Home and Auto Insurance Claims in Spain: Guide to Getting Your Compensation

Insurance claims are one of the most common legal procedures for Spanish citizens. However, the claims process hides complexities that many policyholders are unaware of: strict deadlines, documentation requirements, and frequent discrepancies with insurance company valuations. Law 50/1980, of October 8, on Insurance Contracts (LCS) constitutes the fundamental legal framework governing these relationships.

This guide analyzes the claims process for both home and auto insurance, common reasons for denial, and the policyholder's legal options when the insurer fails to comply.

Legal Framework: The Insurance Contract Act

Fundamental principles

The LCS establishes a protective framework for the policyholder based on several principles:

Contractual good faith (Art. 10 LCS): both parties must act with loyalty. The policyholder must accurately declare the risk and report the claim. The insurer must compensate according to the terms agreed.
Indemnity principle (Art. 26 LCS): in property insurance, compensation cannot exceed the real value of the insured interest. Insurance cannot become a source of enrichment.
Non-waiver of rights (Art. 2 LCS): clauses that are more prejudicial to the policyholder than those provided by law are void. This is a public policy principle.
Pro-policyholder interpretation: in case of doubt about the meaning of a clause, it is interpreted in favor of the policyholder (Art. 1288 CC and consolidated Supreme Court case law).

Policyholder obligations

Pay the premium (Art. 14 LCS): non-payment of the first premium allows the insurer to terminate the contract. Non-payment of subsequent premiums suspends coverage after one month from the due date.
Report the claim (Art. 16 LCS): within a maximum of 7 days from becoming aware of it. Non-compliance only releases the insurer if it was intentional and caused harm.
Truthfully declare risk circumstances (Art. 10 LCS): inaccurate risk declaration may lead to proportional reduction of compensation or contract termination.
Mitigate the consequences of the claim (Art. 17 LCS): take reasonable measures to prevent or reduce damages.

Insurer obligations

Pay compensation within 40 days from receiving the claim notification (Art. 18 LCS).
Offer an undisputed minimum: if the insurer questions the amount, it must provisionally offer a minimum it considers due.
Default interest: if it does not pay within 40 days, the insurer must pay interest of at least 20% annually (Art. 20 LCS). After two years, interest must be at least 20% annually.

Home Insurance Claims

Typical home insurance coverages

Home insurance policies typically cover:

Water damage: pipe bursts, leaks, appliance overflows.
Fire and explosión: including smoke damage and firefighter intervention.
Theft and robbery: unlawful taking with or without violence.
Weather events: storms, hail, floods (partially covered by the Insurance Compensation Consortium for extraordinary risks).
Civil liability: damage caused to third parties (neighbors affected by leaks, objects falling from balconies).
Breakage of glass and sanitary fixtures.

Step-by-step claims process

1. Claim notification (Art. 16 LCS)

Notify the insurer within 7 days by phone, email, or through the app. Provide:

Policy number.
Date and time of the incident.
Detailed description of events.
Initial estimate of damages.

2. Documentation of the incident

Photographs and videos of damages before any repair.

Invoices and receipts for damaged goods (appliances, furniture, jewelry).
Amicable report with neighbors if the incident affects adjoining properties (water damage between floors).
Police report in case of theft or robbery.

3. Insurer's assessment

The insurer will send an adjuster to assess the damages. It is crucial to:

Be present during the adjuster's visit.

Not sign any acceptance document if you disagree with the valuation.
Request a copy of the assessment report.

4. Resolution

The insurer will communicate its decisión: full acceptance, partial acceptance, or denial. The legal deadline for payment is 40 days from the claim notification.

Common reasons for home insurance denial

Lack of maintenance: the insurer alleges damages are due to owner negligence (obsolete pipes not replaced, unmaintained roof).

Coverage exclusión: certain risks are excluded from the policy (condensation moisture, aesthetic damage, pest infestations).
Underinsurance: the declared value of contents is lower than the actual value, triggering the proportional rule (Art. 30 LCS), which reduces compensation proportionally.
Late notification: the policyholder did not report the claim in time.
Inaccurate risk declaration: the policyholder omitted relevant circumstances when contracting the policy.

Auto Insurance Claims

Types of auto insurance coverage

Mandatory insurance (SOA): covers third-party liability for personal and property damage (Consolidated Text LRCSCVM, RDL 8/2004). Minimum amounts: EUR 70 million per claim for personal injury, EUR 15 million for property damage.
Voluntary third-party liability: extends SOA limits.
Extended third-party coverage: fire, theft, windshield, roadside assistance.
Comprehensive with deductible: covers own damage with an amount payable by the policyholder.
Comprehensive without deductible: full coverage for own damage.

Claims process for vehicle damage

1. Amicable report (Amicable Accident Declaration)

Complete the amicable report at the accident scene. This is a document of special evidentiary value, signed by both drivers.

2. Notification to insurer

Within 7 days of the incident. If there are injuries, the claim is processed under Law 35/2015 (see traffic accident valuation scale).

