Generali Protección Familiar — Funeral (Decesos) Policy Conditions (English Translation)

Preliminary — Information clause ↑ top

This information is issued under Article 96.1 of Law 20/2015 and Article 122 of Royal Decree 1060/2015. Insurer: GENERALI ESPAÑA, S.A. DE SEGUROS Y REASEGUROS. Registered office: Pl. de Manuel Gómez-Moreno, 5, 28020 Madrid. C.I.F.: A-28007268. Madrid Commercial Registry, sheet M-54.202. Supervisory authority: the DGSFP. Complaints: via Generali's Complaints and Claims Service (Pl. de Manuel Gómez-Moreno 5, Madrid; reclamaciones.es@generali.com), which must resolve within two months; thereafter the DGSFP Claims Service (Paseo de la Castellana 44, Madrid), without prejudice to the courts. Applicable law: Law 50/1980 on the Insurance Contract (not mandatory where treated as a large risk under Art. 11 of Law 20/2015), Law 20/2015 and RD 1060/2015. Right of withdrawal (distance contracts): under Article 10 of Law 22/2007, the policyholder of a distance contract has 14 calendar days from conclusion to withdraw (not applicable to compulsory insurance or already-executed contracts); notice to canalcliente-clientes.es@generali.com, paying only for the cover period until withdrawal.

Article 1 — Definitions ↑ top

• Sum insured (Capital Asegurado): the maximum the Insurer pays per loss, shown in the Particular Conditions.
• Policy: the document containing the contract conditions (General + Particular Conditions, application and later supplements).
• Premium: the price of the insurance (plus legally chargeable taxes and surcharges).
• Actuarial age: the age at the nearest birthday to the contract's effective date.
• Waiting period (carencia): a period from each guarantee's effective date during which it is not yet in force.
• Loss event (siniestro): any event whose consequences are covered by a guarantee.
• Funeral service: the set of elements and services needed to carry out the burial/cremation of the deceased insured, within the policy's limits.
• Illness: an alteration of health of common or accidental cause, confirmed by a doctor and requiring medical care.
• Accident: a fortuitous event of external, sudden and violent cause, beyond the insured's will, that directly causes bodily injury producing disability or death.
• Hospitalisation: the insured's stay in a health centre for more than 24 hours as a patient (spas, rest homes, asylums, geriatric homes excluded).
• Pet: for this policy, exclusively dogs, cats and ferrets eligible for the Pet Funeral guarantee.

Article 2 — Persons in the contract ↑ top

Policyholder: the person who applies for and contracts the insurance and holds its obligations. Insured: a person resident in Spain, named in the Particular Conditions, on whom the insurance is established. Beneficiary: the person designated to receive the sums the Insurer must pay on the insured's death (except amounts for services provided directly by the Insurer, paid to the providers). Company/Insurer: Generali España S.A. de Seguros y Reaseguros. Pet owner: the natural person who owns the pet and is responsible for its registration.

Article 3 — Object of the insurance ↑ top

The Insurer guarantees, within the policy's limits and on payment of the corresponding premium, the cover of each contracted guarantee shown in the Particular Conditions for each insured. The guarantees are:

• a) Funeral Management & Expenses (Sepelio);
• b) Death Assistance;
• c) Additional Funeral Capital;
• d) Family Assistance;
• e) Death or Absolute & Permanent Disability by Accident;
• f) Hospitalisation for Illness and Accident;
• g) Repatriation;
• h) Pet Funeral Management & Expenses.

Article 4 — Funeral management & expenses (Sepelio) ↑ top

The Insurer guarantees, up to the sum insured, the provision of a funeral service on the death of each insured — itself acting as provider, through its own means or contracted firms. Where the funeral service costs less than the sum insured, the Insurer pays the difference to the policyholder or, failing that, the legal heirs. Where the Insurer could not provide the service (force majeure, or the family used other means), it is not responsible for the quality of the service used, but must pay the sum insured to the heirs — except where the insured was under fourteen years old. The guarantee applies whatever the cause of death, save the expressly excluded risks.

