Insureds have the right to clearly understand the reason why their claim has been denied, delayed, or underpaid. Insurers have the duty to explain how they determined their adjustment and payments.
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Property Insurance Unfair Claims Practices Caused By Releases and Checks Citing “Final Payment”
Unfair claims practices in Puerto Rico was the point of the New York Times article noted in, Puerto Rico Hurricane Maria Claims Still Not Paid—New York Times Reports on the Insurance Claims Crisis in Puerto Rico. Merlin Law Group attorney Chris Mammel and I were talking about the deceptive releases in Puerto Rico and he reminded me that Florida put an end to this wrongful claim practice by issuing a Bulletin following Hurricane Andrew.
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Puerto Rico Hurricane Maria Claims Still Not Paid—New York Times Reports on the Insurance Claims Crisis in Puerto Rico
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.
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Can My Insurance Company Deny Coverage If I Vacate My House After an Earthquake?
In the last two weeks, Puerto Rico has experienced earthquakes that have caused significant damage to homes and buildings, especially in the southwest area of the island closest to the earthquake epicenters. Many of these properties have collapsed and others are under dangerous conditions. The government has asked the people to abandon homes that are not safe, and the Governor declared a State of Emergency due to the seismic activity continues in Puerto Rico.
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Puerto Rico Earthquakes—Could Anything Happen At a Worse Time For Puerto Rico? What Should Those Suffering From Earthquake Damage in Puerto Rico Do?
Puerto Rico Hurricane Maria claims are not close to being finished. Now, we have major earthquakes impacting Puerto Rico. The worst example of poor treatment to policyholders following a hurricane catastrophe is found in Puerto Rico. It is sad and now numerous earthquakes are causing more damage and loss.
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Can I Litigate An Insurance Claim During An Appraisal Process 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.”
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¿Puedo Radicar Acción Judicial Sobre Una Reclamación Al Seguro Tras Haber Iniciado Un Proceso De Appraisal?
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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When Does a Subrogation Clause Apply?
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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Reinsurance and Federal Arbitration Statute at Issue in Puerto Rico Hurricane Losses
Major hurricane losses in Puerto Rico as well as in the United States usually involve insurers having reinsurance treaties reimbursing the carriers for their Hurricane losses. This was a major topic of conversation at our Merlin Law Group holiday party in San Juan where the picture above was taken. That Saturday night party in San Juan was a lot of fun.
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Merlin Law Group (PR) LLC, Gana Caso De Pago En Finiquito En El Tribunal De Apelaciones De Puerto Rico
Como se mencionó anteriormente en mi publicación de blog, Accord and Satisfaction: Will My Insurance Claim Be dismissed If I Deposit A Payment? (publicado: 21 de julio de 2019), muchos asegurados en Puerto Rico que recibieron pagos los depositaron sin estar conscientes de las consecuencias del Pago En Finiquito. Esta ha sido una controversia común en muchas de las demandas presentadas en los tribunales y la razón por la que muchos casos se están desestimando. Afortunadamente, el Tribunal de Apelaciones (Panel V) el 24 de octubre de 2019, revocó la decisión en Samuel Valentín Negrón v. MAPFRE PRAICO Insurance Company y Otros, en relación con el Pago En Finiquito.
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