LEGAL DEFENCE is a clause contained in the vast majority of motor insurance policies.

First of all, we must know that when we suffer a traffic accident, we have the right to choose a private and specialised lawyer, instead of being represented by the company's lawyer, as the latter is just that, the company's lawyer, not the company's insured.

Secondly, we must know what legal defence is and what it is for. Legal defence is a guarantee, coverage or economic item reserved in our car policy to pay the fees of the private lawyer that we choose. In this way, we can choose a private lawyer, trustworthy and specialised in the matter, so that they can represent us in the management of our accident, practically free of charge. 

These clauses usually establish a maximum limit of coverage in most policies, to be determined according to the company and the type of policy. 

In the event of a conflict of interest, the Insurance Contract Law prevents the application of a limit to the legal defence cover. We are faced with a conflict of interests in claims in which, for example, there are two vehicles involved, both insured with Mapfre. 

In short, the legal defence clause is an important coverage when dealing with a traffic accident, as it allows us to choose a private lawyer specialised in the matter to represent us and look after our interests at a minimum cost or zero cost.

Today we are going to talk about permanent disability due to an accident. Better known as after-effects or sequelae, these are a hard time for the victim who must learn to live with a new and different physical or psychological situation that limits him/her to some extent. 

What is permanent disability due to a traffic accident?

We are dealing with permanent disability due to a traffic accident when, after the occurrence of an accident, the victim suffers injuries that result in a physical or psychological situation that prevents him/her from being able to carry out his/her usual profession and/or any other work, either totally or partially. 

The following is a breakdown of the 4 types of permanent disability that can occur after a traffic accident: partial, total, absolute and severe disability. 

Partial permanent disability

Situation in which the worker is partially unable to carry out his or her usual work. This occurs when work performance is reduced by 33%.

Total permanent disability

Situation in which the worker is totally unable to carry out his/her usual work, but not other occupations. 

Absolute permanent incapacity

Situation in which the worker is absolutely unable to carry out his usual work and any other occupation.

Permanent incapacity for severe disability

Situation in which the worker, who is permanently and totally disabled, requires the help of a third person to be able to carry out the basic activities of daily life. 

Claiming compensation for permanent disability after a traffic accident

When we cause permanent disability, in any of its degrees, the victim is entitled to receive the corresponding benefit by means of an administrative application through the Instituto Nacional de la Seguridad Social.

However, when permanent disability is caused by a traffic accident, Law 35/2015, of 22^nd September, on the reform of the system for the assessment of damages caused to people in traffic accidents, also includes various compensation items aimed at compensating the harmful consequences caused to the victim.

Firstly, the law provides for a Medical Scale, with an exhaustive list classifying the different after-effects and their assessment within an individualised range.

Independently, a table of pre-established compensation amounts is set out, depending on the number of sequelae points and the victim's age. These amounts are automatically updated, with effect from 1 January each year, in accordance with the percentage of the pension revaluation index provided for in the General State Budget Law. 

On the other hand, the law assesses the so-called moral damage due to loss of quality of life caused by sequelae, when a certain number of sequelae are exceeded. 

Likewise, the law foresees a compensation item for those injured who need the help of a third person due to permanent incapacity after a traffic accident. 

Finally, when we find ourselves in a situation of permanent incapacity, in any of its degrees, our economy is inevitably harmed. In other words, there is the so-called loss of earnings, which are the amounts that we stop or will stop receiving, for personal work carried out, as a result of a traffic accident. Well, the law contains compensation items to cover those amounts that we will cease to receive for the performance of our profession or any other, and that we will no longer be able to carry out as a result of permanent disability after a traffic accident. 

There are various types of damages and losses that can be compensated for in the Traffic Schedule, and the key to a perfect claim for permanent disability due to a traffic accident is the correct and experienced application of the Schedule so as not to leave any damage caused to which we are entitled.

Contrary to what most people think, medical care for road traffic accident victims is not free of charge. According to the law, it is the person at fault who has to pay the cost of the medical treatment received by the victims of the accident. 

So if you have suffered a traffic accident and you have doubts about who is responsible for paying your medical expenses or which centre you can go to for treatment of your injuries, below we will try to answer all your questions. 

Free public or private health care? 

