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GENERAL Information ON CLAIM MANAGEMENT

(For the accomplishment of article 10.º of the Regulatory Rule of ISP n.º 10/2009-R, of June 25, published in July 7)
 

A. CLAIMS ADRESSED TO EURO INSURANCES LIMITED

1. Reception point and answer to claims
Complaints Management
Insurance Unit
Euro Insurances Limited
Ground Floor
Leaseplan House
Central Park
Leopardstown
Dublin 18
Ireland

2. Form:
Communications made in writing, by e-mail, to the e-mail address ray.foley@euroinsurances.net, to the fax number + 353 1 680 4140, by letter addressed to the attention of the Department of Claim Management to the following address: Insurance Unit, Euro Insurances Limited, Ground Floor, Leaseplan House, Central Park, Leopardstown, Dublin 18, Ireland.

3. Contents:

3.1. The claims must have the following elements:
a) Full name of the claimant, and, when this is a legal person, of its representative and the quality in which it acts;
b) Reference to the quality of the claimant (policy holder, insured person, beneficiary or injured third party);
c) Contact elements of the claimant and, if necessary, of its representative;
d) Indication of the identification document of the claimant and respective number;
e) Description of the facts that motivated the claim, with identification, whenever this is possible, of the intervenient and the date in which the facts have occurred;
f) Date and place of the claim;
g) Number of the policy (if applicable).

3.2 The claims presented will be immediately refused when:
a) They omit essential data that turn it impossible to proceed with its management and that are not corrected by the claimant after Euro Insurances Limited has invited him to do so;
b) If the claim is of the exclusive competence of the arbitral or judicial bodies or when the matter object of the claim has already been solved by such bodies;
c) They repeat claims that have already been filed by the same claimant with respect to the same matter and have already been answered by Euro Insurances Limited;
d) The claim was not filed in good faith or its content is qualified as offensive.

4. Evaluation of the claim by Euro Insurances Limited

4.1. When the filed claim does not include the necessary elements for its management, notably because it does not identify the motive of the claim, Euro Insurances Limited shall communicate such fact to the claimant, inviting him to correct such omission.

4.2. When Euro Insurances Limited knows that the matter object of a claim is pending before arbitral or judicial bodies, it shall refrain from continuing the process of management of the claim and will communicate such fact to the claimant.

5. Costs
The filing of claims before Euro Insurances Limited may not imply any costs or charges to the claimant, as well as any other duties that are not effectively indispensable for the accomplishment of such function.

6. Contacts for the presentation and follow-up of the claims
Letter to:
DEPARTAMENT OF CLAIM MANAGEMENT
Insurance Unit
EURO INSURANCES LIMITED
Ground Floor
Leaseplan House
Central Park
Leopardstown
Dublin 18
Ireland
E-mail to: ray.foley@euroinsurances.net
Fax to:
DEPARTMENT OF CLAIM MANAGEMENT
EURO INSURANCES LIMITED
Fax n.º + 353 1 680 4140

7. Deadlines to be observed

7.1. Maximum duration, from the reception of the complete claim, until the expedition of the answer to the claimant – 20 days

7.2. When the matter object of the claim is complex or when its answer depends from third parties, the indicated duration may be increased, and the claimant shall be informed of such increase and of its fundaments.

B. claIms ADDRESSED TO THE OMBUDSMAN

1. Claims that may be addressed to the Ombudsman

1.1. Only claims that have already been evaluated by Euro Insurances Limited Claim Department may be addressed to the Ombudsman.

1.2. Electable for presentation to the Ombudsman are the claims previously presented to Euro Insurances Limited which no reply was given in the maximum term of 20 days (or in the term defined considering its complexity or of the necessity to obtain information from third parties, and duly communicated to the claimant), or that having been replied to, the claimant disagrees with the decision.

2. Name and contacts of the service to which they shall be addressed to:

CIMPAS - Centro de Informação, Mediação, Provedoria e Arbitragem de Seguros
Address: Av. Duque Loulé, 72 – 7º Piso, 1050-091 Lisbon
Email: provedoria@cimpas.pt
Telephone for information: (+351) 213 827 700
More information in www.cimpas.pt

3. Minimum requirements of the claim
Those set forth in n.º 3.1. A above.

4. Grounds for the non admission of the claim
Those set forth in nr. 3.2. A above.

5. Deadline for answer
The claim shall have a written answer within a maximum deadline of 30 days (the maximum term of the answer is 45 days in cases with special complexity).

6. Costs
The presentation of claims before the Ombudsman does not imply any costs or charges for the claimant, as well as any other duties that are not effectively indispensable for the accomplishment of such function.

7. Evaluation of claims by the Ombudsman

7.1 The evaluation of claims by the Ombudsman does not prejudice the right to resource to the courts or mechanisms of extrajudicial resolution of conflicts, including those related to cross border litigation.

7.2 When the Ombudsman knows that the matter object of a claim is pending before arbitral or judicial bodies, he may refrain from continuing its evaluation.

7.3 The Ombudsman communicates to the claimant, in writing or in another mean that is registered in a hardcopy, the results of the evaluation of the claim and the respective grounds, including, should it be the case, the recommendations it decides to make.

7.4 The Ombudsman informs the claimant in cause, in writing in another mean that is registered in a hardcopy, of the non acceptance by the insurance company of the recommendation he has made.
 

C. OtHER ENTITIES TO WHOM CLAIMS MAY BE ADDRESSED

Instituto de Seguros de Portugal – Avenida da República, 76 - 1600-205 Lisbon