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.

As a means of transport in the city, motorbikes offer many advantages over cars. However, motorcyclists are more vulnerable in the event of a traffic accident because they are very exposed and injuries can be quite serious. In addition to this, claiming compensation for a motorbike or moped accident is more complex.   

If you have suffered a traffic accident on a motorbike, we will tell you what your rights are in case you want to claim compensation.

In what cases can you claim compensation for a motorbike accident? 

Provided that the traffic accident was caused by the fault of another driver, the motorcyclist can claim compensation for the temporary injuries, after-effects and material damage caused by the accident.

On the other hand, if at the time of the accident you were travelling as a passenger, you are entitled to claim compensation regardless of whether the driver was responsible for the accident.

In any case, it will be the insurance company of the responsible party who will pay the financial compensation. 

Motorbike accident compensation 

In motorbike accidents, compensation is calculated according to the system of valuation of damages caused in traffic accidents established by Law 35/2015, of 22^nd September.

Therefore, the driver of the motorbike and his passenger, if there is one, can claim for the physical and patrimonial injury they have suffered, which we will explain in detail below. 

Compensation for temporary injuries 

Temporary incapacity or temporary injuries are those that prevent you from carrying out your normal day-to-day activities. This type of compensation is intended to compensate the injured party during the period of time from the motorbike accident until the injuries are healed or stabilised. 

The items that are included in a compensation for temporary injuries are:

• Damage for days of affection.
• Damage due to surgical intervention.
• The patrimonial injury or damage.

Regarding the damage per days, depending on the degree to which the injuries affect the ordinary life of the injured party, four types of days are distinguished.

Days of very serious personal damage

These are days in which the victim lacks autonomy to carry out the normal activities of daily life. An example would be an admission to the ICU.

Days of serious personal damage 

These are days in which the injuries prevent the person from carrying out most of the essential activities of his or her life, such as when the person is admitted to hospital.

Days of moderate personal damage 

These usually correspond to the days when the injured person is on sick leave, as he/she is unable to attend to his/her professional activities.

Days of basic personal damage

These are the remaining days that elapse from the time the victim resumes his/her professional activity until the end of the rehabilitation treatment or medical discharge. In other words, all those days that cannot be classified in the previous sections.

Compensation for sequelae or aftereffects 

A sequel or permanent incapacity is understood to be those damages that persist as a consequence of an injury once the healing or rehabilitation treatment has been completed. 

The after-effects are assessed using a points system or medical scale where a range of points is established, with a minimum and a maximum, and the after-effects are assessed depending on their intensity. This quantification must be done by a doctor who is an expert in the valuation of the injury. 

In a compensation for after-effects, the following can be claimed:

• The basic personal damage.
• Particular personal damage.
• The patrimonial loss due to loss of earnings and/or consequential damage.

In the item destined to compensate the basic personal damage, two types of after-effects are distinguished whose sum will give the total amount to be claimed for this concept. 

They are the following:

Functional after-effects 

These are the after-effects that affect the functions performed by the organs, tissues, apparatus or systems of the human body. For example, hearing loss or limitation of ankle flexion. 

In the assessment of functional sequelae, these three rules apply:

• Concurrent sequelae. When two or more functional sequelae occur as a result of the same accident.
• Inter-aggravatory sequelae. If several limbs with identical function are affected.
• Aggravating sequelae of the previous condition. In the event that the after-effects aggravate a pathology suffered by the victim before the accident.

Aesthetic after-effects

This item compensates the injured party for all the after-effects that affect his image as a consequence of the accident and that are impossible to correct. 

Here we take into account both the static dimension, scars, abrasions, etc., and the dynamic dimension, as sometimes these types of after-effects also involve a functional impairment, such as the amputation of a limb.

The aesthetic damage, as well as the functional damage, is assessed on the basis of a specific scale that takes into account various factors such as the degree of visibility or the effect on the interpersonal relationships of the affected person, among others. 

