NEW ADMINISTRATIVE CLAIMS REGULATIONS INSURANCE

In Official Gazette No. 337 of June 22, 2023, the new Insurance Administrative Procedure Claims Regulation was published, replacing Resolution No. SCVS-INS-2021-0015, hereinafter the “Regulation.”

Below, we summarize the main reforms incorporated by the Regulation:

1. The main modification is eliminating the power that the Superintendence of Companies, Securities, and Insurance had to settle the controversies between the insurer and the insured or beneficiaries when there was a divergence in the amount of the indemnity to be paid. Thus, the following provision was repealed: “Once the insurer has accepted the occurrence of the loss, without an agreement as to the amount of the indemnity, in which case the competent body shall determine it based on the merits of the administrative file.”
   With this amendment, the Superintendence of Companies, Securities, and Insurance is no longer competent to determine the amounts to be indemnified by the insurers within the administrative claims; thus, allowing the same to be established in judicial proceedings or through alternative dispute resolution methods.
   
   
2. Express acknowledgment of the withdrawal of the parties and the consequent filing of the administrative file for having reached an out-of-court settlement. For this purpose, the supporting documentation of the case, such as the settlement agreement, must be attached.
   
   
3. It is recognized that the place to file the administrative claim shall be the claimant’s domicile.
   
   
4. The obligation of the Superintendence of Companies, Securities, and Insurance to publish the resolutions of administrative insurance claims that have caused status in the institutional web portal is eliminated.

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This article contains information of general interest and does not constitute legal advice about specific matters. Any particular analysis will require the Firm’s legal advice.