Insurance Litigation 2024

Last Updated September 20, 2024

Spain

Law and Practice

Authors



B&A, Blanco y Asociados Abogados was founded in Madrid in 1987. It provides legal services throughout Spain and specialises in insurance law on industrial risks and corporate civil liability. Its professional services are usually employed for the filing of insurance claims, which is one of the firm’s specialties. Its professional services are also usually employed for judicial claims of controversial incidents involving large insurance risks. A significant part of the judicial proceedings the firm handles require a deep knowledge of civil and commercial law in general and insurance law in particular, as well as extensive experience in procedural law in courts of justice and arbitration proceedings. The firm’s activities also include regulatory (both in relation to insurance companies and insurance brokers) and litigation in all lines of insurance.

As far as insurance is concerned, there are several regulations that are relevant. The main regulation is Law 50 of 1980 dated 8 October 1980 on insurance contracts, which regulates the content of the contract itself and the relationship between the insured party and the insurer. It contains a set of general provisions that all insurance contracts must comply with and also deals with the main lines of insurance that operate in the market.

In terms of regulations that affect insurance companies and insurance mediators there are also multiple rules. Two in particular are worth highlighting. The first is Law 20 of 2015, dated 14 July 2015, which covers the regulation, supervision and solvency of insurance and reinsurance companies. It also regulates the activity of national and foreign insurance companies. The second is Royal Decree Law 3 of 2020, dated 4 February 2020, which transposes EU Directive 2016/97 of the European Parliament and of the Council, dated 20 January 2016, on insurance distribution into Spanish law.

As in other jurisdictions, insurance contract disputes are often settled through judicial or arbitration proceedings. Judicial proceedings can be pursued in different jurisdictions: civil, criminal, social and contentious-administrative, depending, of course, on the nature of the dispute in question. Each of these jurisdictions has different procedural regimes. Law 1 of 2000, dated 7 January 2000, on civil procedure is relevant for matters not stipulated in other specific procedural laws.

There are also different types of courts. These are the first instance, instruction, courts of appeal (provincial courts, high courts of justice in some cases) and, as a last resort, the Supreme Court. The Supreme Court only handles cases of great technical complexity. To refer a case to the Supreme Court, the contentious matter must have cassation interest or involve the case deviating from the applicable case law.

Civil Proceedings

The litigation process depends on the relevant jurisdiction. In the civil jurisdiction, all litigation begins with a statement of claim in which the identification details and circumstances of the plaintiff and the defendant and the domicile or residence where they can be summoned must be stated, the facts and legal grounds must be numbered and set out separately, and the details of the request must be clearly and precisely stated.

Once this has been done, the court will admit the claim and transfer it to the defendant so that within 10 or 20 days (depending on the type of trial) he/she may proceed to reply to the claim. The court then sets a date for the pre-trial hearing (at which the evidence to be presented at the trial is proposed, as well as other formalities such as the possibility of making complementary allegations, providing new documentation, etc). Finally, a date is set for the trial at which the proposed evidence is presented and each party then has time to present their conclusion of the evidence and the law applicable to the case.

Once the trial has ended, the judge issues a judgment. The average duration of a civil procedure in the first instance is usually between 10 and 36 months from the filing of the claim until the judgment, depending on the location of the court and the workload pending. This judgment can be appealed before the court of appeal (audiencia provincial) and then potentially the Supreme Court if the requirements are met.

In insurance disputes with large financial claims (the so-called large risks) knowledge of procedural law and the strategy to be developed is essential, so the professional experience of a firm is logically a highly valued asset. It is simply a matter of professional solvency.

Criminal Proceedings

In terms of criminal proceedings, the procedure begins with a complaint or a criminal lawsuit in which the plaintiff sets out the facts that he or she considers to constitute criminal offences. The investigating court (juzgado de instrucción) is responsible for investigating the facts. Once the investigation phase has concluded (generally a maximum of 12 months, although it can be extended), the judge decides whether or not to prosecute the person under investigation.

At this stage, the opinion and allegations of the public prosecutor’s office are usually considered. If the judge considers that the facts constitute a crime and that the proceedings carried out prove that it was committed by the person under investigation, the judge issues what is known as an “accommodation order” and all the investigation proceedings are transferred to the criminal court (which is a different body from the previous one) in charge of holding the trial and issuing a judgment, or to the provincial court, which is a collegiate body, depending on the offence. The ruling issued can be appealed potentially all the way to the Supreme Court.

Judicial Proceedings in Labour Cases

Judicial proceedings before the labour jurisdiction require an initial attempt at conciliation between the parties and if there is no agreement, the judicial process can be initiated. Once the claim has been filed and prior to the trial, a new act of conciliation is attempted, this time in the court itself, and if there is no agreement, the trial proceeds. The trial is verbal, with evidence being taken in it and the conclusions being presented.

The ruling is issued in the following five days (normally it is issued sooner than this) and, as in the other jurisdictions, it can be appealed before the High Court of Justice and potentially all the way to the Supreme Court.

Contentious-administrative Proceedings

As far as the contentious-administrative jurisdiction is concerned, the judicial procedure is very similar to the civil procedure, although in this case the administrative file is of particular importance. It should be remembered that all proceedings before the contentious-administrative jurisdiction result from a previous process that has been followed by the injured parties against the corresponding administrative authorities (local councils, tax authorities, etc).

The procedure is initiated with a notice of the contentious-administrative appeal (this is the name given in this jurisdiction to the first document filed), at which point a file number is assigned and the corresponding public body is notified so that within 20 days it can deliver the entire administrative file. Subsequently, with all the documentation, the corresponding lawsuit is filed. The rest is similar to the procedure in the civil jurisdiction.