Capital indexation: the sum insured is increasing, per the annual-indexation article. If the cost of funeral services rises above the agreed index, the Insurer may propose updating the capital and premium; the policyholder has 15 days to accept or reject; only on express rejection does the capital stay unchanged (the policy capital then being the maximum at a loss).

Premium tariff modes (also for the Additional Funeral Capital guarantee): Level (Nivelada) — the premium stays constant for a given capital; Mixed (Mixta) — based on capital and actuarial age at each renewal up to actuarial age 74, then constant (fixed for the first three years for insureds under 60 at start); Single Premium (Prima Única) — based on capital and actuarial age at inception; paying it frees the policyholder from further premiums for this guarantee for the whole contract.

At a claim: notify the Insurer's 24/365 telephone service as soon as possible; the heirs (following the insured's wishes, if expressed) choose the service components up to the sum insured, per what is available in the locality of residence. If the Insurer did not manage the service, it pays the sum insured to the heirs (except for insureds under fourteen) on production of: the literal death certificate; lawful invoices for the funeral services; the Particular Conditions and last premium receipt; and (if claiming as heir) proof of beneficiary identity, the Last Wills certificate and will (or declaration of intestate heirs), and the Inheritance & Gift Tax payment or exemption. If the deceased was insured under more than one Decesos policy with the same Insurer, only one is recognised (policyholder's choice), with refund of the premiums paid on the others for the deceased.

Article 5 — Death-assistance services ↑ top

Applies to insureds who hold the Funeral guarantee, where specified. It comprises:

• 5.1. National & international transfer + free choice of burial place in Spain: on death in Spain or anywhere in the world, the Insurer organises and bears the transfer of the body from the place of death to the cemetery or crematorium in Spain freely chosen by the heirs, plus embalming and administrative formalities (provided no authority impediment/force majeure, and through the Insurer's designated funeral firm). Burial/ceremony costs are excluded here (they fall under Art. 4). A transfer not notified/authorised in advance, and transfers from countries at war/insurrection, are excluded.
• 5.2. Medico-legal costs: where the funeral service exceeds the sum insured due to medico-legal costs requiring judicial intervention, the Insurer bears that excess.
• 5.3. Special services: a special funeral service (cost not exceeding 50% of the funeral capital) for the death of an insured's child from an involuntary interruption of pregnancy or before the child is 30 days old; burial/cremation of amputated limbs of any insured; and access to the Funeral Provider Network for non-insured relatives at the policyholder's own cost.
• 5.4. Custody/accompaniment reimbursement: €300 for the custody of minor children or accompaniment of persons over 75 or dependants (who must be insureds), provided within five days of the death, on original invoices.
• 5.5. Grief management: a telephone grief-support service for a family member who requests it — up to 5 sessions of 30 minutes.
• 5.6. Gestoría service: personal assistance with the post-death paperwork — obtaining certificates (death, birth, Last Wills, insurance-contracts certificate), Family Book and INSS de-registration; for heirs, marriage certificate, INSS death benefit, widow/orphan pensions; advice on non-contentious succession; and the Inheritance & Gift Tax settlement for the insured death capital. Services outside the EU, and matters arising from judicial process or with non-standard incidents, are excluded.
• 5.7. Digital legacy management: on the heirs' request, deletion of the deceased's online presence (social/professional networks, blogs, email) and review/format of devices (incl. up to 5 hours of an in-home technician), and help with the Google data-protection removal form. Excluded where there is conflict between the heirs.

Article 6 — Additional funeral capital ↑ top

An optional capital, additional to the Funeral guarantee, to meet a higher funeral-service cost (extra services or extended concepts). It is governed in all respects by Article 4 and is complementary to the Funeral guarantee, automatically ending when that guarantee ends.

Article 7 — Family Assistance ↑ top

Applies to insureds who hold this guarantee. It bundles travel assistance and a wide range of further services. The amounts shown are maximum amounts accumulable during the annual period.

7.1. Travel assistance

The insured must be resident in Spain. Cover is worldwide, beyond the provincial limit of the insured's habitual residence (in the Balearics/Canaries, beyond 10 km from home), valid for trips abroad of no more than 90 days each (no limit within Spain).

