Los reguladores y supervisores de las aseguradoras. La DGSFP.
En mi vida he tenido varios siniestros con distintas aseguradoras, y en ocasiones ha ido todo muy bien y en otras ha sido una auténtica pesadilla. Si las leyes son igual para todos, ¿cómo puede ser que haya tal disparidad de criterios y maneras de hacer? ¿Cuáles son los reguladores y supervisores del sector asegurador?
Los reguladores del mercado
Existen actividades como son la banca, los seguros, los planes de pensiones, las petroleras, las eléctricas, las telecomunicaciones, los valores financieros, etcétera, que tienen una complejidad técnica muy grande en su operativa, modo de funcionar, garantías, comercialización de productos o servicios, etcétera, y su actividad debe ordenarse y regularse de una manera muy concreta y estricta ya que podría afectar a muchas personas, y por ende, al conjunto de la sociedad. Podríamos decir que se trata de actividades “sistémicas”, es decir, que pueden afectar al sistema o a un gran número de usuarios.
Debido a esa complejidad, los gobiernos transfieren a unas entidades gubernamentales denominadas Reguladores del Mercado la capacidad reguladora, o sea, la de “fabricar” leyes, decretos, reglamentos y otras normas a fin de ordenar su funcionamiento y establecer las condiciones de quién puede dedicarse a esa actividad, qué requisitos debe cumplir, qué puede hacer y que no, y un sinfín de cosas para delimitar y concretar ese sector.
Es obvio que, si en vez de ser los reguladores los que legislaran, fueran los políticos escogidos democráticamente los que lo hicieran, sería un auténtico caos. Por tanto, la idea de los reguladores es muy acertada y se hace en todo el mundo.
Como ejemplos, el Banco de España es el regulador del sector bancario, la Comisión Nacional de la Energía se dedica a todo el tema de petroleras, gasistas y eléctricas, la Comisión Nacional del Mercado de Telecomunicaciones se dedica al tema que su nombre indica, la Comisión Nacional del Mercado de Valores se dedica al tema de la bolsa, agencias de valores, etcétera y así con otros reguladores de otros sectores que lo precisan.
Los supervisores del mercado
El Supervisor del Mercado es aquella entidad que hace de policía, o sea, está plagada de técnicos funcionarios independientes, los inspectores, que vigilan que las empresas que se dedican a esa actividad regulada hagan lo que tienen que hacer. Vigilan que no hagan trampas. Serían como los Inspectores de Hacienda, que vigilan que la gente no haga trampas con sus declaraciones fiscales (IVA, IRPF, IS,…), pues lo mismo. Pero a diferencia de los Inspectores de Hacienda, los Inspectores de los Supervisores del Mercado son menos famosos porque se dedican a “perseguir” y sancionar a las eléctricas, petroleras, aseguradoras, bancos, etcétera que son unas tramposas, pero la diferencia es que tienen menor impacto mediático. Los árbitros de ajedrez son menos famosos que los árbitros de fútbol, pero todos son árbitros. Con los inspectores pasa lo mismo. Si alguien te dice que es Inspector de Hacienda, “impresiona”. Si alguien te dice que es Inspector de Seguros te quedas igual, ya que no sabes a qué narices se dedica. Pues, entre otras funciones, a perseguir aseguradoras tramposas que incumplen las normas, igual que los Inspectores de Hacienda.
Y hacer trampas es hacer lo contrario a lo que dicen las normas, y por tanto, el incumplimiento de éstas puede acarrear sanciones o incluso la privación de libertad a los directivos o personas que cometen las trampas.
Las funciones de la Dirección General de Seguros y Fondos de Pensiones (DGSFP)
A día de hoy, cuando hemos publicado este post, la DGSFP tiene dos funciones: la de Regulador, que consiste en fabricar leyes y resto de normas que regulan el sector, y la de Supervisor, que consiste en vigilar y sancionar las aseguradoras y resto de empresas que se dedican al sector, como podrían ser, además de las compañías de seguros, los mediadores de seguros. Y decimos a día de hoy porque hay rumores que el gobierno quiere separar la actividad reguladora (fabricar las normas) de la supervisora (inspeccionar y sancionar), para hacerlo más “independiente”.
Y si alguien quiere profundizar más sobre la DGSFP, puede consultar la Wikipedia o el mismo portal de la DGSFP.
Las leyes del sector asegurador y su cumplimiento
Como todo en la vida, y en el sentido que planteamos este post, que una cosa se haga mejor o peor depende de dos circunstancias:
- Que las normas sean claras y justas, diciendo qué puede hacerse y qué no.
- Que la administración haga cumplir las normas, o sea, que a quien cojan haciendo trampas se le castigue con severidad y le salga caro hacerlas.
Y como en el caso de la DGSFP las dos competencias recaen sobre la misma entidad (reguladora y supervisora), si alguna aseguradora no hace lo creemos que debería hacer es, o porque la norma lo permite o, si ésta no lo permite, las medidas coercitivas y/o coactivas de la DGSFP no acaban de funcionar.
