Personal Accident Insurance

What Is Personal Accident Insurance


  • It can be contracted individually or collectively.
  • Their hiring is voluntary.
  • You can pay a one-time compensation or reimburse the expenses incurred for the treatment of injuries caused by an accident.
  • It has a defined validity.
  • A health declaration is generally required before joining the policy.
  • The insured must take into account if there are gaps stipulated in the policy, their characteristics and, if so, if they meet their needs.
  • It operates after SOAP insurance coverage, if the accident was caused by a traffic accident.
  • There are different types of accident insurance: accidental death, accidental dismemberment, accidental disability, reimbursement of medical expenses due to accident, etc.

They normally exclude injuries or deaths caused by:

  • Risky activities or sports, such as extreme sports, handling explosives, working at heights, etc.; or they could be accepted by the insurance company with an increase in the premium.
  • Pre-existing illnesses and health conditions.
  • Injuries or illnesses caused by war, rebellion, revolution, etc.
  • Suicide or self-inflicted injuries.

Exclusion of coverage for pre-existing illnesses or health conditions

The incorporation in the general conditions of the policy of exclusions of coverage for pre-existing illnesses or ailments, must expressly indicate that these correspond to illnesses, ailments or health situations diagnosed or known by the insured or by the person who contracts on their behalf, before the insurance contract.

The insured shall be obliged to honestly declare all the circumstances requested by the insurer to identify the risk and assess its extent.

To provide the statement referred to in the preceding paragraph, it will be sufficient for the contracting party to report the content of what the insurer requests, on the facts or circumstances known to it and serve to identify the risk and assess its extent.

Cautions and warnings

When contracting personal accident insurance, prior to agreeing to the conditions offered by the Insurance Company, it is important to take into account the following recommendations:

  • Read carefully and make sure you understand the insurance proposal before signing the contract, as well as the general conditions of the policy.
  • Before signing the insurance proposal, be clear:
  • 1. How and under what conditions the insurance is renewed.
    2. How the cost of the insurance will be readjusted, in case of renewal.
    3. In which cases the insurance will not pay.
    4. The requirements to collect the insurance.
    5. The period of coverage and validity of the insurance.
  • Ask the insurer or insurance broker your contract and verify that the particular conditions correspond to what was agreed. In the case of group insurance, through the policyholder, the insurance company must deliver to each of the insured a copy of the policy or, at least, a certificate that proves the coverage. In the latter case, both the insurer and the policyholder and the broker must keep a copy of the policy available to the interested parties.
  • Take into account the risk classification of the company that offers personal accident insurance.
  • Check that the insurance brokers are registered in the CMF Registries.
  • Do not deal with unauthorized persons and report any irregularities.
  • Keep in mind that insurance companies pay a commission to insurance brokers for their advisory work, who must act independently with different companies, and in some cases to their sales agents, who can only act for one insurance company. for which they work.