Insurance law calls for the contract, the risk insured and the facts that gave rise to the insured event to be understood together. The construction of the policy, the scope of the cover and of the exclusions, the causal link, the assessment of the loss and the position of the insured and that of the injured party, as well as the possible existence of other liable parties or insurers, may wholly determine the strategy in the matter.
We advise and defend insurers, businesses and individuals in disputes arising from the insurance contract and from the liabilities connected with the insured event. We act in claims for refusal of cover or for disagreement over the amount of the compensation, in recovery and subrogation actions, in the defence against claims brought by insurance companies and in direct actions against civil liability insurers.
More than thirty years of experience from the different positions in the conflict allow us to analyse each dispute with a particularly complete understanding of the interests and the foreseeable arguments of all the parties.
The starting point of any insurance dispute is to determine precisely what risk was insured and what the real scope of the cover is. A policy cannot be analysed by reading one clause in isolation. The general and particular conditions, the covers taken out, the limits in amount and in time, the excesses, the exclusions and the circumstances in which the insured event occurred all have to be examined together.
The “Ley de Contrato de Seguro”, Spain's Insurance Contract Act or LCS, requires the policy to describe the risk and the cover, and requires clauses limiting the rights of the insured to be given specific treatment. Drawing the right distinction between the definition of the risk, exclusions and limitations of cover may be decisive in resolving a dispute. For that reason, before taking a position, we analyse the policy as a whole and relate it to the specific reality of the insured event. It is not enough to determine what the contract says; it is necessary to establish how it must be applied to the facts and what legal consequences it produces for each of the parties.
Since 1992 we have advised and defended insurers against claims brought by insureds, injured parties and third parties, both out of court and before the courts.
The defence requires it to be determined, first of all, whether the event notified is an insured event that is covered and, if so, what the extent of the insurer's obligation is. We analyse the policy, whether the covers were in force and how far they extended, the exclusions that may be relied on, the limits of cover, the liability attributed to the insured, the causal link and the reality and quantification of the losses claimed.
Where there is a reasonable prospect of reaching a negotiated solution, we assess whether it is advisable from a legal and an economic point of view. Where the conflict requires going to court, we prepare from the outset the evidence and the strategy needed to defend the insurer's position.
Once it has paid the indemnity for an insured event, the insurer may have standing to claim the sums paid from the liable third party. Subrogation allows it, within the limits set by law, to exercise against the party liable the rights and actions that belonged to the insured.
Insurers usually handle numerous recoveries, which calls for a volume legal case management system in which scale does not dilute quality. From the volume case management and processes department of our Barcelona office, we combine legal knowledge, organisation and technology applied to the law in order to handle large volumes of claims and court proceedings efficiently, maintaining traceability, rigour and control in every case file. Technology allows us to optimise processes and handle volume; legal knowledge and professional oversight ensure that every step taken follows uniform criteria and a previously defined strategy.
The result is a scalable and responsive service, subject to high standards of responsibility, oversight and legal quality.
We also defend businesses and individuals where it is their own insurer that refuses, wholly or in part, to cover an insured event or disagrees with the amount of the compensation. The refusal may be based on very different grounds, such as those relating to the construction of the risk insured, the application of an exclusion, the limits of the policy, the declaration of the risk, the origin of the loss or the quantification of its consequences.
In these matters we review the policy and all the contractual documentation, reconstruct the circumstances of the insured event and analyse the specific ground on which the insurer relies in refusing to meet the claim. Where the dispute has a technical or economic dimension, we coordinate the expert evidence needed to establish the cause and the extent of the loss.
Our aim is to check whether the refusal or the limitation of cover is genuinely founded on the contract and on the applicable rules. Where it is not, we claim full performance of the insured benefit and whatever consequences follow in law. The claim is first put forward on the basis of a full assessment of the documentation and of the prospects of an out-of-court solution. If the insurer maintains a position that we consider legally unjustified, we take on the defence of the insured before the courts.
In civil liability insurance, the relationship between the injured party, the insured and the insurer introduces a further dimension. The LCS confers on the injured party a direct action against the insurer and lays down a specific regime governing the defences that the insurer may raise against the injured party. That autonomy of the direct action calls for a careful distinction between the questions relating to the liability of the insured and those that belong properly to the insurance relationship.