As a victim of a road traffic accident, you are entitled to receive the medical care you need to treat your injuries, either in a public or private hospital. 

Generally, road accident compensation covers all physical and material damage sustained in an accident, including the costs of medical care, regardless of whether the centre that provided the care is public or private. 

In the case of public health care, the injured party must provide the hospital with the details of the insurer of the vehicle responsible, and at the end of the treatment, he/she will be given an invoice that must be sent to his/her insurance company. 

If, on the other hand, the victim of the accident prefers to go to a private medical centre, then he/she will have to pay all the costs out of pocket and then claim them from the insurance company responsible.

Who is responsible for payment according to the Conventions or Agreements? 

By law, health centres have the right to claim from the insurer of the vehicle responsible for a traffic accident the payment of the cost of the medical care provided to the victims of the accident. 

Injured people who are occupants or passengers of the vehicles involved in the accident will always be covered by the insurance companies and the Insurance Compensation Consortium. However, in the case of drivers, the responsibility for payment will depend on who caused the accident.

In this case, according to the Public and Private Agreements, the person obliged to pay the medical expenses is determined taking into account the assumptions that we will see below. 

Accidents involving a single vehicle 

When only one vehicle is involved in the traffic accident, the insurance company or, otherwise, the Insurance Compensation Consortium is responsible for paying for the medical care needed by the victims, except in the case of the driver of the vehicle. According to the Public Agreement, the expenses incurred for the medical care of the driver are included only up to a maximum amount that is established in the economic conditions of the Agreement. 

Accidents involving more than one vehicle 

In the event that more than one vehicle is involved in the traffic accident, the insurance company is obliged to bear the health care costs only for those occupants or passengers of the vehicle it insures, and also for its driver. In the event that the vehicle does not have Civil Liability Insurance, the Insurance Compensation Consortium will be responsible for the expenses of the victims who are not responsible for the accident.

Injuries to third parties who are not users of the intervening vehicles 

If the traffic accident involves several vehicles and causes injuries to third parties, such as pedestrians or cyclists, then the insurance company of the injuring party or the Insurance Compensation Consortium is responsible for paying the costs of medical assistance to the injured parties.

If the injuries are the result of the displacement of containers, street furniture, etc., then the vehicle that has displaced them is liable to pay.

What are the Public and Private Health Care Agreements? 

The first Health Care Agreements were signed decades ago to facilitate the management and claims between medical centres, insurance companies and the Insurance Compensation Consortium.

These are agreements signed between the health services of the Autonomous Communities, public hospitals, the Insurance Compensation Consortium and the UNESPA association representing private insurers. 

Over the years, these agreements have been refined to extend their functions and coverage. At present there are several types of agreements, but the most important are those that affect both the public and private health care sectors. The versions currently in force are:

• The Agreement on public healthcare derived from traffic accidents for the years from 2022 to 2025
• The Framework Agreement on road traffic accident healthcare for the years 2022/2025 (private sector).

Which health centres should you go to? 

After suffering a traffic accident, the first step is to go to the emergency services of any hospital, whether public or private.

If the injured person subsequently needs specific healing or rehabilitation treatment in order to heal or stabilise their injuries, then they can decide which type of medical centre they want to go to for this treatment. You have the following options: 

• A public health centre. You will have to fill in a form with the details of the vehicles and the insurers involved in the accident, so that the hospital can bill the medical expenses to the insurance company. 
• A hospital proposed by the insurer of the vehicle in which you were travelling or by the insurer of the other vehicle involved. In this case, the insurance company will be responsible for all treatment costs.
• A private health centre of the injured person's choice. If the injured person chooses a private centre, he/she will have to bear all the costs himself/herself and can subsequently claim them from the insurer of the vehicle that caused the accident. If the claim is not possible because he/she is at fault, it will be necessary to see in the insurance contract whether he/she can claim reimbursement.
• A centre adhered to the Private Health Care Agreement (UNESPA). The chosen centre will be the one that requests authorisation from the insurer and then invoices the insurer for the cost of the treatment. Here the injured party will not have to pay any advance payment.

