Protect

From the third year of the policy and while it is in effect on payment of premium, the payable benefit or benefits will be adjusted by increasing by the percentage corresponding to the policy year in which the covered event occurs. It fluctuates between 3 and 15 percent.

We will pay expenses incurred for housekeeping service up to $50 daily, not to exceed $1,000 per lifetime of the insured. The attending physician must recommend the need for the service and services provided by immediate family members of the insured are excluded.

Usual and customary charges for ground ambulance service for transportation to and from the hospital where the patient is being held for treatment of cancer or dreaded diseases. For residents of Culebra and Vieques, the ambulance service includes air ambulance service.

In addition to the surgical procedure, we will pay up to 30% of the cost for anesthesia service. For skin cancer operations, the cost will be up to $100 per operation.

We will pay the insured who received the diagnosis and other included insured, including medical visits to psychiatrists or psychologists, up to $100 per visit not exceeding the aggregate limit of $3,000 for all the insured, if it’s ordered by the attending physician.

Diagnosis of first occurrence of cancer

We will pay $ 1,750 upon the receipt of the first proof of cancer diagnosis after the effective date of the policy. You pay only once during the life of the insured.

We pay the expenses incurred for wigs, special brassieres, hormonal therapies, lymphatic system massages, acupuncture, nutritionists, chiropractors, and naturopaths to improve the quality of life of the insured diagnosed with cancer or dreaded disease up to $100 per month, not to exceed $1,200 per lifetime of the insured, if they are ordered by the attending physician. Services provided by immediate family members of the insured are excluded.

We will pay up to $225 per procedure to remove or burn skin cancer with electricity or nitrogen.

We will pay up to a maximum of $8,500 per surgery for a cancer or dreaded disease condition, according to the policy’s Surgery Table. In case of being subjected to multiple or bilateral procedures during a single surgery, the major procedure plus 50% of the lesser one will be paid.

We will pay additional compensation during the time when an insured parent did not work for his employer as a result of directly caring for an insured child during treatment for cancer or dreaded disease, up to $50 per working day lost by one parent or up to $100 per working day lost by both parents. This benefit is payable after exhausting any employment paid leave to which the parent is entitled.

We will pay the expenses incurred by surgical procedure or medication for erectile dysfunction as a result of prostate cancer, up to $250 for a policy year, if the attending physician orders it.

As a result of cancer or dreaded disease, we will pay up to $5,000 during the first policy year and an annual increase of $250 until reaching $6,500 to the person submitting satisfactory evidence of having incurred in funeral expenses of the deceased insured. The excess of the benefit will be paid to the designated recipient(s).

Benefit of nursing home admittance up to $115 a day for the first 10 days and up to $60 for the next 20 days, similar period to which the insured was hospitalized, or 30 days, whichever is less, as duly ordered by the attending physician.

Of the benefit paid for hospital, we will pay an additional 25% for drugs service.

Usual charge not to exceed $5,000 for breast implants, unilateral or bilateral breast reconstruction surgery, as long as it is as a result of a previous amputation due to breast cancer for which benefits were paid under the policy. We will also pay the usual and customary charge for external prostheses up to one per policy year.

You will receive $800 per month while hospitalized for cancer or dreaded disease.

After the policy has been in force for 24 consecutive months, we will pay up to $50 annually per member covered in the policy for preventive tests aimed at detecting the presence of cancer.

We will pay for the expenses incurred for drugs that control symptoms of nausea caused by chemotherapy, up to $150 per chemotherapy, not to exceed $1,500 per lifetime of the insured.

We will pay up to $125 per daily doctor visit, other than the surgeon, while hospitalized as a result of cancer or dreaded disease.

We cover up to a maximum of $3,500 for other prostheses required due to amputation. For all other prostheses, other than breast, we pay up to $500 per lifetime of the insured.

Usual and customary cost of all initial tests required for a diagnosis of cancer or dreaded disease. This benefit starts at $600 with an annual increase of $100, up to $1,300. If the policy is reinstated, the benefit is reduced to the initial $600 maximum.

To the extent that the charge is not covered by the Hospitalization Benefit – Extended Coverage, as a result of cancer or dreaded disease, we will pay the charges incurred for X-ray tests, CT scans or MRI, to the maximum of $500 for a policy year, not exceeding $1,000 per lifetime of the insured.

Benefit up to $10,000 annually for radiotherapy, chemotherapy, experimental therapy and other treatments to be administered as an alternative to these, as ordered by the attending physician.

