Insurance practical guides

Home Insurance practical guides

What does civil liability cover in Home Insurance?

Civil liability can cover both the content and the container of the home. © Freepik

If you have Home insurance that includes liability coverage or if you are thinking of subscribing to a policy of this type then this guide is for you. In it, we will tell you what this guarantee is about, what damages it covers and the possible exclusions that it may present. Do not miss it!

Although having home insurance is not an obligation unless you have bought your house through a mortgage, the truth is that more and more decide to protect their property against possible claims.

In this sense, there are several types of Home insurance, where each one presents its characteristics and coverage. They range from the most complete, such as Multi-risk policies to the most basic, such as Civil Liability insurance.

Today we will talk about the latter, an extremely important coverage but not everyone knows what it is about. Let’s review its main aspects below:

What is liability coverage in Home Insurance?

The most important thing about civil liability coverage in Home insurance is that it covers the damages that you may cause to third parties, whether they are people or material things, in the area of ​​your private life.

For example:

  • Your kids play ball and break a neighbor’s window.
  • You live in an apartment and thanks to a water leak you have caused a leak on the floor below.
  • You’re doing home renovations and you’re blowing a hole in your neighbor’s roof.

There are many situations in which you can be responsible for the damage to other people and in these cases is where civil liability acts.

What does civil liability cover in Home insurance?

open tap
© Pixabay

The coverage of civil liability in Home insurance will depend on the formula you have chosen at the time of subscription.

As we mentioned before, when contracting this type of policy you can choose to insure only the continent or the container and the content.

Depending on the option you have chosen, the coverage will be the following:

Continent coverage

  1. Damage caused to other homes due to water problems on your property (broken pipes, water leaks, floods, etc.)
  2. Damages caused to a third party caused by any element of your home.
  3. Damage caused to third parties while carrying out work on your home.

Content coverage

  1. Damages that you may cause to third parties, both inside and outside your home.
  2. Some companies cover the damages that the employees of your house or even your pets may cause to third parties.
  3. There are also insurers that cover damages caused to third parties in the performance of your non-professional and sports activities.

Legal coverage

Regardless of the way you have decided to hire, the legal defense of the insured is usually included in all civil liability insurance.

This coverage is activated in the event that, after a claim, a third party makes a claim against you.

What are the exclusions of liability in Home insurance?

More than exclusions, liability coverage in Home insurance sets certain conditions that must be taken into account when requesting compensation for a claim.

Most insurers will not proceed with the coverage if the damages have occurred intentionally or if they have been the result of recklessness on the part of the insured.

Tips to Compare and Choose the Best Home Insurance

Organizing your ideas is a very important factor when comparing home insurance. © Freepik

Today, the home insurance market is increasingly broad and competitive. Given that, and to make a good choice, it is essential to compare the offers and evaluate the characteristics and advantages that each policy presents. Take a look at this guide and learn how to do it!

If you are about to leave your old apartment for a larger and more comfortable one or if you have just bought the house of your dreams, perhaps you have already prepared yourself for all the procedures that you will have to undertake to leave everything in order.

Contract signatures, on the one hand, formalities on the other. Register electricity, find an Internet plan, and change the address in front of the different banks.

However, you are forgetting a much more important task: your home insurance. But, how to compare all the offers and thus save when hiring a room policy?

Follow these practical tips:

Find out about the universe of Home insurance

Before making any important decision and in any area of ​​life it is necessary, first of all, to inform yourself in-depth about the subject under discussion.

For example, when buying your new house you had to define your needs, study the different forms of thermal insulation, heating.

You also had to find out about the city you chose to live in and if there were shops nearby or means of public transport.

In the case of a policy for your house, the same thing happens.

Without knowing your needs and without studying the different types of home insurance proposed by the market or the exclusions that they may present, it will be difficult for you to make a good choice.

So, let’s list the list of information that you should handle before starting to compare.

