Earlier this month, Ashley Harris discussed the Puerto Rico Unfair Claim Adjustment Practices or Actions statute (26 L.P.R.A. § 2716a) in Is the Insurance Company Adjusting Your Claim Fairly in Puerto Rico?

In addition, some important claims handling deadlines of which Puerto Rico property owners and their representatives should be aware are the following:

  • After an insured submits a notice of loss to the insurer, the insurer shall acknowledge receipt of the claim in writing and commence its investigation within 15 days.1
  • An insurer must provide the insured with a copy of the insurance policy within 10 days of the request.2
  • An insurer’s investigation, adjustment and resolution of any claim must be done in the “shortest reasonable period of time,” within the first 90 days.3
  • If an insurer cannot complete its investigation, adjustment and resolution of any claim within the 90 days, the insurer must document the claim file with documents detailing the existence of just cause to exceed the 90-day time frame.4
  • Resolution of a claim constitutes: (1) the full payment of the claim, (2) the written and duly justified denial of claim or (3) closing of the claim due to inactivity of the claimant when the claimant does not cooperate nor furnish the information necessary for the insurer to adjust the claim.5

1 26 L.P.R.A. §2714.
2 26 L.P.R.A. §2703a.
3 26 L.P.R.A. §2716b(1).
4 26 L.P.R.A. §2716b(2).
5 26 L.P.R.A. §2716c.