Tips for coping with a traffic accident 

If you are involved in a road traffic accident, there are two things that are essential in dealing with the situation:

• If you need specific treatment to recover from your injuries, always choose the medical centre that is best suited to your case, even if you have to pay for it initially. Remember that you can claim all the costs incurred from the insurer of the vehicle responsible for the accident. 
• Seek the advice of a lawyer specialising in traffic accidents. He or she will help you to comply with all the deadlines and requirements established by law in order to claim fair compensation for the injuries, after-effects and material damage caused by the accident.

What should I do if I have suffered a traffic accident? 

If you have been involved in a traffic accident, the first thing you should do is go within 72 hours to the emergency department of the nearest hospital or the hospital of your choice, so that they can assess the seriousness of your injuries and prescribe the most appropriate rehabilitation treatment to cure or stabilise them. It is important that you follow all medical instructions given to you, both for your recovery and if you want to claim compensation for a traffic accident.

Do I have to go to the care centre assigned by the insurance company or can I choose another one? 

According to the Insurance Contract Law and Law 41/2002 on patient autonomy, when you suffer a traffic accident you have the right to choose the medical centre where you will receive rehabilitation for your injuries. You can opt for one of your preference or go to the centre recommended by the insurance company, indistinctly.

However, choosing the right rehabilitation centre is fundamental both for the recovery of the injuries, as well as for the process of claiming compensation afterwards. So, as always, seek specialist advice. 

Who should pay for health care costs? 

As we have already seen, in most cases medical assistance as a consequence of a traffic accident is universal and free of charge, although it is not the Seguridad Social that pays all these expenses, but the insurer of the vehicle responsible for the accident.

Insurance companies are obliged to pay for any medical expenses incurred by the victims of the accident. It is therefore essential to determine who is responsible for the facts, as it will be their insurer who will be responsible for payment.

In the event that the at-fault vehicle does not have a Civil Liability Insurance policy, then the Insurance Compensation Consortium will be responsible for paying the costs of medical care for those injured in the traffic accident. 

What can I do if I have already paid for health care?

If you have had to bear and pay out of pocket the health care and rehabilitation costs required to recover or stabilise the injuries sustained in a traffic accident, you can ask the insurance company of the responsible vehicle to reimburse you for all the amounts you have paid by filing a traffic accident compensation claim.

In this type of compensation, there is a specific item intended to financially compensate the victim for all the health care expenses he or she has had to bear as a result of the accident.

When you are in the process of claiming compensation, sometimes differences arise between the insurance expert's and the victim's version of the extent of the injuries. In these cases, it is possible to request the intervention of a forensic surgeon to examine the injured person and make a report. The role of this forensic report in a traffic accident is very valuable, as it is able to relate the injuries and after-effects that a person has to what happened in an accident. 

Until 2016, the only way to obtain a forensic report free of charge was if the road traffic accident was being investigated in criminal proceedings. However, since the entry into force of Royal Decree 1148/2015 of 18^th December, any victim of a car accident has the possibility of requesting a forensic report free of charge and out of court to prove the extent of their injuries.

So if you are currently processing a claim for compensation for a traffic accident, here we explain everything you need to know about the forensic report. 

What a forensic report is and why it is important

A forensic report is a document that links the injuries sustained by a person to what happened in a traffic accident. For this, the medical surgeon takes as a reference the tests that have been carried out on the victim, the injuries diagnosed and the rehabilitation period needed to recover from them. In addition, the forensic report also includes the functional, psychological or aesthetic sequelae of the injured person once rehabilitation has been completed. 

This report is an objective document, since:

• Both parties, the injured party and the insurer, have the right to request that any aspect they consider appropriate be included in the report.
• Neither the victim nor the insurer can choose the forensic surgeon who will carry out the examination and the report.
• The same doctor is never assigned by default to cases from the same insurer. 

Therefore, the forensic report is essential because: 

• It allows the compensation calculators to better quantify the extent of the injuries.
• It helps the injured party to obtain a fairer compensation in accordance with the damages suffered. 
• In the event of having to go to court, the forensic report provides the court with more precise and detailed information, from a scientific and medical point of view, about the events that occurred.

Getting a forensic report? 

To obtain a forensic report, it is necessary to submit a request to the Institute of Legal Medicine and Forensic Sciences of the place where the accident took place or where the victim's home is located.