  1. Needs and characteristics of your home compared to an insurance policy.
  2. Types of home insurance that are marketed in the market (Damage Insurance, All Risk, Multi-risk Insurance ).
  3. Types of coverage of Home insurance (damage to the continent, damage to contents, civil liability in Home insurance).
  4. Special coverage ( electrical damage in Home insurance, flood coverage in room policies, etc.)
  5. Calculation of the content of your home.
  6. Exclusions in Home insurance.

While it is true, there are quite a few points to retain, do not forget that once you have informed yourself you will be prepared to be able to compare the different policies without doubts or hesitations.

Look for companies and types of policies that interest you

Once you have already informed yourself about the different topics that make up the hiring of Home insurance, it is time to look for the insurance companies and policies that may interest you.

At first, you will look for those alternatives that have caught your attention due to some particular factors.

We advise you to pay attention to the following points:

  • Trust you feel in the company.
  • Guy is sure proposed.
  • Premium price

Try to make this first search superficial and do not go into all the details of each chosen insurance. Do not forget that in a fourth stage you will be able to internalize more about each one of them.

Search the Internet, specialized sites, and any other medium that helps you obtain a broad and complete view of the offers offered by the market.

Do not abuse the number of options you choose. Having five Home insurances that correspond to two or three different insurers is more than enough to carry out an in-depth study.

Organize each of the options held

person comparing home insurance
© Freepik

Once you have already obtained your first results and you have chosen the policies and insurers that catch your attention, it is time to do a little manual work that will help you organize your ideas.

The idea is to create a comparison chart where all your options are organized.

Here is an example that you can use as a model:

Home Insurance Comparison
Insurance carrierPolicy typeCoverageExclusionsYearly feeObservations
 one.
 two.
 3.
 Four.
 5.

This table will help you to have a clearer idea when studying in depth each of the proposals.

Once you have created your table, you can discard those options that do not suit your needs.

Find out in-depth about each of them

In this, you should carefully read each of the policy contracts you have selected and (why not?) Contact the insurers to clarify any questions you may have.

The special conditions in Home insurance contracts are usually very different from each other and it is good that you have everything clear from the beginning.

Negotiate with the company

If you have already made a decision regarding the insurance you want to take out, it is time to contact the company and see what they offer you.

On many occasions, insurers can make interesting offers to their future clients. Don’t miss your chance to make a profit!

8 reasons to buy health insurance

The advantages of health insurance are multiple. © iStock

One of the most important and worrying issues for citizens is related to the health and opportunities of each individual to protect himself and his family.

In this sense, access to quality healthcare no longer has borders, and every day more people are looking for other alternatives to provide the best protection for their loved ones and obtain the well-being that public health does not offer them.

What is the current National Health Plan?

Today, the National Health System, which provides health care to anyone, covers more than 100 million people with all kinds of medical needs.

However, a fifth of the beneficiaries, that is, more than 30 million individuals, have chosen to take out private health insurance.

Which is the reason? It seems that while public spending is reduced, private spending is increasing. According to the Institute for the Development and Integration of Healthcare (Idis) “health insurance has gone from being a luxury good to becoming a necessity good.”

Indeed, in recent years, insurers have significantly increased their policy sales. In 2014 alone, for example, more than 300,000 new people took out insurance.

In this sense, and given the possible precariousness that the current public system presents, private health coverage seems to be the best option. But why?

8 advantages of purchasing health insurance

The advantages of health insurance are multiple. Indeed, if it is a question of obtaining specialized medical attention and being able to resort to other types of services without having to wait long periods of time, this would be the best solution.

Let’s review in detail why health policies are so convenient.

Speed

If compared to public health, having private health insurance, the time you have to wait to perform any type of examination or diagnosis drops considerably.

On average, with coverage of this type, the time between taking the test and obtaining the results does not exceed 8 days, while in public health you can easily wait between 30 and 40 days.

