Group Debtor Balance Fixed Annual Amount
– General Information about ASSA
– SUGESE Registration Information
SUGESE Registration Colones
– Claims Procedure
The Policyholder or the Insured, upon becoming aware of the occurrence of a loss, shall notify the Company as soon as he/she becomes aware thereof by any means, confirming it in writing as soon as possible. The term for giving notice of loss shall not exceed seven (7) calendar days from the date on which the loss occurred or from the date on which knowledge thereof was obtained. The main means to give notice of loss are: i.) through the telephone line 2503-ASSA (2503-2772) or; ii.) by e-mail: [email protected].
If notice of loss is not given within the time limit indicated in a malicious manner to avoid or misrepresent the assessment of facts and circumstances, the Company shall be entitled to invalidate the claim. Otherwise, notice of loss or production of proof within the time limits provided in this clause shall not invalidate or reduce the claim if it was not reasonably possible to give such notice or proof and that notice and proof was given as soon as reasonably possible.
- For “Death from Any Cause” coverage, the following must be submitted to the Company:
- Submission of claim form with the documentation required by the Company.
- Statement of account with the outstanding balance of the Debt at the date of death of the Insured Party, including the balance and current interest and the date of commencement of the credit operation.
- Photocopy of the Insured’s identification document.
- Death certificate issued by the Civil Registry indicating the cause of death of the Insured.
- If the death occurs outside Costa Rica, the following must be provided:
- Certification of the death certificate issued by the competent authority of the country where the death occurred.
- Certification of the cremation or burial document in the country of death (if any).
The aforementioned documents must be submitted with the corresponding consular certification or apostille.
For “Total and Permanent Disability” coverage, the following must be submitted to the Company:
1. Submission of claim form with the documentation required by the Company.
2. Statement of account with the outstanding debt balance at the date of the declaration of Permanent Total Disability, which includes the balance, current interest, and the date of commencement of the credit operation.
3. Photocopy of the Insured’s identification document.
4. Medical certificate of said disability issued by the Costa Rican Social Security Fund, and in the event that the Insured Party does not have the means of proof, the Company shall assign a doctor or board of doctors at its own expense, in which the following is clearly stated: The percentage of loss of organic and functional capacity of the Insured Party, Diagnosis of the events that caused such a disability, and that said diagnosis is not subject to review.
5. If the disability was caused by an Accident, the Insured Party must provide a certified copy of the judicial file containing the description of the event and the results of the toxicology tests.
For “Unemployment” coverage, the following must be submitted to the Company:
- The Insured must give written notice of the claim to the Policyholder within thirty (30) calendar days of becoming Unemployed. In case it is not presented within this term, coverage cannot be granted.
- The Policy Holder shall provide the Insured Party with a form supplied by the Company, which shall be completed and returned to the Policy Holder with all the information requested therein as soon as he/she has the requirements indicated in the following point in his/her possession.
- In addition to the presentation of the notice of loss, the Insured Party must provide the following documents:
- Proof from the former Employer of dismissal from previous employment. This certificate must contain: Name of the former employee, identification, period employed by the company, position held, type of labor contract held by the former employee (permanent, co-owner, under contract), and cause of dismissal.
- Proof issued by the Costa Rican Social Security Fund, indicating that the Insured had been contributing to that system during the last twelve (12) months prior to his dismissal, that he was actively working for the same employer, and that he had been continuously employed, at least for a period of twelve (12) months prior to the beginning of this contract..
- For the payment of the agreed monthly benefit, once the deductible period (30 days of unemployment) has passed, the Insured must present proof from the Costa Rican Social Security Fund, that is updated to the corresponding cut-off date to the Policyholder, in order to prove the unemployment condition of every month covered by this insurance through the payment of the monthly benefit. This requirement must be complied with until the Insured resumes his/her employment status or until the number of installments agreed upon to receive the monthly benefit is reached, whichever occurs first.
– Assistance Services
– Time to Resolve Claim
In accordance with Article 4 of Law No. 8653 and Article 48 of Law No. 8956, the Company shall respond to the Insurance Consumer in the event of a Notice of Loss within thirty (30) calendar days, counted from the date of compliance with all documentation.
– Acceptance of Indemnity Claim
In those cases in which the Company accepts the indemnity request presented by the Insurance Consumer, this decision shall be communicated to him/her through the means established for this purpose, and the Company shall proceed with the payment or execution of the benefit, within a maximum term of 30 (thirty) calendar days, counted from the acceptance of the claim.
– Denial of Indemnity Claim
In the event that it is determined that the claim does not have coverage or there are differences in relation to the claim amount, approval shall be requested from Claims Management to decline and inform the Insurance Consumer in writing of the decision by means of a reasoned resolution explaining the reasons for the decision and allowing for a clear and adequate understanding of the reasons for the decision, stating the facts and the contractual provision on which it is based.
Evidence must be provided to justify the rejection in a reliable manner, safeguarding the protection of the Company’s sensitive and undisclosed information. To this end, the reasons for the rejection must be informed in detail, especially when it is due to the origin of an exclusion provided for in the insurance policy. In the aforementioned communication, the Company shall inform the Insurance Consumer of the different instances to which he/she may resort in the event that he/she is not satisfied with the grounds supporting the rejection of the claim.
- Provider network N/A
- Premium amounts and payment procedures
These will be established in the insurance proposal according to the line of business of the insured.
