P.R. Laws tit. 26, § 1360

2019-02-20 00:00:00+00
§ 1360. Limits of liability

(1) In any life insurance policy or annuity or pure endowment contract, the insurer may limit its liability [only in the event] of death occurring:

(a) As a result of war, or act of war, if the cause of death occurs while the insured is serving in the military, naval or air forces of any country, combination of countries, or international organization, provided that said death occurs while a member of any such forces or within six (6) months after termination of service in said forces, if the death occurs as a result of any syndrome related to said act of war:

(i) As a result of the special hazards incident to service in the military, naval or air forces of any country, combination of countries, or international organization if the cause of death occurs while the insured is serving in such forces and is outside of the United States, its territories, the District of Columbia or Canada, provided that said death occurs outside of the United States, its territories, the District of Columbia or Canada or within six (6) months after the insured’s return to the United States, its territories, the District of Columbia or Canada or an area within said forces, or within six (6) months after termination of service, if the death occurs as a result of any syndrome related to said act of war, whichever is earlier.

(ii) As a result of war or an act of war while the insured is serving in any civilian noncombatant unit with said forces, provided that said death occurs while serving in said units or within six (6) months after termination of service in said units, whichever is earlier.

(iii) As a result of the special hazards incident to service in any civilian noncombatant unit with said forces, if the cause of death occurs while the insured is serving in said units and is outside of the United States, its territories, the District of Columbia or Canada, provided that said death occurs outside of the United States, its territories, the District of Columbia or Canada, or within six (6) months after the return of the insured to the United States, its territories, the District of Columbia or Canada, while serving in said units or within six (6) months after termination of service in said units, whichever is earlier.

The word “war” includes, without being limited to, declared war and armed aggression by one or more countries resisted on orders of any other country, combination of countries or international organization. “Acts of war” means any act peculiar to military, naval, or air operations in times of war.

(b) As a result of suicide of the insured, whether sane or insane, within two (2) years from date of issue of the policy. The policy shall provide, at least, refund of all premiums paid, less dividends paid and any indebtedness, during the suicide exclusion period.

(c) As a result of aviation, except as passenger in an airplane with a regular schedule, according to the conditions specified in the policy.

(d) Within two (2) years from the date of issue of the policy, as a result of a specified hazardous occupation or occupations or while the insured is resident in a specified foreign country or countries.

(2) An insurer may specify conditions pertaining to the items of subsection (1) of this section, which in the Commissioner’s opinion are more favorable to the policyholder.

(3) If the liability of the insurer is limited, as provided in subsections (1) or (2) of this section, the amount payable in the event of death under circumstances to which any such limitation is applicable, shall be a determinable sum not less than the reserve for the life insurance and any endowment benefits of the policy, determined by the method prescribed in the minimum standard required by law, and computed according to the mortality table and interest rate specified in the policy for the calculation of nonforfeiture benefits (or if the policy provides no such benefits, computed according to a table and interest rate determined by the insurer and specified in the policy) with adjustment for indebtedness or dividend credits.

(4) The right of the insurer to limit its liability with respect to any sums payable or any benefits provided in event the insured is disabled or suffers dismemberment, or with respect to any additional sums payable or additional benefits provided in the event that the death of the insured is caused by accident or accidental means, shall not be subject to nor be limited or affected by this section, nor by §§ 1342 and 1352 of this title.

History —Ins. Code, added as § 13.260 on Nov. 9, 2007, No. 165, § 1, eff. 90 days after Nov. 9, 2007.