If my disability is recognised after the policy has expired, does the insurance cover me?

Question

José Manuel Alburquerque · Accepted Answer

It may cover you. As a general rule, the “Tribunal Supremo”, Spain's Supreme Court, takes the date of the insured event to be the date of the opinion of the medical panel of the “INSS”, Spain's National Social Security Institute, that proposes the disability. But if it is shown that the illness was already permanent and irreversible while the insurance was in force, the insured event is placed at that earlier moment, even if the decision comes later. The Supreme Court applied this in February 2026 to a lung cancer diagnosed while the policy was in force, even though the policy later lapsed for non-payment. The rule and the exception The rule. The date of the insured event is the date of the opinion of the INSS's “Equipo de Valoración de Incapacidades”, the disability assessment panel. The exception. If the illness was shown to be permanent and irreversible earlier, while the insurance was in force, the insured event occurred then. The later decision merely confirms something that already existed. Both the medical reality and the way the policy defines disability carry weight. If it defines disability as an irreversible physical condition that has been medically verified, without requiring the INSS decision, the exception is clearer. If the policy refers to Spanish social security, the argument is harder to make. The same rule applies if the policy ended because you reached the maximum age for cover or because the agreed term came to an end. What matters is when the insured event occurred. What has to be proved When the illness was diagnosed and when it became known that it was irreversible, with the medical reports from that time. That the illness led without interruption to the disability. That usually requires a report from a medical expert. And do not let time go by. The time limit for claiming is five years and, if you argue that the insured event occurred before the decision, the insurer may try to count it from that earlier date. Non-payment of premiums If the insured event occurred while the insurance was in force, later non-payment of the premiums, often because of the illness itself, does not release the insurer. Even so, do not stop paying the premiums on account of being ill, as every case is open to dispute. If the insurance was linked to the mortgage, the sum insured is paid first to the bank, up to the debt outstanding on the date of the insured event. The rest is yours. You can also claim back the instalments you paid after that date.