On a death abroad: early return of accompanying insureds (scheduled-flight tourist class / first-class train); accompaniment of minors under 15 or dependants back to Spain; accompaniment of the mortal remains; and the insured's return to attend the funeral of a spouse, parent, child or sibling who dies in Spain (within 7 days).

On illness/accident abroad: medical transfer (special air ambulance — Europe and Mediterranean-rim only — helicopter, scheduled flight, first-class train or ambulance, on medical criteria); medical expenses abroad up to €25,000 per period (fees, prescribed medicines, hospitalisation, local ambulance); emergency dental up to €800; hotel extension on medical prescription €175/day, max 10 days; early return of accompanying insureds; reincorporation into the trip; sending of medicines; hotel for a companion during the insured's hospitalisation €60/day, max 10 days; bringing a person from Spain if hospitalised over 5 days (return ticket + lodging €175/day, max 10 days); accompaniment of minors under 15 or dependants.

Other travel services: insured's return on the hospitalisation (over 5 days) of a close family member; search & rescue up to €1,500 (mountain/sea/desert rescue excluded); baggage search/location and forwarding; sending of essential documents/objects (packages up to 10 kg); urgent-message transmission; advance of funds up to €3,000 (repayable within 30 days, against guarantee); emergency hospital payment; advance of a criminal bail abroad up to €12,000 (traffic accident; repayable within 30 days); legal-assistance fees abroad up to €600 (lawyer/court agent for a traffic accident); telephone interpreter service; card-cancellation information; home guard for up to 24 hours after burglary/fire/flood/explosion; a free 24/365 information service; and private civil liability up to €30,000 (Arts. 1902–1910 of the Civil Code) for injury/damage caused to third parties while travelling, including legal costs and bonds.

Private-liability exclusions: liability from driving motor vehicles, aircraft or vessels, or using firearms; from any professional, union, political or associative activity; fines/penalties; dangerous/high-risk sports; and damage to objects entrusted to the insured.

Travel-assistance exclusions: services not previously notified/authorised; pre-existing or chronic conditions; voluntary refusal/delay of the proposed medical transfer; mental illness, preventive check-ups, spa cures, cosmetic surgery and trips to receive treatment; pregnancy diagnosis/follow-up/interruption and childbirth (save urgent care before the sixth month); winter sports; bets/challenges/brawls; competitive or motorised sport and listed dangerous activities (boxing, weightlifting, wrestling, martial arts, glacier mountaineering, sledding, scuba with apparatus, caving, ski-jumping, air sports, rafting/bungee/canyoning, etc. — in these the Insurer only covers from the start of treatment in a medical centre); suicide/self-harm; mountain/sea/desert rescue; alcohol/drugs/non-prescribed medicines; the insured's wilful acts; sudden epidemics/infectious diseases and pollution; war/terrorism/nuclear/natural-catastrophe events. Also excluded: medical transfer for conditions treatable in situ; glasses, lenses and prostheses; and medical/surgical/pharmaceutical costs under €30.

7.2. Legal & living will

Free preparation of a legal or living will for the insured and spouse/partner (online or by phone with a lawyer, plus signature at a nearby notary; one annual amendment; notary fees included, other costs to the insured); a holographic-will advisory service; and, where a will prepared through this service is judicially challenged, legal defence up to €6,000 per loss/year.

7.3. Medical, dental & wellbeing services

No cash indemnity is paid in place of these services. They include: a 24/365 telephone medical-information service (no diagnosis); video-consultation and call-back with general-medicine doctors (09:00–21:00, 7 days); access to a national medical network at agreed prices (paid by the insured); a home doctor service (up to 5 home visits/year free, vital emergencies to the public system); a Senior medical service (over 59 — personal doctor by phone + preferential health check-ups, the check-ups paid by the insured); teleassistance (an alarm device installed after a doctor-prescribed home immobilisation expected over 15 days, free for 6 months — doctor/ambulance dispatch within 50 km, emergency intervention, family alerting); a Second Medical Opinion service for listed serious illnesses (oncology, heart attack, stroke, transplants, etc.) from an international expert network; access to a national dental network at agreed prices, with a long list of free coded acts (oral diagnosis, prescribed X-rays, preventive cleaning, basic operative/periodontics/prosthetics/oral-surgery/implant acts), a free Child Dental Plan (under-14s, on annual review) and a free Senior Dental cover (over-59s); access to a national wellbeing & health network (psychology, physiotherapy, podiatry, optics, nutrition, etc., paid by the insured); and psychology services (telephone and video psychological orientation — non-urgent support, up to 5 sessions); plus telephone legal and social orientation.

