Indemnización por un seguro de vida vinculado a un préstamo hipotecario en Lleida

seguro vida vinculado

 

Mapfre condenada a abonar la indemnización de un seguro de vida vinculado a un préstamo hipotecario contratado con BBVA

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La finalidad de la póliza del seguro de vida vinculado a la hipoteca es liberar al asegurado (incluidos sus herederos) de su obligación de devolver el préstamo, en caso de siniestro.

En este sentido de pronunció la Sección 2 de la Audiencia Provincial de Lleida en sentencia 159/2018, of 6 April.

La demanda que da lugar al litigio tiene su origen en la póliza de seguro de vida individual (concertada con la aseguradora Mapfre) linked to a mortgage loan granted by BBVA,,es,subscribed,,es,for D,,pt,Enrique,,en,deceased husband of Dª,,es,Victoria,,en,This last,,es,claimed the insurer Mapfre S.A.,,es,in his capacity as heiress and beneficiary,,es,the indemnity set out in the life insurance policy,,es,The Court of First Instance nº8 of Lleida,,es,dismissed the claim filed by Ms. Victoria because it understood that the plaintiff had no action that would allow her to claim the compensation sought,,es,lacked active legitimacy,,es,Ms. Victoria filed an appeal against the decision of first instance for the reasons summarized below,,es,He understood that as a beneficiary of the policy,,es, suscrita el 30 January 2009 por D. Enrique, difunto esposo de Dª. Victoria. Esta última, reclamó a la aseguradora Mapfre S.A., en su calidad de heredera y beneficiaria, la indemnización fijada en la póliza del seguro de vida.

Primera Instancia

El Juzgado de Primera Instancia nº8 de Lleida, in sentence 19 April 2017, desestimó la demanda presentada por Dª Victoria porque entendió que la demandante no tenía ninguna acción que le permitiese reclamar la indemnización pretendida, namely, carecía de legitimación activa.

Dª Victoria interpuso recurso de apelación contra la decisión de primera instancia por las razones que se sintetizan a continuación:

1.- Entendió que como beneficiaria de la póliza, could file a claim for an amount claim for the compensation set out in the policy,,es,There would also be no inconsistency in the possible estimate of the appeal and the sentence to the insurer of the payment of the life policy,,es,delivering to BBVA the balance pending repayment of the loan linked to life insurance and to Dª Victoria the remainder,,es,He also considered the interpretation of the Court of First Instance in terms of the interests of the article erroneous,,es,because it argued that these should be recognized because the insurer was in default due to not having complied with the obligation of the,,es,LCS to pay the compensation within the term of,,es. No existiría tampoco incongruencia en la eventual estimación del recurso de apelación y la condena a la aseguradora del pago de la póliza de vida, entregando a BBVA el saldo pendiente de amortización del préstamo vinculado al seguro de vida y a Dª Victoria el remanente.

2.- También consideró errónea la interpretación del Juzgado de Primera Instancia en cuanto a los intereses del artículo 20 Law of Insurance Contract (LCS), porque argumentó que estos debían reconocerse por haber incurrido en mora la aseguradora al no haber cumplido con la obligación del art. 18 LCS de abonar la indemnización en el plazo de 40 days.

Mapfre opposed the appeal, arguing that what was requested in the appeal was different from what was originally requested in the lawsuit, which made it incongruous.,,es,Regarding the interests of art,,es,He pointed out that the doubts regarding the prosperousness of the claim were just cause for not applying the interests indicated in the standard,,es,The Second Chamber to resolve the case in dispute went to the Supreme Court's Judgment No.,,es,December that resolved a similar conflict,,es,The Supreme Court resolution analyzed a life insurance linked to a mortgage loan granted by Caja Guadalajara that indicated in the section of "beneficiaries" of the particular conditions,,es. En cuanto a los intereses del art. 20 LCS, señaló que las dudas respecto de la prosperabilidad de la reclamación eran justa causa para que no se le aplicasen los intereses señalados en la norma.

Apelación Audiencia Provincial del Lleida

La Sala Segunda para resolver el caso en litigio acudió a la Sentencia del Tribunal Supremo nº 669/2014 of 2 de diciembre que resolvió un conflicto similar.

