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  • 2014

Las cláusulas "Claim Made" en el seguro de responsabilidad civil

Published by Editorial Department in Civil Law 2 comments

Las cláusulas “claim made” son propias de los seguros de responsabilidad civil, regulando el ámbito temporal del seguro, y caracterizadas por atender al momento de reclamación del perjudicado para determinar el ámbito de cobertura temporal de la póliza.

Establecen un régimen temporal distinto al general, y se encuentran reguladas en el apartado 2ª del artículo 73 de la Ley de Contrato de Seguro, que establece que: “Serán admisibles, como límites establecidos en el contrato, aquellas cláusulas limitativas de los derechos de los asegurados ajustadas al artículo 3 de la presente Ley que circunscriban la cobertura de la aseguradora a los supuestos en que la reclamación del perjudicado haya tenido lugar dentro de un período de tiempo, no inferior a un año, desde la terminación de la última de las prórrogas del contrato o, en su defecto, de su período de duración. Asimismo, y con el mismo carácter de cláusulas limitativas conforme a dicho artículo 3 serán admisibles, como límites establecidos en el contrato, aquéllas que circunscriban la cobertura del asegurador a los supuestos en que la reclamación del perjudicado tenga lugar durante el período de vigencia de la póliza siempre que, en este caso, tal cobertura se extienda a los supuestos en los que el nacimiento de la obligación de indemnizar a cargo del asegurado haya podido tener lugar con anterioridad, al menos, de un año desde el comienzo de efectos del contrato, y ello aunque dicho contrato sea prorrogado.”.

 

La jurisprudencia de nuestros Tribunales también recoge este tipo de cláusulas en Sentencias como la Sentencia del Tribunal Supremo 366/12, de 19 de junio, o la 87/11, de 14 de febrero, entre otras. Teniendo la consideración de cláusulas limitativas, quedan sujetas a lo establecido en el artículo 3 de la Ley de Contrato de Seguro, debiendo ser destacadas de modo especial, y aceptándose por escrito.

 

Las cláusulas “claim made” responden a situaciones en las que el daño aflora con posterioridad al siniestro, pudiendo incluso ocurrir que la compañía aseguradora que teníamos contratada en el momento de producirse el siniestro, sea diferente a la que tenemos contratada en el momento de realizar la reclamación. A través de estas cláusulas se busca desplazar el nacimiento de la obligación de reparar, al momento en que se produce la reclamación (no al momento de producirse el siniestro), siendo admitidas siempre que sean en beneficio y no perjudiquen los derechos del asegurado o perjudicado, reputándose lesivas en caso contrario.

 

El citado precepto contempla dos modalidades de cláusulas temporales “claim made”: Las cláusulas de cobertura posterior, aludiendo a reclamaciones hechas por el perjudicado una vez vencido el contrato por hechos acaecidos durante su vigencia o cobertura de la póliza; y las cláusulas de cobertura retroactiva, refiriéndose a reclamaciones efectuadas por hechos ocurridos durante la vigencia del contrato, pero ampliada a momentos anteriores a su entrada en vigor.

 

Por lo tanto, con el citado precepto recogiendo las llamadas cláusulas “claim made”, resultan de aplicación dos fechas relevantes a efectos de determinar la cobertura: la fecha de ocurrencia del hecho dañoso, y la fecha de reclamación del perjudicado al asegurado. Sin embargo, la fecha de comunicación del asegurado al asegurador resulta irrelevante a efectos de cobertura de la póliza. 

 

Artículos relacionados con esta sección:

 

Ley modificación Código de Consumo de Catalunya.

Claves de la nueva Reforma de la Ley de Consumidores y Usuarios.

La mora del asegurador.

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2 comentarios en esta entrada

  • abogados que ayudan con deudas has said in 6 de December of 2018:

    Muy buen post, sobre todo porque tocas temas relevantes
    saludos

    Nicolás

  • OMAR KLIPHAN has said in 1 de November of 2018:

    nos mantiene actualizado constantemente,

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