7.4. Integral wellbeing programme

A wellbeing adviser and Health-Status Test, with programmes for stress & sleep, healthy weight loss (4–8 weeks; excluded for BMI under 20 or over 40, serious illness, insulin-dependent diabetes), smoking cessation (1-year programme) and a nutrition adviser.

7.5. Educational assistance — Educasa

For any school-age insured immobilised at home by illness/accident for more than 15 consecutive days: a private tutor in the main subjects, 2 hours a day Monday–Friday (10 hours/week), following the official school calendar, until the pupil resumes school, capped at 12 consecutive months per insured. Valid throughout Spain for primary, compulsory-secondary and bachillerato pupils. A medical certificate is required; the Insurer guarantees the service within 48 hours of the request. Excluded: conditions pre-dating the guarantee and known beforehand, costs arranged without the Insurer's prior agreement, fraud, and congenital illnesses.

7.6. Home-help services

Mostly arranged at agreed prices and paid by the insured (subject to local availability): tele-pharmacy (medicine delivery); home cleaning staff; home catering contacts; home health staff (nursing, physiotherapy); accompaniment service; home hairdresser/podiatry; pet-assistance and home-vet services.

Usage: assistance must be requested via the phone number on the insured's card, stating name, policy number, location and type of assistance. The Insurer is subrogated to the insured's rights against responsible third parties and other insurers/Social Security up to the cost of the services provided; the Insurer is not liable for the insured's decisions contrary to its instructions or its Medical Service.

Article 8 — Death or absolute & permanent disability by accident ↑ top

If an accident causes the insured's death or absolute & permanent disability during the policy's full force, the Insurer pays the capital in the Particular Conditions to the insured or beneficiary. Additionally, if the insured who suffers the accident has a child under 14 insured on the same policy, a single additional capital equal to the contracted capital is paid. Payment for absolute & permanent disability extinguishes this guarantee. Absolute & permanent disability by accident = the irreversible physical and/or mental state rendering the insured totally and permanently unfit for any paid work and for normal daily activities, certified by the Insurer's Medical Service. Disputes are resolved by medical experts (Arts. 38–39 of Law 50/1980). This guarantee is complementary to the Funeral guarantee and ends with it. Claim requires the Loss Declaration plus, for death, the death certificate and judicial certificate of the accident's causes; for disability, medical certificates of origin, evolution, degree and prognosis; plus beneficiary identity, Last Wills certificate/will, and the Inheritance & Gift Tax payment/exemption.

Article 9 — Hospitalisation for illness and accident ↑ top

The Insurer pays the daily sum insured for each day of uninterrupted hospitalisation due to illness or accident, in complete 24-hour periods from admission; no sum for stays under 24 hours. Successive hospitalisations for the same cause count as one period. A single payment of ten times the daily sum insured is made for hospitalisation for any childbirth (single or multiple, normal or complicated) or adoption of a child. An additional daily sum (equal to the contracted one) is paid for uninterrupted ICU (UVI/UCI) stay. For insureds over 69, cover is limited to hospitalisation for illness/accident in the case of surgery. Complementary to the Funeral guarantee. Notify within 48 hours; the Insurer may make payments on account where the loss lasts over 40 days.

Article 10 — Repatriation ↑ top

Optional, for insureds of foreign nationality legally resident in Spain who hold it with the Funeral guarantee. On death in Spain or anywhere in the world, the Insurer organises and bears the transfer of the body to the international airport nearest the place of burial in the insured's country of origin named in the Particular Conditions. In EU countries it also bears the onward transfer from that airport to the burial locality; in the rest of the world, up to €1,000 for the onward transfer (where burial is more than 30 km from the airport), reimbursed on invoices. Embalming, administrative formalities, freight and customs are covered. Burial/ceremony costs are excluded; a transfer not notified/authorised in advance, transport of organs/tissues/embryos, and transfers to/from countries at war are excluded. Includes accompaniment of the remains. Complementary to the Funeral guarantee.

