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?

A policy is a contract and should represent the clear intent of both parties under the agreement. But what happens if what was intended to be covered under a policy is not actually described in the policy?
Continue Reading Can An Insurance Claim Be Denied If The Policy’s Property Description Does Not Match The Property That Has Been Under The Same Insurance For Years?

La Gobernadora de Puerto Rico decretó una Orden de Cierre el pasado 16 de marzo de 2020, como medida de prevención para evitar contagios por el Coronavirus. Muchos negocios y empresas público/ privadas con excepción de aquellas ya señalados por la Gobernadora se verán afectadas.
Continue Reading ¿Cómo Afectará La Orden De Cierre En Puerto Rico Mi Reclamación Al Seguro?

The Governor of Puerto Rico decreed a “Closure Order” or lockdown beginning on March 16, 2020, as a preventive measure to avoid contagions by the coronavirus. Many businesses and public/private companies, with the exception of those already indicated by the Governor, will be affected.
Continue Reading How Will The Lockdown Order In Puerto Rico Affect My Insurance Claim?

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.
Continue Reading Property Insurance Unfair Claims Practices Caused By Releases and Checks Citing “Final Payment”

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

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.
Continue Reading Can My Insurance Company Deny Coverage If I Vacate My House After an Earthquake?

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.
Continue Reading Puerto Rico Earthquakes—Could Anything Happen At a Worse Time For Puerto Rico? What Should Those Suffering From Earthquake Damage in Puerto Rico Do?

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?