La pérdida de actividad o lucro cesante por el Coronavirus (Covid-19)
Estos días hemos tenido muchas consultas sobre si aquellos profesionales liberales o empresas que tienen contratados seguros con la garantía de interrupción de actividad, lucro cesante o pérdida de beneficios, tienen derecho a percibir una indemnización debido a la situación actual y al estado de alarma declarado por el gobierno como consecuencia de la pandemia del Coronavirus (COVID-19). Vamos a intentar esclarecer el tema.
El lucro cesante: ¿cuándo se produce?
En otro post ya tratamos qué es el lucro cesante.
El lucro cesante o pérdida de beneficios es siempre resultado de una interrupción de la actividad debido a una contingencia determinada. Sería el caso de un incendio, inundación, explosión, accidente de tráfico, etcétera. En unos casos el culpable del accidente deberá costear el lucro cesante y, si el «culpable» eres tú, lo deberá costear el seguro que tengas contratado, si es que tienes la cobertura contratada.
No entran dentro de la condición del lucro cesante el que la empresa deje de vender por causa de que sus productos o servicios ya no interesan al mercado por las circunstancias que sean, como sería, su obsolescencia, modas, cambios de hábito del consumidor, mejores precios de la competencia, productos sustitutivos, etcétera.
Requisitos del lucro cesante
Para que se pueda conceder una indemnización por lucro cesante deben darse dos requisitos:
- Que realmente exista y pueda ser probado junto con su relación directa con el daño causado.
- Que se pueda determinar o calcular efectivamente la cuantía económica dejada de percibir.
Taxistas, fábricas de ropa o de vehículos o de tornillos o de lo que sea. Hoteles, industria del entretenimiento, restaurantes y un larguísimo etcétera de actividades. Es obvio que en la mayoría de casos de empresas y autónomos será muy fácil acreditar el cumplimiento de los requisitos tanto de existencia de la pérdida económica como de su cuantificación y relación directa con el daño (la pandemia). Ahora bien, ¿tiene cobertura?
La regulación del seguro de lucro cesante
Desde el artículo 63 hasta 67 de la Ley 50/1980 de Contrato de Seguro se establece lo siguiente respecto a los seguros de lucro cesante:
Artículo 63. De qué trata y a qué obliga el seguro de Lucro Cesante.
Artículo 64. Deber del asegurado a informar a todas las aseguradoras de la existencia de los seguros.
Artículo 65. Conceptos obligados, salvo pacto expreso, que el asegurador debe indemnizar al asegurado por lucro cesante.
Artículo 66. Qué partes del lucro cesante pude asegurar el asegurado y en qué escenarios.
Artículo 67. De existir solo un seguro de lucro cesante no vinculado a escenarios concretos, la indemnización resultará siempre del cálculo resultante objetivamente acreditado.
¿La pandemia del Covid-19 es un siniestro?
El diccionario de la Real Academia Española, entre otros significados, define siniestro como un suceso que produce un daño o una pérdida material considerables. También lo define, para el contrato de seguro, la concreción del riesgo cubierto en dicho contrato y que determina el nacimiento de la prestación del asegurador.
Obviamente la pandemia del Coronavirus (COVID-19) es un auténtico siniestro, como si se tratara de las consecuencias de la radiación de una catástrofe nuclear. Otra cosa es que el «riesgo» de pandemia como causa de siniestro que origine el derecho a cobrar por la garantía de pérdida de actividad o lucro cesante quede amparada en el contrato.
Los contratos de seguro con garantía de lucro cesante
Para las pequeñas y medianas empresas los seguros de lucro cesante habitualmente forman parte de un «seguro paquete» que engloba incendio, robo, responsabilidad civil, lucro cesante, etcétera. En las grandes corporaciones el seguro de lucro cesante es un contrato exclusivo a parte del seguro de daños o de incendio o de otras garantías.
Generalmente en los contratos de «seguro paquete» la garantía de lucro cesante (cláusula delimitativa) va condicionada a que se produzca un siniestro de daños cubierto por el mismo contrato (cláusula limitativa de derechos del asegurado). De este modo el lucro cesante queda cubierto siempre y cuando sea consecuencia de un incendio, que obviamente es un riesgo básico de daños cubierto por el seguro, pero como el riesgo de «pandemia» no es un riesgo incluido, el lucro cesante tampoco queda cubierto.
