They denounce that Caja Piura and Mapfre seek not to pay credit insurance

María Angélica (59 years old) was diagnosed with advanced endometrial cancer and was preparing to begin intensive chemotherapy therapy the following week after three months hospitalized. However, she passed away just two days after her diagnosis, on May 15, 2022.

Her son, Erick, from the moment his mother became ill, took care of the medical costs, organizing the funeral after her death and, on an emotional level, he suffered from stress, as well as grieving for the loss of a familiar.

But the challenges and ordeal were just beginning. In December 2017, María had requested a loan with Piura Box, at the Chiclayo headquarters. For years, he punctually complied with loan payments that included credit liability insurance provided by the insurer Mapfre. This service is designed to cover thea debt contracted with a financial institution in the event of death or total and permanent disability of the insured so that, in this way, his heirs are released from the payment obligation.

When Erick tried to make it effective, he was met with a refusal. The reason was that four years ago, María had marked two boxes on the questionnaire that indicated that she did not suffer from diseases such as diabetes, hypertension, circulatory problems, neurological problems, epilepsy, kidney problems, paralysis, among others. However, her death was caused by cancer, a condition that was not related to the answers on the form.

“They responded that they were not going to pay it because my mother had marked on the Mapfre questionnaire that she did not have hypertension, diabetes, among others. But my mother did not die from those diseases, She was hospitalized for bleeding, which the doctor finally told me was endometrial cancer.“, Erick denounced to La República.

Lack of regulation

Given this negligence, Erick and his lawyer Zunilda Perleche proceeded to report the case to the National Institute for the Defense of Competition and the Protection of Intellectual Property (Indecopi), entity in charge of ensuring consumer rights. Among the reasons, they alleged that it was not possible that, in 2017, María knew that she would suffer from cancer. Added to this is that, in Chiclayo, Mapfre does not have any headquarters, not even within the CMAC Piura offices.

“We were surprised that there are no Mapfre offices in Chiclayo and that María had not undergone any prior diagnosis or test. After insisting, we were able to agree to be shown the complete contract, which was not the original either, but rather a blurry sheet with some marks. It even made us doubt if it was María’s signature,” Perleche said.

Despite the evidence presented, Indecopi ruled against the complaint. For Erick, the sensation was like a hard blow from an organization that should regulate companies.

“I feel abandoned like an ordinary citizen in front of the large staff of lawyers of these large companies. We have had to continue spending money, and we were already in debt for medical and funeral costs,” he lamented.

Hard evidence

Despite everything, Erick and his lawyer decided to continue with their formal complaint and filed an appeal with Indecopi on June 9 of this year, but this time added the analysis of a specialized expert.

“We had to look for a free forensic expert, which charged S/10,000. I went to the medical school, I asked colleagues, until I was able to find one in Chiclayo. Many told me that he would leave the topic, but I wanted to see it to the end,” Erick said.

The results of the expert Juan Alfredo Loayza were conclusive: María’s death was due to unforeseeable consequences and a progressive courseFurthermore, according to the medical history, they had not been previously identified and there was no personal or clinical history.

Likewise, it was indicated that the disease has no causal relationship with previous illnesses and that death is not due to previous causesbut due to endometrial cancer and interstitial lung disease.

“In short, by principles of correspondence and proportionality we find that the diseases that caused the death of the lady were not known before 2017 and even more so were NOT known before 2021, and which were of rapid evolution and fatal. Concluding with this that the causes of death of the patient have(n) no relationship or causal link whatsoever with the patient’s history prior to 2014,” the document reads.

With these results, Erick is awaiting the next resolution from Indecopi, which must be presented in the next 120 days. In the meantime, he continues to assume a monthly payment of close to S/3,000.

“A death marks your life, I never thought I would lose my mother. The bank thing has been mistreatment, she claimed a fair right, but they see death as if it were something commercial,” she warned.

Characteristics of death or disability insurance

According to the Superintendency of Banking, Insurance and AFP (SBS), the credit life insurance They depend on the contracted policy, but mostly they may not apply in cases of suicide, accident while intoxicated or under the influence of drugs due to participation in risky sports, among other reasons.

For Jaime Delgado, a lawyer specialized in consumer law, it could also be omitted if a person is aware that they have a terminal illness and hides it. Which is not the case with María, as the forensic report shows.

“What is reported is that insurance companies always seek exclusion. That is a very common behavior, that is why people do not believe in insurers, because when you have an accident they are always looking for a way not to pay,” Delgado pointed out to this medium.

Shared responsibility

It is important to note that lawyer Perleche indicated that both Piura Box as Mapfre They have responsibility for the negligence of their client. “The financial institution cannot separate itself. There is a conciliation for selling the credit insurance, both entities earn a commission,” he added.

According to information from Indecopi, from the end of 2019 to date, the insurance sector accumulates 1,266 sanctions for an amount that amounts to 1,569.99 UIT (tax unit) and is the fifth sector with the most fines.

For his part, Mapfre It is the third most reported insurer and accumulates 20 violations for a sum of 24.52 UIT. For its part, Pacífico Seguros leads the list with 51 sanctions and 51.7 UIT; Rímac Seguros follows with 24 penalties that reach 36.68 UIT.

The Municipal Savings and Credit Bank of Piura SA C, In 2022, it registered 262 complaints. From January to June of this year, it accumulated 137 user complaints.