since 2/2000
Commercial Premises insurance - Spain
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traducciones juradas (sworn translations)
www.e-despachos.com
Agente exclusivo / Exclusive agent,
I work with Sanitas, member of the BUPA Group in Spain;
Claim control and authorities (Castellano )
A. Control over the Insurance Company's business activity lies with the Spanish State and is exercised through the Directorate General for Insurance and Pension Funds of the Ministry of the Economy and Finance.
B. In case of any type of claim in relation to the insurance policy, for the settlement thereof the Policy holder, Insured, Beneficiary, Aggrieved Third Party or Successor of any of these should proceed to address:
1. The Insurer's Client Service Department by means of a letter addressed to calle Ribera del Loira nº 52 (28042 Madrid) or to fax nº 91 585 24 80 or to the email address clientes @sanitas.es which shall acknowledge receipt in writing and issue a reasoned written decision.
2. Once the Insurer's above-mentioned internal channel has been exhausted, or in the event of not being in agreement with its decision, a claim may be lodged with the Insurance Ombudsman designated by the insurer in the following cases:
a) When it is a case of claims involving an amount of not more than EUR 21,000 that affect the interpretation of the General and Particular Conditions of the Policy.
Claims connected with the personal or professional performance of doctors, hospitals and medical services in general supplying healthcare to insureds may not be submitted to the Insurance Ombudsman.
b) When, even though not meeting the foregoing requirements, the insurer so agrees.
To file a claim with the Insurance Ombudsman, the claimant should remit a written statement to post office box nº 50.072 (28080 Madrid) setting forth the grounds for his / her claim. In the light of this, the Ombudsman shall give written acknowledgement of receipt and declare himself either competent or non-competent and, after studying the claim, issue within 1 month of his declaring himself competent barring exceptions in which this time limit may be extended to the legal maximum of 6 months including the period elapsed since its submission to the Insurer's Client Service Department a reasoned ruling, which shall be communicated in writing both to the claimant and to the Insurance Company, for which it shall be binding.
3. The administrative claim procedure may also be instituted before the Directorate General for Insurance. For this purpose, the claimant should establish that the stipulated time limit for the settlement of the claim by the Insurance Ombudsman has expired or that his / her application has been rejected by the latter.
4. In any case, action may be brought before the relevant Courts and Tribunals.
a) Sanitas S.A. de Seguros
| Seguros médicos / health insurance plans: | Castellano - información sobre los diferentes seguros médicos de Sanitas en España | English - details about different Sanitas health insurance plans in Spain (and worldwide for companies based in Spain) |
| (y por todo el mundo para los empleados de empresas ubicadas en España) | (and worldwide for companies based in Spain) | |
| Sanitas: Control e instancias de reclamación / Complaints procedure: | Reclamaciones - Sanitas |
| Para pedir una cotización o una aclaración / For a quote or details: | |
| saniprof@mail.ddnet.es ( If you don't receive an answer in 24 hours / Si no le contesto dentro de 24 horas ) | |
| Fax: | (+ 34) 91 8032484 |
| Teléfono / 'phone: | (+ 34) 609 522 300 |
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