Short Term Insurance

Social security systems, short and long-term insurance: Which one is better

These were born on December 4, 1956 through the promulgation of the CS:S: whose system is structured through the promulgation of the CS:S: whose system is structured under the principles of Unity, Solidarity, Universality and Efficiency, in the framework of the conceptualization of the labor thesis that establishes the Right to Social Security for all salaried workers in the country.

 Short Term Insurance

They are the insurances that manage the immediate contingencies of life and work, granting them the right to receive the medical attention that is considered essential for their cure and rehabilitation due to: Common Disease, Maternity and Professional Risks (Work Accident and Professional Disease), with the financial support of the employer contribution of 10% on the monthly income of each worker.

The National Health Fund is the only manager of short-term insurance, covering benefits in services, in kind and money and supervising compliance with family allowances that are disbursed from employer funds.

Common Illness Insurance

It covers all the immediate contingencies of daily life, such as common illnesses and accidents, understood as such to any pathological state, organic injury or functional disorder contracted in daily life, which is not related to work activity, covered by the labor contribution of 1.71%.

The worker enjoys the temporary disability subsidy equivalent to 75% of the monthly salary, granted by the Health Insurance.

The first 3 days are 100% the responsibility of the employer company and from the 4th day, only 75% of their contribution salary is recognized, which will be affected by 25% that is not covered by the company.

• Professional Athletes within the Scope of Application of the LGT

If there are no possibilities of recovery within the established periods, it may be determined to be transferred to the Long-Term Pension Scheme, that is, retirement.

maternity insurance

According to Art. 27 and 31 of DL 13214 of 12-24-75, it is a right that the working woman, wife or partner of the active insured or annuitant has, to receive the specialized surgical medical services of External Consultation and Hospitalization for the pregnant woman, granting the worker temporary maternity leave, which consists of 45 days before and 45 days after childbirth, provided that they are not working for pay during these periods, which would imply acting against the end of the subsidy, as of the date This last provision is applied in the CNS, as long as the insured has 4 contributions prior to the month of disability.

It is clear that the doctor cannot accurately establish the end of the pre-delivery subsidy, so it is suspended once the delivery is carried out or it is increased if it is not given in the expected time, in the case of the post-delivery subsidy, it can be increased if as a consequence cases of illness occur and therefore the limit is established by the doctor.

Together with this insurance, it contemplates the benefit of Family Allowances.

According to DS 20991, of 08-01-85, the pregnant worker also enjoys Temporary Maternity Disability, at a subsidy equivalent to 90% of her monthly contributory salary (month prior to the start date of the temporary disability), for a period of 45 days before and after delivery.

• Long Term Insurance

The remaining 10% is paid by the employer in accordance with Art. 89 of the GT In case of PARTIAL AND TEMPORARY disability, compensation that will be equal to the full salary for the duration of the disability, provided that it does not exceed 6 months; Since the month prior to the worker’s leave must be taken as the quoted month, it is worth noting that this quoted salary cannot be reduced even if the post-partum period is extended.

Professional Risk Insurance

They cover the contingencies of work or that are a consequence of it, it is possible to say the accident at work, the professional illness, financed by the employer’s contribution of 1.71% of the: to the cattle; they start or are beneficiaries from the ler. day of the occurrence of the accident or recognition of the occupational disease, with the lower person entitled to 26 weeks of temporary disability, extendable to 26 weeks, prior opinion of the Benefits Commission, as long as there is the possibility of full recovery. These benefits will cease if the worker recovers his health or if he is declared permanently partially or totally disabled by the treating physician.

The accident at work

Under the combined tenor of Arts. 81 of the LGT and 27 of the CSS, an occupational accident is understood as any organic injury or functional disorder produced by the sudden and violent action of an external cause, on the occasion of or as a consequence of work, and which originates the decrease or loss of the capacity of work, earnings of the worker and until the death of the same.

Also included in this parameter are “In Itinere” accidents , understood as those that occur on the normal and logical route between the worker’s home and the source of employment, and vice versa, or when he leaves the source of work for strictly work-related reasons. .

 Occupational Disease

According to Art. 27 of the CSS, occupational disease is any pathological state produced as a result of work, whose evolution is slow and progressive, determining a decrease in the insured’s ability to work and earnings and which is also caused by the action harmful agents found in work environments.

For its part, the LGT in its Art. 82 provides: «The occupational disease must be declared for the exclusive purpose of work and must have been contracted during the year prior to the appearance of the incapacity caused by it.

Rights for Work Accident or Occupational Disease

In the combined application of Art. 28 and 29 of the CSS, in the event of an accident at work or professional illness, the insured from the occurrence of the accident at work or the recognition of the professional illness, up to a maximum of 52 weeks, is entitled to two types of benefits:

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