EL SEGURO PRIVADO DE DEPENDENCIA COMO MECANISMO DE PREVISIÓN VOLUNTARIA DE LA DEPENDENCIA.

Abstract

Additional Provision Two of Act 41/2007 of 7 December regulating the mortgage market and other rules of the mortgage and financing system and regulating reverse mortgages and long-term care insurance introduces the insurance policy as a private way of financing long-term care and bearing the high costs therein involved. The legal bases of long-term care insurance are grounded in mere references to legislation, which are entirely insufficient and require a great deal of work to be done in legislative interpretation and in the adaptation of general insurance regulations to the special features of long-term care insurance. Insurance companies have certain obligations to discharge should a long-term care situation occur as envisioned in section 2.2 of Act 39/2006 of 14 December to promote personal autonomy and care for persons in a situation of dependence. This article gives an analysis of a number of issues concerning the policyholder and the insured person, followed by a discussion of the obligations assumed by the parties, particularly: the duty to declare all circumstances necessary for the proper definition of the risk; the duty to report the claim; premium payment and the different types. One especially significant obligation incumbent on the insurance company is the duty to inform the policyholder properly. Moreover the article examines different variations of the benefits insurance companies are called upon to provide, ranging from mere sums of money to benefits in kind or in the form of services, or both at the same time. As regards how a long-term care insurance policy behaves over time, the article discusses: the point at which insurance policies begin providing the benefits they owe; the legal consequences of negligent delay in benefit performance attributable to the insurer; policy cancellation, at the request of the insurance company or the policyholder, and the right to abandon the contract unilaterally. Because this mode of insurance may be taken independently or as part of a pension plan, the terms governing all matters not regulated by the policy are the terms of the Revised Act Regulating Pension Plans and Pension Funds, approved by Royal Legislative Decree 1/2002 of 29 November. The article ends with a brief reference to the taxation on this type of insurance.