Limitation Periods

The limitation periods depend to a large extent on the action being brought. The general time limit for an insured party to bring an action against their insurer is two years from the date of the loss for non-life insurance and five years for personal insurance under Article 23 of the Insurance Contract Act.

For matters not expressly regulated, for example, when the insurer compensates the insured party and is subrogated in its position to exercise recovery actions against the third party that effectively caused the damage, the action will be time-barred depending on the action in question (five years for contractual actions and one year for non-contractual actions).

The limitation period in traffic accident actions is one year after the injured party has reached a stable condition (ie, the extent of any permanent injuries is known).

During the course of 2023, the Spanish courts issued more than 5,600 judicial decisions involving insurance policies.

There are legal mechanisms for the resolution of conflicts between insurers and insured parties and these are always aimed at complementing judicial proceedings. These mechanisms consist of submitting the parties to arbitration procedures or civil or commercial mediation procedures.

In addition, insurance companies are obliged to attend and resolve the complaints and claims that the policyholders, insured persons, beneficiaries, injured third parties or rightful claimants may file, but these must always be related to their legally recognised interests and rights within the policy contracted. For these purposes, the entities must have a customer service department or service in charge of attending to and resolving complaints and claims. Of course, this service has to be independent and external from the insurance company.

However, it should be noted that, particularly in the case of large claims, arbitration is a solution that is rarely used, with companies preferring to resort to judicial proceedings. This is because the leading insurance law specialists either work for insurance companies or for companies, which is understood to compromise their impartiality.

The Insurance Contract Law is mandatory and is the basic regulation of the contract. However, in the case of so-called large risk insurance, the voluntary regulation that the parties consider appropriate may be applied preferentially because for this type of contract the Insurance Contract Law is not mandatory.

In terms of jurisdiction, Article 22 of the Organic Law 6 of 1985, dated 1 July 1985, on the judiciary, states that in insurance matters, the Spanish courts will be competent when the insured party, policyholder or beneficiary of the insurance has their residence in Spain. The insurer may also be sued before the Spanish courts if the damaging event occurs in the Spanish territory and it is liability insurance or insurance relating to real estate. In civil liability insurance, the Spanish courts are also competent to hear the action brought by the injured party against the insured by virtue of the provisions on non-contractual obligations.

In addition, in other types of actions in which insurance policies may be affected, we must be aware of the type of action that is intended to be exercised. The Civil Procedure Law establishes in general terms that the judge competent to hear any matter will be from the defendant’s residence. Failing that, those who do not have a habitual residence or residence in Spain may be sued in the place where they are within the national territory or in the place of their last residence in it and, if jurisdiction cannot be determined in this way, in the place of the plaintiff’s residence.

Likewise, companies will be sued, in general, where they have their registered office. In the event that the insurer is domiciled outside of Spain, EU Regulation 1215/2012 of the European Parliament and of the Council dated 12 December 2012 on jurisdiction and the recognition and enforcement of judgments in civil and commercial matters applies.

According to Article 36 et seq of EU Regulation 1215/2012 of the European Parliament and of the Council on jurisdiction and the recognition and enforcement of judgments in civil and commercial matters, judgments given in a member state that are enforceable in that member state will also be enforceable in the other member states without the need for a declaration of enforceability. Therefore, judgments of the member states are directly enforceable in Spain. This is directly applicable to all judgments affecting insurance companies.

Similarly, court decisions from Denmark, Iceland, Norway and Switzerland are also enforceable in Spain by application of the Council Decision of 15 October 2007 on the signing, on behalf of the Community, of the Convention on Jurisdiction and the Recognition and Enforcement of Judgments in Civil and Commercial Matters (Lugano Convention).

In relation to third countries (non-EU members), the Hague Convention or, alternatively, the “exequatur” procedure regulated in Law 29 of 2015, of 30 July 2015, on international legal co-operation in civil matters, may be applicable.

One of the major problems we encounter when litigating in Spain on behalf of foreign entities relates to representation. In order to litigate cases involving EUR2,000 or more in Spain, insurers must have the representation of a representant (procurador) and a lawyer. This requirement must be met by both natural persons and legal entities.

The representant is the person who exercises the procedural representation of the litigants and they must have a power of representation issued by the person or persons who have, within the organisation, the authority to grant and guarantee the powers of representation.

In many cases, this task is complex, as insurers have internal structures with a different distribution of power and competences and, in many cases, finding the right person can be an arduous and laborious task. In any case, a law firm with procedural experience has sufficient power models in favour of the representant to appear in court on behalf of the party that appoints them.

Spanish courts and tribunals may enforce all awards rendered by arbitrators at the request of one of the interested parties. In this regard, commercial insurance and reinsurance contracts usually include dispute resolution clauses of various kinds, the most frequently used being submission to the competent courts and tribunals. The contracts also include the possibility of the parties submitting to arbitration proceedings for the resolution of disputes, although this option is usually less common and only applicable, in any case, to non-life insurance.

If the parties submit themselves to arbitration, the courts will refuse to hear these disputes. Once the arbitral award has been issued, courts will only hear the case where the rules of the arbitration procedure have been infringed, excluding the hearing of the substance of the matter resolved by the award, which is not appealable.

In 1977, Spain signed the Instrument of Adherence to the Convention on the Recognition and Enforcement of Foreign Arbitral Awards, signed in New York on 10 June 1958. The purpose of the Convention is to promote the extraterritorial enforcement of arbitral awards, and it has currently been endorsed by more than 159 countries.

In this sense, the jurisdiction to enforce arbitral awards belongs to the courts of first instance of the place where the award was issued, with the procedure being initiated by one of the parties through a claim for enforcement, attaching the enforceable title, the arbitration agreement and the documents proving that the award was duly notified to the parties. This procedure concludes with the corresponding judicial ruling on enforcement, as if it were a normal judgment. The enforcement of awards is usually admitted without objection by the courts.

