As Hurricane Maria insurance claims continue to be litigated, we begin to see how trial courts in Puerto Rico are evaluating case by case the insurance code’s amendments such as the appraisal process. It has been a year since Puerto Rico’s Insurance Code was amended and one of the significant changes made was under law 242-2018,1 which added an “appraisal process” as an alternative to solve insurance claims. These and other amendments were discussed in my blog published on December 5, 2018, “Puerto Rico Approves Amendments to the Insurance Code to Protect Policyholders and Improve Claim Handling Procedures.”
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Mientras se continúan litigando muchas de las reclamaciones al seguro por los daños ocasionados por el Huracán María, observamos como los tribunales comienzan a evaluar y aplicar en cada caso las enmiendas realizadas al Código de Seguros de Puerto Rico tales como el nuevo proceso de “appraisal”. Ya ha pasado un (1) año desde la enmienda al Código de Seguros de Puerto Rico que incluyó como uno de sus cambios significativos bajo la ley 242-2018,1 el proceso de “appraisal” como alternativa para solucionar reclamaciones al seguro. Ésta enmienda junto a las demás fueron discutidas dentro de mi “blog” publicado el 5 de diciembre de 2018, titulado “Puerto Rico Aprueba Enmiendas Al Código de Seguros Para Proteger A Los Asegurados Y Mejorar Los Procedimientos Para Solucionar Reclamaciones”.
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Law360 published an excellent article, The Insurance Landscape For Phishing Claims Is Shifting,1 written by Jason Rubinstein and Jasmine Chalashtori. Their summary about the importance of coverage for these computer fraud claims and the need for brokers to discuss these risks with their business clients was highlighted at the end of their article:
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Additional living expenses can create a number of questions about what items of expanse can be claimed following a loss. FC&S is a publication I encourage those in the claims business to subscribe. While reading the Question and Answer section of the FC&S Coverage Insider, the following additional living expense coverage question was posed:

Our insured has an ISO HO 3 policy, 1991 edition, and recently suffered a fire loss. Coverage for her home and contents is not at issue; however, she has had to relocate to a motel until restoration of her home is complete. Prior to the loss, she stored some of her personal property in half of her two-car garage. Because of the fire, she can no longer use this space until repairs have been completed.

The insurance company is questioning two items under additional living expense—the cost to rent a storage space, and the cost to dry clean the clothing she took with her.

We think this is additional living expense, and should be covered. What is your opinion?


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California is a beautiful state. When I was meeting with our California attorneys and staff at our holiday party, I mentioned that there are so many different and beautiful areas, it is no wonder California is our most populated state. Unfortunately, with wildfires, earthquakes, landslides, and floods, California has its share of insurance problems—especially a recurrent problem of homeowners finding they are underinsured and without sufficient policy limits after large scale catastrophes.
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Happy New Year! Peace and Good Will to all! But, if you really want to have peace of mind, you should make a New Year’s resolution to review your insurance policies for the most common potential insurance coverage gaps and make an appointment with an insurance specialist—not just an insurance agent, but possibly a risk manager.
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The Puerto Rico Insurance Code provides that the right of subrogation is “[t]he right of an insurer to recover damages who has been called to pay an insured under his policy.”1 Under this law, this right arises once the insurance company makes a payment to the insured. The Supreme Court of Puerto Rico has expressed that this provides a legal replacement mechanism whereby an insurance company replaces the insured person in the exercise of the actions or rights that it has against the person causing damage.2 In other words, the right of subrogation of the insurance company arises when it pays the insured; it is the payment that makes the insurer a creditor through subrogation.3
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