Instructions: To begin the claim process, it is necessary to fill out the Claim form for cancer, organ transplant and critical illnesses.[To download the pdf document and print it, go click on]. In addition, you must have available the following documents, as the case may be:
Support documents for the diagnosis for the payment of the benefit (sole payment during the life of the insured person):
• Bypass- Coronary artery
Certification of cardiologist recommending the procedure.
• Cancer
Pathology confirming positive diagnosis.
• CVA or Stroke
Certification of the diagnosis by a neurologist, or copy of the results of radiological images.
• Heart Attack
Certification of the diagnosis by a cardiologist or internal medical specialist.
Reading of the electrocardiogram and results of cardiac enzymes.
• Permanent renal failure.
Certification of the diagnosis by a nephrologist or internal medicine specialist.
• Transplant of principal organs
Summary of discharge of the hospitalization for the transplant of any of the following organs: heart, liver, pancreas, lungs, kidneys or bone marrow.
Note:
All claims must be presented with the corresponding Claim Form duly filled out and signed. The following information is of vital importance.
● Complete and legible postal address.
● Social Security of the person paying for the policies.
All the invoices must include the date of the incurrence, must be duly identified by the provider, medical description and the charge for the services received.
*Please include copy of your last voucher as evidence of the withholding or any other evidence of payment.
IMPORTANT NOTICE
Any person who knowingly and with the intention to defraud presents false information in an insurance application or, who were to present, help or make to present, a fraudulent claim for the payment of a loss or benefit, or were to present more than one claim for the same damage or loss, shall incur in a serious crime and if convicted, shall be sanctioned for each violation with a penalty of a fine no lesser than five thousand (5,000) dollars, nor greater than ten thousand (10,000) dollars or penalty of prison for a fixed term of three (3) years, or both penalties. If there were aggravating circumstances involved, the established prison term may be increased up to a maximum of five (5) years; if there were mitigating circumstances involved, it could be reduced up to a minimum of two (2) years.
