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Insurance in Spain

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1. General information

Insurance is a contract relationship entered into by the insurer and the insured. Such a contract, more commonly called the policy, usually provides that, on payment of the premium, the insurer promises to indemnify and reimburse the insured for any loss incurred by him from certain stated causes.

The policy, as a contract, must contain all of the elements necessary for a valid contract. The mutual considerations here are the premium paid by the insured and the promise of coverage made by the insurance company.

The causes of damage as provided for in the policy are also called "risks". The company specifically stipulates those risks which are covered under the particular policy. Any risk that is not stated shall not be included.

A policy must have a subject which is to be insured. It may be the life of a designated person, a house…

The risk or peril against which the life or property is to be insured must be specified in the policy: the death of a person, liability resulting from the negligent operation of an automobile…

The amount for which the policy covers the loss must be indicated.

The insurance taker is the holder of the policy. Normally the term during which the policy will be in effect is 1 year, after which it is renewed automatically unless you decide not to renew it, in which case you should previously advise the insurance company 2 months before it is due.

2. Proposal for insurance

Your application for an insurance do not oblige you to finally contract it. On the contrary, the insurance company is bound by the terms and conditions of its proposal for insurance for a term of 15 days.

3. Cancellation

An insurance company may cancel an insurance policy only under the following circumstances:

  • If the insured has lied or made false statements on his/her application or in a claim he/she submitted.

  • If the peril covered is increased. In these cases when there is no good faith, the insurance company shall pay the difference between the premium agreed and the premium which should have been paid for the increase of the risk.

  • If the insured object is sold.

  • Failure to pay premiums when they fall due, there is a 30-day grace period available to the insured to give him an opportunity to pay the premium without affecting his rights under the policy.

An insured may cancel an insurance policy in the event that the insurance company refuses to modify the policy when the new circumstances arisen can make the premium reduced. The policyholder is entitled to a refund calculated as the difference between the premium paid and the premium which should have been paid since the peril reduction was noticed.

4. In case the insured event occurs

If the insured event occurs, the policy taker or the beneficiary shall notify the insurance company within 7 working days, unless other period is stated in the insurance contract. Failure to give timely notice can result in an indemnification for the insurance company.

The assured must furnish a list of the items lost or damaged. The insurance company will investigate it and value the damages, it shall pay an indemnity or repair the insured object.

The insurance company shall pay part of the indemnity within 40 days from notice of loss, full indemnification shall be paid within 3 months from the notification date.

The insurance company may not pay the indemnity if it feels that the policyholder engaged in some type of misconduct which voided the coverage.

5. Complaining before the Spanish judge authorities

If the insurance company won't pay the claim or won't pay what the insured think the claim is worth, the insured may file a lawsuit against the insurance company. The type of court procedure will depend upon the amount to be claimed: either ordinary court procedure (juicio ordinario), or oral court procedure (juicio verbal) can be taken.

The period of time within to file the lawsuit will be:

  • 2 years, from the date of the report of the event, if the insurance only covered material damages (property insurance or car insurance), or

  • 5 years, from the date of the report of the event, if the insurance covered personal injuries (life or medical insurance). The insured may also claim before the General Insurance Office (Dirección General de Seguros).

Because of the complexity of insurance policies and because the resolution of coverage disputes often depends on careful analysis of the circumstances of the case, the assistance of an experienced Spanish Lawyer is strongly advisable.

6. Types of insurance

6.1. Homeowner's insurance

The homeowner's insurance (seguro del hogar) covers your house, the home itself and the things you keep in it against disasters: fire, wind…

The premium of the policy will depend on the value of the house, the things you keep in it and the risks you wish to be covered.

While a house is rented, it may only be insured by the landlord, the tenant may insure its content.

There is no law that requires a homeowner to have insurance, however, if you borrow money to buy a house, the bank will normally require you to contract, at least, a fire insurance to protect its interest until the loan is repaid.

6.2. Life insurance

A contract of life insurance (seguro de vida) provides that, in consideration of the premium to be paid, the insurer promises to pay the beneficiary an agreed sum upon the death of the person whose life is to be insured.

