Since January, Andalusia Has No Malpractice Insurance for Patients and Doctors. Since the start of the year, Andalusia has lacked insurance coverage for medical errors and workplace accidents for 8.7 million residents and 130,000 healthcare professionals. Authorities have promised to restore this protection, but for now, patients and doctors risk being left without compensation.
In Andalusia, since January 2026, there has been no insurance coverage for medical errors and professional incidents for 8.7 million residents and 130 thousand healthcare system employees. The regional authorities failed to renew the contract with Berkshire Hathaway and are now forced to look for a new insurer on terms that will cost the budget more than the previous 28 million euros per year.
The situation is an exception for Spain: only Andalusia, the Valencian Community, Extremadura, and the Canary Islands currently lack active civil liability insurance for medical errors. This means that any patient claims regarding medical errors or workplace accidents will temporarily have to be covered directly by the regional administration.
Risks for patients and doctors
The consequences of lacking insurance became evident amid high-profile cases. For example, in Velez-Malaga hospital, five-year-old Analia Cortes died after her blood oxygen level was not measured during her first visit. The family claims the tragedy could have been prevented if the child had been examined by a doctor during the follow-up visit. They are not demanding compensation, but justice and the dismissal of the responsible medical staff.
According to the association El Defensor del Paciente, in 2025 nearly 15,000 suspected medical error cases were recorded in Spain, 951 of which resulted in patient deaths. In Andalusia, lawyers note that most incidents occur during periods of high demand—holidays and summer—when doctors are overworked.
Rising Costs and Market Challenges
In recent years, health insurance costs for regional healthcare systems have surged: in 2019, the national total was 65 million euros, but now it's about 100 million. In Madrid, Cantabria, and Castile and León, premiums have increased by 19–50%. The reasons are more lawsuits, greater specialization among medical law attorneys, an increase in staff numbers, and a higher volume of diagnostic procedures.
The authorities of Andalusia explain that the temporary lack of insurance is due to the inability to renew the previous contract because of an increase in medical staff and service volume. They assure that new insurance will be arranged by the end of the year and will be retroactively valid from January 1. For now, the regional administration bears full responsibility for compensation.
Legal Complications and Compensation
The absence of an insurer complicates the compensation process for affected patients: now they can only turn to the administration rather than directly to an insurance company. According to lawyers, this results in lower payouts and longer proceedings. One example is a case in the Valencian Community, where a woman who had a needle left in her body after childbirth was awarded only 2,000 euros in compensation by the commission, and the court increased the amount to just 5,000.
In recent years, major insurers such as Zurich, Mapfre and SegurCaixa have left the market, making way for foreign companies, including Berkshire Hathaway. However, the new players are also facing losses due to lengthy legal proceedings and high payout costs.
Context and consequences
While the Andalusian authorities promise to restore insurance coverage, patients and doctors remain in limbo. According to experts, the absence of an independent insurer reduces the chances of fair compensation and increases the burden on the regional budget. The issue of insurance in healthcare is becoming increasingly acute against the backdrop of a general rise in the number of lawsuits and dissatisfaction with the quality of medical services.
The topic of social protection and compensation in Spain is becoming increasingly relevant amid other significant changes, such as easing regulations for foreign workers in the agricultural sector, which also impacts the burden on the healthcare system and social services.
