
Insurance talk? It is a dry subject, one that will make most want to reach for the pillow. However in a country where “lead floats and cork sinks”, this seemingly mundane subject can present surprises and in insurance surprise is usually a dirty word. Although the nuances and peculiarities of Nicaraguan insurance are not as straight forward as one would hope; some basic knowledge will help you get on the right path. When shopping for insurance for your family, Nicaraguan home or car it is wise to keep in mind that many of the rules are not the same as at home. Knowing where some of the pitfalls are and how to avoid them is the focus of this article
Nicaragua has five insurance companies; four private and one public. The private companies, founded in the late 1990’s, are owned or closely affiliated with local banks. It is no surprise therefore that the regulatory body for insurance, is basically a sub-department under the Nicaraguan banking commission, (SIBOIF). The one public insurance company was founded in Oct 1979, when all private insurance companies were nationalized and merged into what is now known as INISER.
The State insurance regulator has by law the task of regulating all aspects of the insurance industry. As a matter of practice, it does not get involved much with consumer to company complaints, but focuses more on company issues: such as capital requirements and the quality and type of re-insurance contracts the local companies use. In essence the industry is self-regulating in terms of claims paying procedures, interpretation of policy provisions, premium payments and other company client issues. Well meaning corporate intentions aside, some Nicaraguan companies do a good job and others don’t. This is one of many reasons an honest, experienced insurance broker becomes a valuable mediator between the customer and insurance provider. A professional broker should be able to explain well beyond the details of this article, but this summary is a head start.
The basic fire policy, which covers a structure in case of fire, lightning and explosion, is used in conjunction with the “optional” coverage to create insurance similar to a homeowner’s policy like those in United States and Canada. What most would assume should be standard comes in an optional package called allied lines. This allows great price flexibility for the insurance companies to compete, but also could make many policies close to useless if cost is the only barometer. This allied lines package consists of insurance for earthquakes, tremors, volcanic eruptions, tidal waves, hurricanes, tornados, labor strikes, student riots, looting, collision damage to your home by cars or aircraft (other than your own), and incredibly, flooding. Even with an allied lines package, the rules of the game are often different. One example is that flooding in Nicaragua is covered exactly opposite as it would be in a homeowner policy in the states. In Nicaragua water damage to a house is only covered if it comes in contact with the ground before it enters the structure. So leaks from the roof or water damage from a broken pipe in the ceiling are excluded under Nicaraguan policies.
The stuff inside your house, TV’s, furniture, paintings can be insured under optional contents coverage. Contents in Nicaragua includes everything except; gold, silver, jewelry, precious stones, furs, paper money, stock certificates, checks, stamps, commercial documents, and the catch all “rare objects of art or collectables”. Additional coverage included by some companies at no charge include medical payments for injuries to immediate family, and/or small liability coverage. Many of the insurance companies offer an option that protects your personal property and household items from robbery. Though somewhat incredulously if no one is home when your house is robbed then Nicaragua theft insurance is invalid. If you leave your home alone, it is not covered, although that’s when you need the coverage the most.
In many countries insurance is based on the idea of replacing the loss. This concept is called Replacement Value. Nicaragua uses Actual Cash Value and most of the time value is established at the time of the claim. Sounds reasonable enough. However this can be problematic. First local companies apply a depreciation factor to the lost item. Secondly, as in the case with real-estate, the item insured usually appreciates so the declared value of a house in San Juan del Sur will generally increase over time not decrease.
A misunderstood and little known clause called “rule of proportional insurance” aggravates the idea of replacing your insured real-estate loss. Basically it states if the value of the insured house is higher than the declared amount in the policy, the insured is assumed to be a co-insurer by the percentage difference. Example: you insure your house for $100,000. Two years later it is worth $200,000. The percentage difference is 50% between the policy amount and the Actual Cash Value of the house. A damage claim for $20,000 would be paid out by the insurance company after deprecation and after subtracting 50% co-insurance. It works like this: $20,000 minus deprecation and minus the 50% con-insurer penalty. Truly bad news, but only for those who have not used a competent insurance broker, since the way to eliminate deprecation and the co-insurance penalty from your insurance policies is to have your broker get the insurance company to stipulate to an agreed upon value at the start of the policy.
