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?

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
Continue Reading When Does a Subrogation Clause Apply?

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.
Continue Reading Reinsurance and Federal Arbitration Statute at Issue in Puerto Rico Hurricane Losses

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.
Continue Reading Merlin Law Group (PR) LLC, Gana Caso De Pago En Finiquito En El Tribunal De Apelaciones De Puerto Rico

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?

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.
Continue Reading How To File A Complaint With The Puerto Rico Insurance Commissioner Office About Your Delaying, Denying And Bad Treating Insurance Company

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.
Continue Reading Puerto Rico: Guide To Unfair Settlement Acts By Insurers During The Adjustment Of Claims

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.
Continue Reading Puerto Rico: Guía De Las Prácticas Desleales Por Aseguradoras Durante El Ajuste De Reclamaciones