We bring direct actions against insurers on behalf of those who have suffered the loss and, from the opposite position, we defend insurers against the relief sought by injured parties. These proceedings usually call for a very precise analysis of causation, the technical and expert evidence, the quantification of the loss, the identification of all those liable and the possible concurrence of several insurance policies. The strategy has to address all of this together, from before the proceedings are commenced.
Our experience in litigation allows us to prepare these matters from their earliest stage with a procedural view of the evidence, the defences, the quantification of the loss and the position of each participant, both in negotiation and before the courts. Having acted from different positions is a particularly significant advantage here. Because we have defended insurers, insureds, companies facing claims and injured parties, we know how each party builds its arguments and we can anticipate the questions that are likely to become the centre of the conflict.
A portfolio of hundreds of cases may share a common structure without every matter being legally identical. Volume case management calls for uniform rules to be laid down and, at the same time, for systems capable of detecting the circumstances that require departing from those rules and subjecting the file to individual analysis.
The general application of the European Artificial Intelligence Regulation —the AI Act— on 2 August 2026 marks a turning point in the use of algorithmic systems in the underwriting and pricing of insurance, particularly life and health insurance. Those systems are classified as high-risk and are subject to strict requirements as to governance, data quality, transparency, human oversight and cybersecurity, although part of the obligations for the Annex III systems has been deferred until 2 December 2027. The framework also operates alongside the GDPR and the “Ley Orgánica de protección de datos” —Spain's data protection act—, and alongside EIOPA's criteria on the ethics and trustworthiness of AI, which raises very topical questions concerning segmentation of the insured, the explainability of automated decisions, algorithmic discrimination, refusal of cover and liability where the insurer's decision stems from an algorithm.
Artificial intelligence can substantially improve the handling of large volumes of documents and case files, but its usefulness depends on distinguishing between automating tasks and delegating legal decisions. Classifying information, detecting issues or preparing drafts can bring efficiency; assessing the evidence, taking on risk or defining a strategy continues to require oversight and professional judgement.
The fact that hundreds or thousands of people are affected by the same problem does not necessarily mean that there is a single collective dispute. Identifying which questions are common and which require individual analysis is essential in deciding between the coordinated management of claims, a collective strategy or a combination of the two.
Managing large legal portfolios requires being able to know both the overall position of the matters and the precise history of each file. Technology makes it possible to automate tasks and to control large volumes, but only a proper structuring of the information, combined with professional oversight, ensures traceability, consistency and genuine legal control.
Judgment 531/2026 of 9 April of the “Tribunal Supremo” —Spain's Supreme Court, hence STS— classifies as a clause limiting the rights of the insured a stipulation imposing a 90-day waiting period for myocardial infarction cover under a life insurance policy, holding it to be a surprising clause in relation to a cover expressly taken out. Being a limiting clause, it must satisfy the requirements of article 3 of the “Ley de Contrato de Seguro”, Spain's Insurance Contract Act or LCS: special highlighting and specific acceptance in writing. The decision offers an apt occasion to review the boundary between clauses defining the risk, limiting clauses and prejudicial clauses, one of the main focal points of litigation in the insurance field.
Judgment 283/2026 of 23 February of the “Tribunal Supremo” —Spain's Supreme Court, hence STS— returns to a key question in life insurance with disability cover: when the date of the insured event is to be fixed where the illness manifests itself and is treated while the policy is in force, but the administrative declaration of permanent incapacity comes after the contract has come to an end. The Chamber regards it as decisive that, under the policy and in the light of the medical circumstances, the irreversible condition determining the disability had manifested itself while cover was in place, so that the subsequent decision of the “INSS”, Spain's social security authority, is not necessarily conclusive. The criterion carries a high potential for litigation as regards the temporal scope of the insurance, non-payment of premiums, pre-existing illnesses, the tension between medical reality and administrative declaration and life policies linked to mortgage loans.
Law 5/2025 has thoroughly reformed the regime of compulsory civil liability insurance for the use of motor vehicles and has also created a specific compulsory insurance for light personal vehicles, with effect from 2 January 2026. The reform widens the statutory concept of a motor vehicle, incorporates the changes flowing from Directive (EU) 2021/2118 and strengthens the system for the protection of injured parties, redefining the role of the “Consorcio de Compensación de Seguros”, Spain's insurance compensation fund. This new framework has a direct impact on e-scooters, electric bicycles and other forms of micromobility, and raises practical questions as to which vehicles must be insured, the liability of the owner and of the driver, accidents involving pedestrians and the overlap with home or family civil liability policies.