The request can be made by the injured party, the insurance company or both parties by mutual agreement. However, when it is the insurance company that requests this report, it must have the authorisation of the victim. 

Together with the application, the following documents must be submitted: 

• The reasoned offer presented by the insurer.
• The medical documentation that the injured person has and that issued by the insurer.
• Any other documentation, photographs, reports, etc., that may be useful. 

 Before accepting the application, if the Institute of Legal Medicine notices any error or mistake, it can require that it be rectified within 10 days. If everything is correct, it will summon the injured person for the examination and will inform the insurer. 

During the month following the examination, both the victim and the insurance company will receive the report from the forensic institute and both will have seven days to request any clarification or correction they consider appropriate.

Contents of the forensic report? 

The forensic report serves as a basis for the insurer to submit a second reasoned offer or for the victim to decide to initiate a legal claim, therefore it should include the following information: 

• The details of the injured person, the insurance company and the forensic surgeon who prepared the report.
• An explanation of the circumstances in which the accident occurred and the most relevant details and facts of the accident. 
• The examinations, tests and other assessments carried out on the injured person during the period of medical care that have been taken into account in the report.
• A detailed explanation of the extent of the injuries suffered by the victim, the after-effects and any other damage that the victim may suffer for life.   
• The place, date and time of the examination. 

Who assumes the costs of the forensic report in a compensation claim? 

It will be the insurer of the vehicle responsible for the accident who will be responsible for paying the cost of the forensic report, never the injured party.

However, if the insurance company denies the responsibility of its insured in the accident or it is demonstrated that there is no relation between the accident and the injuries of the victim, or that these are of lesser severity; the intervention of a forensic surgeon cannot be requested.

The alternative is for the injured party to go to a private medical expert and pay for the report out of pocket in order to be able to file a lawsuit against the insurer. In this case, if necessary, this expert can later go to court to ratify his report, unlike the forensic doctor. 

How are the damages quantified in the case of a civil claim?

In order to initiate a civil claim, all the damages suffered by the victim as a result of the traffic accident must be quantified. This quantification is made on the basis of the medical expert's report and the provisions of the accident scale.

For the calculation of damages, a distinction must be made between: 

• Basic personal injury. Here compensation is paid:

• The death of the victim.
• Temporary injuries, depending on the number of days it has taken to heal and the loss of quality of life during this time.
• The after-effects or sequelae, according to the level of help needed for personal autonomy. 

• The particular personal injury. In this case, the specific circumstances of the injured party are taken into account to establish an amount.
• The pecuniary damage. Here it is necessary to differentiate:

• Loss of earnings or loss of income of the injured party.
• Emerging damage or expenses derived from the accident.

Can the insurer lower the amount of the reasoned offer if the expert examination indicates fewer injuries? 

In the event that the forensic surgeon in his report assesses that the victim has fewer injuries and/or sequelae than the insurer's expert in his documentation indicates, the insurance company should not lower the amount of compensation proposed in the reasoned offer. If it did so, it would be acting against the information that it itself has used and provided. 

However, it is not very common for the coroner's examination to determine that the victim's injuries are less than what is reflected in the previous medical documentation. In any case, to avoid this, it is advisable to accept the reasoned offer as payment on account and then request the forensic medical report. 

If the reasoned offer is accepted, do I lose my right to make a claim out of court? 

Not in any case. The acceptance by the victim of the amount proposed by the insurer in the reasoned offer is not a waiver of his or her right to continue claiming, out of court or in court, a fairer amount to compensate for the injuries and damages he or she has suffered in a traffic accident. 

Therefore, after acceptance of the reasoned offer, the insurance company cannot require the claimant to sign any kind of waiver document.   

How much does a medical expert's consultation cost and who has to pay for it? 

If the victim of a traffic accident cannot request the free forensic report, for the reasons given above, then he or she will have to go to a private medical expert if he or she wants to continue with the claim for compensation. In this case, as it is a personal decision, the claimant will have to pay the cost of the report out of pocket.

How much it costs to consult a private medical expert and obtain a report depends on the individual professional. We therefore recommend that you seek the advice of a lawyer specialising in compensation claims, as skimping on this can be counter-productive.

