The mediator of insurance, responsible for settling disputes amicably, received nearly 15,000 requests in 2016. The problems mainly concerned auto insurance, home and insurance borrower.
Individuals are turning more and more to the insurance mediator to amicably settle disputes with their insurers. Which avoids going to court. This trend increased significantly in 2016: mediation requests jumped by 53% (14,803 requests) compared to 2015, according to the annual report of the Insurance Mediation . This unique mediation service of the insurance sector was set up in September 2015. The sharp rise in mediation requests “stems from increased information from insureds, from insurers in contractual documents and letters, and through better visibility of Insurance Mediation “, justify the authors of the report.
Requests are often linked to a refusal of compensation (31%) “or a poor follow-up, real or felt, the claim by the insurer,” says the report. They are also frequently linked to a request for termination of contract not obtained (15%).
As is very often the case, it is home and especially automobile insurance that has by far posed the most problems (56% of disputes). “In cars (37%), the majority of the disputes were about the assessment of liabilities and damages,” says the study. “The disputes relating to the housing contracts concern essentially the extent of the guarantees”.
In life and health insurance (44% of litigation), life insurance was one of the main sources of dispute (23%)! The insurance mediator suggests to the subscribers to pay close attention to the drafting of the beneficiary clause, in particular in order to prevent the contract from falling into “escheat” after their death. Because they have not been able to identify the beneficiaries, the savings will not be paid.
Beware of the guarantees of the borrower insurer
Borrower insurance (linked to consumer and real estate loans) also poses a lot of problems (24% of claims). These contracts include an age limit. When it is reached, the borrower is no longer covered by the guarantees. But, the amount of his contribution does not decrease for all that. “Which raises a misunderstanding among the insured. However, according to the principle of risk pooling and because of the calculation of the contribution from the outset taking into account this cessation, it is not possible to reduce the amount, “says the mediator. This clause is not always clear in the contracts. The health insurance are also often challenged (19%), “it clearly reflects the economic situation,” says the report of the mediation.
In 99% of cases, insurers follow the opinion of the mediator
Of the 56% of referrals last year, the majority of cases were resolved with the help of mediation and prior to the formalization of an opinion. “On average, 28% of the formalized opinions have given reason to the insured”. And in 99% of the cases, the insurance companies followed the advice.
To avoid litigation, the mediator summed the insurers to an “effective questioning” of the insured to oppose a possible misrepresentation, more pedagogy on the consequences of driving while intoxicated or a reminder of the terms of termination.