provided in the contract.

Such contracts are legally regulated in Law 50/1980, of 8 October Insurance Contracts.

 Who can hire life insurance or disability?

Everyone can hire life insurance or disability.

However, Article. 83 of the Law on Insurance Contracts (LCS) provides a number of exceptions is that, You can not hire a life insurance for those under 14 years or for people with disabilities.

Who is the policyholder in a life insurance or disability?

The policyholder is the person who signs the insurance contract and the fulfillment of the obligations arising therefrom undertakes (for example, the premium payment).

In any case, the policyholder also has a number of rights as a contracting. Among others, You have the right to request and receive all the necessary information before signing the contract.

 Who is the insured in life insurance or disability?

The insured is the person whose integrity is ensured. Namely, The person who is under the protection of the policy.

Many times the figure of the policyholder and the insured can match (insurance contract for me) but they can also fall on different people (my parents hire a life insurance for me).

Who can collect the insurance compensation?

Succeeded the insured risk (in this case we speak of death or disability statement) the insurance company will pay the compensation agreed.

In life insurance, the policyholder may designate as beneficiaries of insurance to people who want, regardless of kinship or relationship between them. Also, the order of priority set can be modified at any time while the policy is in force.

But if the policyholder has not designated beneficiaries of the compensation policy will go in the order legally provided, namely; spouse, ascending or descending.

In disability insurance, compensation will be received by the insured, unlike life insurance.

What is the insurance premium?

The premium is the price that the borrower will pay as consideration of the guarantees offered by the insurance.

The amount of the premium depend on various factors such as, risk and capital insured or the insured's age.

What are life insurance single premium?

Insurance contracts Single premium are common when linked to a mortgage loan. They characterized the taker pays a single payment, the premium for the entire term of the contract.

 In life insurance, What is a sobreprima?

The sobreprima refers to economic growth that will satisfy the policy to ensure circumstances, objects or persons involving an increase in risk.

For example, if I will arrange life insurance and my hobby are sports of adventure and risk, usually the insurance company will increase my premium for that extra hazard that aggravates the risk of the insured loss occurs.

What is a health questionnaire?

A health questionnaire is a document issued by the insurer to the policyholder / insured that contains questions about your health. It is obtained by the insurer, a detailed analysis of those pathologies suffered prior to the insurance by the insured, and that may affect the insured risk assessment report.

The health questionnaire is a mechanism with which insurers have to evaluate the risk insured.

Should I tell the truth about what I question the health questionnaire?

Sí, at all times.

Article 10 of the Insurance Contracts Act includes the obligation so that the policyholder has the duty to declare to the insurer, de acuerdo con el cuestionario que éste le someta, todas las circunstancias por él conocidas que puedan influir en la valoración del riesgo.

The risk, as an essential element of the insurance contract, It determines the need for the insurer has full knowledge of what the risk coverage and the likelihood that the event is determined to occur. This gives rise to an obligation by the insured, (or the policyholder if different) of act in good faith, must not hide information that the insurer must know. For the insurer you must know all those diseases or conditions that may determine a greater risk, in order to properly assess it and decide with all the information if no contract with the insured or negotiate a higher premium.

Such premises have adequate regulation in Article 10 de la LCS, as well as Article 89 thereof, explicitly used on people insurance.

What if I did not tell the truth in all questions of health questionnaire?

The Insurance Contract Law, again in his article 10 regulates the situation in which the policyholder answers with dolo o culpa grave questions the health questionnaire.

Specifically jurisprudence (SSTS 12 August 1993, 24 June 1999, 14 June 2006) means <<dolo o culpa grave>> statements that are aimed at deception of the insurer aunque no se tenga la voluntad de dañar a la otra parte (Arts. 1260 and 1261 CC) and the declarations made with a inexcusable lack of diligence.

The consequence of this action is that the insurer is released from its obligation to pay compensation. The beneficiary of the casualty will not receive any amount for compensation.

What if the health questionnaire questions are generic and imprecise?

In this regard include the judgment of the Supreme Court 31 May 2004 by which it was set that, If the insurer does not require health questionnaire or presented incompletely, You must bear the consequences. This is because, Law on Insurance Contracts no proper duty of declaration, but what provides your article 10 is a I must answer the taker-assured about what has been asked, what interested him to the insurer and cares for the purpose of properly assessing risk.