In addition, this section also takes into account whether plastic surgery has to be carried out.

Compensation for patrimonial loss

In a pratrimonial damage compensation, the cost of repairing the damage to the vehicle and everything that the driver has with him, both equipment and personal belongings, will be compensated. 

In order to obtain compensation for damage to the motorbike, a repair estimate must be provided and, in the case of objects, the bills for the purchase of new ones that are similar to the previous ones. 

In addition, other economic damages are also compensated under this heading, such as loss of earnings, i.e. the income that is no longer received after the accident, or consequential damages, which are the additional expenses incurred as a result of the accident.

Example of compensation for a motorbike accident 

Here is an example of the compensation received by a motorcyclist in 2019 after an accident. Please note that the schedule is updated every year, so the amount may vary at present.

While riding his motorbike, A. L. was knocked to the ground by a car that ran a yield sign. As a result of the fall, A. L. suffered a series of injuries for which he received the following compensation: 

• Moderate personal damage (days off work): 58 days x 52 €/day = 3,016 €.
• Basic personal damage (remaining days until the end of rehabilitation): 35 x 30 €/day = 1,050 €.
• After-effects: 
  • Post-traumatic cervical syndrome = 4 points
  • Pain in right shoulder and limitation in abduction and elevation = 9 points
• Patrimonial damage (glasses and helmet damaged in the accident) = 400 €.

The total amount of compensation was 18.299,13 €.

How long does it take to receive the compensation for a motorbike accident? 

Generally, the time it takes for the victim of a motorbike accident to receive compensation depends on the time needed to recover from the injuries or at least to stabilise them. 

Once you are medically discharged, a specialist doctor will then have to assess the damage suffered and any possible after-effects. With this information, you will be able to calculate the compensation you are entitled to and claim it. The deadline for submitting this claim is one year from the stabilisation of the injuries.

If the responsibility for the accident is clear, the negotiation with the insurer does not usually take long. Therefore, if there is agreement with the offer received, the injured party can receive his compensation between 30 and 60 days after receiving the medical discharge. 

However, if legal proceedings are necessary, it is best not to rush. The collection of the compensation will depend on the agility with which the court processes the claim and if the insurer tries to reach an out-of-court settlement.

Main problems in motorbike accidents

The most common problems in motorbike accidents are as follows:

• In most cases, the motorcyclist has to face a presumption of guilt. For this reason, it is very important to collect evidence that clarifies the responsibility for the accident and the damages suffered. 
• Sometimes, due to the seriousness of the injuries, the motorcyclist is taken to hospital before a statement can be taken or a friendly report signed. It is therefore important to contact the police as soon as possible to do so.
• When it comes to compensating the material damage suffered by the motorist, insurers usually take into account the depreciation of the objects due to their age and use. Therefore, it is always advisable to keep the purchase invoices of at least the equipment. 
• When the cause of the accident is a hit-and-run accident, the Insurance Compensation Consortium is responsible for the compensation, but does not take responsibility for the damage to property. In this case, it is essential to have the police report or witnesses.

Advice if you have suffered a motorbike accident

At the time of the accident it is normal to be nervous and not know what to do. For this reason, we give you these tips so that if you have a motorbike accident, you will know what to do: 

Even if you are conscious and can move, don't do it, and if the motorbike has fallen on you, call for help. Injuries can be more serious than they appear and sudden movements can cause more serious damage.

Call 112 and ask for an ambulance and the intervention of the police or Guardia Civil if you are unable to look after yourself. 

If the person at fault is willing to admit fault and you are well, complete and sign the accident report. If not, call the police or the Guardia Civil so that they can draw up a report. 

On the other hand, if the vehicle responsible has fled, try to identify it with the help of witnesses or other means. If this is not possible, the Insurance Compensation Consortium will be responsible for compensation.

In the event that the accident is not the result of an impact, look for witnesses to what happened to clarify the culpability in the accident. 

