Can my private medical insurer drop me or sharply increase my premium because of my age?

Question

José Manuel Alburquerque · Accepted Answer

The law allows the insurer not to renew private medical insurance on expiry and to raise the premium from one year to the next, in both cases giving at least two months' notice in writing. What it cannot do is change the price halfway through the year or terminate the policy before it expires because you fall ill. At least one judgment has held that it is unfair to leave someone without cover, for no justified reason, when they had been insured for many years and were already elderly or had fallen ill. And if the policy guarantees lifelong renewal, the insurer must honour that. Non-renewal The insurer must notify you in writing at least two months before the expiry date. If the notice arrives later, the policy is renewed for another year. In 2010 the “Audiencia Provincial” of Barcelona, the provincial appeal court, held that it was unfair for a medical insurer to refuse, without just cause, to renew the policy of someone who had been insured with it for many years and whose health had deteriorated. It is not settled case law, but it provides arguments for a claim. In addition, the “ley de igualdad de trato” of 2022, Spain's equal treatment act, prohibits refusing insurance or worsening its terms on grounds of age or illness, except for differences that are proportionate to the purpose of the insurance. The policy must highlight that the insurer can object to renewal. If it does not, this too can be challenged. In funeral insurance and long-term care insurance, on the other hand, the insurer cannot refuse to renew. Private medical insurance has no such protection. Premium increases They must be notified in writing at least two months before the expiry date. If you are not notified of the increase in time, you can refuse to pay it that year. In 2020 the Tarragona provincial appeal court refused to let the insurer charge the insured the new annual premium of a medical insurance policy that had gone up by more than 30 % without his knowledge or consent. It is common for the premium to rise by age band if the policy provides for it and it is actuarially justified. A clause allowing increases with no criteria or limit can be challenged. If you do not agree, you can choose not to renew, giving one month's notice in writing. What to do Ask the insurer in writing for the reason for the non-renewal or for how the increase was calculated. If you have been insured for many years and are left without cover at an age when it is no longer easy to take out another policy, seek advice, because there may be grounds for a claim. Before leaving a policy, make sure another insurer will accept you without waiting periods (“periodos de carencia”).