La resolución del Tribunal Supremo analizó un seguro de vida vinculado a un préstamo hipotecario otorgado por Caja Guadalajara que señalaba en el apartado de “beneficiarios” de las condiciones particulares:

Beneficiary until cancellation of the linked loan,,es,Caja de Guadalajara,,es,In the event that the insured capital at the time of the loss exceeds the outstanding balance of the linked loan,,es,they will be beneficiaries for the excess in case of death,,es,the spouse of the insured not separated by court order,,es,your children equally,,es,In the case cited,,es,the claim was filed by the heirs of D,,es,Gines,,en,their children,,es,who requested the insurer Caser the payment of the amount indicated in the insurance policy agreed with D,,es,Gines and delivered to Caja Guadalajara the balance pending repayment of the linked loan,,es: Caja de Guadalajara. En caso de que el capital asegurado en el momento del siniestro exceda del saldo pendiente de amortizar del préstamo vinculado, serán beneficiarios por el exceso en caso de fallecimiento, el cónyuge del asegurado no separado por resolución judicial; failing, sus hijos por partes iguales…

En el caso citado, la demanda fue interpuesta por los herederos de D. Gines (sus hijos) quienes solicitaban a la aseguradora Caser el pago de la cantidad señalada en la póliza de seguro concertada con D. Gines y se entregase a Caja Guadalajara el saldo pendiente de amortización del préstamo vinculado.

The judgment of the first instance understood that the claimants only had the difference between the balance pending amortization on the date of the death of D,,es,Gines and the sum insured,,es,He stressed that D,,es,having hidden his medical history at the time of signing the policy,,es,acted with serious fault or fraud in a way that freed the insurer to make the payment,,es,The decision on appeal recognized the,,es,active legitimation of the heirs,,es,to claim the sum insured and not just the difference between the balance of the loan and the sum insured,,es,but the totality to the extent that the lender entity beneficiary of the policy opted not to claim payment of compensation for disability or death,,es. Gines y la suma asegurada. Recalcó que D. Gines, al haber ocultado sus antecedentes médicos en el momento de suscribir la póliza, actuó con culpa grave o dolo de manera que se liberaba a la aseguradora de realizar el pago.

La decisión en apelación reconoció la legitimación activa de los herederos para reclamar la suma asegurada y no solo la diferencia entre el saldo del préstamo y la suma asegurada, sino la totalidad en la medida que la entidad prestamista beneficiaria de la póliza optase por no reclamar el pago de la indemnización por invalidez o muerte.

The lack of clarity with which the appeal was drafted was not an obstacle to issuing a ruling because congruence does not mean a literality between the motions of the application and the decision of the judgment,,es,but it had to operate an integration of the factual and legal background that make up the whole of what is asked,,es,That decision was the subject of the extraordinary appeal for procedural infringement and the appeal of cassation that are those that give rise to the STS no.,,es,and whose arguments served as a basis for the Provincial Court of Lleida,,es,It is worth noting three key issues,,es,On one side, what was related to congruence was studied,,es, sino que debía operar una integración de los antecedentes fácticos y jurídicos que conforman el todo de lo que se pide.

Esa decisión fue objeto del recurso extraordinario por infracción procesal y del recurso de casación que son los que dan lugar a la STS nº 669/2014 y cuyos argumentos sirvieron de fundamento para la Audiencia Provincial de Lleida. Cabe destacar tres cuestiones clave: De un lado se estudió lo relacionado con la congruencia, of other, the legitimation of the heirs and finally ruled on the interests of the article,,es,the argument of the appeal was analyzed, which pointed out the existence of inconsistency because the judgment of the second instance granted something different and resolved for a different reason than the original claim,,es,The Supreme Court dismissed this reason because, with respect to the duty of congruence, it has always understood that,,es,is summarized in the necessary correlation that must exist between the claims of the parties,,es,taking into account the petitum,,es,petition,,es,y la grounds,,la,cause for asking,,pt,and the ruling of the sentence »,,es,in relation to the extra petitum incongruence modality,,es 20 de la LCS.

Congruencia

En la STS 669/2014 se analizó el argumento del recurso de casación que señaló la existencia de incongruencia porque la sentencia de segunda instancia concedió algo distinto y resolvió por una causa de pedir diferente a la de la demanda inicial.

El Tribunal Supremo desestimó ese motivo porque respecto del deber de congruencia siempre ha entendido que:

se resume en la necesaria correlación que ha de existir entre las pretensiones de las partes, teniendo en cuenta el petitum (petición) y la causa petendi (causa de pedir) y el fallo de la sentencia» (STS 173/2013, of 6 March). In particular, en relación con la modalidad de incongruencia extra petitum, have solved something that was not part of the process object,,es,the Constitutional Court points out that "the judge is bound by the essence and substance of the request and discussed in the lawsuit,,es,not because of the literal nature of the specific claims,,es,as formally formulated by the litigants »,,es,So that ",,es,incongruence is not incurred when host to what is substantially included in the object of the suit or implicitly in the claims deduced in the lawsuit,,es,In the case of the Supreme Court,,es,the plaintiffs requested the conviction of the insurance company to pay the sum insured,,es,The sentence of appeal did not incur incongruity,,es, el Tribunal Constitucional puntualiza que «el juzgador está vinculado por la esencia y sustancia de lo pedido y discutido en el pleito, no por la literalidad de las concretas pretensiones ejercitadas, tal y como hayan sido formalmente formuladas por los litigantes» (STC 182/2000, of 10 July). De tal forma que «no se incurre en incongruencia cuando se da acogida a lo que sustancialmente está comprendido en el objeto del pleito o implícitamente en las pretensiones deducidas en la demanda» (STS 1015/2006, of 13 October)”.

En el caso del Tribunal Supremo, los demandantes solicitaron la condena de la compañía de seguros al pago de la suma asegurada. La sentencia de apelación no incurrió en incongruencia to the extent that the claimant heirs have the right to collect the remainder of the insured sum that results from having amortized before the outstanding balance of the loan,,es,because what was decided was substantially included in the order,,es,the plaintiffs were claiming compensation to cancel the linked loan that involved their delivery to the lender in the corresponding proportion,,es,The Supreme Court admitted that,,es,although the demand was not written clearly enough,,es,by not differentiating between the portion of compensation for the cancellation of the mortgage loan and the remaining portion to be delivered to the claimants,,es,was not an impediment for the Court's decision to establish such differentiation because,,es, pues lo decidido estaba sustancialmente incluido en lo pedido; los demandantes estaban reclamando la indemnización para cancelar el préstamo vinculado que suponía su entrega a la entidad bancaria prestamista en la proporción correspondiente.

Admitió el Tribunal Supremo que, aunque la demanda no se redactó con suficiente claridad, al no diferenciar entre la porción de indemnización con destino a la cancelación del préstamo hipotecario y la porción restante a entregar a los demandantes, no era un impedimento para que la decisión del Tribunal estableciera esa diferenciación debido a que:

“[…] the principle of congruence does not require a strict literality between the motions of the claim and the pronouncements of the judgment,,es,To the extent that the claimant heirs have the right to collect the remainder of the insured sum that results from having previously amortized the outstanding balance of the loan,,es,the sentence does not incongruence when it resolves in the indicated sense,,es,The Provincial Court of Lleida at this point also recalled the,,es,that confirmed everything mentioned in this aspect when expressing that it was legitimized,,es,actively taking the life insurance policyholder with disability coverage,,es.

En la medida en que los herederos demandantes tienen derecho a cobrar el restante de la suma asegurada que resulte de haberse amortizado antes aquel saldo pendiente del préstamo, la sentencia no incurre en incongruencia cuando resuelve en el sentido indicado, pues lo decidido estaba sustancialmente incluido en lo pedido.

La Audiencia Provincial de Lleida en este punto también recordó la STS 5 April 2017 que confirmó todo lo mencionado en este aspecto al expresar que se legitimó activamente al tomador de un seguro de vida con cobertura de invalidez, linked to a mortgage, to claim the fulfillment of the contract with your insurance to the inactivity of the lender beneficiary without prejudice to their obligations to this. states that insurance must respond to the cause for which was hired to be released from the obligation to repay the loan to be provided by the insurer the outstanding principal and also responsible for the insurance of the deficiencies in submitting the questionnaire health if too ambiguous or generic, not being able to appreciate fraud or bad faith of the insured risk in the statement.

Legitimación Activa

As for the standing of the heirs indicated reminded by various statements of the Provincial Court:

In the case of life insurance and disability concerted way linked to a mortgage loan, including the appointment of the lender as beneficiary of compensation for case of disaster, both the insured and, if, his heirs, They hold direct interest worthy of protection for the singular event that the loss occurs, and the beneficiary financial institution chooses not to demand payment of compensation for disability or death. In that case, since estipulantes condition of the insurance contract, They are empowered to action in defense of immediate and direct interest, economic content, entitling them to claim in court the application of compensation due to the cancellation of the loan linked, application outside to meet the lender's interest, meets and covers the interest of the heirs, They are receiving the free mortgaged corresponding assessment. (SAP Madrid No.7 / 2013 20 December 2012).

You can not deprive yourself of action at one of the estipulantes that has a direct interest derived from the insurance contract, more specifically the contractual complex that make up that contract and the loan which is directly linked”. (STS nº119/2004, of 19 February).

what is relevant to direct legitimacy of the beneficiary to urge compliance with the provision does not exclude, of principle and its sole attribution, the promisee to demand it of the benefit of the owner or sue, if, terminate the contract for breach of promisor” (SAP Valencia 24 February 2012).