Injuries often appear within hours of the accident, so go to the hospital as soon as possible, within 72 hours, to get a medical diagnosis. 

Contact your insurance company to report that you have been involved in a motorbike accident. You have 7 days after the accident.

If you are going to claim compensation for the injuries and damages suffered, hire a lawyer specialised in traffic accidents, such as those at Traflex. They will advise you and help you through the process and get you fair compensation for your injuries.

A considerable number of road accidents occur every year, both in cities and on interurban roads, causing injuries of varying severity to their victims. In these cases, clarifying who is solely liable is key to claiming compensation for pedestrian, cyclist or animal injury.

But many times, people who are victims of a collision believe that they are the ones to blame for, so they do not claim any compensation. Therefore, below we explain in which cases and how you can claim compensation if you are hit by a car.

What to do if you suffer an accident (run-over incident)?

In any traffic accident, the most vulnerable party is the one who is most exposed, such as pedestrians or cyclists. So if you have been hit by a car, it is essential that you act quickly in the aftermath. This is the most important thing to do:

• Whether you can move or not, call 112. It is important to be seen by a doctor within 72 hours of the accident. Even if you think you have no injuries, they may appear hours or days later.
• To avoid further collisions or other types of accidents, it is advisable to mark the area until the ambulance and the police or Guardia Civil arrive. Ask for help to do this if you need it.
• In the event that the person responsible for the accident does not want to sign the friendly report or has fled:

• Collect as many details of the vehicle and its driver as possible.
• Keep the details of witnesses so that you can locate them if necessary.
• Call the police or Guardia Civil to draw up a police report.
• Be sure to give your version of events in your statement to the police or Guardia Civil, either at that moment or as soon as you can.

• Try to take photographs of the material damage suffered.
• Follow all the treatments, check-ups and medical protocols prescribed to you, and keep all the documents and reports you are given.
• Do not let the legal deadlines for claiming your compensation pass.

When can compensation be claimed in the event of a pedestrian being hit by a vehicle?

A person who has been hit by a car is always entitled to claim compensation in the following cases:

• If he or she was crossing correctly at a pedestrian crossing or when the traffic light was green for him or her.
• If the vehicle involved in the collision is a vehicle which has run away or does not have liability insurance. In these cases, the Insurance Compensation Consortium will pay compensation.
• Even if the pedestrian was not crossing in the right place, if the driver's conduct was not correct either.

In the latter case, there would be what is called "concurrence of fault", since both parties have contributed to the occurrence of the facts and, as a consequence, the injuries and damage caused. Therefore, the amount of compensation will depend on the degree of responsibility that the pedestrian has had in the accident.

On the other hand, a pedestrian is not entitled to claim compensation if he or she is solely responsible for the accident.

Calculation of damages for pedestrian collisions

Compensation for pedestrian collision is calculated in accordance with the provisions of Law 35/2015, of 22^nd September, which sets out the system for the valuation of damages caused in traffic accidents.

In general, this type of compensation takes into account:

• The days of recovery and rehabilitation required after the accident. The traffic accident scale differentiates between four types of days depending on the seriousness of the damage caused in each one of them.
• The after-effects or permanent disability. Once the rehabilitation treatment has been completed and the victim has been discharged from hospital, a specialist doctor draws up a report in which he assesses the physical, psychological or aesthetic after-effects of the accident, as well as the surgical interventions required and the victim's personal circumstances before and after the accident, using a points system.
• Economic damage. This item compensates the material damages suffered in the accident, the income that has been lost during the healing period and the additional expenses incurred as a result of the accident.

Why do you need an accident lawyer to claim compensation for an accident?

The most common type of collision is one in which the sole responsibility for the accident is unclear. That is why it is essential to be well advised by a specialist road traffic accident lawyer if you want to obtain compensation.

