Insurance Offered Too Little After a Traffic Accident in Spain: How to Check the Settlement
The insurer did not refuse outright — it made an offer. But the amount looks too low: your sick leave days were not counted, the consequences of your injury were ignored, or the repair cost was undervalued. This article explains how to read the reasoned settlement offer (oferta motivada), check the legal injury compensation scale (Baremo), and decide what to do next. If the insurer refused entirely, see what to do when a claim is denied.
Denial vs. low settlement: the difference
These are two fundamentally different situations, even though both are frustrating.
Did the insurer send an oferta motivada?
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Check the oferta motivada for €9.90 →- Full denial (denegación / respuesta motivada negativa) — the insurer claims it bears no liability or that there was no damage. This can be challenged through the insurer's customer-service department (SAC), the insurance regulator (DGSFP) for conduct breaches, or the courts. More on handling a full denial →
- Low settlement (oferta motivada con cuantía insuficiente) — the insurer acknowledges liability but offers less than it should. The strategy here is different: you need to check the calculation, identify what is undervalued, and make a written objection.
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What is a reasoned settlement offer
Under RDLeg 8/2004 (art. 7), within 3 months of receiving the injured party's claim, the insurer must either make a reasoned settlement offer (oferta motivada) or give a reasoned response (respuesta motivada) explaining why no payment will be made.
A reasoned settlement offer is not just a number. It is a document in which the insurer must explain:
- On what basis it accepts liability (or a portion of it).
- Which documents and facts it took into account.
- How each component of the amount was calculated: medical days, permanent after-effects (secuelas), property damage, expenses.
- Which methodology was applied: usually the legal injury compensation scale (Baremo, Ley 35/2015).
How the legal injury compensation scale works
The legal injury compensation scale (Baremo) is the mandatory calculation system established by Ley 35/2015. It must be applied when calculating compensation for personal injury in traffic accidents in Spain. The insurer cannot replace it with a subjective estimate.
The scale covers several components:
- Days on sick leave by category (días de baja hospitalaria, moderada, básica) — each category carries a different daily rate based on severity.
- Rehabilitation days after medical discharge (alta médica) are also compensable.
- The injured party's age affects the applicable coefficient.
- Permanent after-effects (secuelas) are effects recorded by a doctor after medical discharge (alta médica): restricted movement, chronic pain, loss of organ function.
- Each after-effect is rated in points (puntos), converted to a monetary amount based on age and the compensation-scale table.
- Unrecognised or poorly documented after-effects are a common cause of undervalued settlements.
- Pregnancy, dependent care (children, elderly relatives), special working conditions — may attract additional points.
- Aesthetic harm (perjuicio estético) — scarring, deformity — is assessed separately.
- Moral harm (daño moral) suffered by close family members applies in cases of serious injury or death.
What the insurer's calculation must contain
A complete insurer calculation in a reasoned settlement offer (oferta motivada) typically covers several blocks:
- Temporary harm (lesiones temporales): number of days in each category (hospital, moderate, basic), their Baremo rate, total for the period from accident to medical discharge (alta médica).
- Permanent after-effects (secuelas): list of recognised consequences, points per Baremo table, monetary equivalent adjusted for age.
- Specific personal harm (perjuicio personal particular): if applicable — additional items (aesthetic harm, special circumstances).
- Property damage (daños materiales): repair cost per expert assessment, or compensation amount in the case of constructive total loss (siniestro total), or replacement value of lost property.
- Documented expenses (gastos acreditados): pharmacy, physiotherapy, transport to medical appointments, replacement vehicle hire, private consultations.
- Loss of earnings (lucro cesante): during medical sick leave (baja médica), if the gap between INSS payments and actual income is documented.
What to check in the damage assessment
A damage assessment (peritaje) is an expert assessment of property damage (vehicle, possessions). The insurer's expert (perito) estimates the repair cost or determines whether the vehicle is a constructive total loss (siniestro total).
Points to check in the report:
- Who carried out the assessment: the insurer's expert may have an interest in a lower valuation. That does not automatically mean the report is wrong — but it is a reason to verify it.
- What was actually inspected: are all damage items listed, and do they match the photos and the friendly accident report (parte amistoso) or police report (atestado)?
- Repair cost methodology: were official labour time norms and new parts used, or were second-hand parts substituted without your agreement?
- Market value (valor venal): in a constructive total loss (siniestro total), the insurer pays the market value at the time of the accident, not replacement cost. That figure is also checkable.
