Welcome to a new blog post by Ruiz Prieto Asesores. This time we are going to address Why is it good to have a lawyer specialized in insurance claims liability.
Keep in mind that one of the most important insurance for the exercise of a profession or economic activity is liability insurance. On many occasions, this insurance is obligatory to carry out certain economic and professional activities (eg Advocacy, Social Graduate, Architects, Civil and Commercial Mediation, Archaeologists …); while at other times it is optional (eg tax advice …).
However, although in certain cases the subscription to this insurance is not obligatory; It is always advisable that you sign one with a good insurance company so that all your civil liability is insured.
What is a liability insurance?
civil is an obligation contained in the Civil Code, where every natural person
or legal entity has the obligation to repair the physical and / or material damages that
cause third parties:
"He who by action or omission causes harm to another, intervening fault or negligence, is obliged to repair the damage caused,"
(Article 1902 of the Civil Code).
The intentionality does not count when claiming compensation for damages to repair the damage. Simply having caused harm to a third party means that the person responding must pay compensation to repair the damage caused.
What is a liability insurance? Who are responsible?
Also, you have to
emphasize that certain people who hold certain positions are responsible for the
acts that cause harm to people who are under their
care or supervision.
"The obligation imposed by the previous article is enforceable not only by the acts or omissions themselves, but by those of those people who must respond.
The parents are responsible for the damages caused by the children who are under their custody.
The tutors are responsible for the damages caused by minors or disabled persons who are under their authority and who live in their company.
The owners or directors of an establishment or company are also responsible for the damages caused by their dependents in the service of the branches in which they had employees, or on the occasion of their duties (…) ".
(Article 1903 of the Civil Code)
In this sense, parents are responsible for the
acts of their children; the employers of their workers; pet owners
of acts that cause harm to your pets; the teachers of your students …
to liability insurance we can ensure that the company's
insurance I paid all or part of the damage to repair that we have caused
directly or indirectly.
Basically, these insurances are responsible for covering the physical and material damages that the insured may cause to third parties, without any intention. Logically, liability insurance has certain limitations.
What does an insurance cover
of civil liability?
A liability insurance forever is responsible for paying any physical or material damage that the insured has caused to a third party in the case of an extracontractual situation; that is, outside any civil, commercial or labor contract.
For example, when a store employee physically assaults
to a potential client who has not yet purchased any product. It's just
visiting the store. Therefore, there is no type of contract between the
insured and the affected.
However, There are civil liability insurance that also the insurer will take care of those damages caused by certain economic and professional activities.
Logically, the price of the policy will vary depending on what we want to insure and the amounts we insure in our policy.
What does not cover a
This is something that varies depending on the company or
insurance carrier. However, most insurers do not cover the damages that are
it causes a third party intentionally.
To determine intentionality of the action, it is good to contact
with a lawyer specialized in claims of
For example, liability insurance
cover the physical aggressions within the commercial establishment of the
company. Imagine that the insured wants to take revenge on a user who
He repeatedly goes to his store. When you see it appear in your establishment,
He takes out a white weapon and immediately hits him on the head with a baseball bat.
This act is intentional. The insurer will not cover these damages.
However, we are talking in general terms, because insurers are established by a series of contractual clauses in the policy. Before hiring insurance, it is advisable that you carefully read each of them or look for a legal advisor or lawyer to advise you on this matter.
Is it mandatory
contract a Civil Liability policy?
As we have already indicated, it is something that can be
vary according to the activities that are carried out. For example, many professions
as lawyers, solicitors, mediators … they necessarily require hiring
of a civil liability insurance policy to carry out its activity.
Also all those activities that require driving
motor vehicles and certain machinery to circulate, the law establishes
obligatory in all of them; Therefore, in this case, the law obliges
professionals (eg taxi drivers, bus drivers …) to have a
The high positions of mercantile societies (administrators)
They also have their own liability insurance.
In short, a company has a total obligation to
contract at least one civil liability insurance, as established by the
On certain occasions you may have to contract several
Civil Liability insurance, because there are specialized insurance such as
of senior managers and administrators of mercantile companies.
For example, we have a civil liability insurance for our business establishment; as well as one for the activities that I develop as a legal, fiscal and labor advisor.
contract liability insurance?
Basically, every natural person or
that in one way or another may cause damage to a third party.
Although it is recommended that all
people have a contracted civil liability insurance; not all
people have the obligation to do it.
It is mandatory if any of
- Drive by road with motor vehicles.
- Use boats or boats.
- Be an extreme athlete
- The construction companies
- If you train other people.
- The hunters and fishermen.
- The environmental ones
- The elevators.
- Any activity that may affect third parties.
What should I know
before hiring civil liability insurance?
Before hiring insurance
civil liability, it is convenient that:
- Investigate what civil liability is needed. There are different types of civil liability; as well as specialized civil liability insurance for a certain activity. For this reason, it is advisable before hiring a policy to go to your lawyer, legal advisor or a lawyer specialized in insurance claims to advise you on what coverages are necessary for your business or economic activity. In this way, you can contract the exact civil responsibility that is needed.
- Select the policy you are looking for. Once the existing types of liability have been identified, it is necessary to select the different policies; as well as the maximum amount for each one of them so that the result is at the insured person's pleasure according to their interests and personal circumstances. The price can range from € 20 per year to € 1,000 per year depending on the coverage contracted.
- Compare insurance. For this step, the use of insurance comparators can be used. But EYE, always read the clauses and do not evaluate solely for the price. For example, Seguratis.com offers liability insurance with good benefits.
- Hire the one that best suits our personal and business needs.
- Read the contract well before signing.
