How do you complain to Spain's insurance regulator?

Question

José Manuel Alburquerque · Accepted Answer

First, a written complaint must be made to the company, to its customer service department or to its policyholders' ombudsman (“defensor del asegurado”). If the company rejects the complaint or does not reply within one month, the matter can be taken to the complaints service of the “Dirección General de Seguros y Fondos de Pensiones”, Spain's insurance regulator, online or on paper. It is free and you do not need a lawyer. Its report says whether the insurer has acted properly, but does not oblige it to pay. First, the complaint to the company All insurers have a customer service department. Some also have an independent policyholders' ombudsman. If the ombudsman finds in your favour, the decision is binding on the company. Complain in writing, on paper or online, giving the policy and claim numbers, what you are asking for and why. You can do so in Spanish or in Catalan. Keep the receipt showing the date. The company has one month to reply. The complaint to the regulator It is filed via the regulator's online portal, sededgsfp.gob.es, or on paper at any public registry office or post office. You must enclose the complaint made to the company, its reply if there was one and the documents that prove what you are saying. You must also declare that the matter is not before a court. It is not admitted if the matter is already before a court, if the time limit for bringing a claim in the courts has already expired or if more than five years have passed since the events without a claim being made. Nor does it decide what a loss is worth or matters that require experts or evidence that only a judge can assess. What it achieves The service asks the insurer for its version of events and issues a report within a maximum of 90 calendar days from when the complaint is complete. If the report finds in your favour, the company has one month to say whether it accepts it and puts matters right. If it does not reply, it is deemed not to accept it. The report is not binding, but it helps to assess whether going to court is worthwhile and it can be submitted in the proceedings. Moreover, while the complaint is being dealt with, the time limit for bringing a claim in the courts is interrupted. It is most useful when the dispute concerns how the policy has been applied, for example a clause you did not sign, a delay or a lack of information.