Spain is a country where litigation is becoming the most common way to resolve disputes. Arbitration is becoming the second most common way to resolve disputes. However, these procedures tend to be more expensive (depending on the amount claimed) but also don’t last as long.

There are some insurance companies that frequently submit to arbitration procedures for the resolution of disputes. This includes those involved in credit insurance, where the contracting parties are exporters, distributors or companies.

While various arbitration institutions have attempted to promote its use in the field of insurance in recent years, the truth is that its use is limited. On the other hand, it must be assumed that the Spanish Arbitration Law regulates this procedure, based on the fact that natural or legal persons may submit the contentious issues, by prior agreement, to the decision of one or more arbitrators.

Arbitration is a form of single instance dispute resolution (some arbitration courts unusually established double instance procedures in which appeals were possible). The possibility of appealing an arbitration award in Spain is very limited, the only possible means being those indicated in Article 43 of the Arbitration Law on annulment action and review action.

In terms of the first option, this type of action can only be carried out if the arbitration procedure has breached procedural rules to resolve the disputed issue. The review action is limited to the options established by Article 510 of the Civil Procedure Law.

This covers when the award has been issued, decisive documents are recovered or obtained that could not have been available due to force majeure or due to the actions of the party in whose favour it had been issued, if the award was issued based on documents that one of the parties was unaware of at the time of its issuance that they had been declared false in a criminal proceeding, or whose falsehood was later declared criminal.

In short, the judicial review of awards is restricted and is usually difficult for the competent courts to accept.

Spanish case law states that in accordance with the rules of interpretation of contracts, the real or effectively intended will of the parties must be sought. To this end, the literal meaning, as a criteria for interpretation, is the initial assumption, insofar as it constitutes the starting point from which meaning is attributed to the statements made, the specific intention of the contracting parties is investigated and the business purpose projected in the contract is adjusted or delimited.

When the terms are clear and leave no doubt about the intention of the contracting parties, the literal interpretation prevents, under the pretext of the interpretative work, a declaration that is really clear and precise from being modified. This is the response of the rule contained in the first paragraph of Article 1281 of the Civil Code (“if the terms of a contract are clear and leave no doubt about the intention of the contracting parties, the literal meaning of its clauses will be followed”).

On the contrary, literal interpretation also helps to show that contracts, due to their lack of clarity, the existence of contradictions or gaps, or the conduct of the contracting parties themselves, contain interpretable provisions, so that the work of interpretation must follow its course, with the criteria for interpretation at its disposal (Articles 1282 to 1289 of the Civil Code), in order to provide those provisions with a meaning in accordance with the intention really desired by the parties and with what is imperatively provided for in the contractual order.

Notwithstanding the above, the Insurance Contract Law grants the parties the freedom to agree on the content of the insurance that they consider appropriate in everything that does not oppose what it determines as minimum content. For example, with regard to fire insurance, it states that “fire is considered to be the combustion and burning with flame, capable of spreading, of an object or objects that were not intended to be burned at the place and time in which it occurs”, which logically requires that damages due to explosion or others must be included in the coverage by the will of the parties, as they are outside the legal concept of fire.

The policyholder must, before the conclusion of the insurance contract, submit to a rigorous insurance questionnaire in which they must declare all the circumstances known to them that may influence the assessment of the risk. They will be exonerated from this obligation if the insurer does not submit a questionnaire to them or when, even if it is submitted, the circumstances are involved that may influence the assessment of the risk and are not included in it.

In this regard, the insurer may terminate the contract by means of a declaration addressed to the policyholder within a period of one month, counting from the time it becomes aware of the policyholder’s reservation or inaccuracy in the questionnaire. The insurer will be entitled, unless there is fraud or gross negligence on its part, to the premiums relating to the period in progress at the time of making this declaration.

It should be added that the application for insurance does not bind the applicant, but if the insurance is proposed by the insurer, the insured party is bound by this proposal for a period of 15 days. By agreement of the parties, the effects of the insurance may be retroactive to the time when the application was submitted or the proposal was made.

Since the COVID-19 crisis began in 2020, some lines of business such as healthcare, travel and event cancellation, or credit insurance, among others, have been seriously affected with a corresponding increase in claims.

Business interruption insurance has also been affected. This is not yet entirely evident, but we believe that in the coming months we are likely to see an increase in claims. However, given the time elapsed and the limitation periods for the exercise of actions, with the exception of some very high claims filed by large companies, it is not foreseeable that there will be a significant deviation in claims from the usual pre-COVID-19 parameters.

In contrast to the above, it is possible that in the coming months there will be an increase in claims against D&O insurance due to the possible worsening of the economy. The more deteriorated a company’s profit and loss accounts become, the greater the risks that corporate managers will have to take, and D&O insurance is famously the type of insurance where the effects of ill-considered corporate risk-taking are most keenly felt.

Disputes related to insurance contract coverage are usually settled by the courts of the insured’s residence. In the case of disputes concerning the interpretation of certain policy clauses, disputes are usually settled in the first instance by the civil courts. Disputes arising from reinsurance contracts are settled in the same way.

In Spain, policyholders, who are individuals, are usually considered consumers and the vulnerable party in the contract. For this reason, if at any time there is a dispute regarding the interpretation to be given to any clause of the policy, this should always favour the insured, considering the circumstances of the case.

Furthermore, the Insurance Contract Law is drafted precisely to protect the contracting consumers, with various provisions being more favourable to them than to the insurance companies. Article 3 of the Law is a clear example: “The general conditions of cover which in no case should be prejudicial to the insured, must be included by the insurer in the proposal form if there is one and in any event in the policy documents or in a supplement, which shall be signed by the insured to whom a copy shall be given. The general and particular conditions shall be drafted in clear and precise terms. Those clauses limiting the rights of the insured shall be plainly marked and specifically accepted in writing.