Choice of doctor

By contracting health insurance you can access the medical networks that insurance companies have. In this way, you can choose the professional or specialist according to your own needs.

Comfortable and improved hospitalization

By having health insurance, you can choose the hospital you want to be admitted to. In turn, using the coverage offered by a private policy, you can request a single room or even the company during the nights for a family member.

Flexible hours

By having private medical networks, health insurance gives you the possibility to choose the time that best suits you for your medical visit.
Availability is generally quite wide, so you no longer have to put off all your commitments because of your medical appointment.

Expedited emergency services

If one thing is clear, it is that emergency services in private establishments do not register the same influx of patients as public services.

Therefore, by having health coverage, you will obtain faster access to this type of service.

Specialized assistance

Contrary to what happens in the public service, by having health coverage you will no longer have to go to your family doctor to request an appointment with a specialist.

Also, health insurance offers on many occasions, special coverages will vary according to the needs of each client ( optical insurance, dental insurance, health insurance for women, etc.).

High technological standards in medical treatments

Generally, by having a health insurance contract you have the possibility of accessing highly innovative treatments.

In many cases, private care offers you other alternatives and therapeutic options that you will not easily find in public care.

Access to international coverage

It is important that you know that if you have private health coverage you will be able to access medical services almost anywhere in the world.

Currently, insurance companies have agreements in different countries, which favors medical care or some type of treatment when you are abroad.

5 things you should know before you buy dental insurance

There are two ways to purchase dental insurance. © iStock

Are you worried about your oral health? Do you think that Social Security does not give you the coverage you need? Do not worry! You can subscribe to private dental insurance and thus enjoy its additional guarantees. Do you think this is a good idea? Find out about the five things you should know before hiring policy of this type.

The teeth (and the mouth in general) are a very important part of our body. For this reason, brushing daily, avoiding the consumption of products that can stain them, and maintaining good oral health represents one of the first care that we must carry out.

But what happens when an unforeseen event arises and we cannot get the medical care we want?

Toothache, gum infection, orthodontic treatment … no one is free from having to go to a dental emergency or make more than one appointment to perform the necessary care.

In this sense, hiring specialized insurance in this type of care can be very opportune, especially at times when the National Health Plan does not provide the coverage that we might need.

However, before signing dental insurance it is necessary that you take into account some important points.

Let’s explore together the five things you need to know when signing up for additional coverage for your mouth.

What oral coverage does the public health system offer?

Currently, Social Security covers basic dental needs. This means that Spaniards can have free access to primary care that will cover only some treatments for acute processes and certain information and education services.

Among the coverage offered by the State are mainly the treatment for wounds, injuries, infections, and inflammations.

In turn, pregnant women and children can access preventive examinations and specific treatments.

Despite this, there is a fairly extensive list of treatments that are not covered by the National Health Plan.

What is private dental insurance?

As you must already imagine, private dental insurance is a product that you can contract through an insurer, and that gives you access to different dental services in a cheaper way.

How does dental insurance work?

The operation of dental insurance is relatively simple. Once you have chosen the best oral coverage according to your needs and pay the demanded premium, you will be able to access all the treatments and services that appear in your new policy.

In this way, when you want to make use of it, it will be enough to deliver a budget of the treatment you want to perform to your company so that the discount or refund can be made.

It is important that you know that certain insurers will only cancel dental treatment if they have approved the estimate in advance.

How can you buy dental insurance?

If you want to take out dental insurance you have two possibilities:

Through your health insurance

Most medical plans include dental coverage. Therefore, if you subscribe to medical policy, you can check what coverage it includes for dental treatments and see if it suits you.

It is important that you know that the dental coverage included in medical insurance is limited. In general, the basic plans that medical policies include are: consultations and emergencies, as well as one oral cleaning per year.

In this case, you will only have to pay a monthly premium that includes both medical coverage and oral coverage.

Through independent dental insurance

You can also purchase independent dental insurance that only offers coverage in this area.

