Form 6012 EsSalud: Register in +Vida Accident Insurance

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This article is ideal for you if you want to join and insure yourself with It’s Health, you can find everything about its benefits and how to fill out the Form 6012.

Form 6012

Form 6012, As its name describes it, it is a form that must be filled out completely to process the registration of the owner and beneficiaries in + Life Insurance.

The following link is to download the Form 6012 in PDF format.

It is very important to read the conditions that appear in the form and make sure you comply with all of them, to avoid complications in the process. You must fill out all the fields requested by the form, in order to have a successful registration.

How to complete the Form

Completing Form 6012 is a really easy process if all the instructions are followed to the letter. This form is divided into boxes and tables to make the process much more comfortable.

The boxes divide the form by person, that is, there is the box that corresponds to the holder, another to the employer, the spouse or common-law wife, and another to the beneficiaries. Regarding the tables, they have codes for each option that we can choose, for For example, there is table number 2 that indicates the countries, where each country has a code, then you will place the code that corresponds to the chosen option.

To fill in all the requested fields successfully, follow these steps:

  1. To begin with, you need to download the original and updated form, you can download it from the link above.
  2. Later you must read the box where it says «IMPORTANT” all the indications and conditions to carry out the process. and make sure to comply with all the conditions established
  3. It will then proceed to print it.
  4. Once this is done, we will fill in the box called “Employer Identification”.
  5. In this part, table number 2 appears, where you must place the country, then you must look further down the form, where the tables appear and select the code that corresponds to the country and place it in the box.
  6. Box number 3 also appears, where you must indicate the type of Identification Document, as we did previously, you must go to the options of the corresponding table and enter the correct option, and then enter the employer’s identification number.
  7. After this we go to the «Holder Data» box, we will find box number 4, where we will indicate the type of operation, we place the code assigned to our option and indicate the option of tables 2 and 3, later writing the identification number of the owner
  8. In the same box we will place the full name of the owner
  9. We go to a subdivision of the box that corresponds to the owner, where all the data of the spouse or concubine can be indicated, just as we did with the data of the owner.
  10. Once this is completed, we go to the Beneficiaries Data box, we must expose the identification number of the beneficiaries, then table number 5 that corresponds to the link appears, then we will indicate the correct code and place the full name of each beneficiary.
  11. To finish with this box, we place the percentage that each beneficiary must pay, remembering that all the agreed percentages must add up to 100%.
  12. Then to complete the form, we indicate an email, the date of registration and the owner’s signature.

!Ready! We have filled out all the fields requested by Form 6012.

Registration of Holder and Beneficiaries
+Life Accident Insurance

What is?

+VIDA Accident insurance is the accident insurance belonging to the entity isHealth which provides its affiliates with economic support in cases of death and total or partial disability as a result of an accident. Your coverage is backed by partner insurers reinsurance and Rimac Insurance.

This institution provides protection 24 hours a day, every day of the year both inside and outside the nation.

isHealth It is a decentralized public body, which is committed to comprehensive care of the needs and expectations of the insured population. Its purpose is to provide coverage to the insured through the granting of prevention, promotion, recovery, rehabilitation, economic benefits, and social benefits, focused on health.

This entity was founded on August 12, 1936 and since then its vision is to be a leader in Social Health Security throughout the American continent, exceeding the expectations of insured people and employers in protecting their health and being recognized for its quality service, modern management and innovation. .

Its mission is like any public social security entity to provide protection for the insured population by granting health, economic and social benefits with excellence, quality, efficiency and good corporate governance, collaborating with the Peruvian nation to achieve Universal Health Insurance”.

isHealth It stands out for complying with all the principles of Social Security, such as: Solidarity, universality, Equality, Unit, Integrality and Aautonomy.


