Liberty Life (insurance) Español
3. Loss adjustment proceedings
In the event of discrepancy with regard to the classification of a claim, its causes, the date of its occurrence or any other relevant circumstance, the insurer and the insured or policyholder may submit the issue to the decision of loss adjusters, of whom each party may name one, subject to written approval by the other party.
Should either of the parties fail to make the appointment, he / she shall be bound to do so within eight days of the date on which it is required to do so by the party that has already made its appointment. Should it fail to make an appointment in this time, it shall be understood that the party accepts the opinion issued by the loss adjuster appointed by the other party, which shall be binding.
If the loss adjusters reach an agreement, this will be recorded in a joint deed, which will specify the causes of the claim and all other relevant circumstances. In the absence of such an agreement, both parties shall appoint, by mutual agreement, a third loss adjuster. Where this is not possible, this appointment will be made by the judge of the court of first instance with jurisdiction over the residence of the insured, by non-litigious proceedings and in accordance with the procedure for the random designation of adjusters set forth in the Civil Procedure Act.
In this case, the loss adjuster's report shall be issued within the period indicated by the parties or, in its absence, in the period of thirty days following acceptance of his / her appointment as the third loss adjuster.
The parties shall be immediately informed of the opinion of the loss adjusters, whether unanimous or majority, by a means beyond all doubt, and it will be binding, except when either of the parties legally contests it within a period of one month, in the case of the insurer, or one hundred and eighty days in the case of the insured, both periods counted from the date of said notification. If no challenge is made in said periods, the loss adjusters' opinion will become final and unappealable.
In the event of default by the insurer on payment of a benefit that has become final and unappealable, should the insured or beneficiaries be forced to bring legal proceedings, the benefit will be increased pursuant to the terms of Article 20 of the Spanish Insurance Contracts Act.
Each party shall bear the fees of its own loss adjuster. The fees of the third loss adjuster, where applicable, and any other expenses incurred will be equally for the account of the insured and insurer. However, should either of the parties have made the appraisal necessary by insisting on a manifestly disproportionate valuation of the claim, said party shall be solely liable for these costs.