Section I. SUBJECT AND PURPOSE OF THE INTERNAL RULES
- These Internal Rules aim to regulate the procedure for submitting Complaints and Reports by Insurance Service Users in writing, on paper or electronically, as well as the procedures for their consideration and resolution.
- The purpose of the Internal Rules is to create guarantees that all Complaints and Reports of insurance users will be considered in an objective and impartial manner and will be answered within the deadline, and that measures will be taken based on the analysis of the received Complaints and Reports to eliminate omissions and errors by the Broker's employees in the implementation of insurance mediation activities.
Section II. DEFINITIONS
- For the purposes of these Internal Rules:
3.1. BROKER is Insurance Broker "VIGOROUS" EOOD, registered in the Commercial Register at the Registry Agency in 2006 under UIC 175132629. The registered office of the company is: - Sofia, 26 Elemag Str., Bldg. A, floor 3, apt. 7, and Offices: Sofia, 39A Nikola Gabrovski Str., Bldg. B, floor 1, apt. 1.; - Kazichane village, Sofia district / 39 Tsar Boris III N Str., ground floor. The company is managed and represented by the manager – Yordan Iliev Yordanov and is registered in the register of insurance brokers at the Financial Supervision Commission on the basis of Art. 30, para. 1, item 11 of the FSC Act, Decision No. 810-ZB/08.10.2009 and Certificate 194-ZB/10.11.2009 and carries out insurance mediation within the meaning of Art. 301 - 312 of the Insurance Code.
3.2. "Broker's Employees" are the employees of the Insurance Broker who: offer or provide insurance mediation services directly to Clients (determine their requirements and needs, offer and/or provide them with information about insurance products, etc.); and/or directly or indirectly manage the aforementioned persons; are responsible for registering and administering the Complaints and Reports.
3.3. USER OF INSURANCE SERVICES is a policyholder, insured, third party beneficiary, third party injured party, other persons for whom rights have arisen under an insurance contract, as well as a natural or legal person who shows interest in using the services for distribution of insurance products provided by an insurer or an insurance intermediary in connection with its activity, regardless of whether he/she is a consumer within the meaning of the Consumer Protection Act.
3.4. "Complaint" or "Report" is a clearly expressed written, on paper or electronically, dissatisfaction of a User of insurance services, in connection with the insurance and/or reinsurance mediation carried out by the Broker, as well as the manner of service.
Section III. SUBMISSION OF A COMPLAINT OR REPORT
- The persons who can submit a Complaint and a Report are:
4.1. User of insurance services
4.2. A person authorized by the user of insurance services with a notarized power of attorney. The power of attorney is attached to the Complaint and the Report submitted through a proxy.
- Form and requirements that the Complaint and the Report must meet
5.1. The Complaint and the Report should be submitted in writing, as follows: - on paper at the address of activity and correspondence of the Broker - Sofia, N. Gabrovski Str. 39 A, Bldg. B", floor 1, apt. 1 - in electronic form to the email address: vigorous.ins@gmail.com
5.2. The Complaint and the Report should contain at least the following information:
- a) identification data of the User of insurance services: name, middle name and surname, personal identification number, respectively name of the company, UIC; exact address for correspondence, contact telephone number, contact email address, and in case of authorization: name, middle name and surname of the authorized person;
- b) subject of the Complaint and the Report - the circumstances of the case should be stated and copies of all available evidence should be presented;
- c) a clear statement of what the complaint and/or request consists of;
- d) date of submission and signature of the User of insurance services, or of the person authorized by him/her.
5.3. The Complaint and the Report should be submitted without undue delay, after the occurrence or knowledge of the case related to them.
5.4. In case the Complaint and the Report are submitted electronically, they are signed. The Complaint and the Report can be signed with an electronic signature or submitted in scanned form to the Broker's email.
5.5. Anonymous Complaints and Reports are not considered.
Section IV. ACCEPTANCE, CONSIDERATION AND PREPARATION OF A RESPONSE TO A COMPLAINT OR REPORT
- Acceptance of a Complaint and Report
6.1. The Broker is obliged, without undue delay, to review the received Complaint and Report regarding the form and requirements specified in item 5.1. and item 5.2.
6.2. When the complaint relates to non-fulfillment of obligations, or to weaknesses in the activity of another distributor of insurance products, for whom the Broker is not responsible, he/she forwards the complaint to the distributor to whom it relates. When the complaint does not identify the distributor, the Broker is obliged to specify this in the written information to the user of insurance services and return it to him/her.
6.3. If the Broker finds that the Complaint and the Report do not meet the requirements specified in item 5.1. and/or item 5.2 and that they are not sufficiently clear and understandable, he/she sends a written invitation to the User of insurance services with instructions to supplement and/or correct the Complaint and the Report within 14 days of receiving the invitation. In the invitation, the Broker indicates that if the specified 14-day period is not observed, the Complaint or the Report will be rejected.
