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Puerto Rico insurance commissioner presents alternate claims process

By on June 14, 2018

SAN JUAN – As part of efforts to resolve commercial, central government and municipal insurance claims after Hurricane Maria quicker, Puerto Rico Insurance Commissioner Javier Rivera announced an appraisal process aimed at resolving payment disputes.

The appraisal option is an alternate method of conflict resolution related to the amount of a loss that “we are implementing locally to encourage the parties to reach an agreement on the actual value of one or more items contained in the claim. In comparison with an administrative or judicial process, the appraisal is a voluntary, non-contentious process, with a shorter term and relatively less expensive,” Rivera said in a statement.

The process entails that “the insurer and policyholder submit to the consideration of a neutral arbitrator their disagreements as to the amount of claim. The parties are not obliged to undergo an appraisal process without their written consent,” Rivera added.

The appraisal mechanism does nit substitute policyholders’ or insurers’ right to resort to the courts for resolution. The commissioner also said policyholders can still request an investigation by his office or initiate legal proceedings.

He explained that insurers and policyholders may select an appraiser to represent them during the process, who can be the independent adjuster in the case of insurers and the public adjuster in the case of the claimant, and in turn, they agree on a neutral arbitrator.

The Insurance Commissioner’s Office is working in collaboration with the CPA Association and the Engineers and Land Surveyors Association of Puerto Rico to implement the alternate method to settle claims.

“This is where the process would have the expertise of professional engineers, architects and authorized public accountants who would serve as neutral arbitrators between the insurer and the policyholder to reach an agreement on the valuation of the claimed loss,” Rivera stressed, adding that the option could provide a reliable process to expedite payment of claims “that are pending to be resolved mainly due to discrepancies in the real appraisal of the loss or damages claimed.”

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