Generali Vida Riesgo — Life Insurance Policy Conditions
An English translation of the official Spanish policy conditions — provided as a guide for English-speaking clients.
These are the General Conditions of the Generali Vida Riesgo life insurance contract. They are completed and personalised by your Particular Conditions (Condiciones Particulares), which confirm the insured person, the guarantees you have actually selected, the sums insured and the premium — adapted to your individual risk. Only the guarantees listed in your Particular Conditions apply to you.
Need a plain-English explanation of how life cover works in Spain, or a quote? See our life insurance in Spain page, or contact our team. As an authorised exclusive Generali agent, Turner Insurance can explain any clause below and tailor the cover to your situation.
Part 1 — General Conditions
Information Clause ↑ top
The purpose of this Information Clause is to comply with Article 96.1 of Law 20/2015 of 14 July (on the organisation, supervision and solvency of insurance and reinsurance undertakings) and Article 122 of Royal Decree 1060/2015 of 20 November (its implementing Regulation), concerning the insurer's general duty to inform the Policyholder and the Insured.
Name, legal form and registered office of the Insurer
- Name: GENERALI ESPAÑA, S.A. DE SEGUROS Y REASEGUROS.
- Registered office: Pl. de Manuel Gómez-Moreno, 5, 28020 Madrid. Tax ID (C.I.F.): A-28007268. Madrid Mercantile Registry, sheet M-54.202.
Supervisory authority
Supervision of insurance activity corresponds to the Ministry of Economy, through the Directorate-General for Insurance and Pension Funds (Dirección General de Seguros y Fondos de Pensiones, DGSFP), which also protects policyholders' freedom to choose their insurance and the contractual balance of existing contracts.
Complaints — how to claim and the procedure
The Insurer provides a Claims & Complaints Service (Servicio de Quejas y Reclamaciones), whose rules can be consulted at www.generali.es. The policyholder, insured persons, beneficiaries, injured third parties or their successors may submit complaints relating to their legally recognised interests and rights in writing, stating their personal details, signature, address, policy or claim number and the facts, addressed to:
Servicio de Quejas y Reclamaciones, Generali España, S.A. de Seguros y Reaseguros, Pl. de Manuel Gómez-Moreno, 5, 28020 Madrid — or by e-mail to reclamaciones.es@generali.com.
The Service operates autonomously and independently, will acknowledge receipt and must issue a reasoned decision within a maximum of two months (under Law 44/2002 and Order ECO/734/2004). Its decisions are binding on the Insurer. If two months pass without resolution, or if the complaint is rejected, the interested parties may take their complaint to the Claims Service of the DGSFP (Paseo de la Castellana, 44, 28046 Madrid; www.dgsfp.mineco.es) — all without prejudice to their right to go to the competent courts at any time.
Law applicable to the insurance contract
This contract is governed by Law 50/1980 of 8 October on Insurance Contracts (which is not mandatory where, under art. 11 of Law 20/2015, the contract is considered a large-risk insurance), by Law 20/2015, by Royal Decree 1060/2015 and the rules that develop, amend or supplement them, and by the Conditions of the Contract (with all annexes, supplements and appendices), the insurance application and the risk-assessment questionnaire signed by the Policyholder — which is a fundamental document for the Insurer to have given its consent and set the policy conditions.
Article 1 — Parties to the Contract ↑ top
1.1. The Policyholder (Tomador): the natural or legal person who applies for and contracts the insurance, and who bears the resulting obligations, except those that by their nature must be met by the Insured.
1.2. The Insured (Asegurado): each of the persons on whose life the insurance is contracted. If they wish, the Insured may fulfil the duties that in principle fall on the Policyholder.
1.3. The Beneficiary (Beneficiario): each of the persons (natural or legal) who, once designated, hold the right to receive the insured capital or annuities when the event foreseen in the contract occurs.
1.4. The Insurer (Asegurador): the insurance company is GENERALI ESPAÑA, S.A. DE SEGUROS Y REASEGUROS (the "Company"), registered office at Pl. de Manuel Gómez-Moreno 5, Madrid, which assumes cover of the risks under this contract and guarantees payment of the benefits due under its conditions.
Article 2 — Contract Documentation ↑ top
2.1. The "Policy" is the set of documents containing the conditions governing the insurance contract — the declarations, data and agreements between the parties — made up of:
- 2.1.1. The Application (Solicitud): the form on which the applicant (Policyholder) details the guarantees to be contracted and circumstances relevant to assessing the risk, in line with the health-and-activities QUESTIONNAIRE on the Insured, on the basis of which the Company sets the cover, its scope and the price.
- 2.1.2. The General Conditions: the basic principles, drawn from the Law, governing the birth, life and termination of the contract, so that the parties know their rights and obligations at all times.
- 2.1.3. The Specific General Conditions for each insurance type: they govern the scope of the guarantees provided, for both the Main Insurance and each Complementary cover.
- 2.1.4. The Particular Conditions: the individual data of each contract — identification of the parties, determination and amount of the insured guarantees, premium arrangements, etc.
2.2. After it is taken out, the Policy may be amended or supplemented, by agreement with the Policyholder, through consecutively numbered Appendices or Supplements as often as necessary.
Article 3 — Formalisation of the Contract ↑ top
3.1. The contract is formalised by the signing of the Particular Conditions by the Policyholder, the Insured (if a different person) and the Company's representative. If the Insured is a minor, the written authorisation of their legal representatives is also required.
3.2. The Particular Conditions are drawn up in triplicate, with the parties' signature on each and every page. One copy is held by the Policyholder, the second by the Company, and the third by the Intermediary.
