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since 7/2002 Company Platinum - health plan for employees in Latin America and the Caribbean Patrocinadores - América Latina y el Caribe
Fair Trade - pay a bit more to producers! Retirement? How about retiring to Spain?
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www.e-healthinsuranceservices.com Sanitas Health Plan Complete. General Conditions: VII. POLICYHOLDER'S AND / OR iNSURED'S OBLIGATIONS AND DUTIES The Policyholder or, as the case may be, the Insured shall have the following obligations: a) Declare to the Insurer, prior to the conclusion of the contract and in accordance with the questionnaire to which he / she is subjected, all the circumstances known by him / her that may affect appraisal of the risk. He / she will be relieved of this duty if the Insurer does not supply the questionnaire or, even when it does so, if the precise personal circumstances are not connected with the questions in the questionnaire. The Insurer may terminate the contract in writing to the Policyholder within one month of the Insurer becoming aware of the omission, or of the Policyholder's or the Insured's inaccuracy. The premiums for the contract period when this occurs will be retained by the Insurer, in instances of fraud or gross negligence by the Policyholder or the Insured. If a claim arises before the Insurer notifies the Policyholder of the termination, the benefit for this will be reduced according to the level of cover purchased for the agreed premium and the one that would have been applied if the true risk had been known. If there were fraudulent intent or gross negligence on the Policyholder's part, the Insurer would be released from payment of the benefit. b) Notify the Insurer, during the course of the contract and as soon as possible, of all the circumstances that may affect the nature of the risk and are such that if they had been known by the Insurer at the Commencement Date, that it would not have accepted the application or would have included further terms. The Insurer may propose an amendment to the contract within two months of the day on which it was notified of the increased risk. In this case the Policyholder has fifteen days as of receipt of this proposal either to accept or reject it. In case of rejection or of silence on the Policyholder's part, the Insurer may terminate the contract at the end of this period, after giving the Policyholder prior notice, offering him / her a further period of fifteen days to answer. Within the next eight days, the Policyholder will be notified of the final cancellation. The Insurer may also terminate the contract, notifying the Insured in writing, within one month of the day on which it became aware of the increased risk. If the Policyholder or the Insured has not notified the Insurer of the increased risk when a claim is incurred, the Insurer is not obliged to pay any benefits if the Policyholder or the Insured has acted in bad faith. If the Insured or the Policyholder has not acted in bad faith, the benefits payable by the Insurer will be reduced according to the level of cover purchased for the agreed premium and the premium rate that would have been applied if the true risk had been known.c) Inform the Insurer as soon as possible of any change of address. If the change of address represents a lowering of the risk, the provisions of article 13 of the Insurance Contract Act shall apply. This states: " In this case, at the end of the current period covered by the premium, the amount of the future premium should be reduced accordingly, otherwise the Policyholder would be entitled to termination of the contract and reimbursement of the difference between the premium paid and what he / she should have paid, from the time the Insurer was made aware of the reduction of the risk". If it represents an increase of the risk, however, the stipulations of the preceding letter b) shall be applicable. d) Limit the claim by using all the means at his / her disposal. Non-compliance with this duty with evident intent to harm or deceive the Insurer shall release the latter from all benefit obligations resulting from the claim. e) For the use of the relevant services as described in Clause One, the Insured should present his / her Sanitas Health Plan card, which is a personal and non-transferable document. In case of loss or theft of this card, the Policyholder and / or Insured is / are under the obligation to inform the Insurer within forty-eight hours, and a new card will be issued and the mislaid or stolen one cancelled. In addition, the Policyholder and / or Insured is / are obligated to return the card(s) to the Insurer in the event of cancellation, termination and, in general, ending of the contractual relationship, irrespective of what the cause may be.
You can choose the level of cover you need:
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Disclaimer / Aviso Traducciones juradas (Castellano al inglés) / Sworn translations (English to Spanish)
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David M Harris
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