For this, you will have to analyze which coverage is adapted to your needs and pay an additional premium for your medical insurance.

What type of coverage does a dental insurance offer?

When hiring dental insurance you can choose between different types of coverage according to your own needs. Among them are:

Basic dental coverage

When purchasing insurance for your teeth, most companies offer a foundation package, which includes a number of free services.

Each insurer handles different packages of products with zero cost, however, among which are usually included:

  • Dental consultations and check-ups
  • Dental emergencies
  • Budgets and diagnostics
  • Oral cleanings (will be limited to one or two per year)
  • X-rays
  • Simple interventions

Additional coverage

If you want specialized coverage or to be reimbursed for part or all of complex and specific treatments, you can use a type of insurance with additional coverage.

Undoubtedly, the premium that you will pay monthly will be based on the supplementary coverage you wish to hire.

Don’t forget that even if you hire additional coverage, at the time of dental treatment you will have to finance part of the cost.

Additional services include:

  • Orthodontic treatments
  • Conservative dentistry treatments
  • Implant treatments
  • Periodontic treatments
  • Surgeries

Choose and compare

Don’t forget that when choosing the best health insurance or the best dental insurance for you and your family, the first thing you should do is compare the offers.

Find out about everything the market is proposing and review the details of each policy.

8 tips for choosing the best health insurance

It is important for you to know that basic health insurance gives you access to various medical services. © iStock

Do you think you need additional coverage for medical eventuality? Are you thinking of taking out health insurance? Do you know how to choose the policy that best suits your needs? Follow this guide and find out how they differ from each other and what you should take into account when making your decision.

Without a doubt, being protected against an accident, illness or any other medical unforeseen is a priority in the life of any person.

However, and although the National Health System is used by more than 100 million Americans, the coverage provided by the State is not enough for many families who expect more and better quality care.

Given this, many have found the solution to private health insurance. Fewer waiting lists, the possibility of choosing the care center and professionals, speed of services, cutting-edge technology … the list of benefits of medical coverage goes on and on.

But, given the great offer in the market and the great variety in prices and types of insurance, how do you know which one to choose?

Outpatient insurance policy, with copayment, with reimbursement or with medical charts. Do you need help choosing the health insurance that best suits your needs? Pay attention, because here are eight tips to make the right decision.

Analyze your needs

The first step when choosing the best health insurance is to analyze your needs and those of your family group.

For this, it is important that you consider a series of factors that are decisive when calculating the price of a policy and its degree of coverage. Among them are:

  • Age of each of the insurance beneficiaries
  • Sex
  • Health status of family members
  • Life habits

It is important that you know your situation and that of the people who will appear in the insurance because this will make it much easier for you to choose the appropriate coverage.

It is important that you know that basic health insurance gives you access to various medical services such as general medicine, childcare, nursing, rehabilitation, family planning, oral treatments, or preventive medicine, among others.

However, subscribing more or less complete insurance will depend exclusively on your health needs.

Today, the market offers special, such coverages as optical insurance, dental insurance, health insurance for women, or other additional guarantees.

Choose the best insurance company

Choosing the best health insurer is another important point to keep in mind before hiring health insurance.

It is necessary that you put yourself in the background of the different companies that operate in your place of residence and that you analyze how reliable they can be.

What is your experience? What doctors are you working with? Do you have international coverage? Do you know someone who already has medical insurance with that company? … all the information can be useful when choosing.

Find out about existing coverage

Do you already know your needs and those of your family? Then it will be necessary to know the types of coverage available at the time of contracting health insurance.

Currently, each insurance company has a wide range of possibilities and they will vary according to your own requirements.

Let’s review the coverage you can have access to:

  • General medicine
  • Medical specialties
  • Nursing
  • Rehabilitation
  • Family planning
  • Dental treatments
  • Preventive medicine
  • Pediatrics
  • Diagnostic tests
  • Ambulatory surgical interventions
  • Hospital interventions
  • Emergency service
  • Chiropody
  • Ophthalmological care, etc.