3.3. The Policy must be read carefully, paying special attention to any clauses that limit the Insured's rights, which must in all cases be specially highlighted, and which the Policyholder declares they know and expressly accept by their signature.
Article 4 — Initial Effect of the Contract ↑ top
4.1. The contract takes effect on the date and time stated in the Particular Conditions, provided the Policy has been signed by the parties and the Policyholder has paid the first premium receipt.
4.2. If these requirements are met late, the Company's obligations begin from 24:00 (midnight) on the day signing and payment took place.
Article 5 — Indisputability ↑ top
5.1. The Company draws up the contract based on the data the Policyholder provides in the Application and the answers to the prior Questionnaire, as well as the Insured's declarations on their state of health in the Questionnaire or any medical examination.
5.2. If there was concealment or inaccuracy in the Policyholder's or Insured's answers to the Questionnaire, the Company may rescind the contract within one month of becoming aware of it, by written notice to the Policyholder.
5.3. The Company may not challenge the contract once one year has passed from the date the Policy was signed and the first premium paid, except where: 5.3.1. the Policyholder acted with wilful misconduct (dolo) in the declaration — in which case the Company is also released from paying the capital or annuity in the event of a claim; or 5.3.2. the Insured's age was misstated and their true age at the contract's entry into force exceeds the Company's admission limits.
5.4. Otherwise, if as a result of a misstated age the premium paid is lower than it should have been, the Company's benefit is reduced in proportion to the premium received. If the premium paid is higher, the Company refunds the excess without interest.
5.5. If the contract content differs from the insurance proposal or agreed clauses, the Policyholder may, within one month of delivery of the Policy, ask the Company to correct the discrepancy. After that period without complaint, the contract terms apply.
Article 6 — Unilateral Cancellation of the Contract ↑ top
6.1. The Policyholder may unilaterally cancel the insurance contract within 30 days of the date the Company delivers the Policy or provisional cover document.
6.2. This right must be exercised in writing within that period and takes effect from the day it is sent.
6.3. From that date the Company's cover ceases and the Policyholder is entitled to a refund of the premium paid, less the part corresponding to the time the contract was in force.
Article 7 — Modification of the Risk ↑ top
During the life of the contract, the Policyholder or the Insured must inform the Company, as soon as possible, of all circumstances that aggravate the risk and are such that, had the Company known them when the contract was taken out, it would not have entered into it, or would have done so on more onerous terms.
Article 8 — Payment of Premiums ↑ top
8.1. The price of the insurance is the Premium, which, together with its taxes and surcharges, must be paid on the terms stipulated in the contract.
8.2. The first premium receipt must be paid when the Policy is signed. If, through the Policyholder's fault, the first premium is not paid, the Company may cancel the contract or demand payment by enforcement based on the Policy.
8.3. Unless otherwise agreed, if the premium has not been paid before a claim occurs, the Company is released from its obligation; cover does not take effect and the Company is not liable for claims occurring while that first receipt is unpaid.
8.4. Once the first premium is paid, subsequent premiums are paid in the manner and frequency set in the Particular Conditions. The Policyholder has 30 days from the due date to pay. After that period without payment — and unless the Specific General Conditions provide otherwise — cover is suspended, and the contract terminates six months after the due date of the unpaid premium.
8.5. If the contract has not been terminated under the above paragraphs, cover takes effect again 24 hours after the premium is paid, and the Policy is reinstated.
Article 9 — Reduction of the Insurance ↑ top
9.1. For insurance whose Specific General Conditions provide for Reduction values, and once the period set in them has passed, non-payment of premiums does not suspend cover; instead the Insured Capital is automatically reduced, in line with the Reduction Values table in the Particular Conditions.
9.2. Reduction also occurs at the Policyholder's request, once that period has passed.
Article 10 — Reinstatement ↑ top
10.1. If cover has been reduced as above, the Policyholder may, at any time before the Insured's death, ask the Company to reinstate the Policy, i.e. to bring the insurance back into force for the full Insured Capital.
10.2. If requested within five months of the insurance being reduced or suspended, reinstatement is carried out without a new medical examination.
10.3. Once the Company accepts reinstatement, the unpaid premiums or instalments must be paid in a single payment, with any default interest, plus the fees of the doctor who carried out any examination.
Article 11 — Surrender Right (Rescate) ↑ top
11.1. For insurance types whose Specific General Conditions expressly provide for it, and once the period set in them has passed, the Policyholder may exercise the surrender right by application, in line with the values table in the Particular Conditions.
11.2. The surrender right entitles the Policyholder to unilaterally rescind the contract. Total surrender terminates the contract and settles its economic effects by paying the Policyholder the resulting sum.
11.3. Partial surrender modifies the contract terms without terminating it, reducing the insured capital while keeping the premium plan set in the Particular Conditions.
Article 12 — Advance (Policy Loan) ↑ top
12.1. The Company must grant the Policyholder advances on the insured benefit, in the cases and on the terms set in the Specific General Conditions of each insurance type.
12.2. Advances are loans the Policyholder may obtain from the Company, secured against the mathematical provision it holds.
Article 13 — Designation & Change of Beneficiaries ↑ top
13.1. Designating and changing Beneficiaries are exclusive rights of the Policyholder.
13.2. The Policyholder may waive these rights in favour of another person. Such waiver must be express and in writing, and entails the loss of the rights of surrender, advance and reduction, as well as assignment and pledge of the Policy.
13.3. The Beneficiary may be designated in the Policy (recorded in the Particular Conditions), in a later written declaration to the Company, or by will.
13.4. A change of designated Beneficiary must be made in the same way as the designation.
13.5. If Beneficiaries are not named individually but generically (e.g. "the spouse", "the children", "the heirs"), the designation is interpreted as: 13.5.1. Spouse: the person who is the spouse at the Insured's death; 13.5.2. Children: all descendants entitled to inherit; 13.5.3. Heirs: those with that status at the Insured's death.