Regular Coverage: We will pay $400 for the first day, $350 per day from the second day to the tenth day, and $250 per day from the eleventh day to the sixtieth day, while you are continuously hospitalized for treatment of cancer and dreaded diseases. One day of hospitalization means a period of 24 consecutive hours. A single hospitalization period is considered when two or more periods are separated by 31 days or less.

Extended Coverage: Starting on the sixty-first day of uninterrupted hospitalization as a result of cancer or dreaded disease, we will pay 100% of charges incurred and supplies provided by the hospital, up to $25,000 monthly.

Second opinion

We will cover up to $200 for a second medical opinion related to a surgical procedure for cancer or dreaded disease (except skin cancer).

Blood and plasma

Usual and customary charges for blood and plasma not covered by Hospitalization – Extended Coverage in excess of the credit received by donation.

If the attending physician declares the condition of terminal cancer and the insured is sent home after a hospitalization, we pay up to $60 per day for the first 60 days and up to $25 for the following 120 days.

We will pay up to $75 per day, not to exceed $1,050 per lifetime of the insured, for home nurse service that is ordered by the attending physician for the treatment of cancer or dreaded disease, other than you or any immediate family member.

While you’re hospitalized, we will pay a maximum of $125 per day for professional nursing services ordered by the attending physician, other than you or any immediate family member.

We will pay the expenses incurred for legal services following the death of the insured due to cancer or dreaded disease up to $300. Services provided by an immediate family member of the insured are excluded.

Insured: We will pay for standard economy air fare from Puerto Rico to the hospital that will provide special treatments for cancer and dreaded diseases ordered by the attending physician and that are not possible to obtain locally.

Companion: We will pay for standard air fare and affordable lodging for an adult relative of the insured to accompany him or her in hospitalization outside of Puerto Rico, up to $4,500 for any 12-month period.

Ground transportation: We will pay the expenses incurred by rental car up to $100 per day, not to exceed $500 during policy year.

We will pay up to $1,750 for transportation expenses incurred by transporting the insured’s remains to Puerto Rico if he or she dies as a result of cancer or dreaded disease while receiving medical treatment. This benefit will be paid as an additional amount to the funeral benefit.

Benefit for charges incurred or compensation payable for positive postmortem diagnosis of cancer (after the death of the insured) starting from the period of the last hospitalization.

We will pay the expenses incurred by the HPV vaccine to teenaged insured (between the ages of 11 and 18) up to $50 per vaccine and up to $150 per lifetime of the insured.

We will waive the policyholder the monthly basic policy premium payment from the date of positive diagnosis of cancer up to 60 months or until the date of death.

This supplement cancer policy benefits if you suffer an illness.

• The benefit of compensation for hospitalization due to illness provides that, if as a result of a disease, you or your spouse have to be hospitalized, a daily benefit of $25.00 and $12.50 will be paid for a dependent child. If the hospitalization period is less than a month, we will pay based on 1/30 of the monthly allowance for each day spent in the hospital. Two periods of hospitalization due to the same illness separated by less than 30 days will be considered part of the same hospitalization period.
• The home convalescence benefit will be paid at half the daily hospitalization benefit, not exceeding 30 days or a period equal to that of hospitalization, whichever is less.

This supplement to the cancer policy provides benefits if you suffer an injury due to an accident. It was expanded to include compensation to other benefits related to different types of accidents.

• The benefit for torn tendons and ligaments covers the reparation of a tendon or ligament as a consequence of an accident. We will pay compensation between $300 and $600; for a dependent child, between $150 and $300.
• The benefit for lacerations requiring sutures covers you if you suffer from any laceration as a result of an accident, regardless of the size of the wound. We will pay compensation between $100 and $500; for a dependent child, between $50 and $250.
• The benefit for mutilations covers you in case of a mutilation to the fingers on the hand or foot. We will pay compensation between $150 and $600; for a dependent child, between $75 and $300.
• The benefit for dislocation covers a dislocation in the hip, knee, clavicle, sternum, shoulder, ankle, foot, hand, jaw, wrist or elbow, toe or finger. We will pay compensation between $200 and $1,500; for a dependent child, between $100 and $750.
• The benefit for ambulance provides $59 for ground transportation of the insured, by ambulance authorized to operate as such by pertinent authorities, to the hospital or CDT where he or she will receive treatment for an accident.
• The benefit for support equipment will pay $75 per equipment or device that will help you regain mobility during recovery from an accident for which benefits were paid for this endorsement.
• The benefit for follow-up visits will pay $25 for up to follow-up three visits for a treatment for which benefits were paid for this endorsement.
• The benefit for emergency medical treatment due to an accident provides up to $800 per accident if you and your spouse require medical treatment at an emergency room or CDT or emergency surgery due to an accidental bodily injury, for expenses incurred for services rendered with payment obligation by the insured. Each child has a maximum benefit of $400.