The following are the different ways in which ASSA Insurance Company allows clients to pay their policy premiums, both in colones and dollars:
- Credit or debit cards (can be set up for automatic debit)
- Bank deposits
- Wire transfers
ASSA Compañía de Seguros currently has accounts in colones and dollars in:
- BAC San José
- Bank of Costa Rica
- National Bank of Costa Rica
- Citibank of Costa Rica, S.A.
- Banco General (Costa Rica), S.A.
Premiums shall be payable annually, semi-annually, quarterly, triannually, bimonthly, or monthly, and shall be calculated by a method mutually agreed upon by the Company and the Insured Party. In the event that a premium installment is agreed upon (payment periodicity of less than one year), it shall be stated in the Special Conditions, and the following maximum surcharges shall apply:
- Annual payments: 0% in colones or dollars.
- Semi-annual payments: 4% in colones or dollars
- Triannual payments: 5% in colones or dollars
- Quarterly payments: 6% in colones or dollars
- Bimonthly payments: 7% in colones or dollars
- Monthly payments: 8% in colones or dollars
In this type of policy, the client’s statements are required in order to appreciate the proposed risk. These statements must be drawn up in a clear, prominent, and legible manner, and must contain sufficient typographical space to guarantee the client’s separate and independent signature. The client must expand, add, or personally indicate any circumstance in relation to the declared risk, and must subsequently disable the blank spaces in the application or statements.
Any false or inaccurate statement of facts or circumstances known as such by the Insured Party, by ASSA, or by the representatives of one or the other, which could have directly influenced the existence or conditions of the contract, shall render the contract null and void from its origin.
If the falsehood or inaccuracy comes from the Insured Party or its representative, ASSA shall have the right to retain the paid premiums; if it comes from the Company or its representative, the Insured Party may demand the return of the paid premiums plus ten percent (10%) in damages.
In case of mutual deceit, the insured shall only be entitled to receive the paid premiums. ASSA shall make the reimbursement within fifteen (15) working days after the date of notification of the TERMINATION OF THE CONTRACT.
ASSA’s obligation to indemnify shall be extinguished if it proves that the insured person declared, with fraudulent intent or gross negligence, in an inaccurate or fraudulent manner, facts that if they had been declared correctly could exclude, restrict or reduce such obligation, the foregoing without prejudice to the fact that the conduct of the insured person constitutes the crime of simulation.
Right of Reply
ASSA undertakes to respond to all claims, petitions, or requests by means of a reasoned resolution and when appropriate in writing, in the form agreed upon for such purpose, within a maximum term of thirty calendar days, counted from the receipt of all claim documents.
- Quote signed by the insured
- Acceptance letter and appointment of an intermediary
- Insurance Request
- Request for Insured Proposal
- KYC Form
A grace period of ten (10) days is granted for payment of the premium on any due date regardless of the frequency of payment, excluding the first payment. If the premium is not paid prior to the expiration of the grace period, the Insured’s coverage shall automatically terminate at the end of said grace period due to non-payment.
If one or more of the coverages are canceled by the Policyholder during or at the end of the grace period, the Policyholder shall be liable for the payment of a pro rata premium for the time the policy has been in force during said grace period.
The offer and quotation of this insurance do not guarantee its acceptance. In the event of acceptance by ASSA, acceptance shall be evidenced by a certificate of coverage, a box stamp in the particular conditions of the contract issued by ASSA, or delivery of the duly signed contract.
The issuance of this policy shall be subject to the receipt of the premium payment in accordance with the conditions set forth in the “Grace Period” section.
Periodicity of Insurance Validity
Premiums shall be payable annually, semi-annually, triannually, quarterly, bimonthly, or monthly, and shall be calculated by a method mutually agreed upon by the Company and the Policyholder.
Right of Withdrawal
The term of the contract may be terminated early in the following cases:
a. By the INSURED, by means of written notice to the COMPANY at least one month in advance. If such a notice does not indicate a specific date for the revocation or said date is prior to one month of the communication, it shall be understood that it shall become effective immediately as of the date on which the indicated month is fulfilled, which shall be counted as of the day following the day of receipt of the notice. The COMPANY shall have the right to keep the PAID PREMIUM for the term elapsed and shall reimburse the INSURED for the UNPAID PREMIUM, the amount of which shall be available to the INSURED at the COMPANY’s offices no later than ten working days after the expiration of the term.
b. At the COMPANY’s will, at any time by means of written notice to the INSURED and NAMED INSURED sent to their contractual address, not less than one (1) month in advance, counted from the date of receipt of the notice.
c. Should the risk cease to exist, the early termination of the contract shall take place as of the moment in which the COMPANY is notified of such a situation. In such case, the COMPANY shall return the UNPAID PREMIUM, the amount of which shall be available to the INSURED at the COMPANY’s offices no later than ten working days after the expiration of the term of the contract.
The early termination of the contract shall be without prejudice to the INSURED’S right to compensation for CLAIMS occurring prior to the date of early termination.
Deadline for accepting or rejecting risk
ASSA reserves the right to accept or reject the risk posed after the insurance application or proposal. Acceptance will be communicated to the insured within a period not exceeding 30 calendar days, within which time the application will be resolved.
Once the underwriting of the risk has been accepted, ASSA shall send to the insured, within three working days following its assent, a certificate of coverage informing of the acceptance, in the manner set out in the general conditions
Deductibles will be established in the insurance proposal according to the respective line of business and the needs of the insured.