13.6. In all three cases it must be stated whether they are the spouse, children or heirs of the Policyholder, the Insured or another person. If not specified, the right corresponds to the spouse, children or heirs of the Policyholder.
13.7. Finally, if at the Insured's death there is no designated Beneficiary or rules to determine one, the capital forms part of the Policyholder's estate.
Article 14 — Obligations in the Event of a Claim ↑ top
14.1. The Policyholder, the Insured or the Beneficiary must, in the event of a claim, notify the Company of its occurrence within a maximum of seven days of becoming aware of it, and provide all information about the circumstances.
14.2. Once the claim has occurred and the Beneficiary has supplied the supporting documents indicated for each benefit in the Specific General Conditions, the Company pays the benefit within 40 days of receiving the claim declarations and required documents.
Article 15 — Assignment & Pledge of the Policy ↑ top
15.1. The Policyholder may at any time assign or pledge the Policy, provided no Beneficiary has been designated irrevocably. Assignment or pledge revokes the Beneficiary.
15.2. The Policyholder must reliably notify the Company in writing of the assignment or pledge.
Article 16 — Communications Between the Parties ↑ top
16.1. All communications and notifications the parties must make under this contract must always be in writing. Exceptionally, where the applicable rules do not require writing, communications from the insurer to the policyholder and/or Insured made by telephone are valid and fully effective when recorded on a durable medium that guarantees their integrity, provided the recipient has previously given express consent to the recording.
16.2. The insurer may send communications and notifications to the policyholder, insureds, beneficiaries and their successors — with full legal validity and contractual effect — by postal mail, burofax, fax, e-mail or text message (SMS) to a mobile phone. Postal or burofax communications from the Insurer must be sent to the address stated in the policy (or later notified). Fax, SMS or e-mail communications must be sent to the fax number, mobile number or e-mail address stated in the policy (or later notified to the Insurer or intermediary). Communications from the Policyholder/Insured to the Insurer must always be sent to its registered office stated in the policy, or to any of its branches open to the public.
16.3. Communications take effect once received by the recipient, whether or not they read them. Postal/burofax communications take full effect from the Postal Service's first attempted delivery at the address, even if that attempt fails for any reason. E-mail/SMS communications take full effect from the date they reach the destination address or number, regardless of whether or when the recipient opens them.
16.4. Communications by the policyholder to the insurance agent who mediates the contract have the same effect as if made directly to the insurer. Communications by an insurance broker to the Insurer on the policyholder's behalf have the same effect as if made by the policyholder, unless the policyholder indicates otherwise. Communications by the Insurer to the Policyholder/Insureds through the mediating agent or broker have the same effect as if made directly by the Insurer.
Article 17 — Limitation of Actions ↑ top
All actions arising from this contract are time-barred after five years.
Article 18 — Applicable Law & Competent Jurisdiction ↑ top
18.1. This contract is subject to Spanish jurisdiction; within it, the competent judge for actions arising from the contract is that of the Insured's domicile, any agreement to the contrary being void. Spanish law applies.
Article 19 — Risks Covered by the Consorcio de Compensación de Seguros ↑ top
In accordance with the legal Statute of the Consorcio de Compensación de Seguros (a public business entity), approved by Royal Legislative Decree 7/2004 of 29 October, the policyholder of a contract that must compulsorily include a surcharge in its favour may agree extraordinary-risk cover with any qualifying insurer. Indemnities for claims caused by extraordinary events occurring in Spain or abroad (where the insured habitually resides in Spain) are paid by the Consorcio when the policyholder has paid the corresponding surcharges and either: (a) the extraordinary risk is not covered by the policy taken out with the insurer; or (b) although covered, the insurer cannot meet its obligations because it has been judicially declared insolvent or is subject to a liquidation procedure assumed by the Consorcio.
Extraordinary events covered include: natural phenomena such as earthquakes and tidal waves; extraordinary floods (including sea surges); volcanic eruptions; atypical cyclonic storms (including extraordinary winds with gusts over 120 km/h, and tornadoes); and the fall of celestial bodies and meteorites. Also: events caused violently by terrorism, rebellion, sedition, riot and civil commotion; and acts of the Armed Forces or Security Forces in peacetime.
Excluded risks include, among others: those not giving rise to indemnity under the Insurance Contract Act; those caused by armed conflict (even without an official declaration of war); those arising from nuclear energy; certain ground-movement phenomena; bad faith of the insured; claims before payment of the first premium or while cover is suspended for non-payment; and events classed by the Government as a "national catastrophe or calamity".
Extent of cover, notice and payment: extraordinary-risk cover applies to the same persons and sums insured as for ordinary risks. In life policies that generate a mathematical provision, the Consorcio's cover refers to the capital at risk (the difference between the sum insured and the mathematical provision). Claims are notified to the Consorcio by the policyholder, insured, beneficiary, insurer or intermediary — by phone (900 222 665 / 952 367 042) or at www.consorseguros.es — and the indemnity is paid to the beneficiary by bank transfer.
Article 20 — Territorial Scope ↑ top
Unless otherwise agreed, the guarantees of this contract are valid worldwide, provided the Insured resides in Spain. The corresponding indemnities are paid in Spain, in Spanish currency (euros).
Sanctions Exclusion & Limitation Clause: the Insurer provides no cover and assumes no obligation to pay claims under this policy if doing so would expose the Insurer to any sanction, prohibition or restriction under United Nations or European Union resolutions, or to trade or economic sanctions, laws or regulations of any jurisdiction applicable to the Insurer.
