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[F13] Help - Insurance contract guide

[F32][Customer service] Help - Insurance contract guide

Insurance contract

Under the insurance contract, the insurer is obliged, by means of the payment of a premium, and in the eventuality that the event for which the risk is covered should occur, to compensate, within the agreed limits, the damage produced to the insured person, or to pay an agreed income, capital or other benefits.

The insurance policy is the document that contains the conditions of the insurance. The policy comprises, inseparably, the general conditions, the specific conditions and, where applicable, the special conditions and/or the subscription certificates, as well as the supplements that modify or complement the previous ones.

The insurance policy includes a detailed definition of its specific cover in the contract conditions, as well as any exclusions of cover, deficiencies, excesses and co-payments that may be applicable. It is important to read this information prior to signing the contract.


Parties to the insurance contract

The insurance contract is a bilateral contract between the insurer and the policy holder, but the insured and the beneficiary may also be involved. The policy holder, insured person and beneficiary can be the same person or different persons.

Legal entity that assumes the payment of the agreed benefits within the agreed conditions if the risk event that is the subject of the cover occurs.

Insurance policy holder
A natural or legal person who, together with the insurer, signs the contract.

Insured person
Natural person for whom the insurance is stipulated or who is the owner of the insured property.

Natural or legal person(s) with the right to receive the benefit or compensation derived from the cover that has been arranged.


Premium and calculation of the premium

The insurance premium is the price payable to the insurer in order for the latter to cover the insured risks as provided for in the contract.

The insurance premium is calculated by an actuary using statistical-actuarial studies on the quantification and assessment of the risks. The setting of proportional differences in the premiums and benefits of individual persons, when gender is a determining factor in the evolution of the risk in actuarial and statistical data considered to be relevant and reliable, does not constitute discrimination within the meaning of current legislation.