Auto insurance can seem like a no-brainer, with the significant difference being only the price, but this is not the entirely true. While there is considerable standardization in the auto policies each of the five Nicaraguan companies have their idiosyncrasies. One company, for example excludes coverage late at night, or in the early morning hours any where there is (in their opinion) not sufficient security. Seems arbitrary, yet another company has a clause which voids coverage if there is not a certain percentage of tread on the tires. All except one company exclude damage claims when your vehicle is towing a trailer.
Any road worthy vehicle is required by laws to have the minimum third party liability coverage called civil responsibilidad. While “road worthy” is a relative term in Nicaragua the small liability policy required by law is very well written with no exclusions. In many countries of the world auto insurance coverage is totally void if the driver has violated the law, by say being drunk, driving reckless, or without a license. Not in Nicaragua, the drunk driver who smashes into you with insurance will still have his company pay out the minimum amounts of the policy. However this applies only to the minimum liability, all other auto coverages; collision, robbery, and higher liability limits are void if an accident occurs while driver is deemed intoxicated, under the influence of narcotics or in the commission of a crime.
The old adage about insurance being like a parachute… you don’t care about it much until you need to use it … and then hopefully it deploys holds true here as well. Claim disputes and misunderstandings between insured and insurance companies do occur. First there is no legal duty on the part of the insurance local companies to make sure the policies they sell actually are issued correctly for the risk they cover. A rumored internal audit of one national company’s found well over half of the policies they have “on the books” are incorrectly insured. Some common errors are made for businesses run out of a house. Structures (homes) that are used for business purposes have a higher insurance premium than regular homes. Claims loss of these on these properties can be denied. Other frequent errors occur in Granada and Leon, where you have a mixture of adobe and block construction in the same house. Often times the policies are priced on cement block portion of the structure to achieve a lower premium for the homeowner. This practice will result in claim denial as these structures are not considered properly insured by the insurance company.
Compounding the situation is the fact the agents and brokers are not as well regulated and trained as in some other countries. All brokers are required by law to have a 100,000 Cordobas ($5,892) bond for malfeasance, but it is rarely used. Although liability for errors and omissions is a known concept in Nicaragua, pursuing a legal claim against an agent or insurance company in the overburden Nicaraguan judicial system is futile. So what can you do to make sure your insurance works when you need it? Shop around for a broker not insurance. Why? Because unlike other markets, local companies use the same rates for standard risks. For example, insurance for new residential construction cost $4.50 per 1000 of insurance. A house of 132,000 will cost 594.00 plus 15% tax and a small policy fee. There are some slight differences in auto policies pricing because of the different insured values the local companies assign to the vehicles.
A good intermediary can tell you which company is best for your auto, and often times may suggest a different company for homeowner’s coverage. Having an insurance broker represent you costs nothing extra, because the commission paid by the company is built into the cost of the insurance. Understanding policy conditions and wording is the key to being insured correctly. Interview or meet with different agents or brokers then choose one to represent your interest to the five Nicaraguan insurance companies. Ask questions and don’t assume something is covered just because it was in another local. Even knowledgeable agent may not know the answer off the top of his head, however, a good agent will acknowledge he doesn’t know and will find out.
The general feeling in the Nicaraguan business community is that Nicaragua is on the right track economically. This positive sentiment is no more evident than amongst real estate developers along the Nicaragua’s Pacific Coast.
The local real estate boom has attracted many forward thinking American, Canadian and European investors who are in the process of buying, building and developing and finally insuring their “obras”. I have had the good fortune to meet and work with many of them, and an obvious reoccurring theme in our discussions about Nicaraguan insurance is cost.