Part 2 — Specific Conditions (Guarantees)
The following Specific General Conditions complete the Particular Conditions and the General Conditions above. Each guarantee applies only if it has been specifically contracted and is recorded in your Particular Conditions.
How to read this part: for each guarantee we give the full object, definitions, any special terms (waiting periods, age limits, how benefits are paid) and the complete list of exclusions. The standard administrative clauses that repeat across every guarantee — duration & tacit renewal, automatic annual revaluation, premium adjustment by age, and guaranteed values (these complementary covers have no reduction, surrender or advance values) — follow the same common pattern set out in the General Conditions and in 85.01 Death below.
85.01 — Death (Fallecimiento) ↑ top
Object of the guarantee
Under this DEATH GUARANTEE, the Company guarantees the Beneficiary the payment of a Death Capital if the Insured dies within the term of the insurance contract.
Article 1 — Definition
Death Capital: if the Insured dies before the contract's maturity date, the Company pays the Beneficiary designated for this benefit the Capital set out in the Particular Conditions.
Article 2 — Duration & tacit renewal
The term is that stated in the Particular Conditions. At the end of the term the contract is tacitly renewed annually, up to a maximum of the end of the policy year in which the Insured reaches 80 years of age. The Policyholder may object to renewal by written notice given at least one month before the term ends. For this Death guarantee the Insurer expressly waives its right under Article 22 of the Insurance Contract Act to object to renewal. The Insurer must notify any change to the contract at least two months before the end of the current period.
Article 3 — Automatic annual revaluation
At the end of each policy year the guaranteed Death Capital is automatically revalued by a fixed percentage — cumulative or linear, at the Policyholder's choice as stated in the Particular Conditions — or it varies irregularly, or remains constant, as set out there. The increase takes place with no medical requirement.
Article 4 — Premiums
The initial annual premium is that shown in the Particular Conditions. It increases each year according to (i) the automatic revaluation of the Death Capital and (ii) the change in the premium rate with the Insured's age.
Article 5 — Requirements to claim the benefit
The Beneficiary must request payment by submitting the claim form (Parte de Siniestro) provided by the Company, duly completed, together with:
- The Insured's Death Certificate and a copy of their birth certificate.
- A certificate from the doctor(s) who treated the Insured, detailing the clinical history and the nature, cause and circumstances of the illness or accident that caused death.
- Documents proving the identity of the Beneficiaries (or their assignees/representatives).
- Certificate from the Register of Last Wills and, where applicable, a copy of the Insured's last will or the declaration of intestate heirs.
- Proof of payment or, where applicable, the declaration of exemption from Inheritance & Gift Tax.
- The Particular Conditions and the last premium receipt paid.
Article 6 — Guaranteed values
This cover has no reduction, surrender or advance values.
Article 7 — Exclusions
The following are excluded from cover:
- Suicide or attempted suicide within the first year from the Policy's initial issue. (On reinstatement or a non-automatic increase of cover, the one-year period runs from the date that reinstatement or increase takes effect.)
- Death in air or underwater navigation where the Insured acts as pilot or crew, or in aircraft not authorised for public passenger transport, gliders and hang-gliding; accidents while travelling in the Insured's own aircraft, in non-authorised aircraft, or as a crew member in any aircraft (including military personnel on duty in State-owned aircraft).
- Death in a country at war or armed conflict where the Insured travelled there after the conflict broke out, or could have left and did not.
- Death from the Insured's reckless imprudence or gross negligence (so declared judicially or recorded in the official report as the cause), or arising from participation in criminal acts, bets, duels or brawls (unless acting in self-defence or attempting to save people or property).
- Death from illnesses arising from the consumption of alcohol, toxic drugs or narcotics not medically prescribed; accidents arising from the Insured's intoxication (blood-alcohol above the legal road-safety limit) or the effects of such drugs.
- Death in accidents where the Insured was driving without the appropriate licence or without the vehicle's legal documentation, roadworthiness test (ITV) or compulsory insurance.
- Death caused by nuclear energy / nuclear or atomic risks, fission or fusion, nuclear reaction or radiation, and radioactive contamination.
- Death in events classed by the Government as a "national catastrophe or calamity".
- Death caused by natural phenomena: earthquakes and tidal waves, extraordinary floods (including sea surges), volcanic eruptions, atypical cyclonic storms (including extraordinary winds with gusts over 135 km/h, and tornadoes) and falling meteorites.
- Death caused violently by terrorism, rebellion, sedition, riot and civil commotion, by acts of the Armed Forces or Security Forces, or caused directly by any contagious disease classed as a pandemic (only WHO Phase 5 or 6).
Note: extraordinary natural events and terrorism may instead be covered by the Consorcio de Compensación de Seguros — see General Conditions, Article 19.
85.02 — Advance of Death Capital: Absolute & Permanent Disability ↑ top
Object of the complementary guarantee
Under this complementary guarantee, the Company advances — in the amount shown in the Particular Conditions — the Death Capital insured under the main guarantee, if the Insured becomes affected by an Absolute & Permanent Disability before the contract's maturity date.
Article 1 — How the advance works
If the Insured suffers an Absolute & Permanent Disability caused by illness or accident, the Company advances the designated Beneficiary the insured Death Capital, in the amount shown in the Particular Conditions, provided the disability and its triggering cause occur while the Policy is fully in force. A partial advance proportionally reduces the benefits of the main guarantee and of any Accidental-Death and Traffic-Accident-Death guarantees contracted. A full advance automatically extinguishes the main guarantee and those accident-death guarantees.
Article 2 — Definition of Absolute & Permanent Disability
For this guarantee, Absolute & Permanent Disability is the irreversible physical and/or mental condition that makes the Insured totally and permanently unable to carry out any paid profession or work (self-employed or employed), as well as to carry out their normal daily activities, caused by accident or illness arising independently of the Insured's will.
