In the world of insurance contracts there is confusion in the establishment of clauses limiting and/or delimiting rights, despite the time that has passed since the entry into force of Law 50/1980, of October 8, 1980, on Insurance Contracts.
In order to protect the rights of the insured and to shed light on this type of clause, the Supreme Court (STS 853/2006, September 11, 2006), defined them as follows:
- The risk delimiting clauses are those that specify the object of the contract: those that determine what risk is covered, in what amount, for what period of time and in what spatial scope.
- Limitation clauses constitute a restriction, limitation or modification for the insured or policyholders in the contract they sign, and must be expressly accepted in writing.
Both clauses are very important for the insured, as they frame the actual coverage of your insurance. And the problem is that they are not always sufficiently precise or clear.
Logically, it is in case of loss and claim of the contracted coverages that the interpretations appear and, if the amounts are important, it is possible that the matter may go to court.
Other rulings, such as this one by the High Court (STS 353/2022, October 21, 2022), follow the same line as the aforementioned ruling and describe very clearly the requirements that limiting clauses must meet:
- The wording of the clause must be clear and precise. The policyholder must understand its meaning and scope: the wording must be in accordance with criteria of transparency and clarity.
- The clause does not need to be highlighted by capitalization, italics or underlining. Neither is the use of a certain type of typeface or an increase in font size. They must be highlighted in a special way, so that the insured is aware of the risk covered.
- They must be specially accepted in writing, with the indispensable signature of the policyholder. This implies signing both the general and specific conditions of the insurance contracted.
These good practices guarantee the rights of the insured to receive correct, complete and truthful information and also protect the insurers, since it cannot be doubted that the policyholder was aware of the existence of the limitations implied by these clauses.