When a collision occurs, it is the insurer of the vehicle involved in the accident who must pay compensation. Therefore, they will try to blame the accident on negligence on the part of the pedestrian. If you have a lawyer specialised in accidents, he or she will help you to prove that you are not at fault, to calculate the fairest compensation and to meet all the deadlines and legal requirements established by the Law so that you do not miss out on your compensation.

 Collisions with cyclists

In recent years the use of bicycles has increased, both as a means of transport in the city and for sporting activities. As a consequence, there has also been an increase in the number of accidents involving cyclists, usually caused by carelessness or ignorance of the regulations on the part of both drivers and cyclists themselves.

In 2023, five out of every ten road deaths were pedestrians, cyclists or motorcyclists, according to the annual traffic balance of the Ministry of Interior and the National Department of Traffic (DGT). 

Lack of knowledge of regulations and accidents on cycle lanes

In general, there is a great lack of knowledge about the rules governing the coexistence of cyclists with pedestrians and other drivers, as well as the regulations governing the use of cycle lanes.

The regulation of cycling on cycle lanes is the responsibility of the local councils. However, in the event of any accident, the first thing to do is to refer to the provisions of the Traffic Regulations, then to the instructions of the DGT and, lastly, to the specific ordinance in force in each town council.

The existence of a cycle lane does not guarantee that accidents will not occur between bicycles and pedestrians, or between pedestrians and other vehicles. So in these cases, it is also very important to know the circumstances in which the accident occurred in order to determine who is responsible and whether the victim can claim compensation.

When can a cyclist claim compensation in the event of being hit by a car?

In cases where a cyclist is injured as a result of being hit by a car, he or she may claim compensation if:

• A motor vehicle is solely responsible for the accident, in which case the insurance company will be responsible for compensating the injured party.
• There is concurrence of fault, i.e. when the cyclist and the vehicle were both partly responsible for the accident. The cyclist can claim compensation in proportion to the percentage of fault.
• The accident has occurred where the cyclist has the right of way, such as a cycle lane.

If you are a cyclist, when are you at fault?

In the presence of cyclists, other drivers must drive more carefully, but cyclists, for their part, must respect the rules of the road. Therefore, a cyclist will be at fault for an accident, and therefore for the injuries and damage caused, in the following cases:

• If he/she does not respect traffic signs, traffic lights or pedestrian crossings.
• If there is no cycle lane and he rides on the carriageway, if he/she does not ride on the right or along the hard shoulder.
• When you do not clearly signal the direction of movement.
• If you do not use reflective elements or lights that make you visible, both day and night, to other drivers.
• When overtaking on the right.
• If you stand in the blind spots of the car and your driver cannot see you.
• When using a mobile phone or headphones with music while riding a bicycle.
• When you do not respect the maximum speed limit.
• If you are under the influence of alcohol or drugs.

Is it compulsory for a cyclist to have insurance?

It has often been said that the DGT intends to make it compulsory for cyclists to have insurance and a driving licence. However, although this may be logical, there is currently no regulation that obliges them to do so.

Nevertheless, if you are a cyclist, it is highly recommended that you have an insurance policy that covers, as a minimum, civil liability for third parties. So that in the event of an accident with a pedestrian, another cyclist or a motor vehicle, the insurance company will cover the physical and material damage caused, just as it does with other vehicles.

Calculation of compensation for bicycle accidents

As in any other accident, the calculation of compensation for a bicycle accident is based on the traffic accident scale, which establishes a system for assessing the damages suffered in an accident. This system includes the amounts to be paid in the event of compensation for temporary disability, death or permanent sequelae.

In each of these cases, different items are distinguished according to the type of damage or harm suffered:

• Period of temporary incapacity. During the days from the bicycle accident until the medical discharge, an amount is assigned according to the damage caused each of these days: very serious, serious, moderate or basic.
• After-effects or permanent disability. The amount will vary according to the points assigned to each of the sequelae, both functional and aesthetic, suffered by the cyclist after completion of the rehabilitation treatment and discharge.
• Economic loss. This is compensation for the material damage suffered, the extra costs incurred and the income foregone following the cycling accident.

