Seguro de accidentes personales, ¿cuándo me cubre?
La Ley establece que, para que se considere accidente y el seguro de accidentes personales deba pagar la prestación, debe producirse una lesión corporal que derive de una causa violenta súbita, externa y ajena a la intencionalidad del asegurado, que produzca invalidez temporal o permanente o la muerte.
Por lo tanto, tal y como establece el artículo 100 Ley 50/1980, para que el seguro de accidentes pague deberás tener en cuenta que haya una lesión corporal. Además deberá ser consecuencia de una causa violenta súbita y externa. Además deberá ser ajena a la intencionalidad del asegurado (el asegurado y víctima no deberán haberlo hecho con intención). Y por último deberá haber producido invalidez temporal, permanente o la muerte.
Si no se dan todos estos criterios la aseguradora declinará tu reclamación. Por eso es muy recomendable que en casos de conflicto con la aseguradora, o antes de acudir a ella para cobrar, te asesores con alguien que entienda del asunto para saber si en el caso del accidente realmente se cumplen los criterios necesarios para reclamar.
Habitualmente, peritos médicos muy expertos son los que determinan si se han dado los criterios aquí reflejados para que, como beneficiario o asegurado, puedas cobrar la prestación.
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