The other day we commented in the Brokerage an article published in a national newspaper on this subject. It was focused on what the law states, but in the day-to-day operation of insurance is somewhat different. We will see what the law says and how we act when faced with a problem of our policyholders.
The Insurance Contract Law and the different ways to make a claim
When a client/insured party disagrees with the insurer’s decision, there are different ways to complain to the insurer. These are:
- Pursuant to art. 38 of the Insurance Contract LawThe “injured” client may appoint an expert to help him/her prove to the company that the insured is right and corroborate his/her opinion. The cost of this expert would have to be borne by the client. If there are still discrepancies, there is the option of the 3rd expert.
- The Department of Customer Service of the insurance company or also known as “Defense of the Insured” that all insurance companies have, and that has two months to resolve the complaint. The complaint is binding on the company, but not on the client, who has other means of recourse.
- The Directorate General of Insurance also has a service for the defense of the insured, to which those who feel they have been harmed by their insurance company can turn.
Of course, in addition, there would be the judicial route to which any person can resort, but which involves a higher cost.
Insurance Brokerage, why?
As we said, we have seen the different legal options open to the client. All of them involve the consumption of resources, whether economic or temporary. It is no coincidence that the free options, such as the Insured’s Defense Service of the companies or the DGS, take a long time to be resolved.
This is where the role of an insurance broker comes into play. Unfortunately, not all claims are resolved the first time. There are times when a client may claim more damages than the loss adjuster or the company will grant, there are discrepancies in the value to be compensated or a thousand other issues that can go wrong.
The role of a brokerage firm is to defend its insured. Brokerage firms provide this service (we do) without charging the client, since the different companies are the ones who pay us for bringing clients to them. And, however, we owe it to our insured, for whom we must “break our faces” when the company does not fulfill its duty and is not respecting the rights of the insured.
How far does the service provided by a brokerage firm go?
This service in the event of a claim, often involves calls to:
- experts,
- claims handlers,
- guilds and
- different personnel involved in the incident
to facilitate and solve the client’s problem. It is a job that is done, so to speak, “in the shadows” (because in many cases the client does not even see it) but we do it so that the claims are handled in the best possible way.
As we say this service is what justifies that a home insurance policy, a health insurance or a company policy or a self-employed leave policy, is subscribed not directly with the company (that is going to sweep for its side) but with a brokerage that:
- First, it helps you to compare the companies’ offers by advising you on the appropriate coverages.
- Then, in the event of a claim, it will help you to manage it so that the insurer does not take advantage of the situation.
How to choose an insurance that protects me?
We must consider many factors when choosing our insurance, since not only the price variable is important: guarantees, good range of repairers, how is the claims management in the company?
PIB Group Iberia will help you find that insurance company that does not hide or shy away from you in the event of a claim, but really responds when you need it.
