Home Insurance Damage Claims FAQ

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 Should the insurer pay for damages suffered under the home insurance? 

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In this post we are going to expose some of the most frequent questions that arise when you want to claim for the damages covered by the multi-risk home insurance, y la aseguradora se niega.

It may happen that, teniendo un seguro multirriesgo de hogar contratado y habiendo abonado las primas, an accident occurs and, after declaring it to the insurance company, it refuses to compensate the damages that are covered by the policy. In these cases, we must know how to act and, for it, we will solve questions that can help the insured at such a time.

Is it mandatory to take out home insurance?

Although it is not mandatory to take out home insurance when you own a home, it is highly recommended and convenient because, in case of production of an accident, the insurance company could take care of repairing the damage if it is covered by the policy, and you will not have to bear the repair costs.

If your home is mortgaged, it is legally mandatory to have home insurance, specifically, a insurance.

What home insurance is the most recommended?

Es recomendable contratar un seguro multirriesgo de hogar, for, in the event of a claim in your home, It will not only be liable for the damages that occur in the same, but also of damages that affect third parties or, even, to other homes close to yours.

What should I do when a claim occurs in my home?

It is important to take all the photographs or videos necessary to be able to prove the damage caused, inasmuch as, in addition to the expert assessment, what the insured contributes will also help the insurance company to calculate a fair compensation.

Is the damage caused by the accident covered by my policy?

Before the production of a claim, The first thing you have to do is read the content of the contracted policy in detail to know if what you are going to claim from the insurance company is subject to, o no, coverage. With the reading of it, you also have to know the coverage limits, así como los pasos a dar en el procedimiento para interponer la oportuna reclamación a la compañía aseguradora. No obstante, it is advisable to consult a insurance attorney, pues hay cláusulas en las pólizas que pueden ser nulas, si no cumplen determinados requisitos.

What deadlines do I have to report the claim?

Once the loss occurs, the insured must notify the insurance company as soon as possible, although he is legally obliged to report the claim within a maximum period of 7 days from the moment the loss is known, salvo que en el contrato se haya estipulado otro plazo superior. En todo caso, el seguro de daños tiene un plazo de dos años.

What steps should I follow after reporting the claim to the insurer?

Once part of the sinister, you have a deadline of 5 days to communicate in writing to the company the list of the objects existing at the time of production of the claim, the ones you managed to save and the estimate of the damage. You have to prove the preexistence of the objects.

Can I only report, as the insured of the claim?

When reporting the claim to your insurance company, you can do it personally, via telephone, email, etc., or through your mediator or insurance broker. The mediator will be able to advise you and answer any questions you may have while the company processes the claim, but it can also be managed directly by your insurance broker, since the communications made by the broker will have the same effect as if made by the insured himself.

No necesitas un Abogado para la realización de esta reclamación aunque es recomendable su asesoramiento.

Can I repair the damage immediately after the loss occurs?

It is recommended that the repair of the flaws and damages produced by the production of the claim be postponed until the expert has made an assessment of them..

In case your insurance company does not send an expert soon, and you can't wait to repair the damage, it may be advisable to call the necessary technician to repair or lessen the damage. In these cases, it is important to provide the insurer with all the relevant documentation to prove the damage, as budgets, bills, etc.. Tener nuestro propio informe pericial nos evitará muchos problemas.

How long does it take the insurer to pay me the compensation?

After an expert attends the home to assess the damage caused by the accident produced, The insurer will receive all the pertinent documentation and will assess the financial compensation to repair or replace the damages suffered.

The insurance company is obliged to pay, at least the minimum amount of the estimated compensation, within 40 days since the insured reports the claim. To pay the total compensation amount, It is given a legally established period of 3 months.

What if I do not agree with the compensation offer from the insurance company?

After the expert comes to assess the damages and the insurer offer an amount of the damages that have resulted from the production of the loss, If you do not agree, each party will have to appoint an Expert.

What will the Experts do?

Each Expert will make a report. If they reached an agreement, they will prepare a joint act in which they will state the causes of the accident, the assessment of damages and other circumstances that influence the amount of the compensation amount.

What if the Experts do not reach an agreement?

In the event that there is no agreement between the Experts, a third party will be appointed in accordance.

The opinion of the Experts will be notified to the parties immediately and with a binding character.

