Qué Hacer y Qué No Hacer en las Reclamaciones de Seguro

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Qué Hacer y Qué No Hacer en las Reclamaciones de Seguro

Qué Hacer

Llame a su agente tan pronto ocurra un suceso cubierto por el seguro. Tan pronto llegue a su casa luego del accidente automovilístico, o incluso antes de ir al doctor, llame a su agente.

Revise y entienda su cobertura antes de hablar con su asegurador o su agente. Lea las secciones de "Cobertura" y "Exclusiones" en su póliza.

Tome y mantenga notas detalladas de todas las conversaciones con los representantes de la compañía de seguro y tómele el nombre, número de teléfono y título a todas las personas con quien hable, incluyendo el nombre de sus supervisores.

Considere si es posible que tenga cobertura de seguro bajo alguna otra póliza también. Muchas personas tienen más de una póliza que puede cubrir una reclamación. En particular, fíjese en su póliza del hogar, pólizas “globales” [“umbrella”] y materiales que hayan llegado con sus tarjetas de crédito.

Tome fotos, de ser posible. Tome fotos de su vehículo destruido, hogar dañado por un incendio, o lesiones, si puede.

Sea honesto y franco con su asegurador. Aunque sea vergonzoso, es mejor si su asegurador conoce todos los hechos. No ser completamente franco con su asegurador puede invalidar su póliza o causar que le denieguen una cobertura.

Entienda la diferencia entre la cobertura de reemplazo y el valor en efectivo depreciado o real. Si su póliza ofrece cobertura de reemplazo no transe una pérdida de propiedad personal por el “valor en efectivo real”. Tal vez tenga que reemplazar los artículos perdidos antes de obtener su reembolso completo si lo que tiene es cobertura para el costo del reemplazo.

Mantenga todos los recibos de alimentos, hospedaje y compras que haya hecho en relación al tiempo que ha dedicado a procesar su reclamación o recuperarse de sus lesiones, desde el momento en que ocurrió el suceso cubierto hasta el momento de la transacción final con su compañía de seguro.

Qué No Hacer

NO le ofrezca declaraciones grabadas o por escrito a su asegurador hasta tanto esté seguro de que entiende su cobertura. Recuerde que usted no tiene que permitirle a la compañía de seguros grabar su conversación telefónica. Si tiene dudas, consulte con un abogado.

NO acepte automáticamente el estimado o tasación de sus pérdidas que le de su compañía aseguradora. Las aseguradoras con frecuencia tratarán de hacerlo aceptar los estimados de reparación o reemplazo que preparan sus propios contratistas o ajustadores, los cuales pueden ser un poco bajos. NO firme relevos o renuncias de índole alguna hasta tanto no haya obtenido asesoría legal. Una situación económica mala después de una pérdida fuerte puede hacerlo pensar que es necesario aceptar una transacción prematura e inadecuada de su aseguradora. Pero puede que usted recuerde que hay otros artículos destruidos después de haber ya firmado un relevo por el pago de su inventario de propiedades personales o alguna otra reclamación. Por estas razones es aconsejable consultar con un abogado antes de firmar un relevo o una renuncia. Asegúrese de leer las letras pequeñas que detallan las condiciones para cualquier pago de la compañía aseguradora.

NO acepte un cheque que diga "pago final " a no ser que esté listo para hacerlo.

NO pase por alto los límites de tiempo que establece su póliza. La mayoría de las pólizas requieren una prueba de pérdida firmada dentro de cierto límite de tiempo. Asegúrese de cumplir con este requisito a no ser que obtenga una renuncia por escrito de su compañía de seguros. Muchas pólizas le permiten solamente un año a partir de la fecha de la pérdida para tomar acción legal si usted tiene una reclamación que no ajustó de forma justa. Si no se ha transado su reclamación a su satisfacción habiendo ya pasado once meses desde su pérdida, consulte a un abogado inmediatamente. No hacerlo podría resultar en la pérdida de su derecho a demandar.

NO olvide que usted tiene un contrato con su aseguradora. Su aseguradora tiene una obligación legal de proporcionarle la cobertura que le prometió. Insista en que cumplan con esa obligación.

DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.

CLÁUSULA EXONERATIVA: este sitio y la información aquí presentada tienen fines exclusivamente informativos y no se deben interpretar como asesoría jurídica. Para obtener asesoramiento respecto de cualquier asunto jurídico, consulte con un asesor legal competente.

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