One of the interesting aspects of having a national policyholder insurance practice is seeing regional trends of claims processing by insurers. I have come to my own philosophy that differing insurance laws in the various states, whether statutory or by common law, are not right or wrong—they are just different. I am not so certain about claims practices because pushed to the extreme, there are plenty of ways insurance companies can frustrate the purpose of insurance, such as the use of claims processes designed to delay and underpay claims.
Continue Reading Puerto Rico Hurricane Maria Claims Still Not Paid—New York Times Reports on the Insurance Claims Crisis in Puerto Rico

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.”
Continue Reading Can I Litigate An Insurance Claim During An Appraisal Process In Puerto Rico?

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”.
Continue Reading ¿Puedo Radicar Acción Judicial Sobre Una Reclamación Al Seguro Tras Haber Iniciado Un Proceso De Appraisal?

As mentioned previously in my blog post, Accord & Satisfaction: Will My Insurance Claim Be Dismissed If I Deposit A payment (July 21, 2019), many policyholders in Puerto Rico that received payments deposited them without being aware of the consequences of accord and satisfaction. This has also been a common issue on many complaints filed in court and the reason many cases are being dismissed. Fortunately, The Appellate Court (Panel V) on October 24, 2019, just reversed the decision in Negron v. MAPFRE PRAICO Insurance Company, regarding Accord and Satisfaction.
Continue Reading Merlin Law Group (PR) LLC, Wins Accord and Satisfaction Appeal

It has been two years since Hurricane Maria struck and caused catastrophic damage in Puerto Rico. Since then, many policyholders have been struggling to get the reasonable payment owed under their policy to make repairs, but the number of policyholders with unsettled property claims is still very high.
Continue Reading Hurricane Maria’s Second Anniversary – What To Do If Your Claim Has Not Yet Been Settled

After Hurricane Maria, many policyholders in Puerto Rico received payments for the damages caused by the hurricane, and due to the need for repairs to their property, they immediately deposited the checks. The problem with depositing these checks was many included the words “final” or “the endorsement of this check constitutes a total and definitive payment” and without any further explanation, these were mailed and handed to the policyholders. When a policyholder is not satisfied and considers that a property claim is being underpaid, he/she must notify the carrier and ask the consequences of signing and depositing the check.
Continue Reading Accord & Satisfaction: Will My Insurance Claim Be Dismissed If I Deposit A Payment?

Many Policyholders in Puerto Rico are concerned about the notifications of non-renewal or cancellations they received after Hurricane Maria claims. This is a matter that affects both residential and commercial Policyholders. The process of obtaining insurance coverage from a different insurance company can be even more difficult when repairs related to a prior claim have not been completed.
Continue Reading Non-Renewal or Cancellations of Commercial Insurance Policies in Puerto Rico after Hurricane Maria

Condado is a diverse community in San Juan, Puerto Rico, that is 7 miles long but well known by tourists for hotels, restaurants and beaches. For the locals this area it is also known for its numerous condominiums, which were greatly affected in 2017 by Hurricane Maria. To this date, many of the insurance companies have not paid or continue denying coverage to condominium policyholders in this area.
Continue Reading Insurance Recovery for Condominium Policyholders

For some time now, people have been keeping a close eye on several of Puerto Rico’s major insurance carriers due to rumors of insolvency. One of those insurance carriers, Real Legacy Assurance, has unfortunately confirmed these rumors and recently filed for liquidation. According to reports, the carrier has paid nearly $40 million dollars to settle approximately 630 claims – however, many more Hurricane Irma and Maria claims remain unresolved.1
Continue Reading Puerto Rico Update: Real Legacy Confirms Rumors of Insolvency – What’s Next?

A raíz de la catástrofe causada por los huracanes Irma y María, surgió la necesidad de revisar el proceso de reclamaciones ante las aseguradoras en aras de hacer este uno más eficiente. Es por esto que, el gobierno ha trabajado en métodos que ayudarán a mejorar los procedimientos de manejo de reclamaciones ante las aseguradoras. Siguiendo múltiples modelos de varias jurisdicciones de los Estados Unidos, los asegurados en Puerto Rico ahora tendrán herramientas adicionales de protección y que facilitarán la resolución de sus reclamaciones, tanto de propiedades residenciales como aquellas que sean comerciales. Recientemente, el Gobernador aprobó enmiendas al Código de Seguros de Puerto Rico para su inmediata aplicación. Dichas enmiendas pretenden solucionar el atraso y aclarar las ambigüedades que han afectado el proceso de recuperación y resolución de reclamaciones de forma justa y adecuada para el consumidor. A continuación, un breve resumen de las enmiendas realizadas al Código de Seguros ahora disponibles para el beneficio de los asegurados en Puerto Rico:
Continue Reading Puerto Rico Aprueba Enmiendas Al Código de Seguros Para Proteger A Los Asegurados Y Mejorar Los Procedimientos Para Solucionar Reclamaciones