Do you know what to do in the event of an accident? What papers should you present to the insurance company? How much time do you have to present them?
These are the steps of the procedure that you have to follow if you have an unforeseen event to receive compensation from the insurer.
When taking life or general insurance, it is recommended that when you sign the policy you understand the procedure to make it effective. The idea is that if you have an accident or unforeseen, be clear about the steps to follow to act quickly.
Not all insurances have the same requirements to indemnify the beneficiary, however there are stages that are common in each of them.
Here are the steps to collect insurance:
1. Clarify what documents you should have
Remember the documentation will depend on the type of insurance which will be informed at the time of contracting, in some cases they request certain procedures or procedures before making the collection of the claim. For example, they can request proof from the Carabineros (immediately after the incident) or original receipts, bonds and reports for reimbursement of medical expenses.
In case you cannot present these documents directly because you are disabled, you can delegate these procedures to a third party through a simple power of attorney, in other cases it is necessary to present a power of attorney.
2. Report the claim
Each policy determines the procedure to follow to report a claim, with the conditions and deadlines that must be respected. However, in all cases it is essential to report the claim to the insurance company as soon as possible so that it can make the settlement report.
If the policy was brokered by an insurance broker, it is very important to contact him to assist you in the liquidation process.
This settlement may be carried out by the insurance company or an external liquidator (in case you object to it being the same company). Whoever takes responsibility will have 3 business days to contact you -from the day you made the report- in order to communicate who will be in charge.
3. Take the necessary steps and provide additional information
Either the insurance company or the liquidator, must inform you of the steps you must take and the additional information that is necessary to settle the claim. You can also review the attached claim settlement procedure in your insurance policy, which will indicate the actions and deadlines to present the documentation.
Four . Final settlement report
The insurance company or the liquidator, must issue a report in the corresponding period according to the contracted policy, that period can be postponed only in justified cases, however it must be communicated to the insured and also to the Commission for the Financial Market (CMF) , which can cancel the extension and set a new deadline for the delivery of this report.
The settlement report will be sent to both the insured and the insurer. This document will include a technical opinion that justifies the payment or not of the compensation, as well as the amount and parameters that were used to make the determination.
5. Accept or reject the decision
After receiving the settlement report, both the insured and the insurance company have 10 working days to challenge it if they disagree. In the event that it was the insurance company that made the report, only the insured can exercise this right.
If there is a challenge, the liquidator can respond within 6 business days. If after that there is still no conformity regarding the different points of the report, the insurer must notify the final resolution of the claim within a maximum of 5 business days.
Finally, the compensation payment must be made within 6 days of notification of the resolution.
When contracting insurance, it is important to pay attention to all the necessary requirements to receive compensation, which will allow you to be prepared for any unforeseen event and to be able to carry out actions in a timely manner in the event of a claim.