Do not forget that it is you who decides the insurance coverage and the guarantees that it will include.

Think about the type of medical insurance you want to contract

Regardless of the type of coverage you want to contract for your medical insurance, it is important that you think about what type of modality you want to subscribe to, as this decision will have a direct impact on the premium that you will have to pay for your private medical coverage.

The modalities you can access are the following:

Medical chart insurance

With this type of insurance, you will be able to access the list of professionals and clinics associated with your company.

In this case, you can go to a medical consultation as many times as you want and, depending on the chosen formula, without any type of surcharge.

The medical chart modality is perfect for those who do not have a lifelong treating physician or for those who need to consult various specialists.

However, if your GP is not on your insurer’s list and you don’t want to change your professional, it is best to opt for another type of modality.

With or without copays

Insurance with or without copayment is an option that you can choose when subscribing to a medical chart policy.

Medical insurance with copayment: both the insurer and the insured pay a part of the medical fees or services. This option is ideal for those who do not usually go to the doctor regularly.

Medical insurance without copayment: the insurer assumes all health expenses. This option is ideal for those who need continuous care and who regularly attend the doctor.

Refund insurance

Unlike medical insurance, with this type of modality, you can go to the doctor or clinic you want without the need for it to be on the list of professionals of the insurer.

However, you must assume a part of the cost of the care which, depending on the company; is usually between 70 and 100%.

Mixed insurance

Mixed insurance is the modality that brings together medical insurance and reimbursement insurance in the same policy.

In this way, you can go to both the doctors who are part of your insurer’s list and the professionals of your choice.

Find out about all the exclusions

It is important for you to know that health insurers have the power to reject a potential client if they consider them as unprofitable.

Among the best-known exclusions that companies set are:

  • Physical disabilities caused by attacks, wars or epidemics
  • Sports injuries
  • Detoxification treatments for addictions (drugs, tobacco, alcohol, etc.)
  • Plastic surgery
  • Dialysis
  • HIV treatments
  • Transplants
  • Studies of the genetic map, etc.

For this reason, it is very important that you declare any type of illness or deficiency (physical or mental) to your insurer.

Otherwise, your coverage could be canceled for not having declared your situation and lied about your health.

Find out about the waiting periods set by your insurer

The grace period is the time that elapses between signing up for insurance and the day you can start using your coverage.

And although all insurers have similar terms regarding grace periods, you need to be clear about them before signing your insurance.

Among the usual deficiencies, the periods are the following:

  • Surgical interventions or hospitalizations = 6 months
  • Delivery = between 8 and 10 months
  • Assisted reproduction treatments = about 24 months
  • Complex diagnostic tests or clinical tests = between 3 and 6 months

Look at the complementary services

One point that you should not miss before deciding on your health insurance is to ask about the complementary services that will be associated with your policy.

Many times, insurers include complementary services in their health insurance that you have not requested but that will automatically increase your annual premium.

Compare the offers

Finally, it is very important that you compare the offers that the market offers. Read the fine print of contracts, quote, evaluate prices … anything goes when making the best choice.

Today, there are different sites specialized in the comparison of health insurance, do not hesitate to use them.

5 tips to save when buying health insurance

Reviewing the terms of the contract is one of the most important points when saving on health insurance. © Freepik

If you are thinking about taking out health insurance but you don’t know how to choose the most suitable one for your needs without paying more, don’t worry! In this guide, you will find five tips that will help you save money when deciding on a policy.

There are many reasons to buy health insurance. Indeed, having private medical coverage for you and your family can represent a great financial relief in the event of having to face a problem of this type or in case of needing specific treatment.

In this sense, hiring a policy that meets the needs of your family group can be quite an arduous task, especially when you want to have the best guarantees without paying more.