The general conditions of the contract are subject to supervision by the Public Administration in the terms set forth in this Act.

If the Supreme Court declares that a particular clause in the general conditions of a contract is null and void, the competent Public Administration shall take steps to oblige all insurers to modify identical clauses contained in their own policies.”

Circumstances of a third party enforcing an insurance contract or suing an insurer in connection with an insurance contract primarily arise in civil liability insurance. At this point it is important to highlight the importance of Article 76 of the Insurance Contract Law, which states: “The prejudiced party, or their heirs, shall have direct action against the insurer in order to demand compliance with the obligation to indemnify, without prejudice to the right of the insurer to re-claim against the insured in the event of the damages to the third party being due to the fraudulent conduct of the insured. The direct action is immune to the exceptions which the insurer may have against the insured. The insurer shall have the right, however, to oppose the action by alleging the exclusive blame of the prejudice party and the personal exceptions that the insurer has against the latter. In order to exercise the direct action, the insured shall be obliged to inform the prejudiced third party or their beneficiaries of the existence of the insurance contract and its contents.”

Any injured party can therefore claim directly from the insurer of the person or persons who caused the damage without it being necessary to sue them as well.

The situation in which a third party can sue an insurer is a frequent scenario in our jurisdiction. Let us think of any action or omission that causes bodily or property damage to a third party. That third party can, by virtue of the damage caused, file a claim for non-contractual civil liability against the person who caused the damage and his insurance company, or simply against the latter.

Article 7.1 of the Spanish Civil Code states that rights must be exercised in accordance with the requirements of good faith. Extrapolating this precept to Article 19 of the Insurance Contract Law, the legislator established that: “The insurer shall be obliged to pay the indemnity, except when the loss has been caused in bad faith by the insured.”

This concept of bad faith has been interpreted by the Supreme Court in the sense that bad faith is “the malicious intention to cause damage contrary to law,” so “what is relevant is that it must be a conscious and voluntary act of the insured. It must be an intentional and malicious act of the insured.”

There are no administrative sanctions specified in Spanish insurance legislation, although for unjustified delay in the payment of compensation, Article 20 of the Insurance Contract Law requires insurers to pay interest for each day of delay.

In this regard, it is understood that the insurer delays if it has not paid the compensation within three months from the date of the loss or if it has not paid the minimum sum that it knows is owed within 40 days following receipt of the notification of the loss.

Compensation for delay will be imposed at the request of the court and will consist of the payment of interest equal to the legal monetary interest in force at the time of accrual and will be increased by 50%. The interest is considered to be accrued daily without having to be claimed judicially. However, if two years pass from the date of the loss, the annual interest may not be less than 20%.

Judicial proceedings are usually long and, in many cases, from the time the loss occurred until the first instance court judgment is issued, could take between 15 and 24 months or more, so that, taking into account the amounts claimed, the interest payable under Article 20 could lead to significant amounts being owed.

The statements made in the insurance questionnaire by the broker or insurance company about the risk to be insured are not binding on the policyholder. In this sense, Article 10 of the Insurance Contract Law states that the insurer may rescind the contract by means of a declaration addressed to the policyholder within one month from the date on which the insurer becomes aware of the non-disclosure or inaccurate representation by the policyholder.

The statements are always from the policyholder themselves, so the broker cannot replace them unless they have a special power of representation, which is unusual.

Insurance companies usually manage claims internally for medium and large risks. In mass risks, there are usually delegated authorities for the management of the files, as occurs with the management of policy underwriting where insurance agents are involved.

In recent years we have seen an increase in the type of organisations that offer multidisciplinary services to insurance companies in claims management until they are brought to court, at which point they are normally managed by law firms that specialise in the matter.

Civil liability insurance includes coverage for legal costs, whether in the civil or criminal jurisdiction, although in the latter case compensation for damage is also claimed by the injured third party in the process. Financing includes payment of the costs of the process to the losing party, in which case the insurer also pays the legal costs incurred by the winning party in the procedure.

The problem with civil liability insurance is that the assumption of legal costs is required by law, so it is unclear if this will change in the coming years. In addition, due to the competition that exists in the market (especially in relation to some insurance lines such as D&O or professional civil liability), entities have been increasing coverage and limits with lower premiums for years, creating an intrinsic risk for this type of policy. However, this trend has ceased post COVID-19 and the attitude of companies is to increase premiums with less coverage.

In the coming years, the entry of litigation funds willing to acquire litigation and assume the costs of the most expensive processes allows us to foresee a significant increase in litigation.

Legal costs in Spain depend on the economic value of the dispute. Years ago, bar associations in Spain issued Guiding Fee Criteria that lawyers took into account when billing for their services in court. These Criteria are for guidance purposes only and may be modified by the competent judges who hear the matter.

In terms of the complexity of litigation in the insurance field, more and more types of coverage are available on the market due to the circumstances of a constantly changing market, which require greater specialisation that will possibly also extend to the judicial world, as the complexity of the policies and the most important claims is increasing.

The Spanish market offers legal defence insurance, where the insurer undertakes, within the limits established by law and in the contract, to cover the costs that the insured party may incur as a result of their intervention in an administrative, judicial or arbitration procedure and to provide them with the judicial and extrajudicial legal assistance services derived from the insurance coverage (Articles 76(a)-(g) of the Insurance Contract Law).

