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A policy contract that benefits the insurers against the people

SD. The exorbitant earnings that the insurance companies accumulate from the life insurance policies of the Social Security program are guaranteed by Resolution 268-06 from the Superintendent of Pensions.

This contract, approved under the leadership of Persia Alvarez, authorizes the insurance companies to refuse survivors pensions if this benefit is not requested within two years of the death of the policy holder.

In addition, it has the criteria of “pre-existing catastrophic illnesses”, although limited to the first nine months of the contract. This means that if the insured person gets sick within this period and is disabled, he has no rights to a pension.

Also, according to the contract, the family of the insured person loses the pension in case of suicide or attempted suicide, with no importance given to the mental state of the insured person.

However Resolution 268-06 is the continuance of a regulatory framework that, contrary to what is stipulated in the Law 87-01 on Social Security, grants benefits to the insurers at the cost of the rights of the insured.

For example, Resolution 250-05, before the 268-06, refused pensions to the workers in the cases in which the cause of their disability was a preexisting illness which appeared in the first two years of the person’s inclusion in the insurance plan.

And Resolution 189-04 granted the insurance companies the authority to evaluate the pension requests, in open violation of Law 87-01, and in open conflict of interests, which meant the denial of pensions to many of the insured, who by law, were entitled to them.

At the present time, the SIPEN feels that the policy contract should be modified, in order to eliminate the exclusion for pre-existing illnesses and in order to raise the statute of limitations to five years instead of just two.

The SIPEN reports that in 2011 they submitted the modification project to the National Social Security Council (CNSS) but it is still not on the agenda of this entity.

In the meantime, the insurers have received RD$16.5 billion.

Source: DiarioLibre

Category: DR News |

  1. Samson

    When are insurance companies in DR going to realize that paying claims is their only shop window. They are custodians of payments received.

    They treat claimants as thieves stealing their money.

    Fancy protecting Insurance companies from their customers – disgraceful.

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Last updated March 24, 2017 at 2:14 PM
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