KLRA202500053
Tribunal De Apelaciones De Pue...May 12, 2025Background
- Jennifer F. Rodríguez González purchased a Land Rover in August 2023, receiving a free one-year insurance policy issued by MAPFRE PRAICO Insurance Company and paid in full by the dealership.
- Rodríguez González requested a commercial policy but received a personal one; after finding it unsatisfactory, she cancelled the policy and asked for a return of the unearned premium.
- MAPFRE cancelled the policy but refunded the premium to the dealership, not Rodríguez González, arguing the dealership paid the premium.
- Rodríguez González filed a complaint with the Office of the Commissioner of Insurance (OCS), alleging improper refund and seeking investigation.
- OCS ruled that MAPFRE should have refunded Rodríguez González as the named insured, imposed a $3,500 fine, and ordered payment of legal interest on the premium.
- MAPFRE sought judicial review, arguing the agency misapplied the law and issued an ultra vires order.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Who is entitled to premium refund after cancellation? | Rodríguez (insured) should receive the refund | MAPFRE: Dealer should get it as payer | Refund must go to Rodríguez as named insured |
| Was OCS authorized to interpret and enforce the insurance contract? | OCS has authority to enforce the Insurance Code | MAPFRE: OCS exceeded authority | OCS acted within its statutory authority |
| Did MAPFRE violate P.R. Ins. Code by refunding dealer, not insured? | Yes, as policy was under Rodríguez’s name | MAPFRE: No, refund follows payer | MAPFRE violated Art. 27.160(3) and 27.161(1) |
| Was the imposed fine and order for interest within OCS authority? | Yes | MAPFRE: Fine and order arbitrary | Fine and order confirmed as within OCS’s discretion |
Key Cases Cited
- Otero Rivera v. Bella Retail Group, Inc., 2024 TSPR 70 (Puerto Rico) (administrative agency decisions are entitled to judicial deference unless unreasonable or contrary to law)
- Hernández Feliciano v. Mun. Quebradillas, 211 DPR 99 (Puerto Rico) (scope of judicial review for administrative adjudications)
- Super Asphalt v. AFI, 206 DPR 803 (Puerto Rico) (judicial deference and limits to findings of administrative agencies)
- Rolón Martínez v. Supte. Policía, 201 DPR 26 (Puerto Rico) (standard for reviewing administrative agency findings)
- Carrasquillo Pérez v. Asoc. y/o Consejo de Titulares del Condominio Parque 352, 2024 TSPR 101 (Puerto Rico) (insurance contract interpretation and public interest)