Claims under liability insurance are a vital element, because this process is essential before we can properly speak of an insurance claim. In fact, if the individual or legal entity affected does not make a claim, the insured event does not arise in that sense.
However, the Insurance Contract Act does not define exactly what should be understood by a claim, even though the term appears throughout its provisions. It is the Civil Code, when dealing with limitation periods, that refers to out-of-court claims. In practice, a claim under liability insurance may be made out of court or through the courts.
Out-of-Court Liability Insurance Claims
The approval of Law 35/2015 of 22 September, although limited to the field of damage assessment in traffic accidents, introduced an important change in the regulations. It made a prior claim to the insurer mandatory in any civil action. This claim must include the following elements:
- Identification and relevant details of the claimant.
- Description of the circumstances of the harmful event.
- Identification of the person or persons who caused the damage.
- Expert reports, or any appropriate reports, that help quantify the damage.
Interruption of the Limitation Period
Sending the liability insurance claim to the insurer interrupts the limitation period for the event. The period will not begin to run again until the insurer sends the injured party an offer or a reasoned response within the following three months. To achieve this effect, the claim must be sent correctly, for example by burofax or email with acknowledgement of receipt.
The Court Route
If the insurer does not respond to or accept the injured party’s demands, the claimant may still use the court route and, where appropriate, file a complaint with the Directorate-General for Insurance so that the corresponding sanction can be considered.
Oral Proceedings for a Liability Insurance Claim
When the amount claimed is less than 6,000 euros, oral proceedings are used. If the amount is also below 2,000 euros, it is not necessary to be assisted by a lawyer or court representative. The interested party may file the court claim directly.
The injured party files the claim with the competent court, which transfers it to the defendant. The defendant then has 10 days to respond and request a hearing before judgment is issued.
Ordinary Proceedings
Ordinary proceedings are reserved for claims exceeding 6,000 euros. Legal representation by a lawyer and court representative is mandatory. The defendant has 20 days to respond and submit any evidence considered appropriate. After a preliminary hearing between the lawyers and the judge, the next procedural steps are decided.
In conclusion, these are the key points to understand about claims under liability insurance.