Whether an owner of an ocean view villa or a 200-unit condo developer, the
most natural question for both relates to costs for property insurance. Common
to all our buying experience in other countries is the idea price competitiveness,
especially as it relates to insurance premiums. This we use as the benchmark
to judge insurance policies. It works in other jurisdictions because the
law (court system) and public institutions (insurance commissioners or regulators)
have established what a proper insurance policy is. What it covers and what
it does not. In contrast the relatively new Nicaraguan insurance industry
is still evolving, and measuring apples to apples based on price is difficult.
As such, asking for the “lowest quote” when shopping for insurance
in Nicaragua is not necessarily the best first step.
Proper insurance coverage is your responsibility… not the insurance
company’s
Clear understanding of the property to be insured is vital for the Nicaraguan
insurance companies to correctly assess the risk of what they are issuing
coverage for. This is paramount, as claim denials often result from disagreements
over the type and value of real property. This is distinguishable from insuring,
say a 2005 Toyota Land Cruiser which has a clearly established value in the
marketplace. A home or building can have enormous differing values in Nicaragua.
Nicaragua insurance companies pay claims on Actual Cash Value of the property
and most of the time value is re-established at the time of the claim
Additional problems may come into play with the “Rule of Proportional Insurance” which aggravates the idea of replacing your real-estate loss. Basically it states if the value of the insured property is higher than the declared amount in the policy, the insured is assumed to be a co-insurer by the percentage difference.
This comes into play for partial damage claims. Fires in the kitchen or cracked wall caused by earthquakes are common partial damage claims. A claim of this type, say for $30,000 on a $200,000 house that is underinsured with a policy for $100,000 would likely result in the following scenario. The claim for $30,000 would be paid minus deprecation and minus the 50% co-insurance penalty resulting in a claim check for $12,000.
In Nicaragua, insurance underwriters have NO legal duty to verify that the policies they write will actually cover the loss of the insured. Furthermore, agents, and brokers in an effort to compete by providing the “lowest quote” often are unwitting accomplices in mis-representing the nature or value of real property to the insurance companies.
Put another way, imagine a 2500 sq.ft. home, built by renowned architect Matthew Falkiner, located on a bluff overlooking the Pacific ocean. Solid mahogany floors, natural stone counters, hand crafted faucets, custom designed lighting fixtures, solar water heater, infinity pool, and special grey water irrigation system for keeping yard green during the dry season. Popular insurance underwriting practice would describe the house as “beach house on the pacific coast” and would ask for basic type of information on construction, and location. That’s it.
This lack of clarity is exacerbated by the general nature of the insurance applications. In fact, most local insurance companies use the same application to insure a person’s house or condo as they do for a 30,000 sq.ft. factory in the free trade zones!
The answer, like many things in Nicaragua, is simple enough … it just adds a little more cost to the process of insuring a structure. The best way to eliminate ambiguity and establish a real value is to get the insurance company to stipulate to an agreed upon value at the start of the policy. This is accomplished by having a neutral third party appraise the property and use that dollar figure as the contractual agreed upon amount for the insurance policy. We do this routinely for our clients along the Pacific Coast. The cost for this service is any where from $150 for an individual house to $1200 for a large condo development and is paid directly to the appraisal company.
The cost of the appraisal when added to the insurance premium can increase the first year cost when purchasing insurance from my brokerage agency, but the value is clearly established and the insurance company has less wiggle room to deny partial claims. This is in essence why any responsible brokerage agency won’t have the “lowest quote” but rather the most useful one.
Warren “Mike” Newton with 26 years in the insurance industry, advises corporate and individual clients throughout Latin America and the United States. He is a licensed attorney, graduate of Loyola University Law School, and holds a Chartered Life Underwriters (CLU) degree from The American College, Bryn Mawr PA. Mike lives in Nicaragua with his family and is owner of the independent insurance brokerage firm CSISA
© Copyright 2006 CSISA