Today, companies offer a wide variety of insurance, ranging from the most basic to the most comprehensive.

However, for the same type of coverage, prices can vary significantly.

Given this, it is important to be able to compare all the available policies very well and follow some tips to save at the time of the election.

Let’s review some of the most important:

Hire at the beginning of the year

If you want to take out the best health insurance for your family or if you already have one but want to change companies, we advise you to pay close attention to the time of year in which you are.

A good part of the companies offer important promotions at the beginning of the year, so waiting a few more months before deciding on one policy or another could save you a few euros.

Compare and compare again

Given the large number of insurers that currently exist within the market and the wide range of offers they propose, it is important that before choosing between one policy or another, you compare each contract very well.

The first thing to do is to compare the different companies and analyze which one is the best suited to your needs and the one that offers you the greatest security and confidence.

Then, we advise you to compare all the offers offered by the insurers you have chosen. Do not forget that the price is not the only thing you should take into account.

In order to make a good choice, it is necessary that you know your needs and those of your family group, as well as the budget that you have destined to invest in health insurance.

To compare, there are different ways to do it. One of them is to resort to the comparator that this website offers you, which gives you access to the best offers in a quick and simple way.

Look at the characteristics and conditions of the contract

A very important point when it comes to economizing on your health insurance is to analyze in detail the different insurance coverage that you have previously selected.

Don’t forget that even if the two policies seem similar, the contract can include very different services.

Given this, we give you some of the points that can make a significant difference in price within your health insurance contracts.

Hand and health
One of the ways to save when purchasing health insurance is to opt for an annual payment. 
© Pixabay

Payment Methods

Some insurers offer different forms of payment when hiring a policy.

In this case, and to achieve savings of up to 10% per year in the cost of insurance, we advise you to opt for an annual payment.

Monthly payments generally lead to an increase in the total cost of the insurance, so if you can make the payment annually, this could be a good way to save money.

Medical chart

Each company works with its own medical charts, so it is important to review the list of professionals and analyze if there are any you trust.

Remember that choosing a policy with a medical chart can considerably lower the cost of your insurance.

On the contrary, subscribing to an expense reimbursement coverage, where you can freely choose the doctor you want to go to, will automatically increase the value of it.

Copay

The copayment is another good way to save on your health insurance. This consists in that every time you go to a consultation or need a treatment, you pay small participation for it.

Generally, the co-payment rates are between three and ten dollars, however, the price of the policy is considerably cheaper than coverage that does not have this option.

The copayment is a recommended alternative for those who do not go to the doctor regularly or need permanent treatment.

Grace period

Pay attention to the waiting periods, because if your policy has very long periods, you will not be able to use the coverage until it ends and, therefore, you will have to assume all the medical costs that arise.

Special coverage

If a member of your family needs a special type of coverage, it is good that you know that some insurers offer the type of service and guarantees that you need.

Dental insurance, insurance optical, hearing aids … the range of possibilities is wide.

Take out family health insurance

If you plan to subscribe to health insurance for each member of your family, the best alternative to save will be to opt for family coverage.

Most of the companies have this kind of offer and at prices that are much more attractive than that of individual coverage.

Family coverage usually includes medical charts with the most requested specialists, such as: pediatricians, gynecologists and emergency physicians.

Group your insurance

Many of the largest insurers in the country not only offer medical policies, but also car, life, or home coverage.

Given this, and if you already have insurance with a company, we recommend that you contact them and evaluate the possible benefits of establishing a relationship with them.

Generally, if you have two or more products from the same insurer, the prices of each policy will be lower.

Health insurance for women: the current situation

the European Union prohibited differences in the cost of health insurance between men and women. © Freepik

Although the European Union prohibited in 2012 to establish differences in terms of the amount of health insurance for men and women, coverage especially aimed at the female segment continues to have a strong demand within the market. Let’s review the most important points.