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Mi nombre es Yanko Escalona, sufrí un accidente si culpa en Diciembre del 2021, y lesiones en la rodilla derecha, la mas grave que hasta ahora no me recupero, se levanto un atestado a mi favor, reconocimiento del otro conductor, y testigos oculares, se me atendio en el hospital de Badalona, se diagnostico esguince a una primera evaluación de radiografías, pero no se me realizó resonancia alguna, pòsterior a esto comence una rehabilitación en fisoterapia durante una semana y la compañía me suspendio el tratamiento sin mas, los abogados que contrate, no hicieron absoltuamente nada, «Ojo RDI BARCELONA» al cabo de un año me comunican la oferta de la aseguradora Bilbao que resulto ser la misma que la del conductor que me choco, y se burlan de mi con 260€ , además de la neglicencia y o incuplimiento de contrato de parte 1º la Aseguradora Bilbao 2º Bufete RDI de Barcelona , al no asesorarmente debidamente¡¡ continuo lesionado, estoy por sanidad pública, con radiografías y resonancias magneticas, con dolores y casi imposibilitado de caminar y de correr ni hablar¡ se me nego la reparación de los daños ,materiales.
El accidente fue el 26 de Noviembre 2021, la oferta de la compañía se elaboro en Marzo del 2022, y el mal llamado bufete de abogados RDI me informo en Noviembre del 2022, hasta la fecha estoy intentando recuperar mi rodilla pero estoy con posible rotura de ligamentos cruzado, y sin atención de fisio ni nada, solo traumatologo del Cap¡¡
Es posible demandar a esta aseguradora y restablecer mi salud y que se haga justuicia¡¡
Gracias un saludo
Yanko
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En junio de 2022 se rompió la tubería en el techo de la plaza de garaje donde aparco el vehículo. Resulta que la rotura ocasionó daños en la luna del copiloto y la carrocería de esa misma parte. Contacté con el administrador de la comunidad y me aportó el seguro de esta y además hicieron la reparación de la tubería. A su vez yo comuniqué el siniestro a mi aseguradora. Tengo un seguro a terceros.
El problema es que mi aseguradora después de casi un año aún no me ha indemnizado nada del importe de la peritación para la reparación del vehículo. Solo me dicen que no consiguen contactar con la otra compañía y que habrá que ir a juicio. He aportado testigos e imágenes de los daños. Estamos a abril de 2023, ya han pasado más de los 40 días estipulados por ley, por lo que no sé si es legal lo que están haciendo, pero ahí sigo con el coche sin reparar. No paro de quejarme y lo único que me dicen es que mi modalidad de seguro no cubre la reparación (aunque yo sea el perjudicado???), eso sí, han intentado negociar conmigo para pagarme las minutas de abogados e intentar no ir a juicio a lo que me he negado. ¿Puedo reclamar que me paguen la indemnización más los intereses de demora después de tanto tiempo?
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Buenas, el sábado 9 de abril de 2022 la Guardia Civil paró a mi mujer porque le dijeron que el vehículo que conducía no estaba asegurado. Le impusieron una multa de 1500 euros. Hemos pagado religiosamente todos los recibos y la póliza es correcta, pero al hablar con la compañía nos dice que ha habido un error y que le han pasado mal la matrícula a la DGT y les ha «bailado» la última letra. ¿Qué puedo hacer en este caso?. Gracias
Buenas el 2 de mayo estando aparcado mi coche dele reventaron y a otros dos coches más, el señor se fue ala fuga, Le cojieron y dio positivo en alcolemia, esto va por judicial, pero los canceres de mi compañía, meledieron si iestro. Bueno yo me quedo con el auto y melé te paráis rápido, pues al día de hoy estoy sin coche todavía, por mi aseguradora alias, Le vio el perito judicial, Le Le taso más que mi aseguradora, Enel mismo juzgado decirme que como todabia no está reparado mi coche, quisiera denunciar ami compañía por lo que están aciendo con migo, y encima me manda por imein que ya no me renuevan cuando acabe el año sin dar ni un parte, pero que les pasa, aber si alguien me ayuda
Día 25 Marzo, la Dana me causa goteras en el salón por filtración en terraza del edificio, se repara pues estaban pintando las terrazas, y vienen a casa y ven los daños del salón; como estamos en pandemia aceptó que no se repare en 24 h. según reza el servicio de Mafre. El día 6 de Junio me manda un sms la CIA. MAFRE, diciéndome: «Ref L02268111, estimado cliente, comenzamos a recuperar la actividad de nuestra servicio de reparaciones. Debido a la acumulación de servicios, tenemos previsto que el reparador contacte con vd. a partir del día 6/7/2020. Gracias por confiar en MAFRE». Dos días después llamó al pintor que dice que el programa sus partes los viernes, que me llamará; tras dos viernes vuelvo a llamarle y me dice que me llamará, hasta la fecha no me ha llamado, llamo a MAFRE, me dicen que pasan nota al tramitador, sin noticias de ninguno, me quejo ante el administrador del edificio que es quien paga al seguro, hablan con Mafre y no tengo contestación, llamo a Mafre, no me atienden porque están atendiendo otra llamada, que llame a atención telefónica donde me dicen, tras 15 m de espera con publicidad, que si son conscientes de que se ha tramitado, sin solución, fecha, o otra respuesta que me permita disponer de mi tiempo (confinamiento meses sin salir),
MAFRE CIA en 46 países, grandes ganancias, gran equipo jurídico, grandisima publicidad, atención en 24 horas,.