What if I do not agree with the expert opinion?

The opinion may be legally challenged. While the insured has 180 days to go to court to challenge, the insurance company has the term of 30 days, from the date of notification.

If it is not contested by either party, the opinion will become unassailable, companies.

What if the damage is covered, but the insurer refuses?

After reading the policy, if the damages are covered by it, and the insurance company refuses, you will be faced with an unfounded refusal and that is when the claim procedure would begin.

The first thing you should do is ask the insurance company that refuses to compensate the damages, to send it to you in writing, having to explain why.

What is the first step to make the claim?

To file the claim, The insured must contact the Customer Service Department or the Insured's Ombudsman by telephone. After contacting any of them, will state your complaint, to which they will assign a specific number to make the pertinent follow-up. After this phone call, It is important, for the protection of the insured, that the complaint be submitted in writing, either by certified mail, by email, fax, burofax, etc..

What should the claim document contain?

It is important that the letter includes fundamental information about the refusal of the insurance company, recording the telephone calls made, the content of the conversations and the response of the person who attended the insured. The first claim that was made and with which the first denial was obtained by the insurer must also be attached., as well as documentation that can serve as proof to substantiate your claim.

Once the claim has been submitted in writing, Are they obliged to answer?

The insurance company has the term of 30 days to reply after receipt of written complaint. If the insured has not received any response within that period, it is necessary to present it again.

What if I am not satisfied with the answer given by the insurance company?

If they have already passed 2 months without getting any kind of response, or if you have, el asegurado no está conforme con la respuesta, ha de acudir al Servicio de Reclamaciones de la Dirección General de Seguros y Fondos de Pensiones, Banco de España o Comisión Nacional del Mercado de Valores.

What should I do to present the complaint or claim to the Claims Service of the General Directorate of Insurance and Pension Funds?

Para poder presentar la queja o la reclamación en dicha institución, se han de cumplir una serie de requisitos de admisión:

-Se ha de haber presentado de forma previa la queja ante el Departamento de Atención al Cliente de la compañía aseguradora implicada

-Que la queja haya sido denegada, desestimada o no contestada transcurridos 2 meses desde la presentación de la queja.

Presentada la queja o la reclamación en la Dirección General de Seguros, esta emitirá un informe que no tendrá carácter vinculante.

What more extrajudicial channels exist when the insurance company refuses to recognize the coverage of the loss?

Antes de acudir a la vía judicial, el asegurado también puede intentarlo a través de la mediación o el arbitraje.

Can I go to court?

La vía judicial es la última opción, y también la más lenta. Tienes un plazo de 2 años desde la producción del siniestro para interponer la demanda necesaria para proteger tus derechos como asegurador frente a la compañía aseguradora. Tendrás que contar con un Abogado experto en seguros que te lleve el procedimiento.

How much is it going to cost me to go to court?

Si tu preocupación es lo que te puede costar una abogado que defienda tu derecho de indemnización, has de saber que, In most cases, es la compañía aseguradora quien paga la defensa jurídica. En otros casos, hay muchos despachos de abogados que solo cobran si tú cobras, namely, si ganas el procedimiento y consigues tu indemnización. Es importante que sepas que, las pólizas de seguros, by law, incluyen la libre designación de un Letrado.

What does “legal protection” mean?

La protección jurídica es una de las garantías que ofrece la compañía aseguradora en las pólizas de seguro que se contraten con ellas. Sirven para cubrir los gastos que generan para el asegurado un procedimiento judicial o extrajudicial. Esta protección incluye la vía amistosa o legal, el asesoramiento, la reclamación y la solicitud de indemnización por los daños producidos por el siniestro en el hogar.

How long will it take to collect my compensation?

El tiempo que dure el procedimiento judicial dependerá, above all, del juzgado al que, por reparto, le toque llevar tu procedimiento. El proceso suele durar, usually, 1 año o más, but, como se ha dicho antes, depende del caso en concreto y del juzgado.

What are the chances of success if I go to court?

Cuando sea necesario acudir a la vía judicial para ver resarcido el derecho de indemnización, es importante contar con la labor de un Perito como base probatoria para una reclamación judicial eficaz. Su abogado experto en seguros le asesorará sobre las posibilidades de éxito en cada caso concreto.

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