Insurance and Compensation
Review of claims and refusals of cover, complaints against insurers, compensation requests, out-of-court notices, negotiation and assessment of possible court proceedings.
What is included
- Review of the policy and the cover taken out
- Reporting and following up claims
- Refusal of cover by the insurer
- Complaint to the insurer
- Complaint to the insurance regulator (ASF)
- Compensation for financial loss
- Non-financial loss and personal injury
- Road traffic accidents
- Accidents at work
- Contractual and non-contractual civil liability
- Out-of-court notice and negotiation
- Assessment of the prospects of court proceedings
Every situation is assessed individually. These services are provided within the remit of a Trainee Lawyer, under the supervision of Dr. João Nogueira Marques, Lawyer.
What helps prepare for your consultation
- The policy, insurance terms and claim report you already have.
- A timeline of the incident and the insurer’s replies, including any refusal of cover.
- Available evidence of loss, such as invoices, estimates, photographs or reports relating to the incident.
- Your initial notification to the insurer and the claim reference assigned to it.
- Loss adjuster reports, official records or authority reports relating to the incident, where these exist.
- Details of other people or insurers involved and of any payments already received.
What we review with you
We compare the incident with the policy cover and the reasons given by the insurer. We review the evidence of loss and any questions still to resolve. This assessment informs whether to pursue a complaint, negotiation or possible court proceedings. We separate what the policy excludes from what the insurer merely regards as insufficiently documented, because each calls for a different response. We also group the losses by type, separating what is already evidenced from what still needs support.
Official information
Common questions before a consultation
The insurer refused cover. What is assessed first?
The reasons given for the refusal, compared with the policy terms and with what was notified. It matters to separate an exclusion being relied on from a simple shortfall in documentation, because the appropriate response differs in each case.
Which documents best support a compensation claim?
The policy and its terms, the claim report, and then the evidence of loss: invoices, estimates, photographs, loss adjuster reports or authority records. We group the losses by type, separating what is already evidenced from what still needs support.
The insurer has offered an amount. Should I accept?
That is your decision, and the assessment exists to inform it. We compare the offer with the documented losses and identify what may not have been taken into account. We also explain what acceptance involves, without promising that a different figure would be obtained.
How long can resolution take?
A timeframe cannot be given, because it depends on the insurer, the loss adjustment and the route followed. We organise what is within your control, record the correspondence and explain how to follow the claim, without creating expectations about duration or outcome.
Other people were involved in the incident. Does that complicate things?
It widens the assessment, because there may be several policies and responsibilities to consider. That is why we ask who else was involved, which insurers have taken part and whether any payments have already been received from them.
I have already received a partial payment. Can the rest still be assessed?
It can, and it is important to state exactly what was paid and on what basis. That shows which losses have been covered and which remain open, which is the starting point for assessing what might still be claimed.
Do I need my own expert report?
Not always, and that judgement forms part of the consultation. We first look at which reports already exist and what they establish. Whether further technical material is needed depends on what is in dispute and on what the available documents already show.
Can the consultation be held remotely?
Yes. Appointments are held by video call or telephone, in Portuguese, English or Spanish, with documents sent in advance. Anyone in Porto, or who prefers meeting in person, can book at the office.
Editorial responsibility: Carvalhos Advocacia. General information; confirm the current position for your case before acting.