¿Por qué me paga mi seguro del vehículo cuando debe pagarme el seguro del culpable del accidente de tráfico?
En muchas ocasiones nos encontramos ante un accidente de circulación entre dos vehículos y resulta que, siendo perjudicados inocentes y debiéndonos pagar el seguro del vehículo culpable, nos encontramos con que el seguro que nos gestiona los daños a nuestro vehículo es el nuestro, y en muchas ocasiones nos “regatea” nuestro propio seguro. ¿Cómo puede ser esto? ¿Por qué me paga mi seguro?
Los daños materiales de los vehículos en los accidentes de circulación. El convenio CICOS.
Cuando se produce un accidente de tráfico donde hay implicados dos vehículos, y las dos aseguradoras de esos vehículos están adscritas al convenio CICOS, la aseguradora del vehículo inocente recibe el pago de una cantidad de dinero llamada “módulo de compensación” por parte del seguro del vehículo culpable, y de este modo la aseguradora inocente se ocupa de reparar y tramitar exclusivamente los daños materiales de su cliente. O sea, la aseguradora inocente se ocupa de reparar el vehículo inocente, cueste lo que cueste, y la aseguradora culpable queda liberada de su obligación al haber pagado el módulo de 900 €. Es así de simple.
Y ¿por qué lo hacen así de complicado y no es el seguro culpable quien se ocupa de pagar los daños al vehículo inocente?
Lo hacen por las siguientes razones:
- Un accidente es un gasto y supone una reducción de los beneficios. A las aseguradoras no les gusta pagar accidentes ya que es un gasto, y los gastos significan reducir su beneficio.
- Cada aseguradora quiere dar servicio a su cliente. Si para las aseguradoras pagar un accidente a su asegurado es un gasto, pagar un accidente a un perjudicado, que ni tan siquiera es su cliente, es mucho menos deseable. Por tanto, a los perjudicados no quieren darles nada. Ésta es una de las razones por las que cada aseguradora quiere ocuparse de su cliente; para tratarlo según la política de empresa de cada seguro. Ésta es una de las razones por las que se inventaron los convenios.
- La aseguradora no quiere que otra atienda a su cliente. Existen aseguradoras de alta calidad y aseguradoras de baja calidad. Los seguros de alta calidad dan un buen servicio a sus clientes y los de baja calidad dan un servicio pésimo, hacen las mil chapuzas y timan a su cliente. Sin embargo todos los seguros, los buenos y los malos, deben cumplir fielmente con la Ley, por lo que hasta los malos seguros deben arreglar las cosas bien. Los seguros de alta calidad no quieren correr el riesgo que su cliente sea atendido por un seguro de mala calidad y acabe enfadándose, por lo que prefieren que cada uno trate a su cliente como se merece. El seguro de mala calidad timará a su cliente y el de buena calidad lo tratará bien. Ésta es otra de las razones del porqué los convenios funcionan.
- Por un tema de selección de riesgos. Este es el principio más complicado de explicar. Cada aseguradora tiene su política de suscripción y selección de riesgos, y los actuarios de seguros deben calcular las primas en función de la siniestralidad y el perfil de cliente seleccionado (riesgo). Si se dedicaran a pagar los accidentes a los perjudicados no podrían acotar su política de selección de riesgos. En cambio, el convenio de daños materiales permite fijar y concretar muy bien la política de selección de riesgos puesto gracias ello pagan las indemnizaciones a su propio cliente.
Otras cuestiones referente a este asunto
Y pese a lo expuesto, hay aseguradoras que intentarán ganar dinero con el módulo, intentando obtener beneficio entre la diferencia de lo que han ingresado por el módulo y lo pagado por el arreglo del accidente.
Tu seguro “inocente” está obligado a informarte que actúa en nombre y por cuenta de la entidad responsable del siniestro, y que se subroga en la posición de la entidad aseguradora del responsable. En muchas ocasiones esta información no se traslada a los usuarios. Se oculta de manera deliberada, sobre todo las aseguradoras de baja calidad.
Siempre tienes la opción de reclamar directamente a la entidad aseguradora del causante del siniestro en virtud del artículo 76 de la Ley 50/1980 obviando lo que tu aseguradora haga contigo. Lo único que debes tener en cuenta es que jamás debes cobrar más de una vez el accidente, pero por el resto, puedes reclamar al causante, a su seguro o al tuyo como subrogado.
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