INGESA-CCS-UNESPA Agreement 2026-2029: What Auto Insurers Must Do

Key data

Auto insurers with active policies in Ceuta and Melilla have a new and specific obligation as of July 10, 2026: to adhere to the renewed agreement between the National Institute of Healthcare Management (INGESA), the Insurance Compensation Consortium (CCS) and the Spanish Union of Insurance and Reinsurance Entities (UNESPA), and to pay the rates in Annex I for future healthcare assistance to traffic accident victims. The Resolution of August 5, 2026 publishes this agreement, signed on July 10, 2026, which renews the previous framework in force between 2022 and 2025.

The legal basis is Article 113 of Royal Legislative Decree 8/2004, which requires insurers of the responsible vehicle to finance public healthcare assistance provided to victims. The agreement operationalizes this legal mandate with specific rates and procedures for the territories of Ceuta and Melilla, where INGESA directly manages public healthcare.

What does this regulation establish?

The agreement regulates the mechanism by which insurers reimburse INGESA for future healthcare assistance expenses derived from traffic accidents. Payment is activated once the accident victim's injuries are stabilized, that is, when the patient has reached the maximum possible level of recovery and consolidated consequences remain.

The key elements of the agreement are:

• Predefined rates: Affiliated insurers pay INGESA the rates set out in Annex I of the agreement, applicable to the care of lifetime consequences.
• Payment timing: Payment occurs after stabilization of the accident victim's injuries, not during acute treatment.
• CCS role: The Insurance Compensation Consortium acts as subsidiary payer in cases of uninsured vehicles, unknown vehicles or stolen vehicles, ensuring that INGESA always recovers costs.
• Express adhesion: Insurers must expressly adhere to the agreement to be bound by its conditions and rates.
• Exclusive territorial scope: The agreement applies only in Ceuta and Melilla, the two territories where INGESA manages public healthcare (the rest of Spain has its own regional systems).

Economic and operational impact

For auto insurers, the impact is twofold: financial and operational.

From a financial perspective, insurers must provision and pay the rates in Annex I for each accident victim with lifetime consequences treated by INGESA in Ceuta or Melilla. These rates are predefined, which eliminates case-by-case negotiation but requires incorporating them into technical reserve models and in the actuarial calculation of auto policies in those territories.

From an operational perspective, express adhesion to the agreement is not automatic: each insurance entity must formalize its incorporation. Those that do not adhere are outside the regulated framework, which does not exempt them from the legal obligation of Article 113 of RDL 8/2004, but does place them in a position of greater uncertainty in claims management.

For the CCS, the agreement maintains its function as a financial safety net in cases of greater social risk: accidents caused by uninsured vehicles, unidentified or stolen vehicles, where no private insurer responds.

For injured parties, the agreement guarantees that they will receive public healthcare in Ceuta and Melilla at no additional cost, with the insurer of the responsible party (or the CCS in its case) financing such care.

Who does it affect?

• Auto insurers with active policies in Ceuta and Melilla that must respond for traffic accidents in those territories.
• UNESPA as representative of the insurance sector and signatory party to the agreement.
• Insurance Compensation Consortium (CCS), in its function as subsidiary payer for uninsured, unknown or stolen vehicles.
• INGESA (National Institute of Healthcare Management), as provider of public healthcare assistance in Ceuta and Melilla and recipient of payments.
• Traffic accident victims in Ceuta and Melilla with lifetime consequences requiring future healthcare in the public system.
• Actuaries and technical reserve departments of affected insurers, who must incorporate the new rates in their models.

Practical example

An auto insurer has active policies in Melilla. In September 2026, one of its policyholders causes a traffic accident in which the injured party suffers injuries that, once stabilized, generate lifetime consequences. INGESA provides future healthcare assistance to that injured party.

Since the insurer has expressly adhered to the INGESA-CCS-UNESPA 2026-2029 agreement, it is obligated to pay INGESA the predefined rates in Annex I of the agreement for that lifetime care. Payment occurs once the stabilization of injuries is verified, not during the acute treatment phase.

If, instead, the accident had been caused by an uninsured or unidentified vehicle, it would be the CCS that would assume payment to INGESA as subsidiary payer, guaranteeing in any case the financing of public healthcare.

What should companies do now?

1. Verify adhesion to the agreement: Confirm with the legal or operations department whether the entity has already formalized its express adhesion to the 2026-2029 agreement. Adhesion is not automatic even if the entity participated in the previous agreement (2022-2025).
2. Update technical reserves: Actuaries must review reserve models to incorporate the rates in Annex I of the new agreement, especially in policies with exposure in Ceuta and Melilla.
3. Review internal claims procedures: Ensure that claims teams understand the new framework, payment deadlines and activation timing (stabilization of injuries).
4. Coordinate with the CCS: Claims departments must have clear the referral protocol to the CCS in cases of uninsured, unknown or stolen vehicles.
5. Communicate to offices in Ceuta and Melilla: Ensure that local branches are aware of the new agreement and its implications for managing claims with serious injuries.

Official source

Consult complete regulation in official source

Notice: This article is for informational purposes only and does not constitute legal advice. For specific decisions, consult a qualified professional. Source: https://www.boe.es/diario_boe/txt.php?id=BOE-A-2026-17749