Thus, the policyholder-insurer of its duty to declare the risk both in cases of lack of questionnaire as in cases where the questionnaire is so generic that risk assessment will not depend on the circumstances covered by or exonerates the which he was asked by the insured.

If the insurer does not present health questionnaire, who answers?

Then, la aseguradora deberá responder salvo que probase que el contrato de seguro se suscribió mediando dolo o culpa grave.

Is it mandatory to undergo medical examination requesting the insurer?

About, Our Supreme Court in its judgment of 4 enero de 2008, en la que reitera pronunciamientos anteriores, determined that "Article 10 LCS no obliga a la Compañía de seguros a realizar un chequeo médico a los tomadores de las pólizas. Se trata de un contrato bilateral presidido por el principio general de la buena fe entre partes, plus, es aplicación al principio de buena fe expresamente establecido por el artículo 10 LCS, therefore, el reconocimiento médico nunca será necesaria al tener la Compañía aseguradora la confianza y seguridad de la veracidad de los datos ofrecidos por el tomador en la póliza.

Therefore, la LCS no obliga a las compañías aseguradoras a someter a sus clientes a un control médico sobre su salud.

But, en caso de que la Compañía dude acerca de la veracidad de las manifestaciones contenidas en el cuestionario de salud, puede solicitar la realización de un chequeo o revisión médica. En caso de que el tomador/asegurado se oponga, presumiblemente la aseguradora rechazará la suscripción de la póliza.

When life insurance or disability ends?

Los seguros de vida o invalidez pueden finalizar por diversas causas:

1.-Porque se ha alcanzado la edad máxima prevista en el contrato.

Los contratos de seguro pueden finalizar porque el tomador-asegurado haya cumplido la edad máxima prevista en el contrato. Normalmente esta edad se sitúa entre los 70-80 years old.

2.-Porque se ha producido el siniestro asegurado.

In this case, la compañía aseguradora procederá al pago de la indemnización contratada. Posteriormente se resolverá el contrato de seguro a excepción de que el mismo contrato contenga varias coberturas y puedan subsistir el resto (for example, una póliza que asegura el fallecimiento y la invalidez absoluta; declarado el asegurado en situación de invalidez absoluta la póliza seguirá viva respecto de la declaración de fallecimiento).

3.- Por impago de las primas

Si el impago se produce sobre la prima inicial del contrato, la compañía aseguradora tiene derecho a resolver el contrato y finalizarlo o a reclamar el pago judicialmente.

En caso de impago de las primas sucesivas del contrato de seguro, el asegurado seguirá cubierto durante el mes siguiente desde la fecha de vencimiento de la prima. Namely, se le concede al asegurado un mes de gracia.

Pasado este plazo, si la aseguradora no reclama la prima al tomador durante los seis meses siguientes, el contrato se entenderá extinguido.

Can I have more than one life insurance or disability?

Sí, no es incompatible tener varios seguros de vida o invalidez contratados al mismo tiempo con la misma Compañía aseguradora o con diferentes.

Is it compulsory to life or disability insurance with the signing of a mortgage?

Es cierto que los bancos exigen unas mínimas garantías para conceder el crédito, siendo una de las más comunes la de suscribir junto con el préstamo un seguro de vida o invalidez. El motivo es que, en caso de siniestro la entidad bancaria se asegura el cobro de la cantidad prestada al cliente.

Therefore, no existe una obligación legal de contratar la póliza de seguro.

When should I communicate that an incident has occurred?

De acuerdo con el artículo 16 de la LCS, ocurrido el siniestro el tomador, asegurado o beneficiario del seguro disponen de un plazo de siete días desde que han tenido conocimiento de este. Pero ese plazo es solamente para evitar que la compañía aseguradora pueda reclamar por los daños sufridos por falta de comunicación.

How long do I have to claim the insurance policy compliance?

Si producido el siniestro la compañía aseguradora se niega a satisfacer la indemnización pactada, Article according to 23 de la LCS, disponemos de el plazo de five years en los seguros de personas para interponer las acciones que a nuestro derecho convengan.

Se trata además de un plazo de prescripción: Puede ser interrumpido con una reclamación fehaciente a la aseguradora

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