This type of insurance has some requirements that differentiate it from other insurance, such as:

  • it must be the subject of an independent contract or may be included in a separate chapter within a single policy, in which case the content of the guaranteed legal defence and the corresponding premium must be specified;
  • the insured party will have the right to freely choose the representant and the lawyer who will represent and defend him/her in any type of procedure; and
  • the insurance excludes coverage for the payment of fines or sanctions.

Of course, there are also the agreements that can be adopted with litigation funds, which is already a reality that will foreseeably increase.

Article 43 of the Insurance Contract Law states that the insurer after paying the compensation will be entitled to exercise the rights and actions that by virtue of the loss belonged to the insured party against those persons liable for the loss, up to the compensation amount limit. The insurer will not be able to exercise those rights that have been subrogated in prejudice of the insured party. The insured party will be responsible for those prejudices that, by his acts or omissions, have been caused to the insurer in his subrogation rights.

The insurer will also not have the right of subrogation against any person whose acts or omissions give rise to liability on the part of the insured party, in accordance with the Law, nor against those who caused the loss and are, with regard to the insured party, a direct relative or a collateral relative within the third civil degree of consanguinity or adopted parent or adopted child that lives with the insured party. This rule will have no effect if the liability arises from bad faith or if the liability is covered by means of an insurance contract. In this case, the subrogation will be limited in its scope in accordance with the terms of the contract.

In the event of the insurer and the insured party concurring against the third party liable for the loss, the amounts recovered will be shared between them in proportion to their respective interests.

The regulation of the right of subrogation to claim the damage caused by a third party is regulated by Article 43 of the Insurance Contract Law. In this case, the insurer has to base its claim on having paid the compensation to the insured party, thereby providing all of the respective rights.

The case law has established a series of requirements for the insurer to be able to exercise the recovery action. These are:

  • the existence of an insurance contract;
  • the reality of a loss covered by the contract;
  • the effective payment, sufficiently accredited, of the compensation that corresponds to the insured, in accordance with the contract; and
  • the direct liability of a third party, against whom the repetition action is exercised, which in turn requires the causal relationship between the action of the third party and the loss (that is to say, based on the existence of a claim of the insured against the third party liable, as a consequence of the same damage that gave rise to the indemnity).

Following COVID-19, Spain was largely paralysed, like most EMEA territories. The Spanish government implemented a series of measures to totally or partially restrict the movement of people throughout the territory, both national and foreign. In addition, the government paralysed businesses of all kinds, affecting all sectors of economic activity in the country (industrial, services, etc).

Due to the drastic drop in economic activity, the loss rate fell in all lines of insurance, with the direct effect being a decrease in litigation at all levels. Over the course of 2022 and 2023, activity has been recovering and the number of litigation cases has increased proportionally.

In 2024, economic activity has fully recovered in some sectors, while others remain at pre COVID-19 levels. Some of the sectors that are still at pre COVID-19 levels are the construction, artistic and recreational activities or agriculture sectors, while the industrial, tourism or services sectors have rebounded compared to the years before the pandemic. This data confirms a possible trend to know where more claims may be generated and, therefore, an increase in litigation, although there is usually no direct correlation.

We expect an increase in litigation for 2025, although it will be contained and depending on the insurance line in question. We expect a slight increase in vehicle insurance or construction, while the forecasts in other sectors such as healthcare remain the same.

Litigation, and insurance litigation in particular, is very common in Spain. According to Ministry of Justice statistics, more than 5,600 judgments were issued in all jurisdictions on matters related to insurance contracts last year. For this reason, there is no specific factor that will significantly cause an increase in litigation as a result of coverage problems. The Spanish system normally protects consumers, so they submit coverage problems to the competent courts.

There are certain risks that are not usually insured in the local market (food industry, waste treatment, etc) so their outlook has not changed for some time. On the other hand, after COVID-19 there has been an increase in claims in certain sectors, so there has also been a considerable increase in premiums (D&O and cars in particular). At the same time, there are lines such as cyber-insurance where insurance coverage is increasingly reduced. Even so, premiums tend to remain high due to the risk associated with this type of cover.

ESG factors currently significantly influence the underwriting and litigation of insurance risks. Environmental risks, such as climate change and natural disasters, directly impact insurers when adjusting premiums or even denying coverage to companies with a substantial environmental impact, although the Spanish Insurance Compensation Consortium compensates for damages caused by natural disasters (earthquakes, tidal waves, extraordinary floods, volcanic eruptions etc) and other force majeure events (terrorism, rebellion, sedition).

Social factors, such as poor labour practices, are under constant and detailed scrutiny by insurers. Companies that do not demonstrate a solid commitment to these best practices may face serious issues in securing insurance.

How a company is managed and operated with criteria such as transparency and ethics is fundamental. Poor governance may indicate potential legal risks.

These factors also affect litigation trends, with an increase in claims related to natural disasters and social responsibility. Insurers are becoming increasingly cautious about underwriting companies exposed to such risks due to the potential legal issues and lawsuits that may arise.

Data protection laws are increasingly influencing the underwriting and litigation of insurance risks. Insurers, brokers and companies in general must comply with various regulations related to the collection, use, and maintenance of personal data, which directly affect their risk assessments and potential pricing adjustments. Compliance with these obligations involves investment costs that may be passed on to the insured party.

Non-compliance with these regulations is leading to significant legal actions and high fines. Non-compliance can affect the coverage provided by insurance companies as well as the management of claims.

Another relevant aspect is data security breaches or misuse of data, which is a fundamental issue that companies must address in their policies, implementing changes in insurance terms or premiums.

There have been no major regulatory changes in the insurance sector in recent years. The last legislative amendment affecting the sector was to Royal Decree-Law 3 of 2020, dated 4 February 2020, which amended the Insurance Distribution Law. The amendment came into force on 20 March 2024.

