COVID Insurance in Chile

Published 29 September 2021

Among the many and constant changes forced by the pandemic, Chilean legislators passed a new mandatory health policy against COVID 19 (by means of Law No. 21,342 for the gradual and safe return to work). Following, its main characteristics: (1) its hiring and financing is responsibility of employers; (2) it applies for all employees who provide services in the private sector and to the extent that their contracts are regulated by the Labour Code; (3) its term will be of one year from its respective contracting, but in any case, the obligation of the employer to hire it will persist for the workers under “face-to-face modality” until the end date of the health alert; (4) it can be contracted with any of the authorized insurance companies; (5) it covers hospital and worker rehabilitation expenses (applicable after the coverage of the respective pension health entity – FONASA, ISAPRES); (6) it indemnifies for approximately USD 7,000  in case of death from COVID-19; and (7) in its coverage, it should be applied in preference to any other individual or group health insurance policy which includes the reimbursement of medical expenses in which the worker is insured.

The above brings a number of issues when handling a COVID-19 claim related to an employee, beginning with the discussion if said claim may fell under the concept of occupational disease, interaction between the applicable policies, burden of proof in case of a claim, among other issues, all of which may be resolve as claims start to rise.