How do I file an insurance claim?
In the event of loss or damage, contact your insurance company as soon as possible. If necessary, the insurance company will provide information on the content of the insurance policy and explain how to file an insurance claim.
For the same event, you may be able to file a claim under several insurance policies, in which case the insurance company will clarify with you the options and the related procedures. The aim is for you to receive all the compensation and benefits to which you are entitled under the law and the insurance contract, even if you do not know to file a claim for them. The insurance company must also inform you about the time limit for filing a claim and the significance of this.
Who inspects the damage or loss?
The insurance company may use partners to assist in assessing the damage or loss and settling the claim. In the case of vehicle damage, for example, a damaged vehicle may be inspected by the insurance company’s loss assessor or it can be inspected and repaired by a repair shop designated by the insurance company. Correspondingly, in the case of water damage, the moisture survey needed for assessing the damage may be carried out by an external company specified by the insurance company.
When inspecting the damage, the loss assessor will ascertain the nature of the damage and assess the monetary loss. An inspection of the damage is not, however, a promise that the damage will be compensated by the insurance; the insurance company always makes a separate decision claim decision on the damage.
Does the insurance company have to justify a claim decision?
Good insurance practice requires that the insurance company justifies its claim decisions.
The scope of justification depends on the nature and content of the case. The company must justify a decision with special care when the decision is negative or when it deviates from the filed insurance claim. In a negative decision, the company should explain at least the details of the events affecting the case, the applicable parts of the insurance terms and conditions or legal provisions, the connection between the events and the applicable parts of contractual terms or legal provisions, and the final decision.
How soon should the insurance company settle an insurance claim?
The insurance company must pay insurance compensation or benefits without delay and generally no later than one month from receipt of information necessary for making the payment. If the amount of compensation is not clear, the insurance company will pay the undisputed part of the compensation and at the same time notify you that acceptance of the undisputed part does not affect your right to possible additional compensation.
If the processing of the claims is delayed, the insurance company must inform you of the delay and the reasons for this. The company will pay penalty interest on delayed compensation or benefits on its own initiative and in accordance with the law and the terms and conditions of insurance.
What should I do if the claim decision does not match my expectations?
Firstly, you should clarify with the insurance company the grounds for the claim decision. If contacting the insurance company does not bring the desired result, you can contact the Finnish Financial Ombudsman Bureau (FINE), which provides advisory services and, if necessary, investigates problem situations with insurers on customers’ behalf.
If necessary, the case may be directed to the Insurance Complaints Board, the Investment Complaints Board or the Consumer Disputes Board, which issue recommendations for the resolution of insurance cases. Ultimately, disputes concerning claim decisions may be resolved in a general court of law.