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What Is Life Insurance Coverage?

When you hear the word “coverage,” what comes to mind? Something that can protect you from the rain like an awning or umbrella? A blanket to warm you up in the cold? The idea of ​​life insurance coverage is similar, as it constitutes protection against a specific risk, forming life insurance.

A life insurance plan can consist of more than one coverage. Understanding this and knowing which types exist is essential to choosing the best contract for you.

To be able to understand about life insurance coverage, its types and characteristics, check out the post!

How important is life insurance?

We are always concerned about health and safety, both ours and our family’s, but forget about financial security .

If you contribute to the household budget or are a self-employed professional and cannot stop working, what would happen if something unforeseen happened to you, leaving you unable to walk, for example? Would your family be able to afford the household bills?

It is this financial protection that insurance offers, because we often do not have a reserve to support this lack. Also, life insurance does not go into probate. So if something happens to you, your family will have an immediate amount to pay some costs.

So far, we’ve explained what life insurance is, but what about coverage? What difference does it make?

We know that not everyone has the same needs. There are people who have small children and need to pay for their education; people who are single, live alone and need to pay the household bills; others, very elderly, who continue to work. So if needs are different, why should insurance be the same?

Exactly why the toppings are different. There is coverage for those who need to leave money for the family, for those who may have a serious illness due to family history, for those who continued working and are subject to an unforeseen event, such as an accident.

And anyone who thinks that life insurance will not be used by you, but only by someone after your death, can review their concepts. Many insurances guarantee financial protection in life in case of an illness or disability. Some of them also offer residential, personal or car assistance services.

What Is Life Insurance Coverage?

The concept of coverage is to be a guarantee against certain risks. These are the unforeseen events we are subject to every day, such as a car accident or even a fall that causes disability.

Basically, life insurance has two types of coverage: disability and death. When the unforeseen event occurs, for which the coverage was contracted, you receive the agreed amount.

Example: you contracted coverage for serious illnesses with an insured amount of R$50,000. If you have one of the illnesses provided for in the contract, you receive this amount. It is important to remember that the disease cannot pre-exist when the insurance was taken out.

Discover now the most common variations of life insurance:

death coverage

Death coverage is the most common form of life insurance. It can cover death due to accidental (a car accident), natural (due to old age) or both.

In this modality, the contracted amount goes to the beneficiary of the contract, which can be a child, wife or whoever was indicated in the policy.

When taking out your insurance, be sure to inform yourself properly about the excluded risks, such as death due to manipulation of nuclear material, hurricanes, among others.

disability coverage

This is the type of contract you can enjoy in life, as we mentioned. Disability coverage is for cases in which accidents or illnesses cause permanent or total loss of limb movement and organ function. That is, when an accident or illness compromises your ability to work.

Disability coverage has ramifications, the main ones being:

. Coverage for partial or total disability due to an accident

Sometimes silly things happen, like a fall at home, which leaves you unable to walk or get up on your own. It is for this type of accident, or more serious ones, that this coverage is for. If you suffer something that causes total or partial disability.

. Coverage for total permanent disability due to an accident

It is similar to the previous one, but compensation will only be paid if the disability is complete.

. Coverage for total or partial permanent disability due to an accident with an increase

Liberal professionals, such as dentists, doctors, surgeons, hairdressers, who depend on their hands to work, generally hire this type of coverage.

She has different values ​​for certain parts of the body (essential to work) that may be more harmed in order to receive a higher percentage of compensation, known as majoração, especially if she is no longer able to work due to this weakness.

Coverage for total permanent functional disability by disease

In this case, the contracted risk is disability due to illness. But such coverage works in the same way as the others, changing only the cause of disability.

Coverage for total permanent functional disability due to anticipatory illness

Being diagnosed with a disease generates treatment costs that are often high and not covered by health plans, such as medication.

For these moments there is this coverage: if you have a limiting illness, such as some heart diseases, which do not allow you to live in the same way as before, the insurer anticipates the payment of compensation.

Coverage for temporary disability

If you are unable to work for a period of time due to an accident or illness covered by the insurance, you will receive a monthly amount, which is calculated from the daily rate while you are in treatment, up to the limit of contracted daily rates. This coverage varies according to the contract made.

Serious illness coverage

People who have a family history of cancer are more likely to develop the disease. For those who also want to prevent themselves financially, the ideal is to take out a life insurance that has this coverage.

What to do in case of a life insurance claim?

If a life insurance claim occurs, causing disability, discovery of serious illness or death, it is necessary to know when and how to request compensation. In the first two situations mentioned, generally, the person who took out the insurance must contact the insurer and ask for the redemption.

In cases of accidental or natural death of the insured person, who can initiate the process is a close relative, who has the insurance data. This is usually the life insurance beneficiary, which is determined by who took out the coverage.

However, this type of insurance does not need to have beneficiaries. In this case, those who receive the award are the dependents, 50% for the spouse, if any, and the remainder for the children. Therefore, they can make the request for receipt themselves.

In addition, it is necessary to know that there is an insurance company that allows you to trigger all or part of the process through the internet or telephone, although this varies from company to company.

