Letter from the President:

Jaime Aguirre de Cárcer y Moreno

President of Mutua Universal

"Mutua Universal has closed the year with another positive assessment, a clear demonstration of its proven financial health and solvency."

It is my pleasure to present the annual Management and Sustainability Report. Every year through this report we share the work carried out by Mutua Universal during the previous financial year, the details of which are set out in this document.

With the world gripped by the inevitable uncertainty stemming from the wars and geopolitical tensions reshaping the global landscape, the obvious doubts surrounding the short- and long-term development of the political and economic environment, and the inevitable slowdown in global growth, 2025 has been a year of contrasts in Spain.

Despite the extreme weather events that have ravaged much of the country and the instability of the Government, with the consequent difficulty in passing major reforms and new General State Budgets that reflects a parliamentary term heavily influenced by the balance of seats, the domestic market has shown a degree of dynamism and resilience, achieving balanced and healthy growth driven primarily by domestic demand, fuelled by private consumption and investment, which experts indicate will be key pillars of development in the coming years.

This growth, combined with a moderation in the inflation, largely explains the growth in Spanish GDP in 2025, which the National Statistics Institute (INE) has put at 2.8 per cent, more than double that of the Eurozone (1.2 per cent), positioning Spain as one of the region’s main economic drivers. The Social Security system, Spain’s second-largest public administration, reached its highest ever number of registered members, at 21.9 million people in employment, along with a corresponding rise in revenue from contributions. These are very positive figures, however, they stand in stark contrast to the system’s deficit, which now stands at over 7.387 billion euros.

Against this backdrop of a highly volatile external environment but a domestic situation tending towards a moderate degree of stability, the sector of mutual insurance companies that collaborates with the Social Security system has continued to contribute to the sustainability of our shared welfare state, demonstrating the importance of these not-for-profit organisations within the state’s health, social and economic systems.

This is borne out by the figures from the Association of Mutual Insurance Companies for Occupational Accidents (AMAT), the employers’ organisation that represents all the mutual insurance companies collaborating with the Social Security system. As at the end of 2025, these companies provide medical, rehabilitation and financial cover for work-related contingencies for more than 1.4 million companies, representing 98.93 per cent of the total in the system, and more than 19.9 million workers, equal to 97.27 per cent of the system. This also addresses the cost of one of the main benefits under the Spanish welfare system, temporary disability benefits arising from common contingencies, which has become the second-largest expenditure item for Social Security, surpassed only by pensions, and has historically suffered from insufficient funding.

"The importance of mutual insurance companies that collaborate with the Social Security system within the state’s health, social and economic systems contributes to the sustainability of the welfare state".

For far too long now, temporary disability due to common contingencies has had a growing impact on the system as a whole, reaching critical levels. At the end of the fourth quarter of 2025, the absenteeism rate stood at 7.1 per cent of agreed working hours, which means that every day around 1.6 million people do not turn up for their job in Spain. Figures from the report on workplace absenteeism compiled by Randstad.

According to the latest figures published by AIReF (Independent Authority for Fiscal Responsibility), an independent public body that falls under the Ministry of Finance which ensures strict compliance with the principles of budgetary stability and financial sustainability, between 2017 and 2024, the rate of temporary disability leave due to common contingencies rose by nearly 60 per cent, the average duration rose by 15 per cent, and there is also a trend towards repeated claims, which has led to a threefold increase in expenditure over the last ten years (since 2014).

The issue of absenteeism from work, a structural, deep-rooted and persistent problem, has already been raised by the Ministry of Social Security with the Organisation for Economic Co-operation and Development (OECD), an international intergovernmental organisation that works to address global economic, social and environmental challenges.

Here in the sector of mutual insurance companies that collaborate with the Social Security system, we will continue to offer our full support and commitment to improving effectiveness and efficiency, drawing on our extensive experience in the search for solutions. We have been calling for greater powers and emphasising the need to expand collaboration with the government. This point has also been highlighted by AIReF, which proposes the development of an integrated information system to enable full interoperability between the National Social Security Institute (INSS), regional health services, businesses and mutual insurance companies that collaborate with Social Security. Positive progress has already been made in this area in the form of agreements between mutual insurance companies and the government to improve the management of temporary disability due to common contingencies and the provision of healthcare for trauma-related conditions across various autonomous communities. Our door will always be open.

As far as Mutua Universal is concerned, for matters which fall within our remit, the organisation ended 2025 with another positive balance sheet, a clear demonstration of its proven financial health and solvency.

With the number of insured workers exceeding 1.8 million workers for the first time, revenue from social security contributions rose by 4.59 per cent compared with the previous financial year, reaching 1,854 million euros.

Thanks to responsible, meticulous and effective management, Mutua Universal achieved a positive profit to be distributed of 23.98 million euros for the financial year, with adequately funded reserves ensuring the organisation’s financial stability and solvency; the organisation is returning €15.97 million to the General Treasury of the Social Security, a clear demonstration of our commitment to sustaining the welfare state.

"We are returning 15.97 million euros to the General Social Security Treasury, demonstrating our commitment to sustaining the welfare state".

This growth, underpinned by a robust, innovative ecosystem in which we have invested 9 million euros in improving and modernising our facilities and services, reinforces the quality of our hybrid care model, which ensures universal and equitable access to specialist and hospital care by combining face-to-face care with advanced remote digital services.

On my own behalf and on behalf of the entire Board of Directors of Mutua Universal, I would like to express my sincere appreciation and gratitude to the organisation’s team of 2,074 professionals, the driving force behind the organisation, who uphold this model and the very essence of mutual insurance companies, through their commitment, talent and daily dedication. Because behind every administrative process, every action and every service, there are people looking after other people.

I would also like to thank all our member companies, the workers we support and represent, and our collaborating organisations for continuing to place your trust in us, thus giving meaning to our purpose.

I would also like to show my appreciation to our Managing Director, Juan Güell, for his leadership, commitment and strategic direction. He always puts people first while his innovative vision ensures the best possible future for the organisation.

Thank you to the Board of Directors and the Audit and Compliance Committee for their dedication to the governance and oversight of the mutual insurance company, and to the members of the Special Benefits Commission and the Oversight and Monitoring Commission for their support and commitment.

We would also like to thank the public administration, with whom we collaborate and will continue to build a strong relationship, as well as the president and managing director of the Association of Mutual Insurance Companies for Occupational Accidents (AMAT).

I wish to offer a special tribute to our honorary president, Mr Juan Echevarría Puig, who passed away last December at the age of 101. I would like to offer my condolences, on my own behalf and on behalf of everyone at Mutua Universal, to his family and loved ones.

Thanks.