Which doctors can issue an expert report 

In principle, Spanish law stipulates that any medical graduate can produce an expert report. However, not all doctors do so. Doctors with clinical specialties, although they have the capacity to give an expert opinion on any health or scientific issue, have been trained to diagnose and treat patients.   

Therefore, a judge will always give more credibility to a doctor who specialises in forensic and legal medicine, and not all medical experts are.   

What to consider when hiring one 

Choosing the right medical expert is essential if you want to get a fair road traffic accident compensation. Here are some of the considerations you should take into account when hiring one: 

• It is important that they do not work for any insurance company or assistance service linked to them, as in that case they cannot produce expert reports.
• You have to take into account both their professional career and prestige, as well as their training, as not all experts are specialists in legal and forensic medicine.
• Ideally, they should transmit confidence from the outset. 
• In the event that you have to go to court, it is good that you have a certain amount of experience and that he or she has the communication skills to specify, defend and explain your opinion, as well as the ability to respond and improvise.

Importance of the medical history in expert evidence

In a claim for compensation for a traffic accident, it is up to the victim to prove what happened and for this, the medical history is essential because it is the basis on which expert evidence is carried out. 

The medical history is the set of medical documents that have been generated as the injured person has received medical care after the accident with the aim of healing or stabilising their injuries. For this reason, they are undoubted proof of the injuries, diagnosis and treatment received by the injured party in an accident.

The more complete the medical records provided by the claimant in his or her claim against the insurer, the better the chances of obtaining a fair compensation. Thanks to it, your lawyer will be able to defend your position better and the judge will have objective information to reconstruct the facts, to check if the damage caused could have been avoided, to determine if there are any after-effects and how they will affect your life, etc.

Many people are unaware of what a reasoned offer for a road traffic accident is until they are forced to initiate a claim for compensation. The term is relatively new, it was first included in the 2016 schedule of awards and was conceived as a way to try to settle out of court disputes between parties involved in a road traffic accident.

If you are one of those who have never heard of it, we have prepared this guide so that you know what a reasoned offer consists of, what requirements it must meet and what options the victim of an accident has after receiving one.

What is a reasoned offer? 

A reasoned offer is a formal document drawn up by the insurance company after receiving a claim for compensation for a traffic accident. In this document, the company acknowledges the facts and the responsibility of its insured, and at its discretion, makes an economic proposal to the victim as compensation for the injuries and damages suffered in the accident. 

This offer, as its name indicates, must be motivated. That is to say, the insurance company must explain why it offers such an amount and justify it by means of medical reports and data. If this is not the case, the offer will not be considered valid. 

After receipt, of course, the injured party will have to evaluate the offer. 

Requirements according to Article 7 LRCSCVM 

According to article 7 of the Law on Civil Liability and Insurance in the Circulation of Motor Vehicles, a reasoned offer must meet a number of requirements: 

• Present an economic proposal to the victim for the damages suffered as a result of the accident, which is in accordance with the criteria set out in the accident scale of Law 35/2015, of 22^nd September.
• In the event that there is concurrence of fault, the offer must indicate the percentage of the compensation that the insurer assumes.
• Detail and break down which documents, reports or data are available to be able to assess the injuries and damages of the claimant. In addition, you should indicate on which ones you have based the calculation of the economic proposal presented. 
• Include the latest version of the medical report that describes the extent of the injuries sustained in the accident, how many days it took to heal, whether there are any after-effects, etc. 
• If both personal injury and property damage have occurred, the offer should assess them separately and present the amount of compensation for one case and for the other.
• It should state that acceptance of the offer by the injured party does not mean that he waives the right to take legal action in the future.
• Indicate the form of payment of the compensation, which may be in cash or any other means that guarantees the immediate availability of the amount.

Medical report 

Medical reports are essential for the victim of a traffic accident to receive fair compensation, as they serve as a basis for calculating the amounts that correspond to each of the items of which compensation is made up. 

For this reason, it is obligatory for the insurance company to accompany the reasoned offer with a medical report that justifies the quantification of the temporary injuries, the after-effects and the pecuniary damage that has been caused. However, the medical report is not always attached, since if the claim coincides with the amount offered, it is understood that the medical documentation provided by the injured party is sufficient. 

