The medical questionnaire: the document that decides your terms

What this page covers, and what it does not

A cuestionario de salud asks about medication, diagnoses, treatment, hospital admissions and any test you are waiting on, and its answers become part of the basis on which the contract is issued.

What follows is the document and the process: what the law asks of you, who completes it, what happens after you press send, and what a wrong answer actually leads to. It is deliberately not about outcomes. What an insurer does with a condition once you have declared it, whether it accepts, excludes, adjusts the terms, postpones or declines, belongs to pre-existing conditions, which sets out the realistic possibilities and why two insurers reach different answers on the same history. If that is your question, read that guide; nothing here re-argues it.

Why insurers use one at all

Private health insurance in Spain is individually underwritten. The insurer is agreeing to pay for future medical care without knowing what care you will need, so before it commits it wants a picture of the risk. The questionnaire is that picture, captured at a fixed point and signed.

It matters more than a typical application form because of what it is attached to: the declaration you make is what the insurer relied on. If the risk it accepted was not the risk it was shown, the law gives it a route to respond. Hence an unhurried hour rather than five minutes in a browser tab.

The legal position: answer the questions asked

Spanish law is more favourable to applicants here than most people expect, and the rule itself is short. Before the contract concludes you must declare the circumstances known to you that may influence the assessment of the risk, in accordance with the questionnaire the insurer puts to you. The duty is defined by the insurer’s questions, and the law states it from the other direction as well: you are released from it where the insurer puts no questionnaire at all, and where a circumstance is not covered by the one it did put.

That is the whole architecture. Your obligation is to answer accurately and completely, not to compile an unprompted autobiography of every symptom you have had. Answer what is asked, including the parts people skim past, because “or have you ever been advised to have” does real work. And do not try to reverse-engineer what the insurer really wants to know: that is not the test being applied.

If an answer turns out to be inaccurate

This is where a great deal of nonsense circulates, including the claim that non-disclosure “voids” a Spanish policy. It does not. Article 10 sets out a graduated regime, and which limb applies depends on the timing and on your state of mind.

Before any claim: rescission within one month. If the insurer learns of a reserva o inexactitud, a concealment or inaccuracy, it may rescind the contract by declaration addressed to the policyholder, and it must do so within one month of acquiring that knowledge. The premiums for the period then running remain with the insurer. That month is a real constraint, not a formality.

Where a claim happens first: proportional reduction. If the claim event occurs before the insurer has made that declaration, the benefit is reduced in proportion to the difference between the premium agreed and the premium that would have applied had the true extent of the risk been known. The claim is not refused; it is scaled to what correct pricing would have been.

Fraud or gross fault: no payment. Only where there was dolo o culpa grave on the policyholder’s part, broadly deliberate deception or gross negligence, is the insurer released from paying at all.

An innocent mistake and a deliberate concealment are therefore treated very differently, which is why the honest answer is also the safe one, and why “keep it simple, don’t mention it” is such bad advice. It is the one approach that moves you into the limb of the article where nothing is paid.

A forgotten course of physiotherapy

An applicant genuinely forgets a short course of physiotherapy from four years ago and answers a question about past treatment as “no”. Nothing about that omission looks deliberate, and the consequence sits at the innocent end of the scale rather than the fraudulent one. The lesson is not that the omission is harmless. It is that the law distinguishes between forgetting and hiding, and the distinction is worth protecting by declaring things you are unsure about rather than filtering them out.

Who completes it

Each person to be insured completes their own declaration. A family policy is not one questionnaire covering four people; it is four assessments travelling under one contract, and each can come back with a different answer, one member accepted on standard terms while another carries an exclusion.

For children, a parent or guardian completes it, to the same standard of accuracy. And a declaration about someone’s health has to come from someone who actually knows it: if you are arranging cover for a relative, do not answer from memory, sit down with them. Sign nothing you have not read, and never sign a blank or pre-filled questionnaire someone else has completed for you, however helpfully it was meant.

What usually happens next

Once submitted, a declaration is assessed. Most are accepted without further contact. Where something needs clarifying, the insurer typically comes back for more information rather than deciding blind: a request for a medical report from your doctor, discharge letters, recent test results, or occasionally a medical examination.

These requests are routine, and usually good news rather than bad: an underwriter asking for a specialist’s letter is trying to price the actual position rather than assume the worst. Documents help. A discharge letter recording that you were signed off five years ago does more work than any amount of reassuring description.

Timescales and channels are set by product and insurer, so take those from the company you are applying to. What you should do in every case is keep a dated copy of what you sent, and read the terms you are eventually offered against it. Exclusions and special conditions are how a declaration shows up in the finished contract, and they need checking word by word, a matter the policy documents guide takes up in detail.

After the policy starts, your health is your own business

One provision surprises almost everybody, and it is worth knowing. In insurance of persons, which is where Spanish health cover sits, the law says the policyholder and the insured have no obligation to notify changes in the insured’s state of health during the contract, and that such changes are in no case treated as an aggravation of the risk.

In other words, the questionnaire is a snapshot taken before the contract begins. Developing a condition afterwards is not something you must report, and it is not something that can be treated as making you a worse risk mid-term. That is a meaningful protection, and it is the strongest practical argument for arranging cover while you are well.

There is a related provision people sometimes cite about not having to declare oncological history after five years without relapse. That paragraph of article 10 is written for life insurance, and this site will not stretch it to cover something it does not say. If it matters to you, ask the insurer what its own practice is, in writing.

Products sold without a questionnaire

Some products are marketed as requiring no medical questionnaire, and they occupy a legitimate niche, particularly for applicants who have been declined elsewhere. But it is worth being clear-eyed about the trade.

An insurer that does not ask about your health has not stopped managing risk; it has moved the management somewhere else. In practice that usually means some combination of narrower cover, a more restricted benefit set, longer or additional waiting periods, and terms under which pre-existing conditions are handled by definition rather than by individual assessment. The risk that would have been priced individually is instead handled in the wording.

None of that makes such products useless. It does mean “no questionnaire” is a statement about the application process, not about the cover, and the only way to know what you would be buying is to read the general and particular conditions first, not the sales page.

If you are not sure whether something counts

A short protocol, in order.

Read the question again, literally. Note its scope and its time limit. “In the last five years” and “ever” are different questions, and so are “diagnosed with” and “treated for”.

If it is still ambiguous, ask in writing. Put the question to the insurer or your intermediary and keep the reply.

When genuinely in doubt, declare it. Declaring something the underwriter turns out not to care about costs you nothing. The reverse is not symmetrical.

Do not describe medical history in ordinary web forms or email. Health information deserves the proper channel: the insurer’s own questionnaire, or a private, consented conversation with a specialist.

Keep the paperwork: the completed questionnaire, any reports sent with it, and the terms you were offered. Together they are the record of what you actually said, which is the only thing that matters if the question ever arises.

Where this sits

The questionnaire is the first of the documents that decide what a policy is worth to you. The rest arrive once the insurer has answered, and which of them governs is where your declaration finally shows its effect, as an exclusion or a special condition or as nothing at all. If any term on this page was unfamiliar, the glossary of Spanish health-insurance terms defines them.