Sunday 4 June 2023

Caja-INS Agreement says goodbye to the ¢6 million SOA barrier

Those injured in a traffic accident will now go directly to an INS medical center or hospital and remain there until recovered.

Paying the bills


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Paying the bills


QCOSTARICA – Those injured in traffic accidents will no longer be moved from the Instituto Nacional de Seguros (INS) – National Insurance Institute – care to the Caja Costarricense de Seguro Social (CCSS) when they reach the top of the ¢6 million colones of the Seguro Obligatorio de Automóviles (SOA) – Compulsory Motor Vehicle Insurance, which is charged once a year with the Marchamo.

Those injured in a traffic accident will not go directly to an INS medical center or hospital and remain there until recovered.

Now, due to an agreement between the CCSS and INS (both state institutions), patients of traffic accidents will continue in the INS care until they are fully recovered.

In addition, the INS will directly care for those injured in traffic accidents without first having to be taken to a Caja hospital.

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The aim of the agreement is not to occupy beds that can be used for covid-19 patients.

The general manager of the INS, Luis Fernando Campos, reported that they are ready to receive the more than 85 daily traffic accident patients that, on average, that has been the norm during the past several years, according to data from the Ministry of Public Works and Transportation (MOPT).

What is the SOA?

The Compulsory Motor Vehicle Insurance provided by the INS is charged annually and is a requirement to obtain the vehicle’s circulation permit, the Marchamo, and covers the injury and death of people (pedestrians and vehicle occupants), victims of a traffic accident, whether or not there is subjective responsibility of the driver.

The coverage is up to ¢6,000,000 (US$9,800 at the current exchange rate) per deceased or injured person.

Everyone injured in a traffic accident goes to an INS health center for treatment, there are 24 in the country, without exceptions. Patients with life-threatening or serious injuries go directly to the INS Trauma Hospital, in La Uruca.

Before the agreement with the Caja, INS patients who ran out the six million would be transferred to a Caja hospital. However, the difference is that now they will continue at the INS hospital, which in turn will bill the Caja, a procedure between institutions, that does not involve the patient.

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The SOA coverage also applies to injuries sustained on a bus or taxi and people of any age.

The INS president explained, “Children, adults or older adults, if they go in a car, bus or taxi and suffer an accident, now the INS takes care of them directly. Moreover, by regulation, if a person has their life at risk, that amount doubles, goes to 12 million and if those 12 million do is not enough, they are still kept in the INS until full recovery.”

This is with exceptions. “If an accident happens in a remote rural area and we do not have a care center, that person, if their life is at risk, will go to the nearest Caja hospital, but only for a matter of life or death,” said Campos.

The SOA is no-fault insurance, Campos explains “the SOA is for medical expenses and is not about fault, it is about physical harm,” meaning even if the driver is drunk or driving reckless, the coverage is intact.

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Another change that could soon be coming our way is an increase in coverage. Luis Fernando Campos confirmed that there is an ongoing discussion on raising the SOA beyond the ¢6 million, but did not specify when that would occur and what the new coverage would be.

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Paying the bills
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"Rico" is the crazy mind behind the Q media websites, a series of online magazines where everything is Q! In these times of new normal, stay at home. Stay safe. Stay healthy.

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