Liberty accident insurance ( Castellano )
18. Claims processing ( Contents )
The policyholder, the insured or the beneficiary must inform the insurer of the occurrence of a claim within a term of 7 days, and will be held responsible by the insurer for any damage and injury caused by failure to report the claim, unless it can be shown that the insurer was informed by other means.
The policyholder, beneficiary or the insured must, in addition, provide the insurer with all the necessary information concerning the circumstances and consequences of the claim. In the event of breach of this obligation, the loss of indemnity rights or rejection of the claim shall only be carried out in the case of gross negligence or wilful misconduct.
In the event that there are various insurers, this information must be provided to each of them, unless otherwise established, and should include the names of the other insurers, in accordance with that set forth previously in this article.
The insured or the policyholder must undergo medical examinations, at the cost of the insurer, as many times as considered necessary to facilitate any enquiry or verification that the insurer may consider necessary, freeing to this end the professional secrecy of all the physicians who the insured has visited or seen.
The insured, beneficiary or policyholder must provide all documentation related to the accident that is deemed necessary by the insurer.
In the event of the death of the insured the beneficiary must submit the following documents:
- Certificate from the physician who attended to the insured, detailing the circumstances and causes of death, or the physician's death certificate.
- Certified copy of the entry of death in the Registry of Births, Deaths and Marriages.
- Documents identifying the beneficiary and, where applicable, providing evidence of his or her capacity as such.
- Certificate of exemption from Estate Tax or of the payment thereof, as applicable, duly completed by the provincial Tax Office.
- Autopsy certificate, when applicable.
19. Claims - calculation of the indemnity