Although we should all enjoy the same opportunities in terms of medical access, the truth is that men and women do not have the same needs or face the same health problems throughout their lives.

The insurance companies were aware of this situation and, as it happened for up to five years, they offered policies specially designed for women, including all the necessary coverage throughout their lives.

However, the situation changed in 2012 when the European Union prohibited differences in the cost of health insurance between men and women.

What is the current situation? How have insurers reacted to this problem? What are the special coverage for women? Let’s review the various points.

EU regulations against differentiation by sex of the prices applied in Health insurance

© iStock

With the clear objective of achieving equal treatment between men and women, the European Court of Justice in 2012 prohibited insurance companies from differentiating men from women to set the amounts of health insurance and other types of policies.

“Gender equality is a fundamental right in the European Union and the Court of Justice has made it clear that this right also applies to the fixing of insurance prices (…) The insurance sector has had more than a year to prepare for the change to unisex pricing policies and during this period the European Commission has helped the sector to adapt. The Commission will monitor the implementation of these new rules. ‘ (EU Commissioner for Justice)

In this way, this practice, which to date was widely used by different insurance companies, constitutes an illegal act, and violates the orders and mandates of the EU.

The reality

Following the implementation of the European Union regulations that prohibit adjusting insurance prices based on the sex of the client, the different insurers in the country have not been indifferent and have reacted by offering policies that include coverage specially adapted to the needs of the woman.

Coverages designed for women

Although there is no special health insurance for women, many companies offer coverage focused mainly on maternity and the prevention of certain types of cancer that affect women.

Among the guarantees that you can find among the different insurers and that are related to maternity are:

  • Pregnancy monitoring
  • Delivery care
  • Assisted Reproductive Treatments
  • Preparation for delivery
  • Postpartum care
  • Conservation of stem cells from the baby’s umbilical cord
  • Family planning
  • Infertility diagnosis
  • Tubal ligation
  • IUD implantation
  • Port-delivery aesthetic services

It is important to remember that the vast majority of insurers that offer special coverage for women include pregnancy monitoring and delivery care. The rest of the guarantees included will vary from company to company.

At the same time, the coverages that are related to the prevention of certain types of cancer are:

  • Annual Prevention Review for Breast Cancer
  • Annual Prevention Review for Cervical Cancer
  • Annual Prevention Review for Endometrial Cancer
  • Consultations for gynecological ailments

Tips when hiring health insurance aimed at women

If you are thinking of hiring the best health policy that includes guarantees specially designed for women, we suggest that you take notes of these important tips:

  1. Consultation for waiting periods: generally, the coverage for assistance at childbirth includes waiting periods of 8 months. And, in the case of assisted reproduction, these periods can go up to 24 months.
  2.  Try to purchase a product without a copayment.
  3. Find out about medical equipment.
  4. Compare between the different options proposed by the market.
  5. Do not trust the cheapest policies.
  6. Do not forget to read the contract and, above all, the special conditions.

Problems with your health insurance? Learn how to claim

Faced with a conflict with your health insurance, the first thing you should do is try to solve the problems directly with the company. © Pixabay

Have you taken out health insurance and have problems with the company already started? Do not worry! If you want to file a claim, in this guide we explain all the steps to follow so that the process does not become a nightmare.

Over the years, there are many reasons that can generate conflict with your insurance company and your health policy.

In fact, saving by hiring your health insurance or finding the best company does not guarantee that you will not have problems throughout the duration of your policy.

The non – payment of compensation, sudden changes in the contract, undue charges … the list of problems that are usually generated with health insurers are endless.

In this sense, it is best to file a claim with your company. But, how to carry out this procedure? What are the steps to follow to avoid making mistakes and for your application to be effective?

Let’s review each stage of the process in detail:

Define the reason for your claim

Before submitting any type of claim to your health insurer, you need to be clear about the reasons why you want to carry out this procedure.

It is important that you can determine the main existing problem and whether or not it comes from a failure on the part of the company.

