There is a harsh reality and it is that insurers earn much more when their policyholders do not file claims or request compensation, so many companies seek to minimize the payment of the policy that had initially been agreed in the contract or seek to reject the claim based on the called “exclusions” from the contract, which are sometimes not very clear.
Some of the reasons that insurers claim for not paying are:
– The causes of the expiration of the coverage.
– That the event, object of the claim, is not covered by the policy and here they use interpretations of the “exclusions” clauses, if they are not clear in their description.
– That the policy was not paid in the stipulated time.
– In health policies, insurers frequently resort to the pre-existence of illnesses before signing the contract.
These are some of the most popular excuses for not paying or minimizing severance payments.
So, the first thing to do when the insurer does not pay is to review the clauses of your insurance contract in detail to verify the scope of your coverage.
You can call your insurance agent to ask all questions regarding the contract and the event; he is obliged to answer absolutely everything you ask.
Ask the insurer for the reasons for the denial of your compensation in writing and save any conversations you had with the company agent.
If you find that the denial of your payment is unjustified, consult with an experienced insurance attorney to choose the courses of action to force the insurer to take responsibility in the contract.
It is important that you take action as quickly as possible because according to the Insurance and Bonding Institutions Law, the insured has a period of 2 years from the event for which he made his claim, to act legally and even request compensation for the delay in payment.
File the claim with the Financial Market Commission (CMF) . You can also make your claim online against an insurer through the Chile Atiende platform and in writing to SERNAC.