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Shkruar nga Pamfleti
Insurance has one mission: it only covers damages that occur after the contract is concluded and the premium is paid.
They cannot cover events that have occurred previously, nor damages created before the moment of insurance. Insurance is an agreement and as such has obligations for the parties, the insured and the insurer.
Essentially, insurance companies financially recover damages according to the terms of the contract, always in accordance with the legislation and rules of the Supervisory Authority.
Essential time
Time in insurance is essential. Therefore, it is very important that insurance starts at the right time: as soon as we buy a car, as soon as we buy an apartment, as soon as we build a house or a factory. Insurance should be thought about at a young age, especially for life and health insurance. Insurance also has its deadlines, that of activating the policy and its expiration. These are clearly stated in the insurance contracts.
The earlier the insurance starts, the stronger and more stable your insurance history becomes. An uninterrupted history gives security to the customer and trust to the company. A stable and reliable history with the company shortens what is known as the waiting period when the coverage provided in the event of a claim under the insurance contract comes into effect (in the case of health insurance).
Understanding the insurance contract
In practice, we have often seen expectations raised by clients that do not comply with the basic principles of insurance, neither with the letter nor with the spirit of the terms of the contract signed between the parties.
Simply put, it happens that clients give their consent to the benefits, but avoid the conditions and obligations. However, the basis of any contract and taking out insurance is a contract, it means simultaneously assuming certain rights and certain responsibilities.
Categories observed from practice
In practice, people have also been observed who:
want insurance coverage, but avoid the requirement to complete pre-insurance questionnaires;
other people who want coverage, but only after they have determined that they are already sick;
want coverage, but without paying regularly and without reactivating their insurance contract in a timely manner;
they want coverage with no waiting time and no conditions attached, even though they know how important customer history is in a relationship of trust;
they want coverage but do not accurately and thoroughly complete the damage reporting file, clearly stated in the contract terms;
raise coverage expectations, aiming for the most maximum protections, the highest coverage limits, with the most minimal costs (outside of any logic and in conflict with the signed contracts).
Various cases from practice
A travel health insurance, as we often notice, does not cover a 20–30–40–100 thousand euro operation. It is enough to read the insurance contract carefully. It is enough to read the product conditions carefully. Nowhere does travel health insurance exceed this type of coverage. Moreover, there are other products: health insurance, “Gold” cards that go up to 1 million euros in coverage, as well as those that offer coverage for serious illnesses. Of course, their prices are higher. Asking for surgical interventions that cost thousands of euros with a 5 euro insurance, which only provides for outpatient emergencies, is as illogical as it is a misunderstanding of how insurance works.
With basic home insurance against fire, you cannot expect coverage for every damage that occurs to your home: that insurance does not cover earthquakes and floods, unless the client requests and activates them as additional coverages.
An insurance policy for the amount of the obligation as a loan to the bank, in the event of damage, will only cover the value of the obligation to the bank. Additional insurance is needed to benefit from the full value of the damage that your apartment left as a mortgage lien (collateral) may suffer.
A TPL insurance covers material and immaterial damages to third parties, but the insurance company has the legal right to claim back the value of the damage from the person who caused the accident if he is in violation of any of the 6 conditions provided for in article 23 of law 32/2021.
A damage report file, legally, like anywhere else in the world where contracts are legal, cannot benefit from compensation without being completed with all the necessary documentation.
Products have their own conditions, specifications, and exclusions. On the official websites of the companies, along with each product, the conditions for taking out insurance as well as the terms of the insurance product are published.
Not everyone is informed.
These conditions must be studied by the client; company representatives are there to answer any questions. Every company, when signing an insurance contract, assumes that the first step the client has taken is precisely the study of these conditions, rights (benefits) and obligations (conditions to be met).
Of course, here we want to add that not everyone is uninformed. A certain segment, from the beginning, starts with the idea of benefiting outside of what the insurance contract provides, to improperly benefit from coverage that does not belong to them and for which a contract has not been signed. This, in addition to being incorrect, is also illegal. Insurance fraud is a criminal offense provided for in the Criminal Code of the Republic of Albania.
Insurance is an agreement of mutual trust and responsibility. It operates on the principle of fairness, transparency and risk management. Insurance does not make you rich; it protects you from losing everything and will be there when you need it most, after a claim./ sigurime.online
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