The High Court of Justice of the Canary Islands (TSJC) has issued a landmark ruling that reshapes the landscape of insurers' responsibilities in the archipelago's tourism sector. The Social Chamber, in a decision dated May 21, 2026, upheld the appeal filed by Generali España SA de Seguros y Reaseguros, overturning a previous ruling that ordered the company to pay €12.020,24 in compensation to a hotel chambermaid in southern Gran Canaria. The decision exonerates the company from the obligation to pay for the worker's total permanent disability, determining that the contingency did not occur during the policy's term.
The case highlights the complexity of insurance coverage under collective bargaining agreements in a sector as dynamic as the hotel industry. The plaintiff, an employee of Administraciones Apartamentos y Hoteles SL in the south of the island since 1999, began a period of temporary disability on February 3, 2022, due to a knee condition. In February 2024, the National Social Security Institute (INSS) declared her totally and permanently disabled due to a common illness. The crux of the matter was determining which insurer was responsible for the financial benefit agreed upon in the Las Palmas Provincial Collective Bargaining Agreement for the Hospitality Sector, valued at the insured capital of €12.020,24.
During the proceedings, it was established that the employee had been experiencing problems with her right knee since at least 2019, which worsened in 2021. The insurer Generali had taken out a policy with the defendant company, effective from February 23, 2021, to February 22, 2023. Previsora General MPS SA's policy, for its part, began on February 23, 2023. The lower court, considering that the permanent nature of the condition had been established since the start of the temporary disability, had ruled against Generali. However, the High Court of Justice of Catalonia (TSJC) has overturned this interpretation, accepting the arguments of the appellant insurer.
The court, relying on Supreme Court jurisprudence, has established that, except in exceptional cases not proven in this instance, the date of the event giving rise to a voluntary improvement in coverage for common illness must be considered to be the date of the INSS (National Social Security Institute) resolution, and not the start of sick leave, when the disabling effect is uncertain. The Generali policy clearly stipulated that "the date of the claim will be considered to be the date of the economic effects of the Opinion, Resolution, or Judgment of the competent Official Body." Since the INSS declaration of total permanent disability was issued in February 2024, a date on which the Generali policy was no longer in force, the TSJC (High Court of Justice of Catalonia) has overturned the conviction.
This ruling sets a crucial precedent, granting legal certainty to insurance companies by validating the temporary clauses in their collective bargaining agreement insurance contracts and limiting their liability to claims occurring strictly within the policy's validity period. It also upholds the acquittal of the other co-defendants, including the employer and Previsora General, thus denying the employee the financial compensation she had sought on appeal.