There are situations that can lead to a disagreement between you and your insurer. Whatever the situation, you are not obliged to go to court. You can contact an insurance mediator. This article explains the importance of an insurance ombudsman, when and how to contact one.
Why contact an insurance ombudsman?
The insurance ombudsman’s role is to intervene in a conflict between an insured person and his insurer. Indeed, the mediator must use his or her skills to reconcile the two parties. To do this, the mediator must be a person unknown to both parties. He can then do his work in complete neutrality and independence. Moreover, he/she has the necessary means and powers to carry out his/her function.
Moreover, the mediator is chosen unanimously for a period of three years. The president of the National Consumer Institute must be a member of the committee that selects the insurance mediator.
When should the insurance ombudsman be contacted?
If the attempt to resolve the dispute with the insurer fails, the insured person may refer the matter to the insurance mediator. This referral to the mediator is made by means of a written complaint, in accordance with the procedures laid down in the contract.
Moreover, the insured may refer the matter to the mediator after two months without any response from the insurer following its attempt to resolve the dispute. They may also refer the matter to the mediator if the insurer’s response does not meet their expectations.
However, the mediator cannot intervene when a court has already been seized. Nor can he intervene when the insured’s request is unreasonable. That is, the claim is unfounded or abusive.
How do you go to an insurance ombudsman?
Only the insured person or the insurer has the power to refer a matter to the mediator. And the mediator’s consent is also required. Since he can refuse to intervene in your dispute. However, in order for the mediator to intervene, he or she needs to know some information about the dispute. This includes the name of the insurance company, the dates of the situations that led to the disagreement and the insurer’s response that does not suit the insured.
However, the file number and the insurance contract number are mandatory in case of a claim.