Deadline insurance company 

As soon as a claim for compensation is filed with an insurer, the insurer has a period of three months from that date to submit a reasoned offer to the claimant. 

Even if the victim of the traffic accident does not file a claim, from the moment the insurance company becomes aware of the existence of a claim, the law obliges it to assume the compensation that may correspond. Therefore, it must monitor the facts until the injured party is medically discharged.

The injured party has one year to be able to claim compensation, counting from the stabilisation of the injuries or medical discharge. 

Reasoned offer out of time 

If the insurer does not submit a reasoned offer within three months after receipt of the claim and there are no reasons for the delay, then the insurer is in "default". This means that in addition to the compensation of the damages due to the victim of the traffic accident, interest for late payment will have to be added to this amount. 

Difference between a reasoned offer and a reasoned reply 

When an insurer receives a claim for compensation for a traffic accident, the claimant may receive two types of reply: a reasoned offer or a reasoned reply. 

The main difference is that the reasoned offer contains a proposal for compensation to settle the dispute between the parties involved in a claim and the reasoned reply is a statement of reasons why a reasoned offer cannot be made, either temporarily or permanently.

Like the reasoned offer, the reasoned reply also has to meet a number of requirements:

• If the reason is that the insurance company needs more time because it is complex to determine the amount of compensation or because the injured person is still undergoing rehabilitation, then the reasoned reply must include a commitment to submit a reasoned offer as soon as possible. In addition, the insurer is obliged to report every two months on the status of the file.
• If the reason is that it denies the responsibility of its insured for the claim or anything else in order not to pay compensation, the company's reasoned reply will make it clear that it refuses to meet the claim for compensation definitively.

Sometimes, in cases where the healing period of the injured party is undetermined, given the seriousness of his injuries, insurers use the reasoned reply to make a partial offer of compensation to the victim. In this way they avoid interest for late payment on those sums already advanced.

Am I obliged to accept the reasoned offer made by the insurance company?

A victim of a traffic accident is under no circumstances obliged to accept the reasoned offer made by the insurance company.

Once the claimant of the compensation receives the reasoned offer, he/she must thoroughly review whether the financial compensation is in accordance with the traffic accident scale, according to the injuries and after-effects suffered. It is advisable that this review is done with the help of a lawyer specialised in the matter.

If the interested party finally decides not to accept the offer proposed by the insurer, then there are two possible ways to continue with the claim for compensation, which are the following:

Appraisal report to the Institute of Legal Medicine 

There is the possibility of requesting a valuation report from the Institute of Legal Medicine and Forensic Sciences.

In this report, the forensic doctor will determine whether there is a link between the victim's injuries and what happened in the accident. To do so, he/she will take into account the injuries sustained, the diagnostic tests carried out and the time required for recovery or rehabilitation. It will also indicate whether there are any functional, psychological or aesthetic after-effects and will make an assessment of these in order to establish the compensation that the injured party should receive. 

It is important for you to know that this report:

• This can be requested by the injured party or by the insurer in agreement with the injured party. If it is the company that wants to make the request, it must have the claimant's authorisation and have previously submitted a reasoned offer. 
• There is no cost for the victim.
• The doctor who will carry out the report is impartial and independent of both the company and the injured party.

The request for a forensic report obliges the insurer to submit a second reasoned offer within one month of the report being issued. 

Legal action against the insurance company of the vehicle responsible for the accident

Once the deadline for submitting a reasoned offer has expired or if after having received it, there is no agreement on the part of the injured party, he can directly file a lawsuit against the insurance company of the vehicle responsible and/or against its driver.

In order to initiate legal action, it is essential to have the following documentation:

• The claim filed with the insurer.
• The reasoned offer received, if applicable.
• A medical report from a private expert who can attend the trial to ratify if necessary.

As opposed to the option of requesting a forensic report from the Institute of Legal Medicine, the judicial route will involve a financial cost for the claimant, as he/she will have to pay the fees of the expert who carries out the report and of the solicitor, if the amount claimed exceeds €2,000. In addition, there is a risk of being ordered to pay costs and having to pay the other party's legal costs as well. Therefore, if you want to be sure that you make the best decision, always rely on the advice of expert traffic accident compensation lawyers, such as those at Trafilex.

