Universidad
Politécnica de Madrid

A. SCOPE OF APPLICATION

1. BY VIRTUE OF NATIONALITY

The Law of 17th July 1953 laid down compulsory Student Insurance for all Spanish students who meet the statutory requirements (Order 11-08-53, Article 2).

Nationals of all European Union Member Countries, in addition to nationals of countries included in the Agreement on the European Economic Area: Iceland, Liechtenstein and Norway (Regulation (EC) No 307/1999).

Refugees and stateless persons residing in the territory of the aforementioned countries.

All foreign students residing in Spain under the same conditions as Spanish students (Organic Law 4/2000, of 11th January, Article 14).

2. BY VIRTUE OF STUDIES

In the university context, Student Insurance applies to those studying official courses in Spain at the graduate, post graduate, PhD or Final Degree Project level. In the case of a Final Degree Project, the Insurance only applies to the academic year in which students enrol.

3. BY VIRTUE OF AGE

In accordance with the provisions of the Law of 17th July 1953, Student Insurance applies to students aged 28 and under.

Student Insurance cover will continue throughout the academic year in which a student turns 28.

B. STUDENT INSURANCE COVER

Student Insurance covers students included in its scope of application for all contingencies expressly stated therein, provided that the health care expenses are incurred within the territory of Spain in accordance with the principle of territoriality as laid down in the General Law on Social Security.

Student Insurance covers the insured for certain contingencies that may occur to them, to which the following benefits apply:

1. STUDY-RELATED INJURY

A study-related injury is understood as any physical injury suffered by the insured during activities directly or indirectly related to their status as a student, including sports activities, assemblies, study trips, work experience or end of degree trips or similar, provided that such activities have been organised or authorised by the study centre. Students may go to the medical service provider or centre of their choice, although when the medical service provider or centre is not approved as part of the Student Insurance, only the expenses for the amount included therein will be covered and any difference shall be met by the student.

2. NEUROPSYCHIATRY:

Outpatient care, hospital admission and day hospitalisation

3. PULMONARY AND BONE TUBERCULOSIS

4. GENERAL SURGERY

5. OBSTETRICS

6. BURIAL EXPENSES

7. FAMILY HARDSHIP

A minimum level of academic performance and the income level of the family unit will be taken into account. In the event of the death of the head of household, the family income may not be more than €6,010.12 for each member of the family unit, taking into account all the family members who live with the student in addition to their respective incomes.

8. DISCRETIONARY BENEFITS:

Rehabilitation, radiotherapy, radium therapy, cobalt therapy, artificial kidney, maxillofacial surgery.

C. INCOMPATIBILITIES

Student Insurance benefits are incompatible with any other benefits of identical content or those arising from a similar risk of which students may be beneficiaries by virtue of being registered with any Social Security Scheme. In such cases, benefits will be received from the corresponding Social Security Scheme and Student Insurance will cover any difference.

Benefits from the MUFACE, ISFAS and MUGEJU schemes will be regarded in the same way as Social Security Schemes and as such their benefits are considered incompatible with those included in Student Insurance.

However, in the case of benefits of a similar nature in policies taken out with private companies and private insurance companies, no incompatibility exists.

D. IN-COMPANY WORK EXPERIENCE

In relation to Student Insurance cover in the case of students doing in-company work experience, the Directorate General of Planning for the Social Security issued a Resolution on 25th March 1999, according to which work experience done by students under the provisions of Royal Decree 1497/1981 of 19th June, updated by Royal Decree 1845/1994 of 9th September, are covered by Student Insurance provided that the work experience has been organised or authorised in accordance with the provisions of the aforementioned Royal Decree, irrespective of whether or not it is compulsory for obtaining the qualification, provided that the student is enrolled at a university and the payment of the corresponding fee is up to date.

Similarly, such protection includes students doing in-company work experience beyond the scope of the aforementioned Royal Decree, provided that the work experience is authorised or organised by the Study Centre and does not constitute an employment relationship or an activity which may result in the inclusion of students in any other Social Security Scheme.

E. DOCUMENTS WHICH MUST ACCOMPANY APPLICATIONS

In all cases:

1. National Identity Document.
2. Passport in the case of foreign students.
3. For university students, enrolment receipt showing the year of study, the centre at which the student is studying and payment of the Student Insurance premium.

Applications for these benefits, with the exception of a study-related injury, must be presented prior to receiving health care for the recognition of the right to benefits, except in emergencies, in which case applications may be presented within 3 months following admission.

These documents may be presented at any Social Security Information and Support Centre (CAISS), except when assistance is provided at an authorised medical centre.

MEDICAL CENTRES INCLUDED IN STUDENT INSURANCE

ACCIDENT AND GENERAL MEDICAL ASSISTANCE (without specialisation)

PSYCHIATRISTS

DAY HOSPITALS (Outpatient care also available)

FULL HOSPITAL ADMISSION/ DAY HOSPITAL/ OUTPATIENTS

REHABILITATION

IN ORDER TO PROCESS BENEFITS CONCERNING STUDENT INSURANCE, STUDENTS MAY GO TO ANY SOCIAL SECURITY INFORMATION AND SUPPORT CENTRE (CAISS) ON THE FOLLOWING LIST (PREFERABLY THE CENTRE CLOSEST TO THEIR PLACE OF RESIDENCE). Information may also be obtained free of charge by calling 900 16 65 65.

SOCIAL SECURITY INFORMATION AND SUPPORT CENTRES (CAISS)

MORE DETAILED INFORMATION ON STUDENT INSURANCE IS AVAILABLE AT THE INSS (National Social Security Institute), MADRID PROVINCIAL DIRECTORATE, Calle Lopez de Hoyos, 169 – 28002 Madrid. Tel. 91 590 71 00 / 73 76 / 73 87