We can always find ourselves with difficulties in processing a claim, or not being satisfied with the position of the insurance company. Sometimes due to the interpretation of the claim coverage, other times due to the valuation of the damages, or in fact, due to any discrepancy that may arise with the insurer. When we find ourselves in any of these situations, resolving the conflict with the company will not be easy. Below we detail the steps we follow at Canarisk when claiming from the insurer:
- Department of the Insured Ombudsman. It is normal for insurance companies to have an Insured Ombudsman Department, so it should be to this department that we first address the claim. This department must resolve the claim within a period not exceeding two months.
- General Directorate of Insurance and Pension Fund. If the response from the Insured Ombudsman Department has not been satisfactory, or they simply have not communicated a response (something very common), the next step will be to forward the complaint to the corresponding administrative body, which is the General Directorate of Insurance and Pension Funds. To be able to use this route, it is necessary to demonstrate that a claim has previously been submitted to the Ombudsman for the Insured Party and that they have not given a response or it is unsatisfactory. The General Directorate of Insurance must, within a period of four months, issue a report conclusive as to whether there is non-compliance on the part of the insurer. This resolution is not binding, but in addition to being a measure of pressure on the insurer, it is an instrument in our favor in the event that the claim is prosecuted.
- Arbitration or judicial process. Finally, if you have not obtained a favorable result in any of these ways, you can go to court or initiate the arbitration procedure.
We recommend following these steps in order, although, depending on the type of claim and circumstances, you can go directly to court once the friendly claim has been exhausted. At Canarisk we will know how to advise you so that your claim is always resolved in your favor if there are great difficulties for you.