MEXICO Trends and Developments Contributed by: Aldo Ocampo and Arturo Caballero Rossetti, OCAMPO 1890
accident and health. Penetration stood at 2.95% of gross domestic product, and the number of insureds under major medical expenses cover exceeded 14 million. The reading is unambiguous: loss costs are growing faster than premiums, across a materially larger and better-informed insured population. To this must be added the consolidation of a segment of law firms whose business model consists specifically of litigating against insurers, with large-scale digital client acquisi- tion. The authors have found no public evidence of third-party litigation funding directed specifically at the Mexican insurance sector – funds active in the coun- try report concentration in construction, energy and investment arbitration – but the financial infrastructure exists, and the combination of uncapped moral dam- ages awards with indexed default interest constitutes, in expected-return terms, a natural target. It is a trend the sector should anticipate before it materialises. Conclusion: from procedural defence to documentary discipline The underlying shift that characterises this period is that the Mexican insurer’s defence is no longer won principally at trial, but before it. The criteria generating the greatest exposure today – punitive damages for failure to evidence delivery of the general conditions or their registration with the Nation- al Insurance and Surety Commission; presumed moral damage arising from repeated and groundless denial of payment; and the inapplicability of consent inferred from website publication – do not penalise the legal interpretation of the contract. They penalise documen- tary and conduct failures in underwriting and claims handling. They are, without exception, risks capable of being managed through internal control.
Five priorities follow for the sector in the short term. First, audit the traceability of delivery of general condi- tions across all channels, with particular attention to bancassurance and digital sales. Second, verify the timely registration of technical notes and contractual documentation with the regulator. Third, rigorously document the technical reasonableness and timing of every denial of payment, avoiding unnecessary medi- cal or expert requirements where the ground for rejec- tion is already settled. Fourth, recalibrate reserves and reinsurance programmes to incorporate the extension of the limitation period to five years in personal and lia- bility lines, the absence of compensation caps and the indexed accrual under Article 276. Fifth, give serious consideration to early settlement in matters involving a moral damages component or established claimant vulnerability, where the arithmetic of default interest and the real duration of direct amparo mean that the passage of time destroys value. The legal certainty the sector demands will not be restored by legislation in the short term. It will be built, case by case, through technically unimpeach- able files and a claims function that understands that every decision to deny is today, potentially, the open- ing chapter of an award for moral damages.
197 I NSURANCE L I T IGATI O N 2026
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