Based on these rulings by the Supreme Court in that judgment and nº669 / 2014, He said the bank was not interested in requiring the insurer to pay compensation because of his family continued to receive the loan arranged shares, the latter being harmed by the lack of demand for payment of compensation, in the end, exonerate him to continue paying those fees on the loan; reason why the Court ruled that "the incident occurred, compliance must be enabled life insurance to apply the amount established in the same (sum assured) the repayment of the mortgage loan”.

This pronouncement, the Supreme Court emphasized that It is a life insurance with disability coverage linked to a mortgage loan, to the covered loss occurs and before the inactivity of the beneficiary bank lender, the insured / tomadora, He had standing to appeal the fulfillment of insurance in force and, therefore, to claim from his insurer fulfill its contractual obligations, including, and main, payment of the sum insured, without prejudice to respect the rights of the lender beneficiary.

De otro lado, the STS 5 April 2017 it was stated that the jurisprudential doctrine has favored the recognition of the locus standi to the policyholder without prejudice to meet its obligations to the beneficiary, particularly in cases like this life insurance and disability associated with a mortgage loan where the first beneficiary is the lender; doctrine which was confirmed in a ruling TS 1110/2001 he said:

life insurance guarantee concluded in mortgage lending and where the lender (the borrower in) It is first beneficiary are business related.

[…] producido el siniestro (death or disability), good faith and respect for moral (Arts. 7.1, 1255 and 1258 CC) legally determine that is not explicable that the bank does not claim the insurance and decide to continue demanding payment of the outstanding principal insured borrowers”.

So things, Audience recalled the appointment of STS said No. 669/2014 that:

the litigious insurance responded to a shared by the policyholder / insured claimant interest and lending credit institution: of the first, be released from its obligation to repay the loan if the incident occurred; and the second, guaranteed repayment of the loan if the borrower not returned in case of death or disability. But in any case it is more than evident the legitimate interest of the insured, and in case of death of those who succeed him in their rights and obligations, It is that insurance responds to the cause for which he was hired, cash is made and, accordingly, She is released from its obligation to repay the loan then be obliged to repay the outstanding principal in charge of the insurance. I understand otherwise unarmed equals to leave the insured or his family […]”.

Article 20 LCS

Another issue analyzed in the appeal was the disagreement of Ms. Victoria with the conclusion of the judgment of first instance, As for the payment of interest of art. 20 LCS understood that they should be recognized whenever the insurer had in default for failure to pay compensation within 40 days as stated in art. 18 LCS. The decision of the trial judge was denied payment of these by the dismissal of the application.

The Provincial Court noted that the case law concerning the application of that standard was as follows:

“[…] if the delay is determined by the course of litigation, for the opposition of the insurance is assessed as justified in order not to impose interests has examined the merits of it, basis of the findings made by the trial court, which it corresponds fixing the proven facts and the circumstances of a factual nature to integrate budgets applied standard.

This interpretation possible that the mere existence of a process, the mere fact constitute go to the same cause to justify the delay itself, or may be presumed reasonableness of the opposition. The process is not an obstacle to impose on the insurer's interests unless appreciate a genuine need to resort to litigation to resolve a situation of uncertainty or reasonable doubt about the birth of the obligation to compensate (…). In application of this doctrine, the Chamber has assessed as justified opposition from the insurer which lead to the injured or secured to a process when the court decision becomes imperative to dispel doubts about the reality of the loss or coverage (…). (STS 73/2017, of 8 February).

Based on this doctrine, Hall understood that the exemption of paragraph 8 Art. 20 LCS could not apply in this case because the parties there was no contradiction about the existence of the essential elements of the insurance contract and the argument that the lack of veracity of the policyholder, D. Enrique, regarding his health prevented the insurer to assess the risk of concluding insurance, was not accepted because "If allowed in any claims on the basis of life insurance that allegation, which has been completely disproved, is constituted in cause to be exonerated the insurer payment of interest Article 20 LCS , per se and no more than strengthened, would a non-restrictive interpretation and, therefore, contrary to the punitive nature that is attributed to the norm”.

Conclusion

Given all designated by the jurisprudence cited, Lleida Provincial Court upheld the appeal in relation to the coherence and legitimacy, condemning the insurer Mapfre to pay the amount shown in the policy seguro de vida concert with D. Enrique, BBVA handing the outstanding balance of the loan repayment linked to the insurance policy at the time of death, and the remaining balance to the applicant, in order to pay the interest of art. 20 LCS and the coast of first instance.

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