Sanitas Multi - Bases, loss of rights, cancellation and incontestability of the policy ( health insurance )

1. This policy has been agreed on the basis of the declarations made by the Policyholder and the Insured in the insurance application questionnaire regarding his / her state of health and regular occupation.

These declarations constitute the basis for the acceptance of the risk of this policy and form an integral part thereof.

2. The Insured shall forfeit entitlement to guaranteed benefit:

a) if when filling out the questionnaire the Policyholder or the Insured has been inexact or has omitted with fraudulent intent any circumstance known by him / her that may affect appraisal of the risk, the insurer may cancel the policy during the thirty days following the date on which it has become aware of this omission (Art. 10 of the Insurance Contract Act)

b) in case of aggravation of the risk, if the Policyholder or the Insured does not inform the Insurer and has acted in bad faith (Art. 12 of the Insurance Contract Act).

c) When the claim is the result of bad faith on the Insured's part (Art. 19 of the Insurance Contract Act).

3. The Policyholder may cancel the policy when the medical staff is altered, providing that it affects the family doctor or the obstetrician or the local paediatrician or half the specialists making up the medical staff provided by the Insurance Company, which shall keep the full updated list of these specialists at its offices at the Insured's disposal so that it may be consulted.

4. The policy shall be incontestable with regard to the Insured's state of health and the Insurer may not withhold its benefits alleging the existence of prior diseases when one (1) year has passed from the effective date hereof, unless the Policyholder or the Insured has acted with fraudulent intent.

5. In the event of the Insured not stating his correct date of birth, the Insurer may only contest the policy if the Insured's true age exceeds the established limits for this when the policy comes into force.

Otherwise, if the premium paid is lower than that really due because the Insured has not stated his / her age correctly, s/he will be under the obligation to pay the Insurer the difference between the amounts actually paid to it in the form of premiums and those that should have been paid in accordance with the Insured's true age.

On the other hand, if the premium paid is higher that what should have been paid, the Insurer will be obligated to refund the excess premiums received without interest.

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For more information your English Sanitas agent is: David Harris

Mobile / cell: (00 34) 609 522 300

email: saniprof@wanadoo.es or saniprof@mail.ddnet.es - thanks.

(Free messenger service - I cover the whole of Spain (click here...))

Answers to your queries Preliminary clause Definitions

I. Object of the insurance II. Excluded risks III. Bases, loss of rights, cancellation and incontestability of the policy

IV. Waiting periods (moratorium) V. Term of the insurance VI. Insurance premiums

VII. Policy-holder's and / or insured's obligations and duties VIII. Policy-holder's and / or insured's rights IX. Insurer's obligations

X. Duplicate policy XI. Complaints XII. Subrogation

XIII. Prescription XIV. Communications XV. Claim control and authorities

XVI. Other XVII. Jurisdiction

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