As discussed in my previous blog post, Should an Insurance Company Pay Adjustable Claim Amounts Not in Controversy While Another Amount Is Still In Dispute?, the payment of undisputed amounts is an issue that is frequently being argued in Puerto Rico courts for Hurricane Maria claims. As recent as this week (May 12, 2021) the First Instance Court of Carolina, Puerto Rico, granted a Partial Summary Judgement and ordered the carrier to pay the adjustable amounts not in controversy.
Continue Reading Another Win for Adjustable Claim Amounts Not in Controversy

After Hurricane Maria caused catastrophic damage in Puerto Rico, many new laws and law amendments were made to benefit policyholders. As mentioned on my previous blog,1 one of these laws provided policyholders the option of microinsurance but it was not until recently (almost three years after the laws) that the first microinsurance company, Optima Insurance, is now available for policyholders.
Continue Reading What is Microinsurance?

Although appellate rulings are not precedential in Puerto Rico, they are highlighted as very important persuasive authority when the Supreme Court has not made a holding on the issue in controversy. Recently, two appellate court panels ruled on the issue of adjusted amounts that are not in controversy in an insurance claim. Both judicial panels determined the insurance companies should pay these amounts.
Continue Reading Should an Insurance Company Pay Adjustable Claim Amounts Not in Controversy While Another Amount Still Is?

It has been two years since Real Legacy announced their insolvency1 and only approximately 800 of the claims have been paid (excluding 430 cases that are still in court and all claims that did not have an agreement prior to the insurance company announcing its insolvency).2 In other words, it could take three or four more years for Real Legacy insureds to get their Hurricane Maria claims paid.
Continue Reading Puerto Rico Update: Real Legacy Confirms Rumors of Insolvency – What’s Next? Part II

Communications between Insurance Companies and their insureds are always important, and copies of these are requested to understand insurance claims when filing a complaint. Recently, the Puerto Rico Court of Appeals ruled on an Accord and Satisfaction case in which Plaintiff presented a memo received from the insurer that contradicted its allegations against the Plaintiff’s Hurricane claim.
Continue Reading Accord & Satisfaction: Will My Insurance Claim Be Dismissed If I Deposit A Payment? – Part 2

Holidays will be different for all this year, but for many in Puerto Rico it will also be a reminder of the beginning of a series of earthquakes that shook Puerto Rico from December 28, 2019, to mid-February 2020. There are still many people that have been unable to return to their homes or place of work due to the structural damages caused by these earthquakes. And many inspections and repairs were paused due to the COVID-19 Pandemic lockdowns.
Continue Reading Puerto Rico Earthquake Claims

On September 30, 2020, the Puerto Rico Court of Appeals revoked the rulings held on two (2) Accord and Satisfaction cases. The first case, Victor Cruz Perez v. Universal Insurance Company,1 was reversed due to the insurer’s failure to prove that all elements of Accord Satisfaction had been fulfilled.
Continue Reading Puerto Rico Court of Appeals Revokes Two Accord & Satisfaction Rulings on Hurricane Maria Claims

September 20, 2020, marked Hurricane Maria’s third anniversary of devastating the island of Puerto Rico. Since then, policyholders have overcome many obstacles, but many are still struggling with property damages that have not yet been repaired. Insurance companies are still denying and underpaying Hurricane Maria insurance claims, and yet we must ask: What have we learned?
Continue Reading Hurricane Maria’s Third Anniversary – What Have We Learned?

Over the last three years, residents in Puerto Rico have suffered damages from natural disasters such as hurricanes, floods, and most recently this year, numerous earthquakes. Due to these events, many property owners now understand the importance of having property insurance coverage—but most importantly, the correct policy coverage. However, for many policyholders it is still unclear how long it should take for their insurance company to resolve their insurance claim.
Continue Reading Term for Resolution of Insurance Claims in Puerto Rico

After Hurricane Georges hit Puerto Rico in September of 1998, many policyholders considered that their claims were unfairly denied due to the ambiguous language in their policies. The main issue was that the policies did not have a specific deductible language for hurricane damage. If the policy did not have specific deductible language for hurricane, the insurance companies would apply the wind damage deductible but, in some claims, they applied the deductible classified under “basic damages.” Many of the policyholders filed complaints in the Insurance Commissioner’s Office against the insurance companies for the ambiguity in the language related to hurricane damage deductible. Some of those cases were then appealed. Below is what the Court of Appeals of Puerto Rico held in United Surety & Indemnity Company v. Insurance Commissioner of Puerto Rico,1 regarding this issue.
Continue Reading Is it Correct for Your Insurance Company to Consider Windstorm Damage Synonymous with Hurricane Damage?