However, there has been a profound legislative amendment in relation to the Civil Procedure Law that affects all types of actions (summons, appeals, how to draft claims, etc) This directly affects any insurance litigation as the Civil Procedure Law affects all types of actions in the civil jurisdiction.

B&A, Blanco y Asociados Abogados

C/ Lagasca 105, 3º
28006 Madrid
Spain

+34 915 638 407

+34 915 638 347

secretaria@bya.abogado www.bya.abogado
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Trends and Developments


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Hogan Lovells has 2,800 lawyers on six continents who provide practical legal solutions and fresh thinking combined with proven experience to deal with a fast-changing, interconnected world. Its experience in cross-border and emerging economies gives it the market perspective to be a global partner and to ensure that its legal solutions are aligned with its clients’ diverse business strategies. The team’s range of backgrounds and experience gives them a broader perspective, which they can use to their clients’ advantage. As advocates of justice, equality, and opportunity, they believe in giving back to their communities and society as a whole. All staff at Hogan Lovells are asked to volunteer for at least 25 hours a year as part of their normal work duties. Around the world, the firm is making a difference through pro bono activities, community investment, and advocating for social justice.

Trends and Evolution of the Insurance Sector in Spain

The current insurance landscape in Spain reflects a significant transformation in the sector, which has been influenced by technological, economic and regulatory factors.

When it comes to technology, the emergence of AI, blockchain and predictive analytics is changing how insurers operate. These tools enable more accurate risk assessment and improve operational efficiency, especially in claims processing and service customisation.

We have also seen how the implementation of new regulations, such as in terms of environmental, social and governance (ESG), has gained prominence, grouping the most relevant non-financial factors of a company into these three areas. The objective, in principle, is to direct the operations of insurance companies towards greater sustainability, consumer protection and fair competition in the market.

Customer orientation and personalisation are becoming increasingly crucial. Insurers aim to offer products tailored to the individual needs of customers, thereby improving their experience and responding to the day-to-day activities that need to be insured in order to provide greater security and peace of mind to policyholders and, therefore, to society as a whole.

Insurers in Spain are evolving rapidly thanks to technological advancements, new regulations and a complex macroeconomic environment. These trends are redefining the way insurers manage risk and operate in the marketplace.

As is always the case, these changes are being reflected in the design of products and the way insurers and other players in the sector operate. However, it will still take time for these changes to reach insurance litigation in Spain and while we are beginning to see a small shift in extrajudicial claims and the courts, it is certainly still timid.

We will therefore address several issues that are relevant in the courts in Spain or that deserve, due to their relevance, to be analysed in this chapter.

Unit-linked Life Insurance

Unit-linked life insurance has gained popularity in Spain as a savings and investment product. This type of insurance combines life coverage with investment in a variety of financial assets, allowing policyholders to benefit from market returns.

Unit-linked insurance is life savings insurance, where the funds constituting the insurance premium are contributed by the policyholder but are invested, in the name and on behalf of the insurer (which, in most cases, enters into a contract with an insurance agent acting as intermediary or manager), in financial assets, with the policyholder bearing the investment risk. Its main characteristics are as follows.

  • Flexibility: these products are basically the same as a mutual fund portfolio. The policyholder can adapt the investment to the market conditions at the time by establishing the investment term, the value of the premium, the hedges and the investment itself. Sometimes, the unit-linked type of insurance underwritten involves entrusting the management of this investment to a professional manager who carries out the investments in accordance with the investment strategy previously established by the policyholder on a form that he/she fills out at the time of taking out the insurance policy.
  • Liquidity: the policyholder can redeem the policy whenever it is needed.
  • Risk assumed by the insured: unlike other savings insurance policies that guarantee a minimum return, in unit-linked policies the return depends on the performance of the chosen assets.
  • Taxation: as an investment and savings product, capital gains from unit-linked insurance are taxed as savings income and it is possible to defer taxation in the area of personal income tax to the moment in which a redemption is made or the occurrence of the open contingency takes place. In addition, if the beneficiaries are different from the policyholder, the capital will be subject to inheritance and gift tax, which is subsidised in some cases in some autonomous communities.
  • It is not part of the inheritance in case of death: you can choose who will collect the insurance if you die and it may not be your heirs. In fact, this product has traditionally been used to direct money to people who were not the protected heirs. This is one of the most attractive features of this type of insurance and has allowed policyholders on many occasions to have the freedom they long for in the family sphere and give their money to whoever they deem appropriate and not who the Spanish Civil Code states.

However, despite the fact that these insurance policies offer numerous advantages, their concept and essential characteristics have not caught on with policyholders who, when their investment or savings expectations are dashed, take legal action claiming, in most cases, nullity of the investment due to error or lack of consent or, alternatively, termination of the contract due to breach of contract.

Claimants often also argue at first that the product underwritten is a life insurance policy. It is argued that the policies in question do not meet the requirements for a life insurance contract and it is generally asserted that the existence of an investment or savings cannot be associated with the nature of life insurance. One of the criticisms expressed is that there should be no transfer of risk. However, this is a transfer of investment or savings and not a transfer of risk.

This issue has already been resolved by the Spanish Supreme Court and by the European Union Court of Justice who have confirmed that the unit-linked insurance contract is a fully valid life insurance policy.

A unit-linked product is a life-savings insurance product. Although it may resemble a financial product, it is a life insurance contract and therefore has the same characteristics and elements as life insurance.

Article 83 of Law 50 of 1980, of 8 October 1980, on insurance contracts states: “Through life insurance, the insurer undertakes, through the collection of the stipulated premium and within the limits established in the Law and in the contract, to pay the beneficiary a capital sum, an income or other agreed benefits, in the event of death or survival of the insured, or of both events jointly.”