Article 11 — Pet funeral management & expenses ↑ top

The Insurer guarantees a pet cremation service for a pet (dog, cat or ferret) owned by an insured, on the pet's death within Spain, whatever the cause except deliberate. The contracted mode is either Individual cremation (collection, individual cremation, basic urn with ashes returned, certificate) or Collective cremation (collection, collective cremation, ashes not returned). It includes telephone pet-owner assistance and tele-vet services. Waiting period 3 months (90 days) from the pet's addition (save accident); maximum 5 pets; the pet must meet identification (microchip) requirements. Excluded: cover outside Spain; pets under 6 months or over 10 years at addition (or over 10 at microchip registration); pre-existing pathology; and euthanasia in all cases. Notify the death within 24 hours on 911 697 828.

Article 12 — Risks not covered ↑ top

12.1. General exclusions (all guarantees)

• a) serious illnesses pre-existing at the insured's joining date (even without a concrete diagnosis) — those causing evident symptoms or reasonable suspicion before each guarantee's effective date;
• b) armed conflicts (declared or not), riots and civil commotion, nuclear reaction/radiation or radioactive contamination, and any contagious disease classified as a WHO Phase 5 or 6 pandemic;
• c) floods, hurricanes, storms, earthquakes and, in general, events classified by the Government as a national catastrophe or calamity.

12.2. Specific to Death/Disability by Accident

• a) death/disability voluntarily caused by the insured or beneficiary;
• b) an accident where the insured's death is caused by myocardial infarction (heart attack);
• c) from the effects of alcohol or non-prescribed drugs;
• d) from judicially-declared reckless imprudence or gross negligence, or participation in criminal acts, challenges or brawls (save self-defence or rescue);
• e) during underwater or air travel in aircraft not authorised for passengers, gliders and hang-gliders;
• f) in speed/skill competitions in motor vehicles (as driver, co-driver or passenger);
• g) caving, scuba diving with apparatus, or any competitive sport;
• h) any notoriously reckless act;
• i) an accident pre-dating the insurance;
• j) death/disability resulting from a surgical operation.

12.3. Specific to Hospitalisation

• a) scientific expeditions, professional sport, air/motor sports and manifestly dangerous activities;
• b) all pre-existing illnesses (chronic or not) and constitutional/physical defects (even without diagnosis) and their consequences;
• c) war, public-order disturbance, officially-declared extraordinary/catastrophic events or epidemics, and nuclear energy (save a medical treatment based on it);
• d) processes whose sole manifestation is pain, unverified by diagnostic tests;
• e) wilfully caused accidents/illnesses entailing grave risk, and treatment interruption/omission;
• f) alcohol/drugs, brawls, challenges, attempted suicide;
• g) medical examinations, check-ups and stays in spas/rest homes/asylums/geriatric homes;
• h) voluntary medical/surgical acts not from accident/illness, such as purely cosmetic treatment (save reparative surgery after an accident/burn during the policy);
• i) neurological illnesses not diagnosed and verified by tests;
• j) psychoses, neuroses, psychopathies, personality disorders, depression or stress and psychosomatic illnesses.

Articles 13–18 — Contract, premiums & communications ↑ top

Art. 13 — Formation: perfected by both parties' consent and signature, the guarantees taking effect on the date in the Particular Conditions once the first/single premium is paid.

Art. 14 — Duration: one year from the effective date, then automatically renewed yearly (under the Single-Premium mode, until the insured's death). Either party may oppose renewal in writing (one month's notice for the policyholder, two for the insurer); however, the Insurer is bound to the tacit renewal of the Funeral, Death-Assistance and Additional-Capital guarantees while the premium is up to date. The Insurer must notify any contract modification two months before the period ends.