However, in cycling accidents, as cyclists do not have insurance, in order to prove the material damage suffered in the accident, an expert appraisal of the damaged bicycle and equipment must be carried out.

Expert opinion

In the event that the cyclist has suffered damage to his or her bicycle, equipment or personal belongings as a result of the accident, he or she may claim compensation from the insurer of the vehicle responsible for the repair or replacement of the same. In order to do this, an appraisal or expert's report must be carried out to serve as documentary proof of the economic value of the damage caused by the accident.

Having a report drawn up by a bicycle specialist will help the injured party to obtain fair compensation from the insurer and also in the event that a legal claim has to be filed.

Most frequent injuries

The most common injuries that a cyclist can suffer after a cycling accident and for which compensation can be claimed are as follows:

• Injuries to the neck area such as: herniated or fractured discs, tendon damage or pinched nerves.
• Fractures of the wrist, arm, leg, hip or collarbone, as well as dislocation of the jaw, fingers, shoulder, hip or knee.
• Contusions or bruises.
• Severe lacerations.
• Nerve injuries or paralysis.
• Traumatic brain injuries.

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.

Unfortunately, traffic accidents happen every day and many times, the lack of knowledge of the injured parties about how to manage compensation in traffic accidents means that they receive much less than what they are entitled to. Whether you have already been through it or have not yet suffered a traffic accident, we tell you everything you need to know if you want to claim compensation.

Entitlement to compensation in a traffic accident

In principle, anyone who is a victim in a traffic accident is entitled to compensation, unless they are solely at fault in the accident. If you are only partly to blame for the accident, because the other party is also at fault, then you are entitled to compensation if you have evidence to prove that they are at fault. Such as a friendly report, witnesses or a police report. In these cases, your compensation will depend on the degree of your responsibility for the accident. Also entitled to compensation are all passengers and occupants of the vehicles involved in the accident, regardless of who caused it, and pedestrians or third parties who can prove that they have suffered physical and/or material damage in the accident.

You can choose between your insurer and traffic accident lawyers

In order to claim compensation, it is essential to have the advice of a lawyer. The Insurance Contract Law offers you the possibility of choosing the lawyer of your choice: the one offered by your insurance company or an independent lawyer specialised in traffic accidents. In principle, the insurer's lawyer is free, this means that he will get paid the same sum whether you get compensation or not, and whatever the amount of compensation is. So it is normal to think that he will look after his payer's interests more than yours. On the other hand, if you hire a lawyer on your own, his or her fees will be a percentage of the compensation you receive, so he or she will certainly try to make it as high as possible according to your injuries. In any case, whatever your choice, you are entitled to have your insurance pay your lawyer's fees up to the limit indicated in the legal assistance section of the policy you have taken out.

Calculation of compensation 

The calculation of compensation for traffic accidents is based on the injury assessment system in force on the date of the accident.

This system contemplates three types of compensation:

• For cause of death.
• For after-effects.
• For temporary injuries.

Therefore, the amount of compensation will depend on the seriousness of the injuries and damage suffered as a result of the accident. The greater they are, the greater the financial compensation will be.

However, the insurer will not pay any amount for concepts that are not justified by documentation.

Criteria for setting compensation 

The following criteria are taken into account when setting compensation for damages suffered in a traffic accident:

• In compensation for death:

• Basic loss. Compensation is paid for damage that cannot be quantified economically, and is therefore common to all persons.
• Particular loss. This takes into account the specific circumstances of the injured parties, such as the death of both parents.
• Financial loss. The injured parties are compensated for loss of income and expenses resulting from the accident.

