April 16, 2024

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Practical information on insurance

Insurance: what to do in the event of a dispute with your insurer?

Do you no longer get along with your insurer? Start by negotiating with him then enter the customer service of your insurance company and finally seek an outside authority if the dispute persists. Spotlight on the way forward.

How to settle the dispute internally?

A dispute with your insurer over compensation for a claim or the amount of a contribution? Negotiating with your insurer can lead to an amicable solution that will satisfy both parties. To formalize this agreement, each of the parties must not forget to sign a transaction, which will put an end to the dispute.

Take care to inform your insurer of the disagreement by registered letter with acknowledgment of receipt (LRAR) to ensure that your appeal falls within the two-year limitation period.

In the absence of an agreement, you have the option of contacting the services responsible for settling disputes (it may be called “customer service”, “complaint service” or “quality management”). You will find their contact details in the general conditions of the contract.

You can also leave your opinion on Opinion Assurances so that they can respond to you quickly.

If the dispute persists, you can then seize the mediator.

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How to contact the insurance mediator?

Independent authority of the insurance company, the mediator examines and seeks an amicable solution to the dispute resulting from the execution of the insurance contract.

As mentioned in the contract, the mediator can be seized by the insured or the insurer when the negotiations with the insurance company are exhausted (we speak of “exhaustion of internal remedies”).

Referral to the insurance mediator is made by post or email and care must be taken to mention:

  • the name of the insurance company involved in the dispute,
  • the number of the insurance contract concerned,
  • a description of the events and the subject of the dispute.

Remember to attach photocopies of the necessary supporting documents as well as the various letters exchanged with your insurer.

Within a period of between 3 and 6 months, the mediator issues an opinion.

How to contact the Prudential Supervisory and Resolution Authority?

The institution responsible for monitoring the activity of banks and insurance companies, the Prudential Control and Resolution Authority (ACPR) can be seized by individuals and professionals.

However, this institution is not intended to settle a dispute between you and your insurer or an insurance intermediary.

If you have a general question about insurance regulations and practices or bring to the attention of the ACPR a difficulty encountered with your insurer, you can contact them:

  • by mail to the address: Prudential Control and Resolution Authority Commercial Practices Control Department 61 rue Taitbout 75436 PARIS CEDEX 09
  • by email to INFO-CLIENTELE@acpr.banque-france.fr

For your request to be properly processed, do not forget to provide the following information to the ACPR:

  • Your surname, first name, address, and telephone number,
  • The name of the professional concerned,
  • Your question or a summary of the facts to be brought to the attention of the ACPR,
  • A copy of the contracts concerned as well as the letters exchanged with the insurer,
  • All the documents you deem useful.

Terminate your insurance contract

Finally, if you are unable to settle your dispute amicably with your insurer, you may be tempted to terminate your insurance contract. In recent years, various laws have made it easier to cancel with your insurer, in particular the consumer law, known as the Hamon law.

Since January 1, 2015, this legislation has allowed policyholders to terminate their car, motorcycle, and home insurance contracts at any time after one year of subscription. Until this provision, termination was only possible on the expiry date of the insurance contract. From now on, it is possible to terminate whenever you wish and without justification. In addition, your new insurer will take care of the termination formalities to facilitate your process. Simply choose your new insurer, for example by using an online comparator, then send him the information relating to your current contract.

Also note that Law No. 2019-733 of July 14, 2019, facilitated the termination of a mutual health insurance contract. Indeed, since December 1, 2020, you have the right to terminate your contract at any time, without reason, and without charge, once you have spent one year of subscription. Until then, you had to wait until the anniversary date of the contract to be able to terminate. Missing the deadline meant waiting another year.

The principle is therefore the same as for the termination of a car or home insurance contract with the Hamon law, but for your mutual insurance company. However, this measure cannot be applied if your complementary insurance includes death, invalidity, or even incapacity guarantees (provident guarantees). This also works for collective contracts (mutuelle d’entreprise). After one year of commitment, the company has subscribed to the collective contract and may terminate it. But beware, it is up to the employer to make this request, you cannot do it yourself.

To cancel at any time a complementary subscribed for more than one year, you will have to notify the cancellation your insurer by mail in a registered letter. You can also do so by a declaration to the head office or representative of the organization, an extrajudicial document, or by internet (e-mail with notification of receipt, online messaging, mobile application, etc.).

When your cancellation request is made, your insurer is obliged to confirm its receipt and must include its time of execution. He must also inform you of your right to a refund of your balance. Termination is then effective within one month. Finally, if you take out another mutual insurance company, your new insurer will take care of all the procedures, saving you from wasting time on paperwork!