A disability is treated as Absolute & Permanent — and so gives the right to the benefit — when certified as such by the Company's Medical Service; opinions issued by a medical service outside the Company, including Social Security, are not binding. In the event of disagreement on the assessment and degree of disability, the parties submit to medical experts as provided in Articles 38 and 39 of the Insurance Contract Act. The Company may request third-party reports and medical opinions, may have its doctors visit and examine the Insured as often as it considers appropriate, and the Insured (or their representatives) must facilitate such visits and checks.
Article 3 — Duration, renewal & termination
The term matches the insurance term in the Particular Conditions and is tacitly renewed alongside the main guarantee (annual renewals cannot exceed the maximum term). The Company may make continued cover conditional on the Policyholder accepting a premium change reflecting worsening overall disability claims (with at least four months' notice; the Policyholder has 15 days to accept or reject; silence counts as acceptance). The guarantee terminates automatically: when the main guarantee ends for any reason; if premium payment is suspended; at the policy anniversary following the Insured's 67th birthday; or when the Beneficiary receives a disability / loss-of-autonomy benefit under other contracted complementary guarantees.
Articles 4–5 — Revaluation & premiums
The advance is revalued automatically in the same way and percentage as the main Death Capital (no medical requirement). Premiums follow the same pattern as the main guarantee (initial premium per the Particular Conditions, increasing with revaluation and the Insured's age), subject to the premium-change provision above.
Article 6 — Interrelation of benefits
If the Insured becomes Absolutely & Permanently Disabled, the Beneficiary also receives the benefit of the Advance for Professional & Permanent Incapacity guarantee, if contracted. If a Permanent Loss of Autonomy guarantee was contracted, that benefit is paid and this guarantee is then extinguished. If disability arises together with or as a result of a Serious Illness covered by the Serious Illness guarantee, that guarantee prevails: the Beneficiary first receives the Serious-Illness advance, then the advance under this guarantee reduced in proportion to the remaining Death Capital.
Article 7 — Requirements to claim
The Beneficiary submits the claim form with: a copy of the Insured's ID (DNI); a certificate from the treating doctors (on the Company's form) setting out the origin, evolution and nature of the illness or accident and the degree and prognosis of the disability; proof of identity and Inheritance & Gift Tax payment/exemption (if the Beneficiary is not the Policyholder); and the Particular Conditions plus the last premium receipt. The Insured must answer the Company's questions accurately, provide requested evidence, and allow examination by its doctors. Until the disability is verified and accepted, premiums remain payable.
Article 8 — How the benefit is paid
The benefit is paid as follows: 20% of the total once the Company recognises the Absolute & Permanent Disability; the remaining 80% in quarterly payments in arrears, at 4% each, for up to 20 quarters, as long as the disability persists. If the Insured recovers within the 20 quarters, payment is suspended and the main Death Capital is reduced by the amounts already paid. If the Insured dies during the payment period, the Company pays the outstanding Death Capital in a single sum, extinguishing the main and all complementary guarantees.
Articles 9–10 — Guaranteed values & exclusions
No reduction, surrender or advance values. Exclusions — disability is not covered when arising from: alcohol/non-prescribed drugs, or accidents while intoxicated above the legal limit; self-harm or suicide (directly or via a third party); reckless imprudence or gross negligence, or participation in criminal acts, bets, duels or brawls (unless self-defence/rescue); driving without the appropriate licence or valid vehicle documents/ITV/compulsory insurance; violent terrorism, rebellion, sedition, riot, acts of the Armed/Security Forces, or a contagious disease classed as a pandemic (WHO Phase 5 or 6); nuclear energy/radiation; events classed by the Government as a national catastrophe; air/underwater navigation as pilot or crew, non-authorised aircraft, gliders and hang-gliding; conditions related directly or indirectly to an accident or illness occurring before this insurance took effect (pre-existing); cosmetic, slimming or dietary treatments; and the natural phenomena listed above (earthquakes, extraordinary floods, volcanic eruptions, atypical cyclonic storms >135 km/h, tornadoes, meteorites).
85.03 — Advance: Permanent Loss of Autonomy ↑ top
Object
The Company advances the insured Death Capital (in the amount in the Particular Conditions) if the Insured suffers a Permanent Loss of Autonomy before maturity. As with the disability advance, a partial advance proportionally reduces the death benefits and a full advance extinguishes the main and accident-death guarantees.
Definition of Permanent Loss of Autonomy
An irreversible physical and/or mental condition that makes the Insured totally unable to perform, unaided, certain everyday acts, due to anatomical or functional losses caused by accident or illness arising independently of the Insured's will. The everyday acts assessed are:
- Getting up and lying down
- Dressing and undressing
- Washing, combing or shaving
- Eating and drinking
- Bowel control (defecating)
- Bladder control (urinating)
The benefit is triggered by total inability to perform at least three of these six acts. The condition must be certified as permanent by the Company's Medical Service (external/Social Security opinions are not binding); disputes go to medical experts (Arts 38–39 of the Insurance Contract Act).
Payment, mechanics & exclusions
The benefit is paid 20% on recognition + 80% in quarterly instalments of 4% over up to 20 quarters while the loss of autonomy persists (with the same recovery and death provisions as 85.02). Receiving this benefit also entitles the Beneficiary to the disability and professional-incapacity advances if contracted; a Serious-Illness diagnosis prevails and is paid first. Duration & tacit renewal, premium adjustment, automatic revaluation and "no guaranteed values" follow the common pattern; the guarantee ends at the policy anniversary after the Insured's 67th birthday. Exclusions are the same as guarantee 85.02 (alcohol/drugs, self-harm/suicide, reckless imprudence/criminal acts, driving without a licence, terrorism/pandemic Phase 5–6, nuclear, national catastrophe, aviation, pre-existing conditions, cosmetic/slimming treatments and the listed natural phenomena).