On some occasions, complaints are unleashed after poor attention by the health professions or medical center officials and, in light of this, the claims should not be directed to your insurer.

Now, if you have more than one complaint, you should sort them by importance. When you file the claim, it will be easier for you to explain the problem.

Review the conditions of your contract

The second step before filing a claim is to check the terms and conditions of your health insurance contract.

In a large percentage of cases, the claims are due to a misunderstanding of the contract by the client or misinformation of what is stipulated at the beginning of the policy.

If you realize that, in effect, the company is not incurring any type of failure because everything is contemplated in the document, you will be able to analyze the possibility of changing your insurance or modifying its conditions.

Submit your claim to your company’s SAC

angry person
The last instance of claim in the judicial way. 
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If you are sure that the problems with your health insurer are due to a failure, a breach of contract, or poor management, the first thing you should do is file a claim with the company’s Customer Service (SAC).

For this, you should contact your insurer and inform them of your decision to file a claim. They will explain the different ways available to carry out this management.

It is important that you know that your insurer has the obligation to resolve your claim within a period of no more than two months from the moment it is submitted.

Once the company has resolved your claim, it must notify you of its decision within 10 days after it is made.

Defender of the Insured

It may happen that your insurance company has a Defender of the Insured and that, therefore, you should not contact the SAC.

Your contract stipulates the path you must follow in case of problems or if you want to file a claim.

It is important that you know that each insurer has an Ombudsman, however, he works independently from the company.

In order to file a claim with him, you must send it by certified mail or by any other system that allows you to obtain proof of shipment.

The claim must contain your personal data, the policy data, and the reasons for this. Remember that by sending the document to the Insured’s Ombudsman you will not be able to manage another claim by any other means.

Do not forget to attach all the documents that can substantiate your complaint and serve as evidence for a later resolution.

The Ombudsman has a maximum period of 2 months to declare a sentence and 10 days to send you his answer.

In all cases, the insurer has the obligation to assume the verdict. However, the insured is free to take advantage of the solution or not.

Commissioner for the Defense of the Insured and the Participant of Pension Plans

In case you do not want to accept the resolution of the SAC or the Defender of the Insured, you can contact the General Directorate of Insurance and Pension Funds.

This body has a new figure dedicated to helping users who have conflicts with their insurers. It is the Commissioner for the Defense of the Insured and the Participant of Pension Plans.

To try to resolve your case and find a solution that suits you, the Commissioner will advise you throughout the claim process and will process your complaints and inquiries.

In this way, the Commissioner has a period of 6 months to answer and grant a verdict, however, the insurer has no obligation to comply with the ruling.

Given this, and in case you do not agree with the possibilities proposed by the previous instances, you still have other means of claim: the arbitration route and, ultimately, the judicial route.

Resort to arbitration

Trying to find a solution to your problem through some extrajudicial resolution system can be quite advantageous if you consider that you will not have to pay a euro to make your claim valid.

However, you must remember that to access this system you must have the acceptance of the claimed company. That is, the two parties must be willing to resolve the conflict.

If you are interested in going this way, you will only have to submit a request for arbitration in writing to one of the following organizations:

  • Consumer Information Office of your Community.
  • Associations of consumers and users adhered to the arbitration system.
  • Regional Consumer Arbitration Board.

The last option: the judicial route

If you tried by all means but none of the other options resolved the conflict that you have with your health insurer, the only option you can resort to is the judicial process.

It depends on the type of damage suffered, there are two types of claims to make through the courts:

Claim for property damage


In this case, you must file the claim in the Court of First Instance within the year following the claim.

If you do not agree with the sentence handed down by said Court, you must go to the Provincial Court within three days.

Claim for claims with injuries


In this case, you must file the complaint with the Investigating Court within 60 calendar days from the date of the incident.

If you do not agree with the resolution, you can appeal to the Provincial Court within 24 hours.

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