• In compensation for sequelae or permanent injuries, whether disabling or not. A measurement is made by points of the damage caused, with a maximum of 100, and based on this an amount is established:

• Very serious damages: between €90,000 and €150,000.
• Serious damages: between €40,000 and €100,000.
• Moderate damages: between €10,000 and €50,000.
• Minor damages: between €1,500 and €15,000.
• Aesthetic damages: between €9,600 and €48,000.
• Psychophysical, organic or sensory damages: between €19,200 and €96,000.

• In compensation for injuries or temporary incapacity. This takes into account the period that elapses from the time the accident occurs until the healing process is complete. A distinction is made between:

• Days of very serious injury.
• Days of serious injury.
• Days of moderate injury.
• The rest of the days.
• For each surgical operation.

Interest for delay in the payment of compensation

In the event that the insurer does not pay the compensation within the three months established by the Law, from the moment it has knowledge of the existence of victims in an accident caused by one of his insured persons, then it would be in "delay". This means that interest will have to be added to the compensation.

However, interest for late payment can only be claimed if the injured party sues the insurer, not being in agreement with the offer received, and obtains a higher amount than this by judgement.

In this case, the interest rate for late payment to be paid by the insurance company is:

• During the first two years after the accident: the legal interest rate with an increase of 50%.
• After two years from the accident: the interest will be 20% for each year.

The statement 

When claiming compensation, it is essential to determine who is at fault in the accident. Therefore, if it is not possible to do so by means of a friendly report, it is necessary to call the police or the Guardia Civil to draw up a report.

In the statement, the police or Guardia Civil will determine both the circumstances in which the accident occurred and the responsibility for the accident.

A statement or report is an official document, so it will prevail over the statements of the parties involved in the event that there are discrepancies or simply that, given the seriousness of the accident, they do not clearly remember what happened.

The Insurance Compensation Consortium 

The Insurance Compensation Consortium is a public institution linked to the Ministry of Economic Affairs and Digital Transformation. It is in charge of covering claims where private companies do not guarantee compensation to the injured parties.

This body has, among others, the following functions:

• To assume the compulsory civil liability cover for those private vehicles that do not find an insurer in the private market.
• Acting as a Guarantee Fund in the following cases:

• The cause of the accident is an unknown vehicle.
• The vehicle that has caused the accident does not have insurance.
• The damage has been caused by a stolen vehicle.
• The insurer declares itself insolvent to pay compensation.

Reasoned offer

As soon as an insurer becomes aware of the existence of a traffic accident, it must gather all the information about the accident and the personal and material damage caused. Based on this, it calculates the amount it considers appropriate as compensation for the injured parties and draws up a reasoned offer in which it explains why it proposes that amount and on what reports and data it is based.

The insurer has a period of three months to do so, otherwise it will be in default and interest for late payment will have to be added to the compensation.

Once the injured party receives the reasoned offer from the insurer, it is advisable to review the proposal with a specialised lawyer. In the event of not accepting it, in most cases, the next step is to file a legal claim against the insurer.

Contributory fault or negligence

Contributory fault is a legal concept that refers to the percentage of involvement of each of the parties in an accident. This means that several of the parties involved are responsible for the facts, even if in different proportions.

Prior to 2016, in the case of contributory negligence, the compensation received by each of the parties was divided according to the criterion of primary and secondary negligence. Since then, however, the concept of "contribution to the production of the damage" has been used.

Therefore, victims of road traffic accidents can claim compensation, but this will be reduced by up to 75% for:

• Lack of use or inadequate use of seat belts, helmet or other protective elements by the claimant.
• In the case of non-driving victims, if they have deliberately contributed to the damage.
• When the victim maintains a conduct that aggravates the damage caused in the accident.
• In the event that the injured party does not contribute to a quick recovery of the injured party.

Misdemeanour trial

The misdemeanour trial, which is now called a minor offences trial, is a procedure that is held before an examining magistrate's court to try minor criminal offences in an agile and rapid manner, as the intervention of a lawyer and solicitor is not necessary.

