What to do in the event of a claim?

Obligations of the insured party

The insured’s obligations in the event of a loss are as follows:

To reduce the consequences. Once the incident has occurred, the insured must try to reduce its consequences, adopting the rescue measures they consider most appropriate.

To report the claim. To notify the insurer of the claim within the period established.

To always keep the insurance company informed. During the claims process, the insured must provide all the new documentation that may be produced (invoices, medical reports, etc.).

To inform the insurer of any payments. If, after the incident relating to the claim has occurred, the insured obtains any monetary amount from the person responsible for the damage or they recover any property, they must inform the insurer.

Example: if the cause of the fire in an insured dwelling is a neighbor and they are responsible for the loss and agree to cover the value of the dwelling, the insured is obliged to inform the insurance company of this situation.

Notify any injured parties of the existence of the insurance. Doing this benefits an injured third party – the insured must inform them of the existence of insurance that covers any loss or damages.

Obligations of the insurer

Payment of the indemnity. This is the main obligation of the insurance company. This amount is determined on the basis of an appraisal of the damage, up to the maximum limit appearing in the policy.

To notify the parties that the claim has been rejected. In view of the data that becomes apparent and based on the regulations of the policy, the insurance company may decide to reject the claim. It must do so in writing to the insured, expressing the reasons for this, so that the insured can accept the company’s decision or make a claim if they deem this appropriate.