When we have a traffic accident, in which we have suffered material or physical damage, we automatically think about how to claim compensation for the damage caused. At this point, the following dilemma always arises:

Is it better to go to a private lawyer or do I stick with the insurance company's lawyer?

In the following post we will analyse the advantages and disadvantages of choosing a private lawyer or an insurance lawyer after a traffic accident.

The decision to claim compensation is not an easy one, so with this article you can at least make an informed decision.

Private lawyer or insurance lawyer?

First and foremost, the insurance lawyer or private lawyer are professional specialised in traffic accidents. However, we must take into account certain fundamental differences that can either be detrimental or beneficial to us when it comes to requesting our claim.

These fundamental aspects are the cost of the service offered by each professional and the quality of the service.

Depending on the cost, is a private lawyer or an insurance lawyer better?

With regard to the cost of the service, it should be taken into account that the insurance lawyer is totally free, as the expenses generated are paid by the insurance company.

On the other hand, the private lawyer will also be free of charge, since his fees will generally correspond to a percentage of the compensation obtained in the trial.

However, the latter has the guarantee that these fees are recovered by way of legal defence through the insurance policy itself. 

The insurance company has a financial item reserved to pay the fees of a private lawyer, if this is the option chosen.

These two services are free of charge, but it should not be overlooked that the insurance lawyer will charge his or her fees according to a pre-established scale, which is not too generous and independent of the amount of compensation received. In other words, the insurance lawyer's fees do not depend on whether or not the compensation is paid, so it is normal to think that they do not have a strong interest in obtaining compensation during the trial. 

On the other hand, a private lawyer will charge a percentage of the compensation, so the higher the compensation, the higher his or her fees will be, which will be paid when and if the compensation is obtained.

In addition, these fees will later be reimbursed by the insurance company, due to the legal defence cover. 

Depending on the quality of the service, is a private lawyer or an insurance lawyer better?

Another important aspect to take into account is the quality of the service offered by a private lawyer or by the insurance company.

The first thing to bear in mind is that both professionals are specialists and have extensive experience in the sector. 

On this basis, it is important to know that the insurance lawyer is not our own lawyer, but that of the insurance company, in fact, it is most likely that, during the whole processing of the case, we will never meet him personally. 

Therefore, it will not be possible to establish a relationship of trust and closeness with him/her that should prevail in any lawyer-client relationship.

On the other hand, with the private lawyer, a close and confidential relationship can be maintained, with direct access to his office and absolute availability to his or her client.

Furthermore, it is not trivial to consider the workload of an insurance lawyer, as it is usually very high, to the point that he/she will not be able to dedicate even 50% of the time required to each case, as it is materially impossible, which, on the other hand, a private lawyer can do. 

So what should I hire?

In short, a private lawyer will be able to offer a higher quality, specialised and personalised service, at the same cost as the insurance company's lawyer, for whom the accident will be just one of a myriad of files. In other words, by hiring a private lawyer, the client benefits in the majority of cases.

We constantly face with an excessive interest on the part of insurance companies in launching the message that there is a high percentage of fraud against insurers with the aim of collecting undue compensation. 

This message is very recurrent for insurance companies, firstly, because the message gets through, and secondly, because they spread this false belief which, after so much repetition, we end up believing it, thus placing the insurance companies in a position of false prejudice. 

We can observe how, in all types of media, statistical data appear in this sense, always provided by insurance companies and never by other sources outside the sector. 

Well, the reality is quite different, and the fact is that, while the fraud of the insurance companies is minimal (barely 2%), it makes a lot of noise, compared to the real fraud that these companies carry out with each claim received by an injured person, which is devastating, but sounds very little.

The insurers are constantly extorting the success of every personal injury claim in road traffic accidents from the very moment the claim is made, using various practices.

Here are a few examples, among others:

Fraud 1

The companies control the medical treatment. In a traffic accident, the victim must be treated by a centre of the network of rehabilitation clinics whose payment must be authorised and assumed by the company itself.  Often, the companies do not authorise such treatments on arbitrary and unfounded criteria that the courts themselves do not admit, knowingly. But that does not matter, what is important for the insurer is that, if it does not pay, the injured parties cannot receive medical treatment and, from that moment on, they begin to lose their rights to compensation. The company saves on medical treatment, and saves on compensation.

