Personal accident insurance; It ensures the physical damages (daños físicos) that people may incur due to sudden and external events that may happen to them. Assistance can be provided with a single policy as well as death by accident, permanent disability, treatment costs and daily compensation. For this reason, employees are provided with personal accident insurance policy via personel injury lawyer Spanish to protect themselves against unexpected accidents (accidentes inesperados) that may happen and even indirectly their families.
Why Personal Accident Insurance is Necessary?
Personal accident insurance (Seguro de Accidentes Personales) products are offered with attractive premiums compared to the guarantees they provide. When we think about the accidents that may happen in our daily life, besides this product, which can alleviate the financial problems of the insured or the survivors in case of death, assistance services are also included in the policy.
What if You Don’t Have Personal Accident Insurance?
If you live in Spain or go on holiday in Spain, you may have an accident and be injured as a result of any incident. If you do not have personal accident insurance in the event of an accident or injury, you will need a personal injury lawyer (abogado de lesiones personales) to compensate for your damage.
What is Personal Accident Insurance?
Personal accident insurance provides protection against the following risks against the consequences of sudden and unexpected accidents in Spain.
- Death (muerte)
- Permanent Injury (lesiones permanentes)
- Daily Compensation (compensación diaria)
- Treatment Costs (costos de tratamiento)
- Earthquake (terremoto)
What Does Personal Accident Insurance Cover?
The following situations are not considered accidents:
- Diseases or their consequences,
- Any attempt to commit suicide, regardless of any mental state,
- Use of drugs, alcohol and harmful substances.
The following conditions are excluded from the insurance:
- War, revolution, rebellion, insurrection and the complexes arising from them,
- Crime and murder, attempted,
- Participating in strikes, workers’ movements and popular movements,
- That the insured puts himself in danger.
Unless otherwise agreed, the following items are excluded from the insurance:
- Using motorcycles and motor bikes,
- Open sea fishing, hunting in high mountains,
- Speed competitions with sports competitions,
- Earthquakes, floods, volcano eruptions and landslides.
What Coverage Does Personal Accident Insurance Cover?
In addition to the death and permanent disability benefits mentioned below, one or both of the daily compensation and treatment costs guarantees may be given.
If an accident provided in the policy causes the death of the insured immediately or within one year from the date of the accident, the insurance fee shall be paid to the beneficiaries shown in the policy or to the legal right holders.
Permanent Disability Compensation
If an accident provided in the policy causes the disability of the insured immediately or within two years from the date of the accident, the disability insurance fee shall be paid to the insured in accordance with the rates stated in the policy following the termination of the medical treatment and determination of the permanent disability.
If the insured person is unable to work temporarily as a result of an accident, he shall be paid daily compensation written in the policy. This compensation is paid from the beginning of the medical treatment to the day when the insured is recovered and is able to work and this period does not exceed 200 days.
Treatment Costs Coverage
The insurance company pays the treatment expenses specified within one year from the date of the accident to the amount determined for the guarantee in the policy, provided that the treatment costs are also included in the policy where the insurance coverage is included.
Which Conditions Are Included in Personal Accident Insurance?
- Damage caused by the inhalation of gases that suddenly and unexpectedly disintegrate.
- Damage caused by injury to the muscles and nerves as a result of burns and sudden movement.
- Poisoning caused by snake or insect bites.
- Rabies resulting from bite deaths caused by rabies or bodily malfunctions.
How Much Treatment Costs will be Covered Legally?
Provided that the treatment costs are also included in the policy where the insurance costs are included in the insurance coverage, the insurer shall determine the doctor’s fee (honorarios del doctor ) and medicine, radiography, bath, massage, hospital and other treatment costs (costos de tratamiento ) (excluding transportation fees) for this guarantee within one year from the date of the accident. pays up to the amount.
Prosthetic costs of damages caused by accident to natural or artificial fixed teeth shall be compensated up to a maximum of 10 percent of the total amount of treatment costs. For treatment costs, the insurances are deducted from the compensation to be paid by the insurer by the insured’s institution or by statutory insurances.
If the treatment costs are provided by the insurers, these expenses are shared among the insurers according to their guarantees. The insurer shall remain in the place of the insured for the amount he has paid against the third parties responsible for the treatment he has paid.
What Should be Done in Case of Personal Accident Damage?
The steps you or your relatives should take in case of any damages under the personal accident insurance you have made through your insurance company and your personal injury lawyer Spanish who are with you at all times and in all circumstances are as follows:
- Call the insurance company’s customer service (servicio al cliente) and notify them.
- Hand over your paperwork. Deliver the necessary documents to your agency as soon as possible.
- Follow your file. You can follow up your damage file by calling the insurance company’s customer service or your personal injury lawyer Spanish.
What to Do in Case of Disability?
- Accident memorandum (memorando de accidentes)
- Delegation report (informe de delegación)
- Photocopy of the passaport (fotocopia del pasaporte)
- IBAN number of the insured (número IBAN del asegurado)
What to Do in Case of Death?
- Certificate of identity register copy
- Dead examination or autopsy report
- Accident memorandum
- Passport photocopies of the heirs and IBAN information
When and How to Pay the Personal Accident Insurance Premium?
If it is decided to pay the entire insurance premium in installments, the down payment (first installment) must be paid as soon as the contract is made and at the latest in return for the delivery of the policy. Unless otherwise agreed, unless the premium or down payment is paid, the insurer’s liability does not begin even if the policy has been submitted and this shall be written on the front of the policy. If the insurer does not pay the insurance premium or the down payment until the end of the day on which the insurance policy is delivered, the insurance contract will be terminated and the insurance contract will be terminated without any notice if the insurer does not pay the default debt even within 30 days following the date of default. In cases where it is decided that the liability of the insurer will begin with the delivery of the policy even though the premium has not been paid, the insurer’s liability shall continue for the first 15 days of this one-month period (período de un mes).
Provided that the policy (política) is written on the front side, the portion of the premium installments that are not yet due to the realization of the risk does not exceed the amount of compensation that the insurer is obliged to pay becomes due. In cases where the insurance contract is deemed to have been terminated in accordance with this article, the premium corresponding to the period in which the insurer’s liability continues shall be calculated on the basis of day and the surplus shall be returned to the insurer. In case of any problems related to the payments to be made under the personal accident insurance, the personal injury lawyer Spanish may be involved to the process.