The annual limit for benefits payable under this endorsement will not exceed $3,200 in any policy year.

One of the biggest concerns for people is the loss of income due to illness or accident. This loss usually prevents us from meeting the needs of our families in the way we are accustomed. Therefore, we need to protect ourselves in case of this eventuality.

• The total disability benefit provides income you whenever you become disabled through accident or illness. It is a requirement that the insured person is under medical care to qualify for these benefits. You can purchase this benefit in units ranging from $250 to $1,000 monthly. This period of disability shall not exceed twelve (12) months.
• Upon starting a disability period, benefits will be paid from the fifteenth day. The total disability benefit is provided only to the primary insured.

This supplement to the cancer policy provides benefits if you suffer an injury due to an accident.

• One of the available benefits is that for accidental death. You can choose the plan that best suits your needs, from $15,000 to $100,000. In all plans, as the primary insured you will have 100% of the profit gained. In plans with additional members, the maximum coverage for the spouse is $15,000 and $5,000 for each dependent child.
• The benefit for dismemberment covers you if you lose a limb or your sight in an accident. If you purchase a plan with additional members, your spouse and children are also covered by this benefit in the aforementioned amounts.
• The benefit for compensation for hospitalization due to an accident will pay a monthly benefit if you are hospitalized following an accident. The payable monthly benefit varies between $900 and $3,800, depending on the selected plan. If the plan selected covers your spouse and children, the monthly benefit to be paid in case of hospitalization due to accident will be $900 per month. If the hospitalization period is less than a month, we will pay based on 1/30 of the monthly allowance for each day spent in hospital.
• The benefit for compensation for home convalescence paid for each day of home convalescence due to an accident. This period of home convalescence can follow a hospitalization or simply be recommended by your doctor without having stayed at a hospital.

• This endorsement will add to your cancer policy additional compensation in a lump sum that will help you face the many expenses during the recovery process.
• The compensation you choose is payable when a cancer diagnosis is made for the first time after the waiting period has elapsed, which will specify the frame of the policy.

• This endorsement adds to your cancer policy compensation in a lump sum that will help you if you are diagnosed with a heart attack for the first time or you undergo major heart surgery for the first time.
• The compensation you choose shall be payable when one of these events happens after the waiting period has elapsed, which will specify the frame of the policy.
• The benefit of first major heart surgery is equal to twenty percent (20%) of the benefit for the first diagnosis of heart attack

Throughout our lives, we can suffer accidents or serious illness requiring hospitalization in the intensive care unit of a hospital. These units, for their particular equipment, are generally expensive and could affect our finances. The endorsement for intensive care will help you deal with these unexpected costs.

• We offer two types of coverage that provide daily benefits between $250 and $650 with a benefit of $3,750 to $9,750 per hospitalization period. We will pay a maximum of fifteen (15) days whenever you need to be hospitalized in the intensive care unit of a hospital. Coverage begins on the first day if the hospitalization is caused by an accident or illness. Two hospitalization periods due to the same disease or injury separated by less than 30 days will be considered part of the same hospitalization period.
• If you purchase a coverage that includes several dependents, the coverage extends in the same amount for members of your family.

This is one of the most important endorsements due to increased frequency and high cost of transplants. This endorsement helps you meet these expenses if you have to submit to an organ transplant. We reviewed this benefit and applied it to all cancer and dreaded diseases policies that were sold prior to including it. The innovation is that we have determined to pay an initial amount or compensation for each type of transplant performed:

• Heart $75,000
• Cornea $1,000
• Liver $50,000
• Intestine $100,000
• Bone marrow (allogeneic) $65,000
• Bone marrow (autologous) $30,000
• Pancreas $25,000
• Lung (single) $40,000
• Lung (double) $60,000
• Kidney $25,000

If it is a multivisceral transplant, we will pay for the compensation for the organ transplant whose compensation is greater. The following benefits pay 100% of the expenses incurred and paid by the insured in excess of the aforementioned indemnity benefit:

• Acquisition of organ and tissue (deceased donor) up to $10,000
• Acquisition of organ and tissue (living donor) up to $25,000
• Bone marrow culture up to $10,000
• Transportation, lodging and meals up to $10,000
• Expenses of hospital room and other services and materials up to $1,500 daily
• Private nurse up to $10,000
• All other expenses

• $175,000 for any organ transplant
• $500,000 for all transplants of different organs during the insured’s lifetime