The Plenary of the Supreme Court has ruled that the term to be able to claim compensation from an insurer for accident insurance due to death is five years, the one provided for in article 23 of the Insurance Contract Law, and not the general term established in the Civil Code.
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In this way, he condemns the insurer Mapfre to pay 37,000 euros to a plaintiff whose brother died in a tractor accident. As the sole and universal heir of the deceased, the plaintiff claimed compensation from the vehicle insurance, in this case, from Mapfre.
The insurer, for its part, sent the plaintiff a letter in which it made the insured capital, 37,000 euros, available to the beneficiary “demanding that, prior to payment, he deliver certain documentation proving his condition as heir. Said delivery was not conditional on a term some “, picks up the sentence of the Supreme.
However, the judgment highlights several circumstances that “affect the intellectual capacity” of the plaintiff, such as a “low cultural level and income” or difficulty in understanding the scope of the communications. “Once he was informed that he had the papers at his disposal and that he had to pay the invoice for the judicial procedures, he understood that everything was resolved”, a fact that happened on October 19, 2011, three years after the death.
However, at the beginning of 2016, the plaintiff showed the mayor of his town the papers he had at his disposal “and told him that he had received nothing to date.”
“From this fact, the issue is taken up again and on March 21, 2016 all the documentation that had requested is sent to Mapfre and the claim is claimed in accordance with the letter sent. And in the absence of a response, a new letter is sent requesting the copy of the policy “, includes the opinion of the High Court. Again, in the absence of answers, it is when the brother of the deceased files the lawsuit.
For Mapfre, on the other hand, the action had already prescribed because “more than eight years” had elapsed between the death in 2008 and the claim in 2016.
However, the Supreme Court rejects, taking into account the personal circumstances of the beneficiary, that the moment from which the action can be exercised is that of the communication made by the insurer in this case.
“The reduced intellectual capacity of the plaintiff, the death of the brother with whom he lived (precisely in the accident that was the object of compensation) and the lack of stable support prevented him from understanding that communication made by the insurer after the accident. Such knowledge was obtained , within his intellectual disability, some time later when he collected the documentation from the lawyer who was processing the declaration of heirs, “says the court.
Therefore, it concludes that “only then” was it in a position to bring the action and the statute of limitations began, it upholds the appeal, declares the action not prescribed, and substantially upholds the claim. However, it does not impose the interests of article 20 of the Insurance Contract Law on the insurer as its behavior is justified, since it did not receive a response to its communication until eight years later.
The Supreme Court also points out that in this ruling it has applied the principles of protection and effective protection of disabled people by which the public powers must be governed in accordance with article 49 of the Spanish Constitution, article 21 of the European Charter of Fundamental Rights and the New York Convention on the Rights of Persons with Disabilities.