High court: Policyholders can cash insurance checks and still get full compensation
By The Star Staff
In an opinion issued by the Puerto Rico Supreme Court in a case filed by the firm Weisbrod Matteis & Copley (WMC), the court ruled that policyholders in Puerto Rico can collect checks offered by insurers without this meaning that the insured waives the right to claim the entirety of the damages suffered.
“The Supreme Court issued an opinion in Feliciano Aguayo v. MAPFRE, in which it categorically states that the cashing of a check offered by the insurer to the insured does not constitute the payment and total balance of the claim of the insured,” said Juan Saavedra Castro, managing partner of the WMC law firm in San Juan.
Prior to the high court ruling, insurers insisted on saying that when an insured cashed the check offered by his or her insurance company, this constituted the payment and total balance of his or her claim, which prevented the insured from continuing with his or her claim for all the damages suffered.
After the aforementioned ruling, so that an insurer can ascertain that the collection of the check offered constitutes a payment and total balance of the claim under the doctrine of settlement (Accord and Satisfaction), the insurer is obliged to prove that its actions are honest in fact, and are carried out guaranteeing fair treatment to the insured.
WMC President August Matteis described the decision as a “game changer.”
“This is a great victory for the insured,” he said. “Insurance companies have been around for many years using this tactic, to scam policyholders out of hundreds of millions of dollars.”
As of the Supreme Court opinion, the insured in Puerto Rico do not lose their right to claim the compensation that in justice they are owed for the mere fact of having cashed the check.
“Insurance companies have never experienced anything like this,” said attorney Luis Correa Márquez, a legal adviser at WMC. “All of a sudden, the law firm Weisbrod Matteis &
Copley is limiting their comfort zone.”
Saavedra Castro congratulated his work team for having achieved another legal victory of great impact in Puerto Rico.
“I believe that this is an important opinion related to the Doctrine of Payment in Settlement,” he said. “There is no doubt that our team of lawyers, led by Carlos Del Valle (RIP), Claudia Rosa and Luis Correa Márquez, helped change the way the insurance industry in Puerto Rico handles the claims of its insured.”