To do so, you will need to contact the plan’s 24-hour assistance or the broker responsible for it.

If you want to avoid dealing with bureaucracy, it is possible to hire a dispatcher, which generates some costs, which may include a percentage of the compensation. Sometimes, it pays to dedicate more time to the process to receive all the value you are entitled to.

What are the necessary procedures?

After completing the claim procedure, you will need to fill in the claim form. This document is delivered by the insurer. In it, it is necessary to describe the reason why you are requesting compensation and include the insured’s data.

For example, in the case of disability, mention should be made of the reasons that led to this occurrence, such as the accident or process involved. The same goes for the accidental death form, which will report what the accident was and how the insured person died.

After this phase, each insurer will ask for specific documents to continue the procedure and release the money provided for in the insurance. Below, we have listed some of the most requested ones:

disability due to illness

• Medical certificate validating information about sequelae left by the disease, as well as highlighting the level of disability;

• CPF, RG and proof of residence of the insured person;

• copy of the INSS benefit, if the insured person receives it;

• copy of medical examinations performed.

disability by accident

• Medical certificate validating information about sequelae left by the disease, as well as highlighting the level of disability;

• copy of medical examinations performed;

• Police Occurrence Bulletin (BO), if any;

• CPF, RG and proof of residence of the contractor;

• copy of the INSS benefit, if the insured person receives it;

• copy of the Occupational Accident Notice (CAT), if the situation requires it;

if the reason for the accident is related to a car accident, the insured person’s driver’s license must be presented.

accidental death

• Contractor’s death certificate;

• Police Occurrence Bulletin (BO);

• marriage or birth certificate of the insured person;

• report from the Legal Medical Institute (IML);

• CPF, RG and proof of residence of the insured person;

• if the reason for the accident is related to a car accident, the insured person’s driver’s license must be presented.

natural death

• Contractor’s death certificate;

• marriage or birth certificate of the insured person;

• proof of residence of the insured person;

• RG;

• CPF.

Other documents

• Original declaration of sole heirs. Generally, the insurer provides a standardized template;

• original authorization for crediting the account in the event of a possible payment. The insurance company also usually has a standardized model for this;

• simple copy of birth certificate for minor beneficiaries;

• simple copy of the CPF for beneficiaries between 16 and 18 years old;

• RG, CPF and proof of residence for beneficiaries over 18 years old.

It is worth noting that, in general, these are the most requested documents. However, the insurer may request others for, among other purposes, registration complements or related to the claims that caused the situations described.

In the case of a serious illness, it may be necessary to bring statements and medical examinations pointing out the illnesses. It is necessary to mention that the disease in question must be included in the list of illnesses covered by life insurance.

If you have costs with hospitalization, wake, medical treatments and other items that are described in the life insurance and need reimbursement, remember to keep the receipts and invoices to prove them. That way, you can claim compensation more easily.

What is the deadline for payment of compensation?

According to the rules of the Superintendency of Private Insurance (Susep), the insurer has a maximum period of 30 days to indemnify the insured person or his beneficiaries after requesting and delivering the basic documents.

However, the counting of days may be suspended if there is a justifiable and well-founded doubt that requires more documents to be resolved. In this way, the count restarts from the business day following the one in which the new requirements by the beneficiaries or contracting party were fully complied with.

In order to avoid problems, it is essential to ask the insurer for the appropriate protocol that identifies the date of receipt of the claim notice and the respective necessary and requested documents.

How is the price of life insurance determined?

There are a number of factors that go into determining the  cost of life insurance . Typically, the main items evaluated are:

• Age of the insured person: the older the person, the higher the value of life insurance coverage tends to be;

• profile of the insured person: this point takes into account their lifestyle habits and behaviors, to find out if they are healthy or not;

• profession: depending on the occupation, the amount may be higher or lower, as there are dangerous or unhealthy activities that increase the potential for accidents;

• health status and history: here, it is evaluated whether the individual has already had illnesses, what they were, if there are cases of serious illnesses in the family, etc. Daily habits related to harmful addictions are also checked, such as cigarette and alcohol consumption;

• policyholder’s net income;

• spouse’s net income;

• number of beneficiaries;

• recurring overheads for beneficiaries;

• assets and financial investments to measure if there are conditions to pay the insurance and if the compensation is sufficient;

• possible expenses related to the death of the insured person, etc.

This data is checked to assess the value of the benefit, whether the contractor will be able to pay the monthly fees, whether he has the right profile for the chosen life insurance coverage, among other things.

In addition, you must also calculate the value of the life insurance you want to put together a good financial plan that includes the installments.

As we have seen, life insurance can have multiple coverages. It is important that you, if you are interested in taking out insurance, carefully assess your need for protection and do research on the subject.

Understanding how life insurance coverage works allows you to plan better and choose the option that best fits your personal needs and those of your family. Thus, you guarantee a more stable future for your loved ones and gain peace of mind to enjoy life!

Now that you understand a little better how life insurance coverage works, its variations and other details, would you like to get a quote to find out how much one would cost you?

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