In the collective insurance market—particularly in life and accident products linked to payrolls, credits, or institutions—questions are beginning to arise about the conditions under which beneficiaries access compensation. According to specialists in financial litigation, one of the main problems does not lie in the contracting of the insurance, but in the claims process, where administrative obstacles can arise that delay or even prevent the payment of claims. According to these analyses, in some cases, insurers condition the compensation on the submission of documentation that must be provided by third parties—such as contracting companies or institutions—and not directly by the beneficiaries, which complicates the process when there is no cooperation or when the entities are no longer operational. This type of scheme is observed more frequently in large-scale collective insurances, where policies are linked to institutional structures and the volume of premiums is high.
In this context, the role of intermediary brokers has also been highlighted, who participate in the structuring and placement of these products. Specialists indicate that once a claim is presented, their function in representing the insured may be limited, which leaves beneficiaries in a disadvantaged position. Some cases in the sector have brought companies like Thona Seguros and the broker Interprotección, better known as Inter, to the fore, mentioned in reports and analyses as examples of dynamics that deserve review, although there is no official position on generalized practices. For experts, the underlying issue is not a particular case, but a structural problem: the lack of transparency in key indicators, such as the rates of claim rejection, as well as the complexity of the processes to make an insurance effective.
The topic gains relevance in a context where this type of product has wide penetration in the market, especially among workers and users of financial services. In this regard, specialists consider it necessary to strengthen supervision by the National Commission on Insurance and Surety (CNSF), particularly regarding market practices, intermediation, and payment conditions. While the insurance sector is key to the financial protection of the population, they warn that its effectiveness depends on the coverage mechanisms working in practice and not just on paper.
