Group insurance: life, health and accidentsFAQs

In this type of insurance, the three roles are distributed differently from how they were explained in the first section. The policyholder is the company, which takes out the policy, signs it and is responsible for paying the premiums. The insured is the employee — and, in health insurance, optionally their immediate family — whose life, health or physical wellbeing is protected by the policy. The beneficiary is the person, usually designated by the employee, or the company itself, who will receive the payout if a claim occurs.

It's a single insurance contract that provides cover for a group of people — the workforce — linked by a common bond: their employment relationship with the company. Compared with taking out individual insurance for each employee, a group policy simplifies management and allows terms that aren't usually available under individual contracting.

It's the fixed amount of money the insurer will pay in the event of an employee's death or disability. It can be the same figure for the whole workforce, or calculated as multiples of each employee's annual salary, depending on how the policy was designed.

Total Permanent Disability for any occupation (IPA, Incapacidad Permanente Absoluta) compensates the employee if they suffer an illness or accident that irreversibly prevents them from carrying out any type of profession or trade. Total Permanent Disability for own occupation (IPT, Incapacidad Permanente Total) compensates the employee if they're unable to carry out the tasks of their usual profession, even if they could take up a different activity. The difference lies in the scope of the disability: unable to do any job at all, versus unable to do their usual job only.

It's the arrangement under which the employee allocates part of their gross salary to pay for health insurance. It lets them save on income tax, while for the company it has a net cost of zero euros, since it doesn't add an extra expense on top of the salary budget already committed.

It's an advantage exclusive to group policies at large companies, under which the insurer agrees to cover illnesses the employee already had before taking out the insurance, without penalising them. In an individual policy, those pre-existing conditions are usually excluded or require an extra premium.

It's another advantage of group contracting: it removes waiting periods, letting the employee use complex services — such as surgery or childbirth — from the very first day the policy is in force, without having to wait out the waiting periods usually required under individual policies.

Under the medical network option, the employee visits doctors under agreement with the insurer at no extra cost. Under the reimbursement option, the employee can see any doctor anywhere in the world, and the insurer refunds a high percentage of the bill, usually between 80% and 90%.

It's a policy the company is legally required to take out if the collective agreement for its sector requires specific compensation for employees in the event of death or disability from a workplace accident. It isn't a company decision: it's imposed by the collective agreement that applies to its activity.

A workplace or occupational accident is a bodily injury suffered by the employee arising out of or as a direct result of the work they carry out for the employer, and it includes commuting accidents — travelling to or from work. A non-occupational accident, or private-life accident, is one the employee suffers outside their working hours and professional duties — for example, a fall while skiing at the weekend. Voluntary company policies usually cover both settings, 24 hours a day.

It's the situation where, following an accident, the employee is not only unable to work but needs assistance from another person for the most essential everyday activities: dressing, eating, moving around. It's the most severe level within permanent disability.