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The Problem Around the ‘Consented Claim’

Published 20 July 2022

The insurance contract law (LCS) has expressly regulated the consequences of the delay in the insurer’s response, under the name of “consented claim”. Thus, Article 74 of the LCS provides that once the information under the responsibility of the insured is completed, the insurer must issue a response otherwise the claim is considered to be consented. The development of this institution does not present a development in the LCS, nor in the Claims Payment Management Regulations, however, it is reasonable to think that the scope must be carried out in accordance with the legal and technical rules of the insurance system.

Recently, INDECOPI has been distorting the scope of the institution. putting the insurance system at risk, by arguing that such an institution, as it has no exception of application expressly indicated in the law, could be applied without limitation, by which in early 2022, issued two resolutions indicating that it was sufficient for the insured to question the rejection so that the period of the decree of the consented claim would run again for reconsideration (something that the LCS does not say, and even violates the express regulations on the subject of financial customer service); and has recently issued a resolution expressly stating that it is irrelevant that the coverage claim is related to a risk that is not part of the positive coverage of the policy: if not answered on time, must be paid per consented loss. Without prejudice to the contentious actions initiated against the corresponding resolutions, we consider that actors of the insurance system must take a vigilant position against this problem, which could affect the insurance market.

Key Contacts

Pedro Richter

Lima

+ (551) 225 5333

prichter@tcpr-abogados.com.pe