He has a lawyer specialized in
claims of liability insurance?
When hiring insurance, You have to take into account that in this legal business there are both the insurance broker, the Insurance Entity or in some cases also the Subscription Agency. Each of them plays a role in this type of contract: drafting and subscription of the policies; inform the taker of its content; etc.
To all these people, we must add the lawyer specialized in insurance claims, given that all insurance companies have their own legal department Y; Individuals in the event of an incident should go to lawyers to advise and process claims to your company if it does not comply with the clauses signed in the insurance policy.
The lawyers specialized in insurance claims perform the following tasks or operations:
1) Interpret the clauses contained in an insurance policy. Most important function of the lawyer specialized in insurance claims.
On many occasions they are transferred from
Anglo-Saxon law and often does not even pass through the filter of the Right
Spanish, leading to the issuance of policies that not even the signatories
they can interpret with some legal certainty. The lawyer thanks to his
training may break down each of the provisions signed by the
parties to defend their client. In fact, conflicts are very frequent
in the Courts because of the interpretation of clauses of the policies.
You have to have in
account that in the interpretation of any clause or dark aspect of the
Subscribed contract must always favor the weakest party, ie the
2) Legal defense in case of accidents.
Logically, one of the functions of a lawyer
specialized in insurance claims is the
legal defense (before Courts) in case there is a conflict between
Taker / insured and the insurer.
For insurers it is imperative
have a lawyer specialized in
insurance claims to properly manage the claim resolution.
In this sense it is absolutely necessary to have the proper specialization, in this case, the lawyer should be specialized in insurance claims of civil liability; since a sinister located in a home (home insurance) is not the same as a commercial establishment (civil liability insurance). They are not the same type of accident, nor can they have the same treatment.
In fact, if it is about liability insurance for professional activities; this lawyer specialized in claims of civil liability insurance should not only know the insurance itself; but also know the profession you want to protect. If you defend a doctor or an economist it is convenient that you know many ins and outs of each of these professions.
Therefore, it is not about knowing
perfectly the profession, but to know the difficulties that these have
professionals, know the idiosyncrasy of who hires us (their way of working, their tools
of work, its philosophy in relation to the way and way of processing the claims);
and know how to go to a certain expert in
if you need it and look for the relevant evidence.
In the same way, you should know the
jurisdiction to which the trial will be processed. It is not the same
social jurisdiction (labor and social protection) than civil-commercial jurisdiction, which
the criminal or the administrative (or even the military).
3) Search the relevant evidence and refute
the evidence of the opposite party.
If you go to court, the lawyer specializing in insurance claims that defends one of the parties should look for evidence to blame the other party and; refute the evidence presented by the opposing party.
4) Inform your client how you are doing
the process of the complaint and the processes.
In this sense, the lawyer must
Communicate with your client constantly to notify him of all events
that may affect your defense.
Likewise, you must notify the state of
the demand; as well as the possible procedures that exist in case of losing or
win the trial.
Once the trial is over, you must
Attach the sentence to your client.
All this communication process must
do it by means of the deontological code of the profession; that is, listening to
your customer; keeping the secret of profession; Empathizing with your client; the
5) Negotiate with the other party.
A lawyer must
always explore the negotiating path with the other parties involved, being
proactive, offering solutions before going to a trial.
The good lawyer specialized
In claims, it does not let the loss advance; waiting for the last day to try to resolve in a negotiated way the
conflict; but will contact the other party to look
alternatives to conflict resolution.
However, this negotiation
You must always respect the wishes of your own client that you represent.
6) Analyze the possible consequences of the losses. One of the most common tasks of the lawyer specialized in insurance claims.
The specialized lawyer
in claims must also correctly analyze the risks inherent in the
sinister from the legal point of view.
It should always
analyze whether the clauses cover the total or partial protection of the policies
of insurance and; what possible risks exist from a legal point of view to
your client (be it the policyholder or insured or the insurer). In this way,
Before hiring a policy, you can include reservations or modify some
provisions to adapt them to the needs of your client.
If you work for the insurer, you must also transfer the court decisions that may affect the insurer when signing this type of insurance.
What to do if the insurance company refuses to pay the compensation?
We know that insurers' refusal to pay is very common
take charge without problems of the accident from the beginning. It is normal, then
all they really want is to make money when they sign
However, you should know that although they have that right, That refusal is total or partial must be communicated obligatorily to the insured by means of a written; which must be motivated and must obligatorily argue the causes for which the insurance company rejects coverage of the incident.
Since Ruiz Prieto Asesores We recommend that in order to combat this situation of superiority from which the insurance companies leave when it comes to claiming or filing a complaint; contact a legal advisor or a lawyer specialized in insurance claims as soon as possible so that from the first moment we can negotiate with the insurers the conditions of the accident. In this way, you will also get a professional who will know how to collect all the appropriate evidence in case you have to go to a trial.
It is very common that insurers prefer not to reach any type of extrajudicial agreement. In this type of case the only way to solve the conflict is through a civil mediation or resort to a lawsuit in the corresponding court against the insurance company for breach of contract. In these cases, It is extremely important to keep all the evidence of the accident and all documentation relative to it for the trial.
What to do before claiming insurance?
Before claiming insurance, You have to read carefully all the clauses that we signed when contracting said policy.
Once you have finished reading them, analyze if
our personal and accident circumstances coincide with what is insured. If so, you will have to gather evidence before negotiating for
if you have to go to court.
The most convenient is to be cautious when hiring any type of insurance and prior to your signature ensure that we know perfectly the content of the contract.
Remember that we advise our clients when contracting insurance. You can contact us if you need it.