The person whose life is insured is generally called the "insured". The person named in the policy to benefit from the death of that person is called the "beneficiary". Where the policy contains the identity of the beneficiaries, they will not have to wait for the estate partition to be made in order to perceive the indemnity.

The insurance company normally requires a medical exam from people who are applying for life insurance.

The company may specifically exclude certain coverage, such as the coverage of death by suicide.

6.3. Health insurance

In this case the insurer agrees to pay to the insured a stipulated sum in the event of illness or temporary disability, as well as cover the cost of medical assistance.

There are two types of health insurance:

  • Medical assistance: The insurance companies have a wide range of doctors who may assist you. The coverage will depend upon the terms agreed in the policy.

  • The reimbursement of expenses for medical assistance: in this case you choose the doctor, the insurance company shall return the medical expenses to you within certain limits.

The health insurance does not cover some specific situations such as the hospitalization in case of transmissible diseases (AIDS), medical treatment for alcoholism, addiction to drugs, labor accidents …

Frequently the insurance companies do not admit insurances for persons aged over 60 years old, in case they admit them, the policy cost will be increased.

Coverage period is for 1 year, the policy costs are increased every year.

6.4. Automobile Insurance

Insurance in Spain relating to automobiles can be divided into 2 categories:

  • Third party liability insurance (seguro de terceros o de responsabilidad civil obligatoria)

  • Full comprehensive insurance coverage (Seguro a todo riesgo)

6.4.1. Third party liability insurance

The third party liability insurance (seguro de terceros o de responsabilidad civil obligatoria) is mandatory in Spain. It is the minimum insurance required by Spanish law to drive a vehicle in Spain.

It covers the risk for causing personal injury and damage on third party's property (driver and passengers in another car with which it collided, passengers on the car who are not members of the insured family, pedestrians…).

The maximum indemnity this type of insurance covers is:

  • In case of personal injury: € 336,566.78 per victim

  • In case of property damage: € 96,161.94 per victim

In case of personal injury, the responsible for the accident will not be obliged to pay indemnity when proving that the injuries resulted from the injured party negligent operation or from force majeure.

This type of insurance does not cover:

  • Personal injury of the insurance taker, the driver or the owner of the insured car.

  • The damage caused to the insured vehicle, the things it kept in it, personal property of the insurance taker, the driver, the owner of the insured car and the spouse and relatives.

This type of insurance will not cover the damages caused in any of the following cases:

  • If the driver were under the influence of drugs or alcohol.

  • Where the vehicle is driven by a person that the owner did not authorize

  • Where the driver does not have driving license

However, in any of these cases, the insurance company shall pay the corresponding indemnity to the injured party, which may be protested against the insurance taker.

Extra cover can be added to the insurance policy, driver and passenger insurance (seguro de ocupantes) is strongly recommended as the third party liability insurance does not cover the driver or his family and they must be insured separately.

6.4.2. Full comprehensive insurance coverage

The Full comprehensive insurance coverage (Seguro a todo riesgo) covers the injuries and damages non-covered in the third party liability insurance:

  • The injuries to the insurance taker, the car owner, driver and the spouse, ascendants, descendants, relatives and the car passengers.

  • Damages to the vehicle irrespective of how it is caused. This insurance also includes coverage against fire and breakage of glass.

  • Damages of the car contents.

  • Theft of the vehicle….

If the insured fails to pay the policy, he or she will have 5 months to pay it, when paid within this period of time, coverage will be recovered in 24 hours.

If you wish to contract an automobile insurance in Spain, it is advisable to bring proof of no claims from your previous insurance company, as this will help reduce your insurance premiums. If you have moved from another European country perhaps your old insurance company also operates in Spain, this might help you to get a better rate as they can check your claims history faster.

These are only general guidelines and not definitive statements of the law, all questions about the law's applications to individual cases shall be directed to a Spanish Lawyer.


Article by iAbogado Servicios Jurídicos SL (Madrid, Spain). Visit www.iAbogado.com for more original content like this.

 

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