Before 2015, the date of the latest reform of the Criminal Code, claims for injuries in traffic accidents were handled in misdemeanour trials. Since then, however, these matters have been tried in the civil sphere, before the Courts of First Instance.

However, there are some road accident claims that are still handled in the criminal courts:

• Serious injuries, even if they are the result of slight negligence.
• Injuries which, although not serious, are the result of serious negligence on the part of the defendant.

Compensation for traffic accidents 

In 2022, the schedule has been increased by 2.5% compared to last year's schedule of compensation for traffic accidents. In addition, with the new scale, 9% more will be paid for loss of earnings in the case of compensation for death.

Another of the new features of this year's scale is the increase in coverage for consequential damages in medical expenses or vehicle repairs. In addition to a 49.1% increase in compensation for injuries with non-disabling sequelae and 91% for those with disabling sequelae.

In the case of temporary incapacity, compensation may increase by up to 57% depending on whether the incapacity is absolute or total.

Why hiring a traffic accident specialist like Trafilex?

The time taken by an insurance company to deal with a traffic accident claim is usually very long, as they delay the response time as much as possible. In addition, many insurance companies try to pay very small compensations, without knowing the exact extent of the injuries caused by the traffic accident. The complexity of interpreting the scale and the constant changes in the regulations make it essential to have lawyers who specialise in claiming compensation for traffic accidents. Therefore, by hiring the services of a lawyer specialised in traffic accidents you can obtain the maximum compensation established by the Law and in a much shorter period of time. In addition, a lawyer will give you the best advice on medical matters, as it is very common for insurers to fail to provide the best possible rehabilitation.

How much does it cost to hire Trafilex?

Most insurance policies include Legal Defence cover, which can be used to cover the costs of lawyers. This cover provides the insured with money to hire the services of a lawyer external to the insurer, with the amount varying depending on the policy and the company with which the insurance policy is taken out. That's why at Trafilex we don't charge you if you don't get paid.

If you need to claim compensation for injuries and damages suffered in an accident, do not hesitate to contact Trafilex. You will be advised on how to proceed throughout the process and they will help you claim fair compensation for your injuries.

One of the most common injuries after a car accident is the whiplash trauma or injury, it is that common that it costs insurers millions of euros a year in compensation. So if you want to claim compensation for whiplash caused by a car accident, here is everything you need to know about this type of injury, the scale and how to present your claim to the insurance company.

What is whiplash trauma?

A cervical sprain or whiplash is an injury that occurs as a result of an energetic and rapid flexion and extension movement of the neck, from back to front, which causes a tear in the bony tissue and soft tissue that joins the cervical vertebrae.

This abrupt hyperextension of the neck usually follows an unexpected impact in which the energy of the blow is transferred to the neck and, because the muscles are relaxed, cannot react in time to limit the range of motion.

Types or degrees of neck sprain or whiplash

The symptoms that appear after suffering whiplash are what indicate what type of whiplash injury you may have. Therefore, you should know that there are three types or grades of whiplash.

Grade or Type I sprain

This is the most superficial sprain in the classification and is sometimes difficult to detect. In this type of injury, the stretching of the tissues of the neck is small, without rupture, and therefore the resulting sprain is mild.

Although there are no physical signs of injury in this grade, you may feel pain in the nape, neck, head or upper limbs (neck pain or cervicalgia) and/or stiffness and reduced mobility of the neck.

Cervical sprain Grade or Type II

In this type of sprain, the contracture that occurs is more significant, as there is a moderate elongation of the muscles and ligaments. In some cases, there is partial rupture of the tissues, although they do not separate, and this can limit the movement of the joint. In this case we are talking about a grade 2b cervical sprain.

In injuries of this type, you may feel pain on palpation and even have considerable swelling. In addition, there may be a rectification of the normal curvature of the cervical area.

