Had an accident or loss?

Notifying the insurer

Report it on the spot: the insurer needs to send an adjuster and, after a theft, start searching for the vehicle. By law you have at most five days to give written notice unless the policy sets another term, and late notice can reduce your payment.

Documents usually requested

• Current policy and proof of payment
• Valid driver's license and official ID
• Vehicle registration card (tarjeta de circulación)
• Total loss or theft: original invoice endorsed to the insurer, proof of vehicle tax payments, plate cancellation, keys and the report filed with the public prosecutor
• Bank statement with CLABE in the insured's name for the payment

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

The adjuster decides the route: a repair order at a body shop or dealer, payment for damages, medical referral for the injured and, for total loss or theft, compensation based on the value set in your policy (commercial, invoice or agreed value) minus the deductible.

Watch out for

• Do not sign agreements or acknowledge debts without the insurer: they are not binding on it.
• Read the adjuster's statement before signing it and ask for a copy.
• Driving without a valid license or under the influence is usually excluded; check your policy.

Notifying the insurer

Give written notice of the accident or illness on your insurer's form. By law the limit is five days unless the policy sets another term.

Documents usually requested

• Signed accident or illness notice (or claim form)
• Medical report from the treating doctor
• Tests and results confirming the diagnosis
• For reimbursement: invoices (CFDI) in the name of the insured or policyholder, prescriptions and proof of payment
• Official ID and bank statement with CLABE

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

With direct billing, the insurer pays the network hospital and doctors and you cover the deductible, coinsurance and anything not covered. With reimbursement, you pay and the insurer refunds what applies. Payment is due 30 days after the insurer receives all the documents.

Watch out for

• Check waiting periods and pre-existing conditions before scheduling.
• Using hospitals outside the tier you bought can raise your coinsurance.
• Keep the originals of invoices, prescriptions and tests. We review your file before you send it.

Notifying the insurer

Notify the insurer in writing as soon as you can; by law the limit is five days unless the policy sets another term.

Documents usually requested

• The insurer's claim form
• Medical report and tests
• Medical bills, if your policy reimburses them
• For loss of limbs or accidental death: public prosecutor's records, expert reports and the death certificate, as applicable

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

Reimbursement of medical expenses up to the sum insured, or a payment based on your policy's schedule of benefits for loss of limbs or accidental death.

Watch out for

• Each loss has a percentage in the schedule of benefits in your general conditions; check it before you claim.

Notifying the insurer

Notify the insurer as soon as you can. The right to claim the death benefit of a life policy expires after five years; in all other cases, after two.

Documents usually requested

• Certified death record and medical death certificate
• Birth certificate of the insured
• Official ID, CURP and proof of address of each beneficiary
• Claim form and medical report requested by the insurer
• For accidental or violent death: the complete public prosecutor's records

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

The insurer pays the sum insured to the named beneficiaries; if there is none, it goes to the insured's estate. A guardian is usually required for minors. In savings or retirement plans, the value set in the policy is paid at maturity or surrender.

Watch out for

• Keep your beneficiaries up to date, in writing, with the insurer.
• If you want to name minors as beneficiaries, ask us how to appoint a guardian or set up a trust.

Notifying the insurer

Report it to the insurer as soon as it happens and confirm in writing; by law the limit is five days unless the policy sets another term. After a hurricane there are many claims: report early.

Documents usually requested

• Policy and proof of payment
• Photos and video of the damage
• List of damaged or stolen items with invoices, photos or other proof of ownership
• Repair estimates
• For theft, the report filed with the public prosecutor

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

The insurer repairs, replaces or pays for what is covered up to the sum insured, minus the deductible and, for hurricane, flood or earthquake, the coinsurance set in the policy. If you insured for less than the real value, unless agreed otherwise you are paid proportionally.

Watch out for

• Do not make permanent repairs without the adjuster's approval.
• Check every year that the sum insured is enough to rebuild your home and replace your belongings.

Notifying the insurer

Report it as soon as it happens and confirm in writing (five days at most unless the policy sets another term). For large losses the insurer assigns an adjuster and may appoint experts.

Documents usually requested

• Policy and proof of payment
• Written claim with an estimate of the loss
• Invoices, inventories, accounting records and repair estimates
• For theft, the report filed with the public prosecutor; for fire, the fire department's report if there is one
• For loss of profits: financial statements and sales for the period

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

Repair, replacement or payment according to the policy, minus deductibles and coinsurance. For large losses, advance payments can be agreed while the loss is adjusted.

Watch out for

• Keep a record of extra expenses to keep operating: some policies cover them.
• Do not throw away debris or do a full clean-up without the adjuster's agreement.

Notifying the insurer

The law requires notice as soon as compensation is demanded from you and, if there is a lawsuit, giving the insurer the information and evidence for your defense.

Documents usually requested

• The claimant's demand: letter, email or lawsuit
• Description of the facts, photos, witnesses and expert reports
• Related contracts, logs or files

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

The insurer pays the injured third party what is due up to the sum insured; the law treats that person as the beneficiary of the policy from the moment of the loss. Defense costs are covered according to your policy.

Watch out for

• Do not acknowledge debts or sign settlements without the insurer: they are not binding on it.
• Admitting that something happened is not admitting fault; the law tells them apart.

Notifying the insurer

Report it immediately: cargo policies usually set short deadlines for notice and for claiming against the carrier.

Documents usually requested

• Policy or shipment certificate
• Commercial invoice and packing list
• Waybill or bill of lading with the damage noted
• Claim to the carrier and its reply
• Police report, in case of theft

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

Compensation for the insured value of the damaged or lost goods, minus the deductible.

Watch out for

• Do not sign for the cargo as received “in good condition” without inspecting it.

Notifying the insurer

Notify the assistance center at the time. For reimbursements, check your certificate for the deadline to submit documents.

Documents usually requested

• Travel certificate or policy and passport
• Medical report and original receipts
• Luggage: the airline's property irregularity report and boarding pass
• Cancellation or delay: proof of the reason and of the expenses

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

Direct payment to providers in the assistance network or later reimbursement, according to your policy.

Watch out for

• Getting treatment without notifying the assistance center can reduce or void the reimbursement.

Notifying the insurer

The surety company may ask for information within the first 15 days and you have 15 days to provide it. Once the claim is complete, it has up to 30 days to pay or explain in writing why it does not apply.

Documents usually requested

• Written claim stating the amount claimed
• The bond and its endorsements
• The contract or guaranteed obligation
• Proof of the default: records, demands, settlements or rulings

Each insurer's claim forms are on its page, under “Documents and forms”.

How it is paid

The surety company pays the beneficiary what is due and then recovers that payment from the principal and the joint obligors, because the law subrogates it to the creditor's rights.

Watch out for

• If you disagree with the answer, you can go to CONDUSEF or to the courts.
• The claim interrupts the statute of limitations: the right expires after three years or the term of the guaranteed obligation, whichever is shorter.