The parties to unit-linked insurance are, as in any other life insurance, the policyholder, the insured party and the beneficiary. The only difference to other life insurance policies is that the premiums paid for this type of insurance are invested in mutual funds or baskets of mutual funds and, as anticipated, the policyholder assumes the investment risk. When the insured event occurs (death or survival), the policyholder either decides to surrender the insurance, or the policyholder or beneficiary does not receive an indemnity corresponding to the amount determined when the policy was taken out, but rather the value of the policy at that moment (which will obviously depend on market fluctuations).

In short, unit-linked life insurance offers significant advantages in terms of flexibility and profitability potential, but it also carries certain risks. The key to avoiding legal claims is to ensure clear and transparent communication about the concept, risks and features of the product, as well as providing appropriate advice that aligns with the client’s profile and expectations.

Vaccination and Informed Consent on Adverse Effects

Spanish Supreme Court case law limits the position of the insurance company in healthcare insurance contracts. It has determined that the insurance company is not a mere intermediary between the doctor and the insured party but a guarantor of the service. This means that the contract is not only limited to covering the damage caused to the insured party when he has to assume the costs for the restoration of his health but is aimed at providing the health services included in the policy through doctors, clinics and adequate facilities.

The benefit the insurer is obliged to provide in healthcare insurance is, therefore, a service to be provided, consisting of rendering a medical, surgical or hospital service when requested by the insured party. The Supreme Court has ruled on this matter on several occasions and determined that the insurer is obliged to ensure not only that a health service is provided but also that the performance of the services by the centres or professionals is adequate.

Applying this to the context of vaccinations provided for in the vaccination schedules of minors and as a result of some relevant resolutions, it is worth asking whether there is any requirement for coverage to be effective in the context of Spanish case law where the parents of the minor are not informed of the adverse effects of these vaccines.

Article 8 of Law 41 of 2002, of 14 November 2002, on patient autonomy establishes that any action in the field of a patient’s health requires the patient’s free and voluntary consent. In the case of minors, this consent is given by “representation”. The majority doctrine agrees that written informed consent is not necessary for paediatric vaccination.

In terms of the content of this information, it seems logical to think that it should include complete and understandable verbal or written information on the vaccines that their children can receive, including all authorised and indicated vaccines, whether they are financed by the national health system or not and on the benefits and risks of vaccination, non-vaccination, frequent or infrequent side effects, and how to deal with them. This would make it possible to express doubts and ask for additional information in order to be able, finally, to give free consent on the acceptance of the proposed vaccinations.

However, the Supreme Court has ruled on this issue on several occasions and determined that with regard to financed vaccines and vaccination campaigns, it would be sufficient to inform verbally about the mild consequences, duration and palliative measures, as well as the typical risks (see, among others, the judgments of 25 March 2010, 10 November 2011 and 2 January and 30 January 2012). The Supreme Court has stated that “the duty of information cannot be understood as generic or in terms of hypothetical probability, nor does it cover the requirement of excessive and disproportionate information with the curative or preventive purposes of medical science, such as that relating to non-normal risks, not foreseeable according to the medical literature, or based on specific characteristics of the individual, which previously could not have been manifested as relevant or susceptible to a medical assessment”.

However, there are other courts that initially did not follow the jurisprudential line of the Supreme Court. They considered that when the risk is so “particularly serious, even if it is an atypical risk because it is infrequent” there is a duty to inform (see the judgment of the High Court of Castilla-León, 2 January 2012), but this opinion has recently changed.

The High Court of Justice of Castilla-León itself in its recent ruling of 8 February 2024, accepts the reasoning of the Supreme Court against its own 2012 ruling and states that only frequent and general adverse effects must be reported and not infrequent ones, no matter how serious they may be.

It therefore seems that in a case in which one of these infrequent but possible adverse effects manifested itself after a vaccination, we would not be faced with a case of defective performance of the healthcare service due to lack of information.

It seems therefore that both the Supreme Court and the other courts, at the moment, are clear – there is an obligation to only report frequent and general adverse effects prior to the administration of a childhood vaccine in order to understand that the insurer is providing the correct healthcare.

The Impact of the Product Liability Directive on Product Liability Policies

Since the adoption of Directive 85/374/EEC on 25 July 1985, significant changes have occurred in the chain of placing products on the market. On 28 September 2022, the proposal for a Product Liability Directive was published and was finally approved on 12 March 2024.

In general, many of the changes introduced by the new directive respond to this need for updating. However, others raise particular practical questions.

  • The definition of “defectiveness” changes: the new directive maintains the classic description of “defect” in the product (“it shall be considered defective when it does not offer the safety that a person has the right to expect”). However, Article 7 introduces a list of “circumstances” to be taken into account when assessing the defectiveness of a product, which include the reasonably foreseeable use of the product, the effect on the product of its ability to continue to learn or acquire new characteristics after it has been placed on the market or put into service, the reasonably foreseeable effect on the product, the safety requirements of the product, any recall of the product or any other relevant intervention by a competent authority or economic operator, the specific needs of the group of users for whose use the product is intended, in the case of a product whose purpose is precisely to prevent damage or any failure of the product to fulfil that purpose.
  • Burden of proof and presumption of defect and causal link in some cases: another of the main novelties that changes the current burden of proof is found in Article 10, which contains a series of presumptions regarding the defective nature of a product:
    1. when the defendant breaches the obligation to disclose relevant evidence;
    2. when the claimant proves that the product does not comply with mandatory safety requirements established in Union or national law that are intended to protect against the risk of the damage produced; and
    3. when the damage is due to an obvious malfunction of the product during normal use or under ordinary circumstances, the causal link between the defectiveness of the product and the damage will also be presumed when it has been established that the product is defective and the damage caused is of a type typically compatible with that defect.
  • The limitation period for bringing an action is increased from ten to 25 years in cases of latency of personal injury: the new directive extends liability to 25 years in cases where the claimant has not been able to initiate proceedings due to latency of personal injury.