¿Cómo valorarias a tu aseguradora?Comparte tu opinión con otros usuarios en RankiSeguros. |
Cláusulas delimitativas y limitativas de derechos
Siguiendo lo que decimos en el apartado anterior y si consultas el post sobre las cláusulas verás que, dado el caso que no hayas aceptado específicamente por escrito las cláusulas que limitan los derechos del asegurado (artículo 3 LCS), podrás reclamar la cláusula delimitativa del riesgo de lucro cesante de acuerdo a la sección quinta de la LCS y por tanto tendrás derecho a la indemnización hasta el límite de la suma asegurada sin que se vea condicionada a otra garantía. En caso contrario deberás plantearte lo que sigue en el próximo apartado.
Cláusulas abusivas
Los artículos del 82 al 91 de la Ley General para la Defensa de Consumidores y Usuarios (RDL 1/2007) establecen lo que hace referencia a las cláusulas abusivas en los contratos, y de considerarse alguna como tal, son consideradas nulas. Y evidentemente esto también afecta a los contratos de seguro, más aun cuando se trata de contratos de adhesión. Obviamente deberá estudiarse detenidamente si, aunque se hayan aceptado por escrito las circunstancias contractuales que limitan los derechos del asegurado para que tengas derecho de percibir la indemnización por garantía de lucro cesante, ésas sean consideradas como abusivas por el Juez bajo su criterio e interpretación del Derecho. Por tanto, en este escenario del Coronavirus (COVID-19) deberías percibir la indemnización por lucro cesante aunque hubieras aceptado esa cláusula que lo excluye si es considerada abusiva.
¿Y los plazos? La responsabilidad civil del asegurador frente al asegurado
Ten en cuenta que desde que declaras el siniestro a la aseguradora hasta que ésta te lo pague todo hay un plazo máximo de 40 días naturales. Y si en ese plazo el seguro no te indemniza, deberá justificar el porqué no te indemnizó todo en ese plazo y qué circunstancias o información les faltaban por conocer para que no liquidaran la totalidad que debías percibir. No vale pagar lo que les dé la gana. Los pagos deben estar acreditados del mismo modo que tú deberás acreditar tu reclamación.
Y si resulta que el seguro no te pagó el lucro cesante en los 40 días teniendo la obligación de haberlo hecho y debes cerrar el negocio, podrás reclamar al asegurador la pérdida de tu fondo de comercio por no haberte pagado a tiempo. Porque en las empresas, autónomos y particulares no solo va de cobrar la indemnización, sino también de cobrarla a tiempo. Porque percibir la indemnización de aquí a 3 años, por muchos intereses que te paguen, no resuelve nada. La cuestión es recibir la indemnización a tiempo. Y obviamente la pérdida del fondo de comercio, que a efectos prácticos es el valor de la empresa a precio de mercado excluyendo los fondos propios que de perderlos en el siniestro también deberían computarse, lo deberá asumir esa aseguradora por responsabilidad civil por no haberte pagado a tiempo. Y esta segunda indemnización no irá vinculada a ningún contrato sino a una responsabilidad del propio asegurador frente al propietario de la empresa «fallecida» o «tocada de muerte».
¿Qué perderás?
Cada uno debe calibrar su estrategia y estudiar detenidamente su caso, y para muchas empresas que van a «morir» ¿qué les cuesta intentarlo? Si igualmente la empresa muere da lo mismo morir por 100 que por 200. Morirá intentándolo. Pero si ganas, al menos salvarás tu negocio y aquellas familias que dependían de él. En tu mano está intentarlo.
Nota final
Ya sabes que en ClaimCenter somos expertos en temas de seguros en lo referente a temas post-venta, tramitación de siniestros y accidentes de todo tipo. Puedes solicitar tranquilamente a tu aseguradora que seamos nosotros quienes peritemos o gestionemos tu caso. Si tu aseguradora no acepta que seamos nosotros quienes nos ocupemos de tu caso por alguna extraña razón, siempre puedes contratarnos para que te nos estudiemos tu caso, te asesoremos y, dado el caso que tengas razón, reclamemos al seguro.
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(This can apparently also be achieved through tantric sex, but between Westworld and the new season ofGirls, we haven’t had time to try that at home.)
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Squirting, while totally real for some women, is also the stuff of male fantasy (just look at RedTube). If you’re not able to squirt, it’s like you’re letting your partner down.
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I ‘d be lying if I said I didn’t love a good spanking. I’m sure you’ve quickly surmised this thorny little detail, but I do mean spanking in a sexual way.
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She adds that practitioners of spanking describe it as an opportunity to enter into a consensual, time-bound interaction with someone they trust and feel close to
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Both partners deserve to fully immerse themselves in the act of sex, after all, and explore what truly makes the experience amazing for each person.
