El engaño de los malos seguros: las ofertas motivadas, los finiquitos y las renuncias en las indemnizaciones.
En el mercado hay buenas y malas aseguradoras. Del mismo modo pasa con los médicos, peritos, operarios, políticos, jueces, talleres, etcétera. Es la condición humana. Habitualmente las malas aseguradoras, que no las buenas, quieren timar a los asegurados o perjudicados en accidentes para así obtener un beneficio de lo que no les pertenece. En este post explicaremos cómo lo hacen para timar y blindar el timo.
¿Qué significa que un mal seguro tima al asegurado o perjudicado?
Cuando hablamos de esto nos referimos a:
- Que el mal seguro le quita dinero que legítimamente pertenece al usuario haciéndole creer que algo falso es verdadero.
- Que el mal seguro condiciona al usuario el pago de una cantidad muy inferior a la que en derecho le corresponde aprovechándose de la urgente necesidad de cobrar la indemnización.
- Que el mal seguro paga menos de lo que toca al usuario aprovechándose del elevado coste dinerario, burocrático y temporal que supone plantear una reclamación, y por tanto el mal seguro sabe por experiencia que ése no iniciará la reclamación.
Y es obvio que si pasan estas cosas es porque la Ley no contempla las medidas coercitivas suficientes para evitar que todo esto suceda.
La transparencia
Si un asegurado o perjudicado reclama al seguro unos daños sobre un objeto accidentado, por ejemplo unas gafas graduadas siniestradas, deberá aportar como mínimo una prueba que acredite que las gafas están rotas como una fotografía o las propias gafas quebradas; una factura, presupuesto o tasación para acreditar su valor, y por último, la versión de los hechos exponiendo las circunstancias del accidente. Y del mismo modo la aseguradora, si paga menos de lo reclamado por las gafas, deberá acreditar con evidencias objetivas el porqué no paga lo reclamado y oferta menos, o simplemente por qué no liquida nada. De este modo, tanto el usuario como el asegurador sabrán de manera objetiva cuál es la postura de cada parte, y el usuario sabrá el porqué le pagan menos de lo que pretendía. A esto se llama transparencia recíproca. Y así es como establece la Ley que hay que hacer las cosas.
Por tanto las aseguradoras tienen el derecho de pedir a los usuarios que reclaman, y éstos tienen la obligación, de acreditar las circunstancias y consecuencias del accidente junto con la valoración de los daños. Pero de manera inversa, los usuarios tienen el derecho, y las aseguradoras la obligación, de acreditar y justificar de manera motivada y objetiva la resolución del accidente y de dónde se obtiene la propuesta de indemnización si ésta es inferior a las pretensiones del usuario. Y si el pago de la prestación es el mismo que el reclamado, también deberán acreditarlo. Y la pregunta es: ¿Por qué no lo hacen? La respuesta es muy sencilla.
Las malas aseguradoras no quieren dejar rastro de sus irregularidades. No quieren dar las pruebas periciales u otros elementos al usuario para que éste se asesore con algún entendido y descubran el lío. Cuanta menos información tenga el usuario mejor. De este modo, en caso que el usuario quiera presentar una demanda judicial contra la aseguradora para reclamar lo que en derecho le corresponde, no tendrá la prueba objetiva para demostrar al juez cual es el hecho concreto de desacuerdo, y de este modo, el usuario lo tiene mal. Las malas aseguradoras lo hacen para protegerse. Por esta razón la Ley obliga a la transparencia para todas las partes, tanto por parte del usuario como por parte del asegurador. Es una exigencia mutua de los usuarios hacia los aseguradores y a la inversa. No vale una simple carta generalista que diga que «una vez estudiado el caso se ha determinado resolver de ese modo concreto». Hay que profundizar hasta el más mínimo detalle y acreditarlo todo.
¿Qué son los finiquitos, las renuncias y las ofertas motivadas o acreditadas?
Además, las malas aseguradoras utilizan mal una serie de instrumentos para blindar sus irregularidades.
El finiquito, que es un documento donde el usuario y el seguro acuerdan saldar o rematar una cuenta pendiente derivada de un accidente donde se certifica que se da constancia de que están ajustadas al siniestro, y por tanto, queda satisfecho el alcance que resulta de ellas.
La renuncia, que es otro documento que puede estar incluido en el finiquito, donde el usuario hace una dejación “voluntaria”, dimisión o apartamiento de parte de una indemnización que podría tener.
La oferta motivada, que son un conjunto de documentos que acreditan y justifican con evidencias objetivas y explícitas una cantidad monetaria o en especies ofrecida al usuario, que sirve para saldar los daños y perjuicios a los que el usuario tiene derecho y donde se explican las razones o motivos que se han tenido para realizar esa oferta concreta. O sea, se explica y se acredita objetivamente de dónde salen los importes de la oferta de indemnización realizada.
Estos instrumentos son útiles cuando se utilizan bien, pero perversos cuando se utilizan por malas aseguradoras cuyo objeto es blindar y poner escollos al usuario para que, si se da cuenta del timo o ha cogido “aire” con la insuficiente indemnización recibida, pueda reclamar aquello que justamente era suyo.
Conclusión
Si estás ante una injusticia nunca debes firmar nada ni fiarte ya que no sabrás si estás delante de una mala aseguradora timadora o ante una buena aseguradora honesta. La publicidad es engañosa y en muchas ocasiones las aseguradoras que más se vanaglorian de darte tranquilidad y cubrirlo todo son auténticos lobos con piel de cordero.
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