Art. 15 — Premiums: annual (or single, or in instalments). The first premium is due on formation; non-payment lets the Insurer terminate or enforce, and unpaid before a loss releases the Insurer. Successive premiums have a one-month grace period, after which cover is suspended; if the Insurer does not claim within six months, the contract is extinguished.

Art. 16 — Basis: the policyholder's declarations and risk questionnaire are the basis; the Insurer may cancel within one month of learning of reservation/inaccuracy; a misstated age can only void the policy if the true age exceeds the admission limits.

Art. 17 — Duties: to declare all risk-relevant circumstances before signing and any aggravation during the contract (the Insurer may propose a modification or, on rejection/silence, cancel); undeclared aggravation/inaccuracy reduces the payment proportionally (or releases the Insurer if in bad faith); a decrease of risk entitles a premium reduction; address changes must be notified.

Art. 18 — Communications: in writing (telephone valid only if recorded with consent); by post, burofax, fax, e-mail or SMS; effective on receipt (postal on first delivery attempt); communications via the mediator have the same effect as if made directly.

Articles 19–25 — Insurable persons, waiting periods, beneficiaries, territory, indexation, jurisdiction, prescription ↑ top

Art. 19 — Insurable persons: save agreement otherwise, actuarial age 69 or under at joining; for Death/Disability by Accident, ages 14–64 (death) and 64 or under (disability); for Hospitalisation, 64 or under.

Art. 20 — Waiting periods: 20 days for Funeral, Death-Assistance, Additional Capital, Family Assistance and Repatriation (under the Single-Premium mode, Death-Assistance has a 12-month waiting period); Hospitalisation 3 months (or 8 months for adoption, pregnancy and childbirth); Pet Funeral 3 months (90 days). All waiting periods are waived where the loss is caused by an accident.

Art. 21 — Beneficiaries: the policyholder may designate and change beneficiaries (in the policy, in a written declaration, or by will). Generic designations (“spouse”, “children”, “heirs”) are interpreted as at the date of death; failing any designation or rule, the capital forms part of the policyholder's estate.

Art. 22 — Territorial scope: worldwide, provided the insured is resident in Spain (the Pet Funeral guarantee is Spain only); indemnities paid in Spain in euros. A sanctions clause releases the Insurer where cover would expose it to UN/EU/UK/US sanctions.

Art. 23 — Annual indexation: at each renewal the sum insured of each guarantee is revalued by a fixed cumulative percentage in the Particular Conditions; the premium adjusts accordingly.

Art. 24 — Jurisdiction: Spanish law and jurisdiction; the competent judge is that of the insured's domicile (any contrary agreement void).

Art. 25 — Prescription: actions are time-barred after five years.

Article 26 — Cover of extraordinary risks (Consorcio) ↑ top

Under the legal Statute of the Consorcio de Compensación de Seguros (CCS, RDL 7/2004), indemnities for losses from extraordinary events in Spain (or abroad where the insured is resident in Spain) are paid by the CCS where the surcharge was paid and the risk is not covered by the policy, or the insurer cannot meet its obligations (insolvency). Extraordinary events: natural phenomena (earthquakes, tidal waves, extraordinary floods incl. sea surges, volcanic eruptions, atypical cyclonic storm incl. winds with gusts over 120 km/h and tornadoes, falls of celestial bodies); violent events from terrorism, rebellion, sedition, riot and civil commotion; and acts of the Armed/Security Forces in peacetime. Excluded: losses not indemnifiable under the Insurance Contract Act; persons insured where the CCS surcharge is not compulsory; armed conflicts; nuclear energy; other natural phenomena (water-table rise, landslip, etc., save rainwater causing extraordinary flooding); lawful demonstrations/strikes; the insured's bad faith; losses before the first premium or while CCS cover is suspended; and Government-declared “national catastrophe”. For personal insurance, the cover reaches the same persons and sums insured as for ordinary risks. Claims are notified to the CCS (900 222 665 / 952 367 042, www.consorseguros.es), which values and pays by bank transfer.

Closing note of the booklet: “These General Conditions have been drafted in a simplified form to make them as easy as possible to understand.” — ref. G51714, 04/2024. Insurer: GENERALI España, S.A. de Seguros y Reaseguros.