Policyholder Rights — How to Enforce Your Claims

Taking out insurance gives you peace of mind. But that peace can quickly break when, after a loss, your insurer does not respond as expected. At that moment, knowing your rights and how to act is key to ensuring you are not left unprotected.

This article clearly explains what policyholder rights are, how to enforce them with your insurer, and what current regulations say about insurance claims. If you feel your insurer is not fulfilling their obligations, this content will help you claim with confidence.

What Are Policyholder Rights?

Policyholder rights are a set of legal principles and guarantees that protect you, the insured, from abuse, malpractice, or non-compliance by insurance companies.

These rights are mainly regulated by:

The Insurance Contract Law (Law 50/1980, of October 8)

The Insurance Supervision and Solvency Law (LOSSEAR)

Royal Decree 1060/2015 on the legal framework for supervision

The regulations of the Directorate-General for Insurance and Pension Funds (DGSFP)

Main Policyholder Rights in Spain

Right to clear and truthful information: You are entitled to complete and accurate information before signing a policy. This includes conditions, coverages, exclusions, and obligations.

Right to receive a copy of the policy: The insurer must provide a written copy of the full policy with all terms and signatures.

Right to file a complaint in case of non-compliance: If the insurer fails to respond, offers an unfair settlement, delays payments, or breaches any term, you can file a formal complaint.

Right to complain without penalty: Exercising your rights cannot result in higher premiums, exclusions, or cancellation, unless legally justified.

Right to a timely response: Insurers have two months to respond to your formal complaint. If they don’t, you may escalate the matter.

Right to an independent appraisalIf you disagree with the insurer’s expert, you can hire your own and start a contradictory appraisal process.

When Should You Exercise Your Rights?

Situations include:

Unjustified rejection of a claim

Insufficient compensation

Unfair or biased appraisal

Unreasonable delays

Denial of coverage for items listed in the policy

How to File a Claim Correctly

Gather documentation: policy, claim form, photos/videos, expert reports, invoices, rejection letters.

Submit a written complaint: send it to the insurer’s customer service with evidence and request a review. Response deadline: 2 months.

Escalate to the DGSFP: if unsatisfied, file with the Directorate-General for Insurance and Pension Funds online, by post, or in person. They issue a resolution (not binding but influential).

What the Law Says

Regulations require insurers to have customer service, respond in writing, and avoid retaliation. Breaches may result in sanctions. (Source: Law 44/2002 and Order ECO/734/2004).

FAQs

Can I complain if I already signed the settlement? It depends — if signed under pressure or misunderstanding, yes. Seek advice.

How long do I have to file a claim? Usually 2 years for civil claims. Internal claims should be filed as soon as possible.

What if the insurer doesn’t reply? Silence counts as denial — you can go to the DGSFP.

Conclusion

Having insurance is not enough. To ensure real protection, you must know your rights and act when the insurer fails.

At MataSeguros, we help defend your rights. If your insurer has failed you, you are not alone. Tell us your case, and we’ll help you claim what you deserve.