85.04 — Advance: Professional & Permanent Incapacity ↑ top
Object
The Company advances the insured Death Capital (in the amount in the Particular Conditions) if the Insured suffers a Permanent Professional Incapacity before maturity, with the same partial/full advance effects as the other advance guarantees.
Definition of Permanent Professional Incapacity
An irreversible physical and/or mental condition that makes the Insured totally and permanently unable to carry out their habitual profession or occupation, or another similar one suited to their training and professional knowledge, caused by accident or illness arising independently of the Insured's will. (This is a broader trigger than Absolute & Permanent Disability, as it relates to the Insured's own profession rather than any work at all.) Certified by the Company's Medical Service; external/Social Security opinions are not binding; disputes go to medical experts.
Payment, mechanics & exclusions
Paid 20% on recognition + 80% in quarterly instalments of 4% over up to 20 quarters while the incapacity persists (same recovery/death provisions as 85.02). If the disability or loss-of-autonomy advances are also contracted, those contingencies are paid and this guarantee is then extinguished; a Serious-Illness diagnosis prevails and is paid first. Duration, renewal, revaluation, premiums and "no guaranteed values" follow the common pattern; ends at the anniversary after the Insured's 67th birthday. Exclusions are the same as guarantee 85.02.
85.05 — Accidental Death (Fallecimiento por Accidente) ↑ top
Object & definition
The Company pays a Capital additional to the main Death Capital if the Insured dies as a result of an Accident before maturity (if the main Death Capital is reduced, this additional capital reduces proportionally). Accident is defined as any fortuitous event, from an external, sudden and violent cause, beyond the Insured's will, that directly causes bodily injury resulting in disability or death.
Claim requirements
The Beneficiary submits the claim form with: the death certificate (literal transcription from the Court); a Court certificate setting out the causes of the accident; proof of the Beneficiaries' identity; the Register of Last Wills certificate and the will or intestate-heirs declaration; Inheritance & Gift Tax payment/exemption; and the Particular Conditions plus the last premium receipt.
Exclusions
This cover has no guaranteed values. Excluded are:
- Death deliberately caused by the Insured or the Beneficiary.
- Death by myocardial infarction (heart attack) — not treated as an accident.
- Accidents linked to alcohol, non-prescribed drugs, or intoxication above the legal limit.
- Reckless imprudence or gross negligence, or participation in criminal acts, bets, duels or brawls (unless self-defence/rescue).
- Terrorism, rebellion, sedition, riot, acts of the Armed/Security Forces, or a contagious disease classed as a pandemic (WHO Phase 5 or 6).
- Driving without the appropriate licence or valid vehicle documents/ITV/compulsory insurance.
- Nuclear energy/radiation; events classed as a national catastrophe; air/underwater navigation as pilot or crew, non-authorised aircraft, gliders and hang-gliding.
- Speed or skill competitions in motor vehicles (as driver, co-driver or passenger).
- Motorcycles as rider or passenger — except mopeds up to 50 cm³.
- Accidents pre-dating this insurance; death resulting from surgery; and the listed natural phenomena (earthquakes, extraordinary floods, volcanic eruptions, atypical cyclonic storms >135 km/h, tornadoes, meteorites).
85.06 — Advance: Absolute & Permanent Disability by Accident ↑ top
Object & definition
The Company advances the percentage (shown in the Particular Conditions) of the additional Accidental-Death Capital if the Insured suffers an Absolute & Permanent Disability caused by an Accident before maturity. This cover requires the Accidental-Death guarantee (85.05) to have been contracted. A partial advance proportionally reduces, and a full advance extinguishes, the Accidental-Death guarantee. The disability definition matches 85.02 (total, permanent, irreversible inability to do any paid work and normal daily activities) but caused by an Accident as defined in 85.05; certified by the Company's Medical Service (external/Social Security opinions not binding).
Payment, mechanics & exclusions
Paid 20% on recognition + 80% in quarterly instalments of 4% over up to 20 quarters while the disability persists (same recovery/death provisions as 85.02). It is paid in addition to, and extinguishes, the ordinary disability/professional-incapacity advances; ends at the anniversary after the Insured's 67th birthday. Exclusions mirror 85.05/85.02: alcohol/drugs, self-harm/suicide, reckless imprudence/criminal acts, driving without a licence, terrorism/pandemic Phase 5–6, nuclear, national catastrophe, aviation, pre-existing accidents, disability resulting from surgery, and the listed natural phenomena.
85.07 — Death by Traffic Accident (Accidente de Circulación) ↑ top
Object
The Company pays a Capital additional to the main Death Capital if the Insured dies as a result of a Traffic Accident before maturity. The Beneficiary also receives the Accidental-Death benefit (85.05) if that guarantee was contracted. If the main Death Capital is reduced, this capital reduces proportionally.
Definition of Traffic Accident
A fortuitous event, from an external, sudden and violent cause beyond the Insured's will, directly causing bodily injury leading to disability or death, arising:
- As a pedestrian, caused by a land vehicle;
- As driver or passenger of a land vehicle — except motorcycles over 50 cm³;
- As a user of public transport (land, sea or air).
Land vehicles include: car, train, tram, trolleybus, moped, motorcycle, bicycle, horse-drawn carriage, lift/elevator, truck, tractor unit and agricultural tractor. Public transport also includes: boat, aeroplane, cable car, ski lift and chairlift.