Servicio de subcontratas, y 4 pintores para Murcia, el seguro cobra religiosamente en su día, muy pala, pésima atención al cliente. No veo cómo podemos ejercer nuestros derechos, a día 30/Julio, no he tenido llamada ni de Mafre ni del pintor, no me tienen en cuenta no soy objeto de derecho para ellos, ni les veo respeto ni dignidad, ni profesionalidad. ¿Que hacer? Deciren los medios que pueda que es una pésima CIA, que mienten, que no respetan ni sus deberes para con el cliente. NO CONTRATEN CON MAFRE.
Lo que debe hacer usted es tomar fotografías de los daños, reparar y, con la factura de reparación, las pruebas (fotografías) y la exposición de las causas y consecuencias del accidente plantear la reclamación a MAPFRE para que le paguen la indemnización (lo que se gastó) en virtud de la Ley y del contrato.
Las aseguradoras están obligadas a indemnizar, no a repararar. Las aseguradoras proponen a los usuarios reparación de automóviles, viviendas, etcétera porque les salen mucho más baratas realizarlas con sus proveedores Low Cost que no pagar las facturas de los profesionales que usted libremente escoja. A usted le venden «comodidad de no preocuparse de nada», pero lo cierto es que casi siempre se traduce en malas ejecuciones de los trabajos y malos servicios, aunque en ocasiones hayan milagros y esas reparaciones resulten excelentes. Hay que ser justo y decir que hay ocasiones que, aunque Low Cost, las cosas salen bien. Son pocos los casos. En otras ocasiones no se presentan como es su caso.
Repare por su cuenta y reclame el coste a la aseguradora.
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Hola ,mi caso es que el vecino me enunda,en armario (ropero)y no se abre la puerta ,me sale bichosen dormitorio y unidad olor,esta avisado a mi seguro ,
Más de 3 años, stuverun los peritos tardaron mucho en venir ,no se ponia de acordos mi seguro ni del otro ,,,,Baño del vecino pega con mi pred del armario,,me an destruido el armario el parquet.,y sabe ?cuando vino el perito de mi seguro me a llenado majo y manita,,como que yo poido arreglar el armario,,pero la gotera del vecino?¿al abogado dicen que no le interesa denunciar porque no cobra mucho y si aver si hegan a un acordo,,Y nos avisó, que no hay indemnización,,,,Emos dicho
boino, lo que queremos que solucione la gotera y que nos deje vivir..y sabe que !,,!,nada hasta ,día de hoy le an mandado una carta para presentarse en julgado y no se presentó , dice que es de la COMUNIDAD!!,,,y es seguro de mi hipoteca!!! An pasado más de 3 años ,,,y hasta .hoy,,nada.que hago?gracias.
Parece que su caso trata de una fuga de agua cuyo origen es la comunidad de propietarios, o uno de sus vecinos, y entre los peritos de las aseguradoras no se ponen de acuerdo de quién y cómo arreglar la fuga y su origen, y el tema es que desde hace tres años la cosa sigue igual y usted es el perjudicado.
Su tema es bastante claro aunque necesitaríaamos su contrato de seguro y realizar un peritaje para poder informarle exactamente de cómo debe usted actuar, qué puede usted reclamar, quién lo debe pagar y qué le cubre su seguro. Para ello le recomendamos que siga las instrucciones contenidas en nuestra página web.
Buenas tengo un problema con un vecino que al hacer la maniobra con su vehículo se a empotrado con mi cochera y me a destrozado la puerta hemos dado parte seguro del vehículo me dijo que pidiera presupuesto en un herrero lo que costaría ponerla se lo pasamos a la compañía le pareció excesivo envío a su perito a valorar los daños y la contestación es que nos da una cuarta parte de lo que nos dijeron en el presupuesto por lo cual no estoy de acuerdo con esa cantidad no quiero que me den el dinero quiero que ellos busquen al herrero albañil o quien necesiten y me vuelvan a dejar la puerta como estaba no que encima tenga yo que poner dinero para arreglar una cosa que no e roto ni tengo culpa ninguna
Deberíamos estudiar el caso pero si es cierto lo que cuentas, que no lo dudamos en absoluto, se trata de una aseguradora timadora o de un perito corrupto. Una de las dos opciones.
Hay varias maneras de proceder en su caso dependiendo del escenario, pero para resolver el tema rápido y si usted tiene un buen seguro del hogar, le recomendamos dar parte por su seguro del hogar, que le indemnicen rápidamente por la garantía de impacto (que suponemos la debe tener), y sea su seguro del hogar quien se pelee con la aseguradora del culpable.
También existe la opción de reclamar directamente a la aseguradora del culpable el importe, pero es un proceso más largo y costoso del que podemos asesorarle dado el caso que nos facilite absolutamente toda la documentación del tema.