Fraud 2

Out-of-court claims are rejected in their entirety by the companies, forcing the injured parties to pay the cost of legal proceedings, so that the competent court finally upholds their claim and grants the injured party the corresponding compensation. But that does not matter, because many claims fall by the wayside, again saving the companies money.

Fraud 3

Out-of-court claims involving serious injuries to which the company amicably makes fixed offers of between 3,000.00 and 6,000.00 euros. Once in the legal proceedings, there are countless cases in which we have managed to obtain compensation of up to 50,000.00 euros, light years away from the offer for which the company intended to close the case. Again, saving thousands of euros at the expense of the injured parties who, due to lack of advice, decide not to go to court. 

Fraud 4

Offers made by insurance companies without accompanying them with an expert medical report to back them up, despite the obligation imposed by law. This is in order to save the cost of commissioning the corresponding Medical Expert. This also means that the injured party does not have sufficient elements of judgement to be able to decide whether or not to accept an offer. 

 Fraud 5

Derisory legal defences. In some cases, they present a maximum limit of 200 euros, so that the injured party has to pay for the fees of a private lawyer and a private solicitor. This renders this clause, which has been considered abusive by the courts, meaning that it is devoid of content.

In short, the cost saved by the insurance companies, to the detriment of the victims of traffic accidents, with this type of practice that they carry out on a daily basis is immensely greater than the cost that the minimum percentage of fraud that exists can suppose. 

This is why we cannot allow this false dogma to continue to spread, simply because it does not correspond to reality. It is a hard task to fight the insurance lobby, but not impossible.

After suffering a traffic accident, material damage may have been caused in the collision between several vehicles. In this article we are going to study how to claim for material damage in a traffic accident, and everything related to this damage, which does not involve physical or personal harm, but which can cause considerable economic damage.

Damage caused by a traffic accident considered as material damage

What are considered as material damages derived from a traffic accident? 

Damage sustained by our vehicle and its accessories when it suffers damage as a result of a traffic accident. 

Deadline for claiming material damage in a traffic accident

To claim for material damages in a traffic accident, there is a period of one year of prescription before the responsible company, whose dies a quo is the day after the date of the occurrence of the accident. 

Deadline for reporting to the insurance company

The first thing to do when you have had a traffic accident is to report it to the insurance company, in order to be able to subsequently file a claim for material damages, if applicable. 

According to the Insurance Contract Law, the insured has seven days to notify the insurance company of the occurrence of the accident.

Assessment of material damage in a traffic accident

It is a simple and quick procedure. Normally, once the insurance company has been notified of the claim, the company's expert will contact the insurer to set a date, time and workshop where the expert appraisal will be carried out, and finally the vehicle will be repaired. 

The insured person has the right to choose the garage where the vehicle will be repaired.

It is advisable that while the expert report the damage, you are present to ensure that the expert includes in his report each and every one of the damages caused by the accident, and does not leave any of them out of the report, as once it is closed, it is practically impossible to get the company to reopen it. 

What is the owner of the vehicle involved in the accident entitled to?

When a vehicle has been damaged in a traffic accident, and you wish to claim for material damages, there are two possible situations: 

The vehicle is damaged and the cost of repair does not exceed the market value of the vehicle

We are entitled to have the vehicle repaired and restored to the condition it was in before the accident.

The vehicle is damaged and the cost of repair exceeds the market value of the vehicle

In other words, the vehicle is declared a loss. In this case, we are entitled to be paid the market value of the vehicle, which is the sale value of the vehicle on the used car market. 

In addition, however, it is also possible to claim the so-called affection value, which compensates the attachment to the lost vehicle, if any, and which can be up to 50% more than the market value. 

Who pays for material damage in a traffic accident?

There is an agreement between companies for the repair of material damage resulting from traffic accidents, commonly known as CICOS (Centro Informático de Compensación de Siniestros).

By application of the CICOS Agreement, in practice, the company of the innocent vehicle will be in charge of everything related to the material damage to the vehicle, assuming also the payment of these, always after acceptance of responsibility by the company of the vehicle causing the accident, which will pay a compensation module pre-established for this purpose through the Agreement.