WHAT CAN BE EXPECTED FROM ALTERNATIVE DISPUTE RESOLUTION

The Insurance Ombudsman typically takes 54 days to reach a resolution in alternative dispute cases. However, the governing law provides for a 90-day period for dispute resolution, which may be extended if the specific circumstances of the case and the conduct of the dispute necessitate additional time.

As a participant in alternative dispute resolution, the consumer is not required to have legal representation and may choose to withdraw from the process at any stage. Submitting a proposal to initiate a dispute with the Insurance

Ombudsman and participating in the resolution process are both free of charge.

The outcome of an alternative dispute resolution conducted by the Insurance Ombudsman can include:

The conclusion of an agreement between the parties involved in the dispute

The primary objective of an alternative resolution to a consumer dispute is to facilitate a compromise between the parties involved, which is formalized through a private law agreement. By reaching such an agreement, the parties can effectively avoid litigation and the associated costs of pursuing or defending their rights. The agreement reached through alternative dispute resolution is legally binding for both parties; however, this does not preclude them from seeking judicial resolution on the same issue if necessary. To date, there have been no instances where parties failed to voluntarily comply with the agreement or needed to pursue the same matter in court after resolving it through the Insurance Ombudsman.

Issuance of a reasoned opinion

A reasoned opinion is issued when the parties to the dispute do not reach an agreement and the Insurance Ombudsman determines, based on the facts uncovered during the alternative dispute resolution, that the insurance company has violated the consumer's rights under consumer protection regulations. Although this opinion is not legally binding, it can serve as a basis for further enforcement of the consumer’s rights through the court.

Postponement of the consumer proposal

The Insurance Ombudsman will postpone the consumer’s proposal if no agreement is reached between the parties and if the Ombudsman does not find evidence that the insurance company has violated the consumer's rights under consumer protection regulations. Each postponement is detailed with an explanation in the resolution of the dispute, ensuring that the consumer receives clear information about why their expectations regarding the insurance were not met.