The Consumer Protection Commission No. 1 of the Indecopi ordered the company Mapfre Peru Vida Compañía de Seguros y Reaseguros SA activate the credit life insurance of a consumer who died due to COVID-19, the same that will release his family from the obligation to pay a mortgage credit.
In this way, Indecopi fined Mapfre 10 UIT, equivalent to S / 44,000 and imposed the payment of the costs and costs of the procedure in favor of the spouse.
Through Final Resolution No. 2637-2021 / CC1 of September 29, 2021, the Commission, in the first instance, declared founded the complaint filed by the victim’s wife, for violation of articles 18 and 19 of the Code of Consumer Protection and Defense, since it was proven that Mapfre unjustifiably refused to activate the aforementioned insurance, arguing that the policy considered as a cause for exclusion, the death of the insured due to a disease declared as an epidemic by the Ministry of Health (Minsa).
In that sense, the Commission specified that the death of the consumer was as a consequence of COVID-19, a disease that was not declared by the Minsa as an epidemic, because, prior to the presentation of the first infections in Peru , World Health Organization (WHO) had declared COVID-19 a pandemic.
This, in application of the provisions of Law No. 29946, Insurance Contract Law, which establishes that the coverage exclusions must be interpreted literally and, in case of doubt, in favor of the insured.
In effect, for the Commission it was not simply a matter of terms, but rather that said difference was determined by the type of specific risk that was foreseen as covered by the insurer at the time the policy was issued, since at that time it evaluated and determined only that such event (death due to an epidemic declared by Minsa) was capable of causing damage from which a patrimonial need arises that is not eligible for coverage due to the characteristics that it possessed.
In addition, the lack of anticipation of the death of the insured due to a pandemic as a risk exclusion, meant that the insurance company, from the turn of its business, considers that it would be part of its coverage (for example, because it is a statistically risk of almost impossible occurrence). This, taking into account the nature of the service they provide in the market and the careful evaluation of the risks (actuarial calculation) that comprise the policies offered to consumers.
The company Mapfre It is in the period of appeal before the Specialized Chamber for Consumer Protection, second administrative instance of Indecopi.
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