Exclusions
No guaranteed values. Excluded (broadly as for Accidental Death 85.05): death deliberately caused by the Insured or Beneficiary; death by heart attack; alcohol/drugs/intoxication; reckless imprudence or criminal acts/bets/duels/brawls; driving without the appropriate licence or valid vehicle documents/ITV/insurance; nuclear; national catastrophe; aviation as pilot/crew; speed or skill competitions; motorcycles over 50 cm³; accidents pre-dating the insurance; the listed natural phenomena; and terrorism, rebellion, sedition, riot or acts of the Armed/Security Forces in peacetime.
85.08 — Advance: Absolute & Permanent Disability by Traffic Accident ↑ top
Object & definition
The Company advances the percentage (in the Particular Conditions) of the additional Traffic-Accident-Death Capital if the Insured suffers an Absolute & Permanent Disability caused by a Traffic Accident before maturity. This cover requires both the Death-by-Traffic-Accident (85.07) and the Accidental-Death (85.05) guarantees to have been contracted. The disability definition matches 85.02 but caused by a Traffic Accident as defined in 85.07. Certified by the Company's Medical Service (external/Social Security opinions not binding).
Payment, mechanics & exclusions
Paid 20% on recognition + 80% in quarterly instalments of 4% over up to 20 quarters while the disability persists (same recovery/death provisions as 85.02). Paid in addition to the accident- and ordinary-disability advances if contracted; ends at the anniversary after the Insured's 67th birthday. Exclusions mirror 85.07/85.02 (alcohol/drugs, self-harm/suicide, criminal participation, reckless imprudence, driving without a licence, nuclear, national catastrophe, aviation, speed competitions, motorcycles >50 cm³, pre-existing traffic accidents, natural phenomena, terrorism and peacetime acts of the Armed/Security Forces).
85.09 — Advance on Serious Illness Diagnosis (Enfermedades Graves) ↑ top
Object
If the Insured is diagnosed with one of the pre-defined Serious Illnesses, the Company advances all or part of the contracted Death Capital (the percentage shown in the Particular Conditions). If the Insured later dies during the contract, the Company pays the remaining (non-advanced) part up to the full Death Capital. The illness must be diagnosed for the first time after the contract takes effect and after the waiting period. A partial advance reduces the remaining capital and proportionally reduces any complementary guarantees.
Article 2 — The 17 covered Serious Illnesses
Only physical harm caused by the following illnesses is covered (each with its medical definition):
- Cancer — malignant tumour with uncontrolled growth/spread of malignant cells invading normal tissue; includes leukaemia, lymphomas and Hodgkin's disease. Excludes chronic lymphocytic leukaemia, non-invasive/"in situ" cancers, and skin cancers except malignant melanoma.
- Stroke (cerebrovascular accident) — destruction of brain tissue from thrombosis, embolism or haemorrhage, with neurological sequelae for more than 24 hours and permanent neurological damage. Excludes transient ischaemic attacks and slowly reversible conditions.
- Myocardial infarction (heart attack) — death/necrosis of part of the heart muscle from coronary obstruction, confirmed by all of: typical chest pain, new ECG changes confirming infarction, and raised cardiac enzymes; must have been treated in hospital.
- Renal failure — end-stage chronic, irreversible failure of both kidneys requiring regular dialysis (at least weekly).
- Paralysis — complete, permanent loss of muscle function or sensation in two or more limbs, continuous for 12 months and confirmed by neurological tests.
- Vital organ transplant — undergoing surgery as the recipient of a heart, pancreas, kidney, lung, liver or bone-marrow transplant.
- Cardiac surgery for chronic coronary artery disease — open-heart bypass surgery (on a cardiologist's recommendation) for narrowing/obstruction of two or more coronary arteries. Excludes balloon angioplasty, laser and other treatments.
- Multiple sclerosis — unequivocal diagnosis by a specialist neurologist, with more than one episode of well-defined neurological symptoms confirmed by investigation (e.g. scan).
- Severe burns — third-degree burns covering at least 20% of the body surface.
- Parkinson's disease — unequivocal diagnosis by a specialist neurologist; only idiopathic/primary Parkinson's (of unknown cause) is covered.
- Alzheimer's disease — deterioration/loss of intellectual capacity from irreversible organic degenerative disorders requiring continuous supervision. Excludes neurosis and psychiatric illness.
- Loss of sight — complete, permanent and irrecoverable loss of sight in both eyes.
- Loss of speech — complete, irrecoverable loss of speech from injury or illness, confirmed after a continuous 12-month period.
- Other dementias — significant loss of brain function confirmed by a neurologist, requiring continuous supervision/intensive care. Dementia caused by drug or alcohol abuse is excluded.
- Coma — failure of brain function with total unresponsiveness, lasting at least 96 hours requiring artificial life support, leaving significant permanent loss of brain function (neurologist-confirmed).
- Encephalitis — severe inflammation of brain tissue leaving significant permanent neurological sequelae (neurologist-certified).
- Loss of limbs — total, irrecoverable loss of use of both hands, both feet, one hand and one foot, one hand and sight in one eye, one foot and sight in one eye, or sight in both eyes.
Articles 3, 10 & 11 — Waiting period, residence & exclusions
Waiting period: the benefit applies only if a covered Serious Illness is diagnosed after a three-month period from the contract's effective date. Residence: this guarantee stays in force while the Insured resides in Spain; the Policyholder must notify the Company in writing if the Insured leaves Spain, in which case the Company may increase the premium or modify/cancel the guarantee by written notice. No reduction/surrender/advance values. Exclusions: (a) any Serious Illness diagnosed, or for which the Insured received treatment/surgery, before the cover took effect — though oncological conditions are not excluded once five years have passed since the end of radical treatment with no relapse; (b) illness caused violently by terrorism, rebellion, sedition, riot, acts of the Armed/Security Forces, or directly by a contagious disease classed as a pandemic (WHO Phase 5 or 6); (c) illness due directly or indirectly to drug addiction, alcoholism or attempted suicide; (d) any Serious Illness not listed above. If a disability/incapacity/loss-of-autonomy advance is also contracted and arises with the illness, the Serious-Illness benefit prevails and is paid first.