  • Compensates the member or beneficiaries for risks that arise due to accidents in the event of death or total or partial permanent disability.
  • It is a voluntary insurance, independent and complementary to other insurance.
  • The +VIDA Accident Insurance policy has a monthly validity, you have the option to renew it automatically through the monthly installments with the payment of the corresponding premium.
  • This insurance protects you as a member in case of disability, compensates your spouse or concubine, declared if the owner dies.

How is the proccess?

Before starting a process with +Life Accident Insurance, We must know the conditions that must be applied in order to be affiliated with this insurance:

  1. You must not have a serious physical condition such as blindness, deafness, paralysis or others that may significantly complicate and aggravate the risk.
  2. To be assured of +LIFE You must be: Agrarian Insured, Regular +INSURANCE Insured, Optional +HEALTH Insured, Affiliated to It’s Health.

For the registration and affiliation of holders and beneficiaries in +Vida Accident Insurance there are two options:

  • Affiliation of dependent workers to +Vida: The employer or responsible entity makes the corresponding payment through the mechanisms established by SUNAT.
  • Affiliation of independent workers to +Vida: The insured himself makes his payment through the mechanisms that are implemented in EsSalud.

Next we will explain how to register and join according to the options mentioned:

Affiliation of independent workers to +Vida


Identification document of the owner

The Form 6012 Registration of Holder and Beneficiaries + Life

To register you must follow the following steps:

  1. Download the Form 6012 and verify that you meet the established conditions and requirements.
  2. Print the form and indicate in it who or who your beneficiaries are.
  3. Request affiliation, for this toCome to any of the National Insurance and Economic Benefits Offices and request your affiliation to +Life.
  4. Proceed to pay your insurance.
  5. Pay your monthly insurance premium at Banco de la Nación.

Affiliation of dependent workers to +Vida


Follow the instructions below:

  1. Download the form and verify that you meet the established conditions.
  2. Print the form and fill it out.
  3. Request affiliation, to achieve it you must request to your employing entity, responsible entity or boss who makes the payment of of your monthly insurance premium through the collection mechanisms implemented by SUNAT.

!Important! If you want to report an accident, you must call the number 012110211 in Lima or 080010800 in the provinces.


  • It allows the holder and his direct relatives to have comprehensive medical care in the situation in which they find themselves.
  • Economic support so that difficult moments are more bearable, such as the death of one of the family members or any other loved one.
  • Comfortable payment system.
  • Necessary guarantees to cover a situation of disability or dependency as a result of an accident or illness.
  • Grants health benefits, protection, welfare, social promotion and economic benefits to the workers of an employer entity.
  • Possibility of modifying the policy over time.
  • It offers peace of mind and well-being to those who hire them, providing them with the necessary support and protection.

Benefits of the Affiliate Holder:

  1. In the event of the owner’s death, +Vida grants an amount of up to
  2. S/75,000.00as well as special coverage for mourning and funeral.
  3. For total or partial permanent disability, the holder can receive a little more than S/54,000.00.

Benefits of the Spouse or Concubine:

  1. For accidental death or total permanent disability due to accident, receive up to S/36,228.15.
  2. Additional coverage for family abandonment and for the death of both parents in the same accident is granted. S/46,004.00.
  3. In addition to this, if the concubine or spouse is pregnant with the holder and he dies, she will receive S/2,300.00.

Other benefits:

  1. Death by burning, drowning, or electrocution receives S/1,725.15.
  2. Total and definitive loss of hearing or vision, receives in the same way an amount of S/1,725.15.
  3. For amputation of both arms or both legs you also receive S/1,725.15.

Additional Special Coverage Benefits:

  1. Mourning and burial benefit: is received by advance benefit S/6,900.60. This applies when both the owner and his spouse or concubine die or when the death is only the owner, the same amount is still received.
  2. Special Life Coverage: Accidental death due to medical negligence that has been declared in a final sentence, is granted S/18,041.60.

Now that you know everything about the services and benefits of +Life Accident Insurance, EsSalud you can begin to enjoy this entity and thus provide you and your family with the security and protection they need.

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