Some of these changes may generate legal uncertainty and practical problems in their application and will certainly have a clear impact on product liability policies. The modification affecting the burden of proof is an example of this.

Although the new directive is careful to make it clear that this change does not imply a reversal of the burden of proof, the reality is quite different. The presumptions included in the new directive (among others, the one that indicates that the defect is presumed when the defendant has not provided sufficient evidence of its non-existence) leave the classic obligation to prove the defect, the damage and the causal relationship between the two behind.

If manufacturers have to prove that the product is safe, the reversal of the burden of proof is clear and reinforces, in the claimant’s favour, the objective nature of liability, leaving manufacturers at a disadvantage as these presumptions will become a “catch-all” where all unfounded claims will have a place.

The concept of defectiveness is another of the modifications where the new directive moves away from the classic theory of civil liability, leaving manufacturers in a difficult situation when it comes to disassociating, for example, the withdrawal of a defective product from the market. In these cases, manufacturers’ liability will once again be a kind of strict liability, leaving them without the right to a process with all the procedural guarantees that, in theory, are included in the Spanish Civil Procedure Law.

Faced with these changes, “Product CR” policies will have no choice but to adapt. Insurance companies will have to carry out an analysis of the increased risk they will have to cover in this new scenario (which, being a higher risk, will obviously have an impact on the agreed premium). On the other hand, they will have to modify the clauses of the coverage of this type of policy and include previously unforeseen exclusions such as, for example, damage resulting from the withdrawal of a product.

In addition, the extension of the manufacturers’ liability period to 25 years from the date the product is put into circulation in cases of latent damage may affect the time coverage of these policies, limiting them to damage occurring strictly during the term of the contract. Coverage would otherwise be extended ad infinitum.

In short, the changes introduced by the new directive will mean a major revolution, not only in terms of the burden of proof for insurers that their product complies with the applicable regulations, but they will have to go further and, in order to try to avoid a sort of strict liability, they will have to allocate enormous resources in the post-marketing phase of the product and in the modification of their product liability policies.

Cut-Through and Pay to Be Paid Clauses in Insurance and Reinsurance Policies and its Validity Under Spanish Law

In accordance with Articles 77 and 78 of Law 50 of 1980, of 8 October 1980, on insurance contracts, the insured party is not entitled to demand any type of benefit directly from the reinsurer. The insured party must claim the full amount of the indemnity from the insurer, and the insurer, in turn, would have the right of recourse against the reinsurer.

However, in practice, especially in large risk policies (eg, aeroplanes, ships), there are clauses that allow the insured party to claim directly from the reinsurer. These “cut-through”, “simultaneous payment” or “pay to be paid” clauses, which come from Anglo-Saxon law, transform the reinsurer into the material insurer, leaving the insurer as a formal figure or involved in “fronting”.

“Cut-through” clauses allow the insured party to approach the reinsurer directly to demand payment of the reinsured sum, thereby avoiding the application of Article 78 of the Insurance Contract Law.

“Simultaneous payment” clauses provide that the insurer is not obliged to pay the insured party until it receives the funds from the reinsurer. In addition, the insurer will only pay the insured party the amount received from the reinsurer, even if this amount does not cover the total indemnity claimed. These clauses circumvent the second paragraph of Article 77 of the Insurance Contract Law, which obliges the insurer to pay the indemnity without prejudice to its right of recourse against the reinsurer. Despite the apparent contradiction with Articles 77 and 78 of the Spanish Insurance Contract Law, these clauses may be valid and admissible in certain cases.

Article 77 refers to “internal reinsurance”, where the insured party does not participate in the agreement between insurer and reinsurer. If the reinsurer binds itself directly to the insured party, this would be “external reinsurance” and would therefore not be subject to the limitation of Article 78.

If the reinsurer assumes a direct obligation to the insurer and the insured party, this covenant could be valid by offering more guarantees of recovery to the insured party. Although these clauses seem incompatible with Article 78, they are valid in external reinsurance cases. This is because the precept is not mandatory and benefits the insured party by allowing them to claim from two different entities.

“Simultaneous payment” clauses present major problems as they reduce the rights of the insured party. The insurer is only liable if it previously collected a sum from the reinsurer and only for the amount collected. This leaves the insured party dependent on the reinsurer, which may not be authorised to operate in Spain and, therefore, this scenario complicates collection when payment does not occur voluntarily.

The situation changes if we go into policies insuring large risks, for which Article 44 of the Insurance Contract Law declares the precepts of the Law as non-mandatory.

In summary, “cut-through” clauses do appear to be recognised and valid under Spanish law, while “pay to be paid” clauses are not. However, given the limited number of rulings to date, we will have to wait for the evolution of case law in this area to determine their definitive application and validity.

Hogan Lovells

P.º de la Castellana, 77
28046 Madrid
Spain

+34 913 498 200

MadridOffice@hoganlovells.com www.hoganlovells.com/es
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Law and Practice

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B&A, Blanco y Asociados Abogados was founded in Madrid in 1987. It provides legal services throughout Spain and specialises in insurance law on industrial risks and corporate civil liability. Its professional services are usually employed for the filing of insurance claims, which is one of the firm’s specialties. Its professional services are also usually employed for judicial claims of controversial incidents involving large insurance risks. A significant part of the judicial proceedings the firm handles require a deep knowledge of civil and commercial law in general and insurance law in particular, as well as extensive experience in procedural law in courts of justice and arbitration proceedings. The firm’s activities also include regulatory (both in relation to insurance companies and insurance brokers) and litigation in all lines of insurance.

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