85.10 — Serious Illnesses — Children (Enfermedades Graves Hijos) ↑ top
Object & scope
The Company pays a Capital if a Serious Illness is diagnosed in any minor child of the Insured (the "Insured" here being the insured under guarantee 85.09). The illness must be diagnosed for the first time after the contract takes effect and after a three-month waiting period. Cover applies to all the Insured's children aged between 3 months and 18 years who are under parental authority; children born in the future are covered (each from the first policy anniversary after their birth). Cover ends for each child at the end of the policy year in which they turn 18 (or earlier on a covered diagnosis). If a child reaches 18 with no covered diagnosis, the Company maintains Serious-Illness cover plus a Death Capital for that child — via the main Serious Illness guarantee, on the same terms, with no medical examination.
Covered illnesses & exclusions
The covered Serious Illnesses for children are eight of those listed in 85.09, with the same definitions: cancer, stroke, myocardial infarction, renal failure, paralysis, vital-organ transplant, cardiac (bypass) surgery, and multiple sclerosis. The Policyholder must keep the Company informed of any change in the number of children (premiums adjust accordingly). The guarantee stays in force while the children reside in Spain. Exclusions mirror 85.09: pre-existing illness/treatment before the cover took effect (with the same five-year oncology exception); terrorism/pandemic (WHO Phase 5 or 6); illness due to drug addiction, alcoholism or attempted suicide; and any illness not listed.
85.11 — Health Assistance & Wellbeing Services ↑ top
Object
For the Insured who has taken out this guarantee (as recorded in the Particular Conditions), the Insurer provides the following services. These are services, not cash benefits — no cash indemnity is paid in their place, and many ancillary costs (e.g. a doctor's fee or treatment) are met by the Insured. The five categories are:
1. Probate & administrative management on death (Gestoría)
On the Insured's death, a representative provides personalised help to the legal heirs at their Spanish home and handles official paperwork, including: obtaining the death and birth certificates, the Register of Last Wills certificate and the certificate of death-cover insurance contracts; deregistering the deceased (Family Book, INSS); obtaining the INSS death grant; arranging widow's and orphan's pensions; non-contentious succession advice (opening the will, determining the estate, acceptance/allocation); and managing the partial Inheritance & Gift Tax settlement on the insured Death Capital, plus gathering the documents needed to collect the benefit. Excludes services outside the EU and matters arising from judicial proceedings.
2. Legal & Living Will (Testamento Legal y Vital)
The Insured and their spouse/partner can draft a will (legal or living will) free of charge online or by phone with a lawyer's guidance, with signing arranged at a notary near their home (or at home if the Insured is dependent or immobile), including one annual modification. Also included: advice on a holographic (handwritten) will; and legal defence if a will made through this service is challenged in court, up to €6,000 per claim/policy year. The service covers legal advice, will drafting and notary fees; other costs are the Insured's.
3. Medical & Wellbeing Services
- 24/7 telephone medical consultation (information, not diagnosis) on symptoms, medication, understanding reports, test preparation, child health/vaccines, on-call centres, diet and exercise.
- Video consultation / call-back with a general-medicine doctor (09:00–21:00, every day).
- Access to a national network of medical professionals/centres at pre-agreed prices (paid by the Insured).
- Medical check-ups (basic or complete) at preferential prices in selected centres.
- Home medical service when illness prevents travel to the surgery — up to 5 home visits a year at no cost (life-threatening emergencies go to public services).
- Tele-assistance after an accident or serious illness causing doctor-prescribed home immobilisation expected to exceed 15 days — an alarm unit is installed and the service is free for 6 months (finding/sending a doctor, ambulance to hospital within 50 km, family alerts, emergency response).
- Second Medical Opinion from internationally renowned experts for listed serious conditions (oncology, heart, stroke, transplants, etc.), with an internal medical consultant supporting the process.
- Access to a wellbeing/health network (psychology, speech therapy, acupuncture, physiotherapy/osteopathy, podiatry, optics/audiology, eye surgery, dietetics, spas & gyms, aesthetic medicine) at pre-agreed prices.
4. Psychology Services
Non-emergency telephone psychological guidance (emotional support, risk assessment, follow-up plan; up to 5 sessions of 30 minutes) and video psychological consultation (09:00–21:00, every day) for anxiety, depression, relationship/family/work issues, support after a serious diagnosis, and child/adolescent behaviour questions.
5. Comprehensive Wellbeing Programme
A health-coaching programme to support an active, healthy lifestyle: a wellbeing adviser; an online/phone health-status test; stress management & better sleep (psychologist-led); a 4- or 8-week healthy weight-loss programme ("Get Fit", designed by nutritionists and sports doctors; excludes BMI under 20 or over 40, relevant illness, insulin-dependent diabetes); a one-year smoking-cessation programme; and a nutritional adviser. During the first three policy years the premium for this guarantee is fixed.
Generali's note on the original: "These General Conditions have been written in a simplified form to make them as easy as possible to understand. Please read them carefully and ask your Intermediary, or any Generali branch, for any clarification you need." — Generali España, S.A. de Seguros y Reaseguros, Pl. de Manuel Gómez-Moreno 5, 28020 Madrid. C.I.F. A-28007268. (Document ref. G51726, edition 01/2024.)