Frequent Questions

Frequent Questions

The insurance is a contract whereby, a party called insured, transfers to another party called the Insurer, one or more risks in exchange for the payment of a premium, the latter being obliged to indemnify the damage suffered by the insured, or to pay a capital , an income or other agreed benefits, as long as the conditions of the contract are met.

The policy is the supporting document of the insurance contract.

Economic contribution to be paid by the contracting party or insured to the insurance company as consideration for the risk coverage that it offers.

It is the time during which the Insurance Company assumes the risks covered by the policy.

The purpose of the insurance is to provide economic security against risk, it is intended to obtain economic protection of goods or persons that could suffer damage in the future.

It is the person "owner" of the insurance, who transfers the risk to the Insurance Company

It is the person designated in the policy by the insured or contractor as the holder of the indemnification rights established in said document, or who demonstrates the insurable interest of the property

Corresponds to the set of risks that are transferred to the insurer due to the insurance contract and whose occurrence forces the insurer to pay the insured an indemnity up to the limit of the insured amount and in accordance with the terms established in the general and particular conditions of the policy.

The general conditions are the clauses of the standard contracts, which must be used by the insurance companies in the contracting of insurance and which contain the regulations and minimum stipulations by which the respective contract is governed, such as, rights and obligations, insured matters, risks covered, etc.

They are those stipulations that regulate aspects that by their nature are not the subject of the general conditions, in addition, they allow the singularization of a certain insurance policy, specifying its particularities such as, insured and beneficiary, contractor, insurance requirements, individualization of the insurer, deductibles, etc.

It is the concrete manifestation of the insured risk, which produces damages guaranteed in the policy up to a certain amount.

It is the formal communication of the Claim by the Insured, to his Insurer or Insurance Broker.

  • To make claims for claims, the insured or the complainant may do so through electronic means, websites, telephone service or other similar services.

  • Company must provide the insured or complainant with proof of receipt of the complaint at the time it is made.

  • Once a claim has been reported in the company, it may proceed to pay compensation under the terms agreed in the policy or well arrange your liquidation.

  • The settlement of the claim can be carried out directly by the Insurance Company or entrusted to a liquidator. This decision It must be communicated to the insured or their beneficiaries within the 3rd day.

  • The Insured has 5 days to oppose the direct settlement, in which case it must be assigned to an external liquidator.

As established in DS 1055, in its art. 12, insurance liquidators are natural or legal persons who, registered as such in the Superintendency of Securities and Insurance (SVS), investigate the occurrence of claims and their circumstances and determine whether or not they are covered by the policy and the Amount of compensation that corresponds to pay the insured or beneficiary, where appropriate. The liquidator must always maintain objectivity and ensure that the report is issued in strict accordance with technical criteria.

The most relevant are:

  • Investigate the causes of the claim and decide on its coverage.
  • Determine the value of the object at the time of the loss, the amount of the damages and the amount to be compensated, if applicable.
  • Propose to the parties the measures to adopt to avoid the increase in damage or save the remains of the damaged object.
  • Inform the parties about the possibility of pursuing the liability of third parties.
  • Have "adequate mechanisms" for the insured to consult the progress of the settlement.
  • Inform the victims in a timely manner of the steps that correspond to them, requesting the background information that they are usually required for the claim in question.
  • Make known to the Superintendency the abnormalities that it detects in the actions of the audited entities.
  • Maintain "adequate" contingency plans to face catastrophic claims.

a) General rule: 45 calendar days, counted from the complaint.

b) 180 calendar days for maritime hull or general average claims.

c) 90 days for claims of individual Policies with an annual premium higher than UF 100.

d) Up to 180 days in cases of catastrophic events or multiple claims, which is set by the SVS ex officio or at the request of the Liquidator or the Company, if applicable.

e) In the case of those insurances in which it is not possible to count the term for settlement, said term will be counted from when it is put into knowledge of the liquidator the occurrence of the event necessary to properly configure the claim.

The terms of Regulation DS 1055 are business days, unless otherwise established. Business days are Monday through Saturday.

It consists of increasing the term for settlement, thus, the terms can be successively extended - for the same periods - if there are reasons and the specific steps to be taken are indicated. This must be communicated to the insured and to the Superintendency of Securities and Insurance, which can render it without effect and order the issuance of the Settlement Report

As established in article 24 of DS 1.055, the Liquidator may issue a pre-report, in those cases in which problems and differences in criteria arise during the liquidation process regarding their causes, extension of coverage or risk assessment.

It is an official document issued by an insurance adjuster after having carried out an investigation of the circumstances of a claim, through which the latter makes a technical statement on the value of the insured object at the time of the claim, the amount of the damages and the sum that corresponds to indemnify, if applicable.

In general, the way to compensate the loss is in money. However, the parties may stipulate that compensation be paid through the replacement or repair of the insured item.

Amount or percentage established in a policy, which is not transferred to the insurer and which must be assumed by the insured himself in the event of a claim.

Situation that arises when the value that the insured or contractor attributes to the object guaranteed in a policy is lower than it actually has at the time of the loss.

The Insurer is only obliged to indemnify the loss pro rata between the insured amount and the part that is not.

It is the act of refuting or challenging a settlement report. Once the Report is received, both the insured and the Insurance Company will have 10 days to challenge it. If the settlement is direct, the only one empowered to challenge is the insured.

In the event of a challenge, the Liquidator has 6 days to respond to the objections that have been raised.

In the case of individually contracted insurance, in which both the insured and the beneficiary are legal entities and the amount of the annual premium agreed is greater than UF 200, and the insurance of hull and maritime and air transport, the period to challenge the settlement will be 20 days and the response to the challenge will be 12 days.

If the differences between the insured and the insurer persist within 5 days after the settlement process, the insurance company must notify the insured of its final resolution regarding the claim.

It is the clause normally provided for in insurance contracts, by virtue of which the differences arising between the insured, contracting party or beneficiary and insurer regarding the interpretation of the conditions of the policy, its compliance or non-compliance, or any compensation or obligation relating to it to it, they will be submitted to the decision of an arbitrator, who will be appointed by common agreement by the parties once the dispute arises.

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