6.4. If the submitter of the Complaint and the Report does not respond in writing and does not provide or supplement the necessary information according to item 5.1. and/or item 5.2., the Broker rejects the Complaint and the Report and informs the User in writing, stating the reasons why the Complaint or the Report are rejected.
6.5. If the Broker does not find any violated requirements regarding the Complaint or the Report, specified in item 5.1. and item 5.2., or the inconsistencies are resolved according to the procedure of item 6.3., he/she proceeds to consider them.
- Consideration and preparation of a response to a Complaint and Report
7.1. When preparing a response to a submitted Complaint and Report, the Broker is guided by the following main guidelines: * a) comprehensive clarification of all facts and circumstances related to the subject of the Complaint and the Report; * b) preparation of a written response in clear, understandable and accurate language; * c) proposal for a possible solution to the problem, if possible; * d) written response to each Complaint and Report submitted to the Broker. * e) responding to each Complaint and Report within a short period, which in all cases is no longer than 10 days from their receipt;
7.2. A response to a submitted Complaint and Report is prepared after a thorough and impartial investigation of the facts of the case and consideration of the explanations and objections of the interested parties, and the Broker: * a) fully accepts the submitted Complaint and Report by offering the User a possible solution to the problem, if such is available; * b) partially accepts the submitted Complaint and Report, stating the reasons why they are not fully accepted; * c) rejects the submitted Complaint and Report in full, stating the reasons why they are rejected; * d) informs the User that he/she is not competent to rule on the submitted Complaint and Report, informing the same to whom he/she can turn.
7.3. When making a decision that does not fully or partially satisfy the claimant's request, the Broker informs him/her of his/her rights to contact the Financial Supervision Commission, to refer to a body for out-of-court dispute resolution, to file a claim with a competent court, and to file a claim with the insurer under the mandatory insurance "Professional Liability", if he/she believes that he/she has suffered damages.
7.4. The response to the complaint or report is sent within 10 (ten) days of receipt.
7.5. When the Complaint and the Report are sent to the Broker through the Financial Supervision Commission, the Consumer Protection Commission, the Competition Protection Commission, the Personal Data Protection Commission, the Ombudsman or another state institution, the deadlines for response specified in the relevant law and set as a requirement in the letter addressed to the Broker also apply and are observed.
7.6. The response to the User of insurance services is sent by registered mail with a return receipt to the contact address, or to the sender's email address, specified in the Complaint or the Report, as well as to the relevant institution under Art. 7.5.
7.7. All deadlines specified in these Rules are counted in calendar days. The day of receipt of the respective Complaint or Report is not counted. When the last day of the term is a non-business day, the term expires on the first subsequent business day. Written responses are deemed to have been made within the deadline if they are sent by mail, courier, or email before the twenty-fourth hour of the last day of the term.
SECTION V. COMPLAINTS MANAGEMENT FUNCTION
- The management of complaints is carried out by the sole manager of the Broker.
- The manager is obliged to ensure the fair and timely handling of complaints and the identification and limitation of possible conflicts of interest in the distribution of insurance products.
SECTION VI. REGISTER OF RECEIVED COMPLAINTS
10. A register of complaints is created, in which the following is entered:
10.1. unique serial number of submission
10.2. data about the complainant:
- names/company that are specified in the complaint;
- contact details (address, telephone, email address, etc.)
- subject of the complaint and a summary of the allegations and requests of the complainant.
10.3. available information regarding:
- insurance class;
- name of the insurance product;
- insurance policy number;
- date and outgoing number of the complaint response;
- summary content of the complaint response;
- information about the archiving of the complaint file.
- Information from the register of received complaints is provided to the FSC upon request.
- The manager creates and archives a file for each complaint, which is stored for the statute of limitations period in which claims can be filed in court, and when the complaint does not concern rights that are legally defensible, up to 5 years from the date of preparation of the response.
- The manager prepares an annual document in which an analysis of the received complaints is carried out and decisions are made when necessary.
- In case the User is not satisfied with the response to the submitted Complaint or Report and, according to him/her, the Broker has not offered a solution to the problem, he/she can file a complaint to the Deputy Chairman of the Financial Supervision Commission, managing the "Insurance Supervision" Directorate or to the Sectoral Conciliation Commission for Dispute Resolution in the field of insurance and insurance mediation (SCC) at the address Sofia 1000, Central Office of the Consumer Protection Commission, 4A Slaveykov Square, tel. +359 2 9330 588, website www.kzp.bg, email address: adr.ins@kzp.bg. The broker has the right to accept or refuse the consideration of the dispute by the SCC. The proceedings are free of charge for the parties and are conducted in absentia. The written conciliation proposal of the SCC for resolving the dispute is not binding, but must be approved by both parties to have the force of an agreement between them.
- The submission of a complaint is free of charge for the interested parties.
- These Internal Rules for the organization of the handling of complaints and reports from users of insurance services are adopted on the basis of Art. 290 para. 2 of the Insurance Code.
