La prescripción de la acción indemnizatoria bajo la cobertura de gastos médicos del Seguro Obligatorio de Accidentes de Tránsito (SOAT)

In Judgment SC3075-2024 of 19 December 2024, the Supreme Court of Justice clarifies its position on the limitation period for actions arising from insurance contracts, in the context of SOAT medical expenses coverage. The Court specified that these actions, even when exercised by beneficiary healthcare providers, are governed by Article 1081 of the Commercial Code and expire after a period of two years counted from the occurrence of the loss. It emphasised that the invoice, on its own, does not serve as support for enforcement, as in the SOAT scheme it only has strictly accounting and evidentiary purposes. It cannot be considered a negotiable instrument, as there is no contract for the sale of goods or provision of services between the healthcare provider and the insurer to justify its issuance. Similarly, it noted that the judge must assess with equal rigour the fulfilment of the evidentiary burdens of both the insured and insurer, especially in the context of SOAT, where the beneficiary need only prove the occurrence of the loss with the documents required by special regulations. In this specific case, the Court overturned the judgment of the Superior Court of the Judicial District of Barranquilla, for having improperly assessed the evidence and having erroneously interpreted the applicable limitation period.