What are pathways to claim to an insurance company. Disputes with insurers are more common than they appear, but the majority of users do not know what we have to do in the event of conflict or what avenues of complaint to insurers. While we don’t have any incident, there is no problem, the conflict arises when we have an accident and do not agree with the opinion of the insurer, because we do not know well that we need to do or where we need to go in order to solve the problem.
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Way of claim to the insurer
Mediator or broker of insurance, or insurance company
The first thing we have to do in any situation of conflict with the insurance is to go to our mediator or insurance broker, because he is who better knows our situation and who can better advise us.
If we have not contracted the insurance mediator or insurance broker, we can go directly to the insurer to ask our problems or our complaint.
If still has not resolved, can attend the following way of claim to the insurer: the defender of the insured and the customer service.
The defender of the insured and customer services
By order, the first option to any problem with our insurance company is the defender of the insured and customer services.
The steps to follow to attend this avenue of complaint are as follows:
complaint before the Ombudsman of the policyholder (named by the own insurer) in writing or in default, to the Department or customer service. First of all, the writing must be send by certified mail with acknowledgement of receipt, fax or a means allowing to have proof of your presentation.
If after two months since the claim is presented it has not been resolved, has been denied admission or request that has not been accepted we needed, we can go to a second way.
There is now also a new figure: the Commissioner for the defense of the policyholder and of the participant’s pension plans. This new figure is regulated in the rules of procedure of the Commission I for defense of the client’s financial services.
It’s a body belonging to the General Directorate of insurance and pension funds, which aims to make it easier for users arriving in their complaints, complaints and consultations, the relevant authorities of the insurance companies and protect the rights of users of insurance and pension plans.
Consumer associations
Consumer associations have as objective to protect users or clients against firms, and these partnerships we can obtain information and may help us on possible options which we have against the insurance companies.
The arbitration route
Arbitration is an out-of-court which allows you to resolve conflicts between insurer and insurance in a way that is fast, effective and above all. Usually the option more favourable to the insured, because you don’t have to deal with high legal costs that can be derived from the courts.
To attend this via the insured must submit in writing the request for arbitration to:
The information offices of the Community consumer.
Consumers user associations attached to the arbitration system.
Personally in the Regional Consumer Arbitration Board.
All those conflicts that have not been able to be resolved by any of the previous routes, may arise before the courts of Justice.
Competent judges to resolve all kinds of conflicts with insurers are the judges and courts of the domicile of the insured, fit the possibility of making an otherwise agreed.
There are two types of claims to make judicial:
Claim for damage.
Claim for accidents with injuries.
Claim for damage
To attend the courts by damage in the absence of agreement between the parties, you must do the following steps:
Presentation of the demand within the year following the completion of the claim in the Court of first instance. And if you disagree with the judgment rendered by the Court, we can go to the Provincial Court in within three days.
What are pathways to claim to an insurance company
Claim for accidents with injuries
In this case to go to the courts in the absence of agreement between the parties, should:
The complaint in the magistrate’s Court in 60 calendar days following the date of the incident, and if you disagree with the ruling, you can appeal to the Provincial Court in the next 24 hours.
How we see there are different ways to claim insurance companies, although most advisable is to solve in the most peaceful possible, being judicially the least advisable, at least in the first instance.
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