Aviso legal: Esto no constituye asesoramiento jurídico. La legislación y la jurisprudencia cambian. Consulte siempre con un abogado cualificado para su situación específica.

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Derecho de seguros

Contratos de seguro, deber de presentación justa, siniestros y marco regulatorio.

Introducción

El derecho de seguros rige los contratos entre aseguradoras y asegurados, incluyendo deberes de divulgación y reclamaciones.

Principios fundamentales

1

Duty of Fair Presentation — Before a commercial insurance contract is made, the insured must make a fair presentation of the risk to the insurer, disclosing every material circumstance known or which ought to be known (Insurance Act 2015, s.3).

2

Consumer Disclosure — For consumer insurance, the insured must take reasonable care not to make a misrepresentation (Consumer Insurance Act 2012). The insurer cannot avoid the contract unless the misrepresentation was deliberate or reckless.

3

Insurable Interest — The insured must have a legally recognised interest in the subject matter of the insurance at the time of loss.

4

Indemnity — Insurance is a contract of indemnity: the insurer undertakes to compensate the insured for actual loss, not to provide a windfall. Exceptions: life and personal accident insurance.

5

Subrogation — Once an insurer indemnifies the insured, it is subrogated to the insured's rights against third parties responsible for the loss.

6

Proximate Cause — The insurer is liable only if the loss was proximately caused by an insured peril. If multiple causes exist, the court determines which is the dominant or effective cause.

7

Warranties and Conditions — Under the Insurance Act 2015, breach of warranty suspends the insurer's liability rather than discharging it entirely. The insurer's liability is restored when the breach is remedied.

8

Late Payment — The Insurance Act 2015 (as amended by the Enterprise Act 2016) implies a term that insurers must pay valid claims within a reasonable time. Breach gives rise to a claim for damages.

Leyes clave

Insurance Act 2015

2015
Ver →

Consumer Insurance (Disclosure and Representations) Act 2012

2012

Casos principales

Carter v Boehm

(1766) 3 Burr 1905

Versloot Dredging v HDI Gerling

[2016] UKSC 45

Escenarios comunes

Insurer refuses to pay a valid claim

Under the Insurance Act 2015 (as amended), insurers must pay valid claims within a reasonable time. If they fail, the policyholder can claim damages for late payment, including consequential losses flowing from the delay.

Non-disclosure on a home insurance application

For consumer insurance, the Consumer Insurance Act 2012 applies. The insurer's remedy depends on whether the misrepresentation was deliberate/reckless (contract can be avoided) or careless (proportionate remedy based on what the insurer would have done).

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