Frequently asked questions about Payment Protection Plan (PPP)

The Protection Plan insurance helps minimize the impact of unemployment or illness by providing compensation for income loss. In case of death or permanent disability due to an accident, compensation is provided up to the amount specified in the Particular Conditions.

Waiting period is the period between the subscription date and the earliest date a claim can be filed. For Protection Plan insurance, this period is 90 days.

Absolute temporary incapacity for work (illness or accident) and involuntary unemployment

Payment is made after 30 days, covering eligible expenses for up to 6 months. Once regular activity resumes, new compensation can be requested 6 months after the last medical consultation or treatment related to the prior incapacity.

Involuntary unemployment (employees)

Payment is made after a period of more than 30 days, with reimbursement of expenses covered for a maximum of 6 months.
After returning to regular activity, new compensation can be requested after 6 months of permanent full-time employment.

Hospitalization (self-employed workers)

Payment is made after a period of more than 7 days, with reimbursement of expenses covered for a maximum of 6 months, after which coverage for temporary total disability for work can be activated for 11 months.

Payment of capital in case of:

Death or permanent disability

Death: in the event of death of the insured person as a result of an accident.

Permanent disability: a condition of lasting functional limitation resulting from an accident.

To calculate compensation, a permanent disability deductible of 9% is applied.

Only devaluations of 10% or more will be considered for death or permanent disability coverage. For permanent disability, devaluations of 66% or more will be considered as 100%, entitling the insured to the full amount of coverage.

You must go to a branch and fill out the claim report. In addition, you must submit some documents required for the claim analysis.

You must report the claim as soon as possible, considering the waiting period and the coverage activation terms.

Absolute temporary incapacity for work:

• Photocopy of reports of additional diagnostic tests;
• Photocopy of the Hospital Discharge Note Report
  (Documents must be attached to the claim report, if available);
• Photocopy of the Dismissal and Renewal Bulletin
  (must be sent to Ocidental whenever you complete more than 30 days of incapacity);
• Photocopy of invoices/receipts of expenses debited in the account relating to the period of incapacity
  (for the Salary Protection Plan and the Expenses Protection Plan, the document must be sent monthly for reimbursement to Ocidental);
• Photocopy of tax return
  (Document must be sent every month in the case of Temporary Insurance or Monthly Income Protection).

Death compensation:

• Death certificate;
• Heir Qualification Certificate, whenever there are no designated beneficiaries. Certificate of the complete copy of the birth record, whenever there are minors;
• Autopsy report and results of toxicological blood tests and Police Report if death results from a road accident;
• A declaration from the Transport Company stating that the vehicle was on public transport service (whenever the claim is due to a public vehicle).

Permanent disability compensation:

• Medical report with the injuries suffered and the degree of devaluation of the permanent disability assigned based on the Personal Accidents devaluation table that is part of the General/Special Conditions of the Personal Accidents branch;
• Report of Occurrence whenever the accident is due to a road accident.

Unemployment:

• Photocopy of DGSS Model RP 5044
  (provided to the worker by the employer for Unemployment Subsidy application);
• Declaration from the Employment Center where you registered proving your registration
  (this document must be claimed at the Employment Center 30 days after the Unemployment start date and sent monthly to Ocidental);
• Written notice indicating the date you started your activity at the last company;
• Copy of the Employment Contract and Termination Letter.