Taking out an insurance plan

By Paula Martins, in Business, Consumer Rights · 21-05-2021 01:00:00 · 0 Comments

Taking out insurance is still complicated for many consumers. What do we need to know?

In an insurance contract, the insurer covers a certain risk of the consumer or from another person or family member and is obliged to perform an agreed benefit in case of a problem or event for which the insurance has been established, for example an accident or illness.

It is forbidden to take out an insurance contract that covers risks related to criminal, administrative or disciplinary liability, such as kidnap and other crimes against any kind of freedom right, as well as discriminatory practices related to the principle of the equality of citizens.

In case of refusal to conclude an insurance contract or increase the respective premium due to disability or aggravated health risk, the insurer must, based on the data obtained, provide the consumer all the information on risk factors, regardless of their nature, and must do so in a clear and unambiguous way.

If the duty of information is not fulfilled by the insurer, or because it did not provide all the information, or because it did not do it clearly, or simply didn’t inform anything at all, the consumer must file a complaint with the Insurance and Pension Funds Supervisory Authority (ASF), which is the entity responsible for this sector.

Health insurance or health card?

In times of pandemic, most consumers are concerned with health care and consequently with the associated costs. The question of whether to take out insurance or a health card often arises for consumers who want to be prepared for any unforeseen health problem.

The cost of the two options is often a decisive factor in the final choice, although it is not the only one.

Health cards are usually more affordable and therefore more attractive, but in reality, they are not an insurance substitute. There are many consumers who, considering their lower cost, decide to get a health card, concluding that its use is very low, as in their area of residence there are no medical assistance services where they are able to use the card.

Additionally, health insurance, which is more expensive, does not always mean consumer satisfaction for all treatment and medical care options. The most common example refers to dental treatments, which often drive consumers to take out insurance, and then sometimes they verify that the treatment they need is not covered.

How to choose health insurance?

The price, as we have seen, can be a key factor, but the consumer or a family should analyze the expenses covered and the maximum amount covered by the insurer in each area of health.

The previous evaluation of the many insurance proposals existing on the market must also pass through the verification of exclusions and (period between the beginning of the contract and the date when the insurance starts to be able to be used). It should be included in this assessment as expenses related to hospitalisation, as well as treatments during hospitalisation, including general nursing, medications and used materials.

For a prudent choice, compare insurance policies and evaluate the interest of including situations such as childbirth, dental treatment, and medical assistance during the trip, etc, according to the interests of all the family.

Do you know the European health insurance card? It can help in an unforeseen event.

Before travelling abroad, consumers, especially those who do not have health insurance and are going to travel to a European country, must apply for the European Health Insurance Card, which allows them to access public health care (doctor, pharmacy, hospital or health centre) under the same conditions as residents in the host country: medicines, treatments, emergencies, user fees or other expenses in the event of an accident, illness. It is valid in the 27 countries of the European Union, United Kingdom, Iceland, Liechtenstein, Norway and Switzerland.

You can apply for the card over the internet, at the Social Security Direct portal or at the services of the health subsystem from which you benefit (for example, an ADSE). You must do this in advance, but if it has a delay, a provisional certificate is issued.

The card, valid for three years, is free and sent to the holder’s home within seven days. If healthcare is not free, the cardholder will be reimbursed immediately or later when he returns to his country.

No one will deny you a health service if you don’t have a card, but you may have to pay. You must keep all proof of expenses to apply for reimbursement when you return.

Always count on DECO’s support. Please, visit their website at www.deco.pt or contact their services through 289 863 103 or by email: deco.algarve@deco.pt



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