Rivera Candela y otra v. Universal Insurance Company
2024 TSPR 99
Supreme Court of Puerto Rico2024Background
- Abraham Rivera Candela and Alexandra Lozada filed a lawsuit against Universal Insurance Company regarding damages sustained to their insured property in Luquillo, Puerto Rico after Hurricane María in 2017.
- Petitioners allege that Universal issued an applicable and effective insurance policy covering their property and personal belongings, and they complied with all premium and policy requirements.
- The plaintiffs claimed Universal underpaid their claim, failed to properly adjust losses, acted in bad faith, and violated both contract obligations and several provisions of the Puerto Rico Insurance Code.
- Universal moved to dismiss the claim, arguing that petitioners did not satisfy the statutory pre-suit notification required under Article 27.164 of the Insurance Code.
- Lower courts dismissed the complaint entirely, reasoning the claim was based on the Insurance Code and notification was jurisdictional.
- On appeal, petitioners argued their complaint stated both a civil law (contract) claim and a code-based claim, and should survive dismissal at least in part.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Does failure to notify under Article 27.164 bar all claims based on Insurance Code? | Rivera: Only bars Insurance Code claim, not contract | Universal: Entire case based on Insurance Code | Only the Insurance Code claim is barred; contract claim may proceed if properly alleged. |
| Can both Insurance Code and Civil Code (contract) claims be pled together? | Rivera: Yes; concurrence of actions allows both | Universal: Claims are essentially the same | Both may be pled, but only one remedy can ultimately be pursued (to avoid double recovery). |
| Is detailed legal labeling in the complaint required to state a contract cause? | Rivera: No; facts control over legal labels | Universal: References to Code show Code claim | Liberal interpretation applies; facts pled supporting civil claim suffice to survive. |
| Should the entire complaint have been dismissed by the trial and appellate courts? | Rivera: No; contract action viable even if Code fails | Universal: Yes; all claims fail without notice | No; only Insurance Code claim is dismissed. Contract claim remains. |
Key Cases Cited
- Consejo Titulares v. MAPFRE, 208 DPR 761 (P.R. 2022) (concurrence of causes of action under Insurance Code and Civil Code; only one remedy allowed)
- Con. Tit. 76 Kings Court v. MAPFRE, 208 DPR 1018 (P.R. 2022) (notice under Insurance Code Art. 27.164 is jurisdictional requirement)
- Feliciano Aguayo v. MAPFRE, 207 DPR 138 (P.R. 2021) (standards for resolving insurance claim litigation)