3. Vehicle assessment

The insurer will send an adjuster to value the damage. The policyholder may appoint their own adjuster if they disagree.

4. Repair or compensation

Repair at approved workshop: the insurer repairs the vehicle at its network of workshops.
Compensation for repair at independent workshop: the insurer pays the repair cost (sometimes limiting labor costs to those of approved workshops).
Total loss: if repair costs exceed the vehicle's market value, total loss is declared and compensation includes market value plus sentimental value (Supreme Court case law: 20-30% additional).

Collateral damages: replacement vehicle, lost earnings

The policyholder may claim:

Replacement vehicle: during repair time if coverage includes it, or as consequential damage if the third party is liable.
Lost earnings: income lost if the vehicle is used for professional activity (taxi drivers, transport operators).
Diminished value: vehicle depreciation from having been in an accident (consolidated Provincial Court case law).

What to Do if the Insurer Denies or Underpays

Contradictory assessment (Art. 38 LCS)

When there is disagreement between the policyholder's and insurer's valuation, either party may request a contradictory assessment:

Each party appoints an adjuster.
If the adjusters cannot reach agreement, a third adjuster is appointed by mutual agreement or judicially.
The third adjuster's report is binding (except for judicial challenge for manifest error).

Claim to the Insurance Ombudsman

Insurers have an Insurance Ombudsman (or Customer Ombudsman), an independent body to which the policyholder can submit their complaint free of charge. The resolution deadline is 2 months.

Claim to the DGSFP

The Directorate General of Insurance and Pensión Funds (DGSFP) handles policyholder complaints. Although its resolutions are not binding on the insurer, they exert regulatory pressure.

Judicial route

If the above channels do not resolve the dispute, the policyholder may go to court:

Verbal trial: if the amount does not exceed EUR 6,000.
Ordinary trial: if the amount exceeds EUR 6,000.
Default interest under Art. 20 LCS: the defaulting insurer must pay at least 20% annual interest from the date of the incident. This penalty serves as an incentive for insurers to pay promptly.

Key Deadlines in Insurance Claims

Action	Deadline	Legal basis
Report the claim	7 days	Art. 16 LCS
Payment by insurer	40 days from notification	Art. 18 LCS
Statute of limitations (property insurance)	2 years	Art. 23 LCS
Statute of limitations (personal insurance)	5 years	Art. 23 LCS
Claim to Insurance Ombudsman	No specific deadline	Internal regulations
Claim to DGSFP	After Ombudsman response or 2 months	DGSFP regulations

How Lexiel AI Facilitates Insurance Claims

Insurance claims require specialized knowledge of the LCS, case law on unfair terms, and assessment procedures. Lexiel AI assists you throughout the process:

Policy analysis: Lexiel identifies applicable coverages, exclusions, deductibles, and compensation limits in your policy.
Claim notification generation: drafts the formal notification meeting all requirements of Art. 16 LCS.
Default interest calculation: if the insurer delays, Lexiel automatically calculates Art. 20 LCS interest.
Insurance Ombudsman claim: generates the complaint adapted to each company.
Case law search: locates judgments on similar denials, underinsurance, unfair terms, and judicial damage valuations.
Judicial claim generation: if court action is necessary, Lexiel prepares the claim draft with appropriate legal grounds.

Frequently Asked Questions About Insurance Claims

How long does the insurer have to pay?

The insurer has 40 days from the claim notification to pay compensation (Art. 18 LCS). If it fails to pay within that period, default interest of at least 20% annually accrues (Art. 20 LCS).

Can I claim if the insurer pays less than I expect?

Yes. You can request a contradictory assessment (Art. 38 LCS) by appointing your own adjuster. If there is no agreement, a third adjuster will resolve the matter. You can also complain to the Insurance Ombudsman, the DGSFP, or go to court.

What is the proportional rule in home insurance?

If the declared value of insured contents is lower than the actual value (underinsurance), the insurer applies the proportional rule under Art. 30 LCS: compensation is reduced in the same proportion as the underinsurance. For example, if you insured for EUR 30,000 but the contents are worth EUR 60,000, you receive only 50% of the claim.

Can I choose my own workshop to repair my car?

Yes, you have the right to choose the workshop of your preference, although the insurer may limit labor costs to those of its approved workshops. Supreme Court case law recognizes the policyholder's right to free choice of workshop (STS 591/2015).

When does an insurance claim expire?

Actions arising from a property insurance contract expire after 2 years (Art. 23 LCS). Actions from personal insurance (life, accident, health) expire after 5 years. The period begins from when the policyholder became aware of the incident.

What if I am robbed at home and do not have invoices for the stolen items?

It is not essential to have invoices for all goods. You can prove pre-existence through photographs, testimonies, bank statements of purchases, appliance warranties, and any other means of evidence. The insurer cannot exclusively require invoices.

¿Having Problems with Your Home or Auto Insurance?

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