JUSTIFICATION AND ACKNOWLEDGEMENT OF THE RIGHT TO THE INSURED AMOUNTS. 4.1. In case of disability, without prejudice to the remaining obligations provided for in article 19 of the General Conditions, the Policyholder and/or the Beneficiary indicated in the Schedule must:
a) Send to the Insurance Company, within sixty (60) days following the confirmation of total permanent disability, a statement from the treating physician, for the account of the Policyholder or the Insured/Insured Person, indicating the onset, causes, nature and evolution of the disability;
b) Attach an exact description of the activity performed by the Insured/Insured Person before the disability.
4.2. The Insurance Company reserves the right to require any additional justification and to proceed to the investigations it deems convenient in order to determine the exact state of health of the Insured/Insured Person, having him/her examined by its physicians at its discretion. In this case, any costs arising therefrom shall be borne by the Insurance Company, and the Insured/Insured Person must authorise his/her treating physician to provide, on a confidential basis, to the physician representing the Insurance Company any medical information regarding the reported claim.
4.3. The non-compliance by the Policyholder and/or the Beneficiary with the provisions in 4.1. and 4.2. implies their accountability for loss and damage arising therefrom or the suspension of this cover during the period of non-compliance.
4.4. The lack of truthfulness in the information provided to the Insurance Company implies the loss of the right to the insured amounts.
4.5. In case of dispute, the parties may resort to the means of dispute settlement provided for in the law.
4.6. While disputes are being settled, the premiums and premium surcharges regarding the Death cover, as well as the premiums and premium surcharges regarding the disability cover, that may fall due during the discussions, must be paid to the Insurance Company. If the Insurance Company loses the dispute, it shall return the amounts received and pay, if that is the case, the amounts due plus interest of 1% per year, counted from the end of the period indicated in article 3 of this Special Condition.
JUSTIFICATION AND ACKNOWLEDGEMENT OF THE RIGHT TO THE INSURED AMOUNTS a) In case of a serious illness, the Insured/Insured Person must send to the Insurance Company a report from the treating physician, after the precise and detailed diagnosis of the serious illness, describing his/her medical history and mentioning the date of the first symptoms. This statement, for the account of the Insured/Insured Person, must be sent to the Insurance Company within sixty (60) days following the diagnosis of the illness;
b) The serious illness must manifest during the term of the Contract and/or during the period in which this cover is in force regarding the Insured/Insured Person;
c) Upon the subscription of the insurance Contract, the Insured/Insured Person must authorise his/her treating physician to provide, on a confidential basis, to the physician representing the Insurance Company all medical information regarding the reported claim;
d) The non-compliance by the Beneficiary or the Insured/Insured Person with the provisions in a), b) and c), as well as the lack of truthfulness in the information provided to the Insurance Company may imply the loss of the right to the insured amounts or the suspension of this cover during the period of non-compliance;
e) The Insurance Company may proceed, at its discretion, to the investigations it deems necessary regarding the Insured/Insured Person in order to determine his/her real state of health or about the declared illness. Except in cases of force majeure, refusing the Insurance Company free access shall imply the suspension of the Guarantee. The Insured/Insured Person must authorise his/her treating physician to provide, on a confidential basis, to the physician representing the Insurance Company any medical information regarding the reported claim;
f) Within the scope of this Additional Cover, after the diagnosis has been reported and after all additional documents have been produced, that may possibly be requested by the Insurance Company, the Insurance Company undertakes to inform the Insured/Insured Person and/or the Beneficiary, within the maximum period of thirty
JUSTIFICATION AND ACKNOWLEDGEMENT OF THE RIGHT TO THE INSURED AMOUNTS. 7.1. In case of invasive cancer, without prejudice to the remaining obligations provided for in article 18 of the General Conditions, the Policyholder and/or the Beneficiary indicated in the Schedule must send to the Insurance Company, within sixty (60) days following the confirmation of invasive cancer, the biomedical report with the final diagnosis and the medical report regarding the tumour with the date of the initial diagnosis and the date of the first medical appointment.
7.2. The Insurance Company reserves the right to require any additional justification and to proceed to the investigations it deems convenient in order to determine the exact state of health of the Insured/Insured Person, having him/her examined by its physicians at its discretion. In this case, any costs arising therefrom shall be borne by the Insurance Company, and the Insured/Insured Person must authorise his/her treating physician to provide, on a confidential basis, to the physician representing the Insurance Company any medical information regarding the reported claim.
7.3. Non-compliance by the Policyholder and/or Beneficiary with the provisions in 7.1. and 7.2. makes them liable for losses and damages arising therefrom or may give rise to the suspension of this cover during the period of non-compliance.
7.4. The lack of truthfulness in the information provided to the Insurance Company implies the loss of the right to the insured amounts.
7.5. In case of dispute, the parties may resort to the means of dispute settlement provided for in the law.
7.6. While disputes are being settled, the premiums and premium surcharges regarding the Death cover, as well as the premiums and premium surcharges regarding the invasive cancer cover, that may fall due during the discussions, must be paid to the Insurance Company. If the Insurance Company loses the dispute, it shall return the amounts received and pay, if that is the case, the amounts due plus interest of 1% per year, counted from the end of the period indicated in article 4 of this Special Condition.
