Get Form Art. 27.164

Form Art. 27.164 is essential for individuals seeking to bring a civil action under the provisions of the Insurance Code of Puerto Rico. This guide will provide clear, step-by-step instructions on how to fill out this form online, ensuring all necessary information is accurately provided.

Follow the steps to complete the Form Art. 27.164 online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Provide the full name of the insurer in the designated field. Next, fill in the mailing and/or street address of the insurer. Include the name of the entity or representative responsible for the alleged violation.
3. Enter the information about the affected party or person bringing the civil action. This includes their full name, claim number, and indicating their status, whether they are the insured, a third-party claimant, or other. Complete the mailing address, phone number, and email.
4. If applicable, provide the name and full address of the attorney representing the affected party. Also, include the name of the insured and the policy number.
5. Select the type of insurance or risk associated with the alleged violation by marking the relevant option—these may include motor vehicle, life and annuity, residential property, and more.
6. Specify the section of the law that has allegedly been violated by the insurer and provide details on why it is considered a violation.
7. Briefly state or refer to the specific language under the policy coverage relevant to the alleged violation, if any. If the person bringing the action is a third-party claimant and hasn’t received a copy of the policy, this step may be skipped.
8. Explain and describe the events and circumstances leading to the alleged violation, ensuring clarity and detail.
9. Certify that all information provided is true and accurate, and include the date, location, printed name, and signature of the individual filling out the form.
10. After completing all sections, users can save changes, download, print, or share the completed form as needed.

Complete your Form Art. 27.164 online today to ensure your civil action is properly registered.