Policyholder, insured and beneficiary

When it comes to private health insurance, it is common to come across terms that, although they may seem similar, have different meanings. Understanding who is who within a policy is essential to know what rights and responsibilities each person involved has.

Here we will explain the differences between policyholder, insured and beneficiary,

1. The Policyholder: The person who is primarily responsible

The policyholder is the natural person or legal entity that signs the contract with Sanitas, that is, the person who signs the policy and pays the premium.

In short, this is the person who has a direct relationship with the insurer.

It is important to note that the policyholder does not necessarily have to be an insured person. For example, a mother can be the policyholder for a policy for her children (over 3 years old), assuming the payment and management of the insurance, but without benefiting from the medical services herself.

Rights of the policyholder:

• Modify the policy (add or remove insured persons, update data, etc.).
• Choose the coverage and conditions of the insurance at the time of contracting.
• Cancel the insurance if you so decide, according to the conditions established in the contract.

Responsibilities of the policyholder:

• Ensure that the premiums are paid on time and in the correct manner.
• Report any relevant changes to the insurer.

2. The Insured: The person covered by the insurance

The insured is the person whose health is covered by the policy. He or she is the person entitled to receive the benefits of the insurance, such as medical consultations, hospitalizations or treatments, as stipulated in the contracted coverage.

In a policy, there may be several insured persons, for example, all members of a family.

3. The Beneficiary: The person who receives the payment in the event of reimbursement

The beneficiary is the person who receives the economic benefits that the insurance may generate. In a health insurance which includes reimbursements, the beneficiary will be the person who receives the corresponding money.

Attention ! On many occasions, the term 'beneficiary' is used as a synonym for 'insured', although technically they are not the same; The insured is the one who receives the medical benefits, while the beneficiary is more related to the economic compensation stipulated in the policy.

Conclusion

Understanding the roles of policyholder, insured and beneficiary in private health insurance is essential to make the most of your policy and avoid confusion. Before taking out the policy, carefully review the conditions to know exactly who has what rights and responsibilities.

If you have specific questions or need advice, do not hesitate to contact us! We will be happy to help you find the insurance that best suits your needs.