When taking out insurance, it is necessary to take into account that the insured has rights and duties
As an insured you have the right to:
- Hire and choose the most convenient National insurance pay coverage for your needs and interests, in order to obtain the due protection you require through a specific policy.
- Choose freely and voluntarily the insurance company that will assume the insurance coverage, as well as the insurance intermediary or broker that advises you when taking out the insurance and during its validity.
- Access accurate, timely, clear and complete information on the conditions that govern the insurance you are contracting. The information must include the necessary background that allows you to know and appreciate the basic aspects and characteristics of the service offered.
- Request a copy of the policy.
- If you have any complaint or if you would like to file a claim about the actions of an inspector, you can make a written submission addressed to the latter’s office, who are obliged to process and reply in writing to the submissions they receive within a period that It cannot exceed 20 business days, counted from its receipt.
In the event of a claim, you have the right to:
- Settlement of the claim.
- To the payment of compensation in the event of an accident that is covered by the policy.
- Make and obtain answers to your queries and claims.
- Exercising the respective legal actions contemplated in the policy. In most of the policies, the intervention of an arbitrator is contemplated, who can be appointed by common agreement by the parties, or failing that, by the ordinary courts.
- The Commission for the Financial Market (CMF), according to the law, can act as an arbitrator in qualified cases, provided that the amount claimed does not exceed 120 UF, or 500 UF for mandatory insurance.
As an insured you have the following duties:
- Responsibly inform yourself and read the documents that are presented to you to contract insurance, in order to understand the content and characteristics of the services offered.
- Inform or honestly declare the risks that you want to insure, in order to allow the Insurance Company to identify the insured object and appreciate the extent of the risks that you are going to assume.
- Pay due care to the insured goods and prevent the occurrence of the accident.
- Not aggravate or extend the insured risks.
- Pay the insurance premium, in the manner and term agreed with the Insurance Company. Failure to comply with this obligation may release the insurer from its obligation to indemnify the loss, in accordance with the conditions of the respective policy.
- Preserve the damaged objects and take all necessary measures to save or recover the insured object or to preserve its remains.
- Inform or denounce the accident, indicating its causes, consequences and other facts that allow the Insurance Company to duly impose itself on the event. The claim must be reported to the insurer, within the term provided in the policy, which varies according to the different types of insurance in question.
- Provide the insurance company or loss adjuster with all required background information.
Do not forget that the breach of the duties as an insured could mean the refusal of the payment of the indemnity or the early termination of the insurance contract.
In addition, the policies may establish special obligations for the type of risk insured.
In the event of an accident, in some cases compliance with certain mandatory procedures or procedures is required , which will depend on the type of insurance contracted. Among these, the following are worth mentioning as an example:
- Leave immediate police record of the accident, in the insurance for motor vehicles.
- Presentation of budgets or quotes, delivery of vouchers, receipts, bonuses, etc. to request reimbursement of medical expenses.
- Report of the attending physician in health or life insurance, etc.
- Once an accident occurs, it is recommended to review the conditions of your insurance policy and also consult with the insurance company or with your insurance broker, if applicable.
Likewise, Insurance Companies must comply with obligations, some of which are:
- Responsibly evaluate the risks they assume.
- Issue the policy and deliver it to the insured in individual insurance and to the contracting party in group insurance.
- Respond to written submissions made to you.
- Communicate to the insured its resolution regarding the coverage of the accident.
- Make available to the insured the undisputed amount of the claimed compensation.
Insurance Brokers must also comply with obligations, some of which are:
- Communicate in writing to the proposer when the company rejects or modifies the proposed risk.
- Advise the Insurance Company on the identity of the contracting party and the existence and location of the risk.
- Advise the insured during the contracting period, validity and termination of the insurance.