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como reclamar por tener que cerrar obligatoriamente el bar durante la pandemia
Buenas tardes. Conozco el caso de una empresa que esta buscando asesoría legal por pérdida de beneficios debido a retraso en la construcción de su nueva refinería a causa del COVID 19. Esta póliza tiene una extensión de enfermedades infecciosas y lesiones corporales. Conocen casos de éxito en las reclamaciones de este tipo a nivel global?
Debe estudiarse el caso, el contrato de seguro y la legislación del país. Cada circunstancia es distinta y las reclamaciones de interrupción de actividad debido a una pandemia como el COVID19 más aun.
EN MI POLIZA DE SEGURO HAY UN APARTADO QUE DICE . POR PARALIZACION DE LA ACTIVIDAD, PREGUNTO , SI TENGO DERECHO A RECLAMAR ALGO, GRACIAS.
Obviamente estará cubierto dependiendo de lo que haya contratado y de las circunstancias de contratación. Esto debe estudiarse.
Cuando fallece la persona con ocasión del COVID 19 y el mismo era conductor de taxi, pero la póliza para ellos solo esta la cobertura de accidentes de transito.
No acabamos de entender muy bien su pregunta. No sabemos si su cuestión se refiere a que si la garantía de fallecimiento del conductor de un taxi que hay en el seguro del automóvil cubre la indemnización al beneficiario en caso de fallecimiento del taxista por causa del COVID19.
Si esa es su cuestión le diremos que debe estudiarse detenidamente su caso. En principio la cobertura se limita a fallecimiento por accidente de tráfico pero hay que estudiar el contrato de seguros para ver si esa cobertura puede ser extensible a otras causas de fallecimiento.
Ponemos un ejemplo: La causa de fallecimiento del COVID19 es una causa extraordinaria (una pandemia), y como tal, el Consorcio de Compensación de Seguros (CCS) cubre el fallecimiento de aquellas personas que tengan suscrito un seguro de vida con esa garantía cuya causa sea un fenómeno extraordinario. Como ya sabe, existen corrientes como la nuestra que entendemos que el CCS debe hacerse cargo de esas indemnizaciones.
¿se podrian cobrar las clausulas de perdida de beneficios por covid 19 o no?
Primero hay que estudiar el caso. Piense que se trata de un tema de ELEVADA DIFICULTAD, no existen precedentes y hay probabilidades que se DESESTIME la reclamación por Consorcio de Compensación de Seguros y, posteriormente, por la Autoridad Judicial, Nosotros creemos que existen posibilidades, por lo que antes de realizar cualquier acción extrajudicial y/o judicial exponemos por escrito nuestra estrategia al cliente para que sepa los riesgos que existen.
La conclusión más acertada podría desprenderse del estudio global de la jurisprudencia del Tribunal Supremo, y es que, en realidad, las cláusulas, incluso las de definición del objeto del seguro y las de delimitación de riesgo, se equiparan siempre a las cláusulas limitadoras en cuanto a sus requisitos de aplicabilidad al asegurado siempre que recorten, por cualquier motivo incluido su delimitación legal, las expectativas razonables de cobertura del asegurado de acuerdo con la modalidad de seguro contratada, o como dice la Sentencia del Tribunal Supremo de 18 de mayo de 2009 (RJ 2009/2924), lo decisivo es que el asegurado vea limitados o restringidos los derechos en relación, por ejemplo, a los que le han sido atribuidos a la parte de la póliza que negoció. Es decir, las coberturas y capitales del condicionado particular.
Muchísimas gracias por su aportación. Es muy interesante y a tener en cuenta.
Me parece un disparate lo que se expone, no es una clasula de EXCLUSION, es algo que no está incluido y por lo tanto el tratamiento no debe ser como una clausula limitativa. Saludos.
Un contrato de seguro es un contrato privado entre dos partes donde pueden pactar casi lo que les dé la gana. De hecho el artículo 44 de la LCS, si el asegurador «ordinario» quisiera, podrían cubrir los riesgos extraordinarios y hasta los derivados de los conflictos armados haya o no declaración de guerra. Si se fija en la última frase del primer párrafo se establece «salvo pacto en contrario».
De hecho hay algunos aseguradores que cubren la pérdida emergente de una actividad mercantil por causas de fuerza mayor no condicionadas a las garantías contratadas.
En nuestra vida profesional, dentro del sector asegurador, hemos visto y vivido en primera persona miles de «disparates» de cosas auténticamente inverosímiles donde podríamos rellenar una enciclopedia, por lo que hemos aprendido de que las cosas pueden verse e interpretarse de multitud de formas y todo es cuestión de interpretación.
Gracias por su comentario.
Me gustado mucho vuestra exposición al respecto
Comulgo con vosotros al 100%
Gracias
Muchas gracias por su comentario, Mikel 🙂