Insurance ombudsman rules amended for better policyholder complaint resolution – About Your Online Magazine


On March 2, the government notified comprehensive changes to the 2017 Insurance Provider Rules to improve the functioning of the Insurance Provider mechanism and facilitate the resolution of complaints regarding deficiencies in insurance services in a timely, economical and impartial manner.

The name also changed to the Executive Council of Insurance Companies, which manages the ombudsman mechanism, as the Insurance Ombudsman Council.

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“The amended rules broadened the scope of complaints to ombudsmen, from previous disputes only to service deficiencies by insurers, agents, brokers and other intermediaries. In addition, insurance brokers were brought into the scope of the ombudsman mechanism, for empowerment the ombudsman’s offices will also condemn insurance brokers ”, says a note from the Press Office (PIB).

Under the amended rules, the mechanism’s timeliness and cost-effectiveness have been substantially enhanced. Policyholders will now be able to make complaints electronically to the ombudsman and a complaints management system will be created to allow policyholders to track the status of their complaints online. In addition, the ombudsman can use videoconferencing for audiences. In order to make access to the franchise via the ombudsman mechanism possible, even if there is a vacancy in the ombudsman position, it is foreseen to assign additional charges to another ombudsman, pending the filling of the vacancy.

A number of changes have been made to ensure the independence and integrity of the Ombudsman’s selection process, while creating safeguards to ensure the independence and impartiality of appointed persons while acting as Ombudsmen. In addition, the selection committee will now include an individual with a history of promoting consumer rights or advancing the cause of consumer protection in the insurance industry, according to the PIB statement.

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Paula Fonseca