- Associated property: luggage, child seat, roof-mounted bicycle — these are also property damage (daños materiales) and should be included.
Documents to gather
- Joint accident report (parte amistoso/DAA) or police report (atestado).
- Photos from the scene: vehicle positions, damage, tyre marks.
- Repair estimate (presupuesto de reparación) from a trusted garage.
- Independent damage valuation (tasación independiente) — if commissioned.
- Emergency report (informe de urgencias) — initial treatment immediately after the accident.
- All subsequent medical reports (orthopaedic, neurological, rehabilitation specialist).
- Diagnostic results: X-ray, MRI, ultrasound, CT scan — with dates.
- Medical sick leave (baja médica) — certificate with start and end dates.
- Medical discharge (alta médica) — discharge document: without it, the temporary-harm (lesiones temporales) calculation cannot be completed.
- Permanent after-effects report (informe de secuelas) — doctor's assessment after discharge.
- Rehabilitation records — sessions attended, dates, number of sessions.
- All receipts and invoices: pharmacy, physiotherapy, private consultations, taxi to clinic.
- Invoices for a replacement vehicle during the repair period.
- Documents on lost earnings: payslips during baja, INSS payment records, the income gap.
- Receipts for damaged property (other than the vehicle): luggage, electronics, child seat.
- Reasoned settlement offer (oferta motivada) — the insurer's offer document with the itemised calculation (or a request to receive it).
- Reasoned response (respuesta motivada) — any interim responses from the insurer.
- Claim file number (expediente) — your claim reference.
- Report by the insurer's expert (perito) — request it if you do not have it yet.
- All correspondence: emails, letters, screenshots of online portal submissions.
What to do when the amount is too low
- Obtain the reasoned settlement offer (oferta motivada) in writing and in full. If the insurer sent only a figure, request the full itemised breakdown for each component: temporary harm (lesiones temporales), permanent after-effects (secuelas), property damage (daños materiales), documented expenses (gastos acreditados). This is your legal right. Send the request in writing with proof of delivery.
- Request the report by the insurer's expert (perito) and all expert assessments the insurer relied upon. The insurer must disclose the documents underlying its calculation. If there is an independent medical report, request that too.
- Check the calculation element by element. Count the actual temporary-harm days (from medical sick leave to medical discharge), identify any permanent after-effects (secuelas) in your medical records that the insurer did not include, compare the repair cost against your independent estimate, and check whether all documented expenses were counted.
- Prepare a written objection (escrito de impugnación). State precisely: which element you disagree with, which documents support your position, what amount you consider correct and why. Attach all supporting documents. Send with a formal notice (burofax) or email with a read receipt.
- If needed — commission an independent damage assessment. If the vehicle damage valuation is disputed, an independent assessment may produce a different figure and become a strong argument. The cost of the independent assessment is typically recoverable as documented expenses.
- File a complaint with the insurer's customer-service department (SAC, Servicio de Atención al Cliente). If the insurer does not respond to your objection or refuses to review the calculation, file a structured written complaint to SAC with a chronology, attachments and specific demands. Response deadline: up to 1 month. RightNOW prepares the complaint →
- Insurance regulator (DGSFP) — for conduct breaches by the insurer. If the insurer breached procedural obligations — failed to provide a breakdown, missed deadlines, refused to disclose documents — that is grounds for a complaint to the Dirección General de Seguros y Fondos de Pensiones. Note: DGSFP assesses conduct, it does not calculate compensation amounts.
- Suitable dispute resolution (MASC) and court — for amount disputes. If SAC and DGSFP do not produce a result and the gap between the figures is significant, prepare a suitable dispute-resolution procedure (medio adecuado de solución de controversias, MASC), the mandatory pre-litigation step under LO 1/2025, then a verbal civil proceeding (juicio verbal) for claims up to €15,000 or a civil claim.
A real case: €3.7 million under the Baremo — what a full calculation contains
In February 2020 in Pamplona, a driver with no valid licence and under the influence of drugs mounted the pavement and hit a couple. The court calculated €3,747,828 under the Baremo and made the insurer pay as directly liable party. The car ran 20 metres along the pavement at 64 km/h, where the limit was 50, and struck two pedestrians walking with their backs to the traffic. The woman, aged 30, was awarded €2,004,244.57: serious moral harm for loss of quality of life, loss of the ability to work in any job, and third-person help for four hours a day at home. The man, aged 31, received €1,260,510.79 plus lifelong future healthcare costs and a separate sum for third-person help, which the court left to be fixed at the enforcement stage (the court's communication names €483,074.56). The judge also recognised “exceptional harm”: the couple had a long relationship and a shared life project. The accused accepted four years in prison on the first day of the trial; the amount of compensation was examined separately.
