When a flood, an earthquake, or an especially violent meteorological phenomenon causes damage, it is common to think that the Insurance Compensation Consortium will automatically respond. However, the Consortium does not operate as a public fund that compensates any affected party.
To access its coverage, it is necessary for the person, the property, the vehicle, or the damaged business to be protected by a policy included in the extraordinary risks system. The insurance must be in force and have paid the corresponding surcharge in favor of the Consortium.
The specific cause of the damage is decisive. Within the same storm, some damages may correspond to the Consortium and others to the private insurer.
What extraordinary phenomena the Consortium covers
The Regulation of the extraordinary risks insurance establishes that the Consortium compensates for damages caused by the following natural phenomena:
- Earthquakes and tsunamis.
- Extraordinary floods.
- Volcanic eruptions.
- Sea strikes.
- Tornadoes.
- Extraordinary winds with gusts exceeding 120 kilometers per hour.
- Fall of celestial bodies and meteorites.
- Certain violent cyclones or intense cold storms that meet legal requirements.
The coverage also extends to damages caused violently as a consequence of terrorism, rebellion, sedition, riot, or popular tumult, in addition to certain actions by the Armed Forces or Security Forces and Corps in peacetime.
The public designation of the episode does not alone determine coverage. That a storm is presented as a DANA or a historic storm does not mean that all damages automatically fall to the Consortium. It must be verified what phenomenon caused each damage.
What is considered an extraordinary flood
The Consortium covers the flooding of land caused by the overflow of rivers, estuaries, lakes with natural outlets, or surface watercourses, as well as by rainwater flowing over the land and by sea strikes on the coast.
The most important distinction affects rain. The Consortium does not cover water that falls directly on the property, enters through the roof or facade, accumulates on a terrace or patio, or seeps through the drainage network. These damages must be claimed from the private insurer if they are included in the policy.
It is also not considered extraordinary flooding, unless the break derives from another covered risk, the water coming from dams, channels, sewers, collectors, or other conduits built by humans that break or malfunction.
What assets and damages can be compensated
The coverage can reach homes, homeowners' associations, vehicles, businesses, offices, industries, and other insured assets. In homes, it can include both the structure and the contents, always within the contracted capitals.
Vehicles are covered even when they only have the mandatory civil liability insurance. The compensation will depend on the cost of the repair and the value that the vehicle had immediately before the incident.
The Consortium can also compensate for deaths, disability, or temporary incapacity when the affected person has life or accident insurance included in the system.
Loss of business profits, uninhabitability of a home, or loss of rents may be covered, but only when the ordinary policy already includes that guarantee and there is a direct relationship with the extraordinary damage suffered.
It is mandatory to have an active insurance
The fundamental condition is to have a valid policy and to have paid the premium. A home is usually included when it is insured against common risks such as fire, theft, glass breakage, or damage to property.
Those who do not have the affected asset insured cannot claim its value from the Consortium. There is also no coverage if the policy was suspended or terminated due to non-payment when the incident occurred.
In newly contracted insurance, a general waiting period of seven calendar days applies for material damages caused by natural phenomena. There are exceptions, for example, when the new policy replaces a previous one without interruption of coverage. This period does not apply to personal damages.
What damages the Consortium does not pay
Among the most relevant exclusions are:
- Damages caused exclusively by direct rain.
- Hail, snow, or wind that does not reach extraordinary thresholds.
- Defects arising from inherent defects of the asset or lack of maintenance.
- Assets that were not insured.
- Amounts that exceed the contracted capital.
- Damages occurring during the waiting period.
- Indirect losses not included in the ordinary policy.
The forest fires do not appear by themselves among the extraordinary risks covered by this system. The damages caused directly by the fire must be communicated to the private insurer according to the contracted fire coverage.
Who pays for the damages caused by a DANA
A DANA can give rise to two different files. The Consortium can assume the damages caused by an extraordinary flood, while the private company can respond for rain, hail, or ordinary wind leaks.
In case of doubt, the affected party can communicate the claim to their insurer. In wind damage, the Consortium itself recommends starting the processing with the company, which will subsequently determine whether it is appropriate to request reimbursement from the public body.
How much does the Consortium pay and what franchise applies
The Consortium does not grant a fixed amount per catastrophe. The compensation is calculated according to the insured goods and capital, the conditions of the policy, and the valuation of its expert.
If the contracted capital is less than the real value of the asset, a proportional reduction may be applied. In the material damages of businesses, offices, and industries, there is generally a franchise of 7% on the compensable damage.
This franchise does not apply to direct damages in homes, homeowners' communities, vehicles, or personal insurance. In profit losses, the franchise provided in the ordinary policy is used.
How to request compensation from the Consortium
The claim can be submitted through the website of the Insurance Compensation Consortium or by calling the toll-free number 900 222 665, available Monday to Friday between 9:00 AM and 6:00 PM.
The organization recommends communicating the damages as soon as possible, preferably within seven days after the incident, although it also accepts requests submitted later.
To initiate the file, the policy details, the identification of the insured, the location of the damaged asset, and a bank account are needed. It is advisable to keep the receipt of the premium, the estimates and invoices, and the damaged remains until the expert's visit. If they must be removed for safety or health reasons, one should take photographs beforehand and keep the invoices for any urgent repairs.