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.
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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.
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It is important for policyholders to know and understand the steps they must complete before filing a complaint when an insurance claim has been delayed, denied and bad treated by an insurance company. As mentioned in a previous post, (please see my blog on this topic published on December 5, 2018: Puerto Rico Approves Amendments to the Insurance Code to Protect Policyholders and Improve Claim Handling Procedures), Puerto Rico’s Insurance Commissioner has established new requirements for the process of filing a complaint against an insurance company when it has delayed, denied, and treated their insured badly.
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Hurricane season 2019 is officially underway, and so now is the time to take action and prepare before a possible hurricane threat. It’s imperative that policyholders understand the coverage and rights provided under their insurance policy. Therefore, one of the first things a policyholder should do is request a copy of their insurance policy now and confirm that they have the coverages provided are correct and appropriate for the type of property or interest being insured. Additionally, the policyholders should have a good understanding of the exclusions provided under their insurance policy, in other words, what is not covered under their policy if they suffer a hurricane loss.
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Ha iniciado la nueva temporada de Huracanes 2019, y son muchos los preparativos que debemos llevar acabo ante la posible amenaza de un huracán. Es imperativo que los asegurados entiendan la cobertura y los derechos bajo su Póliza de Seguros. En primer lugar, cada asegurado debe solicitar una copia de su póliza de seguros y confirmar que las coberturas sean las correctas según su propiedad o interés en asegurar. Además, el asegurado debe entender cuáles son las exclusiones bajo su póliza de seguros si sufre daños a causa de un huracán, en otras palabras, lo que no está cubierto bajo su póliza.
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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.
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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.
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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
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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:
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