Grade or Type III cervical sprain

In this grade of sprain there are already signs of neurological injury. The tissues of the neck have ruptured and separated as a result of extreme stretching or elongation. The movement of the neck is totally limited, given the intensity of the contracture, and in most cases the use of a neck brace is necessary.

In this case, the pain on palpation of the area is very acute and symptoms of neurological involvement appear, such as tingling, lack of strength in the limbs, numbness or loss of reflexes, among others.

Most frequent symptoms of cervical sprains

The most common symptoms that occur immediately or shortly after whiplash are:

• Severe pain in the neck and shoulders (cervicalgia).
• Stiffness and pain when moving the neck.
• Muscle contracture.
• Headaches or cephalea.
• Dizziness, vertigo or blurred vision.
• Confusion and disorientation
• Tingling and numbness in arms or legs.
• Sensitivity to noise.
• Insomnia, anxiety and difficulty concentrating.
• Tiredness or weakness.

Compensation according to the accident scale for cervical whiplash

When you suffer a cervical sprain, or whiplash, the compensation is calculated according to a scale that takes into account the type of injury suffered and its after-effects. In this document, this type of injury is considered "minor trauma to the spine".

Compensation for whiplash, according to the scale, is made up of several sections or items:

• The main one is the item for temporary injuries or health days. This corresponds to the period between the date of the accident and the last day of rehabilitation, not the day of discharge. During this period, moreover, the days are compensated differently:

• Days of very serious injury, in case of admission to the ICU.
• Days of serious injury. If there is hospital admission. 
• Days of moderate injury. When there is an incapacity to carry out daily activities.
• Days of basic injury. Those in which you can carry out your normal activity, but rehabilitation has not yet been completed.

• The amount for the physical, intellectual, aesthetic and sensory sequelae that persist once the rehabilitation period has ended, after discharge. This amount will have to be determined by a medical expert in damage assessment.
• The item for patrimonial loss, i.e., for the healthcare expenses incurred (consequential damage) and for the loss of earnings or income lost during the period of healing of the injuries.

How to claim compensation for whiplash: 72 hours to go to the doctor

If you have suffered whiplash, there are a number of steps to follow if you do not want to be left without compensation.

First of all, it is very important that you go to the hospital as soon as possible, within 72 hours after the accident, otherwise the insurer may say that the injury is not a consequence of the accident. So make sure you go to the doctor and keep all the documents they give you.

The next step is to report the claim to your insurer, you have one week to do so. Subsequently, they will call you to evaluate the material and physical damage of the accident, and they will indicate that you have to go to a specialist doctor. After this procedure, the insurer will make you a proposal of compensation with which you can agree or disagree.

The article of the schedule dealing with compensation for whiplash injuries

The section of the Law on Civil Liability and Insurance in the Circulation of Motor Vehicles that specifically affects victims of accidents with cervical sprain is article 135, which deals with "compensation for minor spinal injuries".

This article establishes four criteria to determine whether or not there is an entitlement to compensation:

• Exclusion. That there is no other circumstance that justifies the injury.
• Chronological. That the symptoms of the injury manifest themselves during the 72 hours following the accident.
• Topographical. There must be a relationship between the affected area of the body and the injury that justifies the pain.
• Intensity. That the hit to the vehicle is of sufficient severity to cause the injury.

Hence the importance of going to hospital as soon as possible, even if the discomfort is minor.

How much will compensation be paid for whiplash?

As we have already mentioned, compensation for whiplash is made up of several items. Therefore, the amount of compensation will vary depending on the type or degree of whiplash suffered, as this will influence the days of healing required, the recovery costs incurred and days off work, as well as the possible after-effects that may remain.

So in general, the compensation for whiplash can range between:

• Grade or type I sprain: 1.500- 3.000 €.
• Grade or type II sprain: €3,000- €6,000.
• Grade or type III sprain: €6,000-€10,000, depending on the evolution of the injury.

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.