The non-obvious detail. The total is not one “after-effects” line but separate items, and each has its own condition. Moral harm for loss of quality of life (arts. 107–108) is due when the after-effects prevent or limit the victim's autonomy in everyday or personal activities or in work; the degree — from slight to very serious — is set by that loss, and with after-effects of six points or less no loss of quality of life is presumed unless the victim proves it — except where the after-effects limit the work the victim was doing, which counts as slight harm regardless of points. Future healthcare costs (art. 113) rest on three grounds: the after-effects the law names outright (coma, severe neurological damage, spinal-cord injuries of 50 points or more, amputations or other after-effects requiring a prosthesis); a rebuttable presumption for an after-effect of 50 points or a combined total of 80; and, for after-effects of 30 points or more that by their nature may need periodic treatment, medical expert evidence of the foreseeability of the costs. In every case the frequency and amount of the costs are established by a medical report. Third-person help (arts. 120–123) is set by the table for an after-effect of 50 points, a combined total of 80 or a specially affected personal autonomy, and outside the table only where expert evidence shows a comparable loss of autonomy (art. 121); it is not paid separately when the victim is permanently in an institution at the insurer's expense (art. 122.1). Exceptional harm (art. 33.5) covers only significant damage from singular circumstances that the system's rules do not provide for. A missing line does not by itself prove undervaluation: check the insurer's calculation against the report on stabilisation of the injuries and dispute the items whose condition your documents meet.
Outcome at this stage: €3,747,828 in total; the insurer pays as directly liable party, the car's owner — the convicted driver's mother — subsidiarily. The judgment of 17.11.2022 could be appealed to the Audiencia de Navarra; the court's communication covers the first instance.
Limits of the case. This was a criminal trial in which the judge set the compensation, not a dispute over a specific reasoned offer: the court's communication does not say what the insurer offered before trial, or when. The case shows what a full Baremo calculation under Ley 35/2015 contains where the after-effects are severe, not what sum to expect for minor injuries. Provisions checked in the BOE on 24.09.2026: arts. 33, 107–108, 113, 120–123 LRCSCVM.
Juzgado de lo Penal n.º 4 de Pamplona · 17.11.2022
Keep the reasoned offer with its breakdown, hospital discharge papers, the report on stabilisation of injuries and post-discharge prescriptions. NAVI helps match each line of the calculation against the Baremo and choose the first formal step.
Check the insurer's calculationFAQ
1. The insurer made an offer — does that mean the amount is correct?
No. A reasoned settlement offer (oferta motivada) is an offer, not a final calculation. You are entitled to request an itemised breakdown and to challenge it in writing.
2. What is the legal injury compensation scale (Baremo) and is the insurer required to use it?
The legal injury compensation scale (Baremo, Ley 35/2015) is the mandatory calculation system for traffic-accident injuries. Insurers must apply it. An arbitrary or subjective estimate is a breach of the law.
3. Can I commission an independent damage assessment?
Yes. It is your right. An independent report may produce a different repair cost or reclassify the vehicle as a constructive total loss (siniestro total). Its cost is typically recoverable as documented expenses.
4. Where should I complain if the insurer offers too little?
First, a written objection to the insurer. Then the insurer's customer-service department (SAC). For conduct breaches — the insurance regulator (DGSFP). For amount disputes — suitable dispute resolution (MASC), then a verbal civil proceeding (juicio verbal) or a civil claim.
5. Can I accept a partial payment and still claim the rest?
It depends on the wording. If you sign a waiver of all future claims, then no. If the payment is "a cuenta" without a waiver, further claims remain possible. Check the wording before signing.
The insurer made an offer but the amount looks too low?
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Prefer to handle it yourself?
You can also use the official channels directly, often at no cost: Banco de España for bank complaints, DGSFP for insurance, OMIC or consumer services for consumer claims and Defensor del Pueblo for problems with public administration. Or go through the claim with RightNOW: we prepare the text, evidence and action path, then accompany the case through to the result.
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This guide is general information about Spanish law, not a legal opinion on your case. Rules change and outcomes depend on your own facts and documents — check your situation before you act on it.