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including:
Procedures (free of
charge):
Insurance Ombudsman
a. Complaints
and disputes, if they have been
brought to the attention of the
relevant Affiliated Parties and
they have not been handled to
the satisfaction of the
consumer or the Affiliated
Party has not responded within
a reasonable term, as well as
requests for information can be
presented to the Ombudsman both
verbally and in writing.
b. Complaints
and disputes must be presented
within one year after the
relevant Affiliated Party has
announced his final position to
the complainant, or within one
year after the expiry of a
period of one month within
which the complainant has given
the Affiliated Party the
opportunity to respond to the
complaint in question.
c. If the
person who presents a complaint
or dispute to the Ombudsman
does not fulfill the request to
present the Ombudsman with
(further) information within
the stipulated period, he will
be deemed to have withdrawn his
request for handling the
complaint or dispute and there
will be no further handling
thereof.
d. The
Ombudsman will handle a
complaint or dispute or request
for information by:
e. The
Ombudsman can at all times
consult experts regarding
complaints and disputes or
requests for information
presented to him.
Insurance
ombudsman regulations
(44
KB)
Insurance Supervisory
Board
a. The Board
will always consult and make
decisions regarding matters
placed before it with at least
three members.
b. An
investigation to be carried out
by the Board will be
commenced:
c. A request
for carrying of an
investigation will be presented
to the Board, stating the name
of the Affiliated Party in
respect of whom an
investigation is desired,
stating furthermore all details
known to the party requesting
the investigation and upon
submission of all those
documents which could be useful
for the investigation. In
specific, the request will set
out the facts and circumstances
pursuant to which the
requesting party believes that
the relevant Affiliated Party
has not maintained the good
name/reputation of and
confidence in the industry.
d. A request
for carrying out an
investigation as referred to in
the preceding paragraph will
only be taken into
consideration if the consumer
has presented his complaint to
the Affiliated Party and the
latter rejects such or has not
responded within a reasonable
period of time. If the
Affiliated Party is bypassed
and a complaint is presented
directly to the Supervisory
Board, the Board will advise
the complainant to present his
complaint to the relevant
Affiliated Party.
e. A request
for information and a complaint
or a dispute which can be
handled by mediation, will
always be passed on to the
Ombudsman. The parties involved
will be informed in the event
the matter is passed on to the
Ombudsman. If a complaint does
not contain any disciplinary
aspects, the Board will hold
the complaint to be
inadmissible.
f. If the
Ombudsman requests the Board to
carry out an investigation on
the basis of Article 8 of the
Insurance Ombudsman
Regulations, the Board will
hold that by not complying with
the recommendation the
Affiliated Party is harming the
good name/reputation of and
confidence in the industry. The
provisions of the preceding
sentence do not apply if the
Board is of the opinion that
the recommendation of the
Ombudsman, in connection with
contents or manner of making,
is not fair under the
circumstances.
g. In the
event of a whole or partial
declaration that the complaint
is well-founded, the Board will
set out in its judgment the
obligations of the Affiliated
Party vis-à-vis the
complainant.
Complaints or
disputes are to be submitted in
writing, preferably accompanied
by prior correspondence
containing the point of view of
the parties involved. (for
details on the procedure :
Article 7 of the Insurance
Ombudsman Regulations and,
Article 6 of the Insurance
Supervisory Board
Regulations)
Insurance
Supervisory Board
Regulations
(44
KB)
Nature of decisions:
Insurance Ombudsman
The Ombudsman
will handle a complaint or
dispute or request for
information by presenting a
substantiated, written
recommendation which he
exclusively discloses to the
parties in question. The
Ombudsman will request the
Board to carry out an
investigation in a case in
which an Affiliated Party
refuses to comply with a
written recommendation given to
him by the Ombudsman or has not
made a statement that he will
comply with a written
recommendation made by the
Ombudsman within a term fixed
by the Ombudsman of at least
fourteen days.
If the
Ombudsman requests the Board to
carry out an investigation on
the basis of Article 8 of the
Insurance Ombudsman
Regulations, the Board will
hold that by not complying with
the recommendation the
Affiliated Party is harming the
good name/reputation of and
confidence in the industry. The
provisions of the preceding
sentence do not apply if the
Board is of the opinion that
the recommendation of the
Ombudsman, in connection with
contents or manner of making,
is not fair under the
circumstances.
Insurance Supervisory
Board
In the event
of a whole or partial
declaration that the complaint
is well-founded, the Board will
set out in its judgment the
obligations of the Affiliated
Party vis-à-vis the
complainant.
The Board will
present its substantiated
decision to the complainant and
the relevant Affiliated Party.
The Board will also give notice
of any decision relating to an
Affiliated Party which is a
member of a professional or
industrial organization as set
out in the appendix to the
chairman of such
organization.
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