ISA: The number of complaints resolved in favor of policyholders increased by 83%
The number of complaints filed by policyholders in the first nine months has doubled compared to the same period last year. During this period, based on complaints received from discontented policyholders, the ISA has imposed four measures on three Insurance Companies, two of which are fines
The Insurance Supervision Agency (ISA) has increased by 83 percent the number of complaints resolved in favor of discontented policyholders during the first nine months of this year, in comparison to the same period last year. By the end of September, 22 complaints were resolved in favor of policyholders who were dissatisfied with the insurance companies’ operation, and during the same period last year, 12 complaints were resolved in favor of policyholders.
As of the end of September this year, the ISA received 127 complaints from discontented policyholders. In comparison to the same period last year, when 62 complaints were filed, this year their number has doubled.
14 complaints are in the process of being resolved, and 76 complaints have been resolved in favor of the companies. 12 of the filed complaints were found to be unfounded, and three were withdrawn by the appellants.
Regarding the type of insurance, most complaints – 55 were filed for losses incurred in Auto Insurance (the most common class of insurance that is compulsory by law). 15 of them were resolved in favor of the discontented policyholders. There were 24 complaints filed for claims for losses covered by Casualty Insurance, two of which were resolved in favor of the policyholders. Out of 10 Property Insurance complaints, two were resolved in favor of the policyholders. Five complaints were filed for Health Insurance, and one for each of the following: Crops and Fruit Insurance, Travel Insurance, Kasko Insurance and Financial Loss Insurance. Four complaints were filed for other types of non-life insurance. 13 complaints were filed for Life Insurance, two of which were resolved in favor of the policyholders.
In 50 cases, the reason for the complaint had been the basis for loss payment. In 34 cases, the reason for the complaint had been the amount of compensation (the ISA does not decide on the amount, but considers the circumstances and arguments on the basis of which the compensation is determined).
There are seven complaints about the deadline for loss payment, and the same number complained about the loss processing. Three policyholders complained about the amount of recourse, and two about the response they received from the company to their complaint. 12 more complaints have been filed on other grounds.
Of the total number of filed complaints, 106 have been filed by citizens (natural persons), and 22 by legal entities.
A complaint is filed to the ISA if the policyholder is not satisfied with the response of the insurance company to the claim or if the policyholder has not received a response within 30 days. The ISA does not investigate anonymous complaints or cases for which court or other proceedings are being conducted.
The Insurance Supervision Agency (ISA) is an independent regulatory body that regulates the insurance market, supervises the operation of insurance entities, takes care of the protection of the rights of policyholders and contributes to financial education and inclusion of the population.
The fifth edition of Financial Literacy Days shall be held next week
The fifth edition of Financial Literacy Days shall be held next week, November 1-3, organized by the financial regulatory institutions in cooperation with their financial companies. To be more precise, the organizers of such event are the National Bank, the Ministry of Finance, the Securities Commission, the Agency for Supervision of Fully Funded Pension Insurance – MAPAS and the Insurance Supervision Agency and the private financial sector is also expected to become one of the organizers.
This year, due to the conditions imposed by Covid-19 pandemic, Financial Literacy Days shall be organized primarily as educational lectures via video conference which will allow large number of interested citizens to attend the event. All institutions participating in this year’s edition will inform the citizens via their websites and social network pages about the planned activities and e-events, also notifying about the registration method for every interested citizen.
The financial regulatory institutions ask the citizens to monitor the information about the planned activities and to be actively included in this year’s edition of Financial Literacy Days. The purpose of this action is to strengthen the financial education, encourage financial inclusion and raise the awareness and protection of the users of financial services.
In the course of the year, the financial regulatory institutions implemented most of the planned activities in the sphere of financial education and financial inclusion, while being adjusted to the conditions of the “new normal”. Additional strengthening of such activities is expected in the forthcoming period, considering the commenced implementation of the first National Strategy for Financial Education and Financial Inclusion, adopted in July this year by the financial regulators.
The number of paid damage increased by 15% i.e. EUR 31.5 million were collected by the insured.
In the first six months of this year the insurance companies paid the total of 35,163 damages for non-life insurance, whereby the insured collected EUR 31.5 million i.e. 20% more than last year. The private health insurance has the highest increase of paid damage i.e. by 68% compared to the same period last year.
In the first six months of this year the insured collected 35,163 damages from the insurance companies. That is 15% increased number of paid damages for non-life insurance compared to the same period last year. In the first six months of this year, 11 insurance companies for non-life insurance paid damages in the total amount of MKD 1.94 billion (EUR 31.5 million). The aforementioned shows an increase by 20% compared to the first six months in 2020, as presented in the official data of the Insurance Supervision Agency (ISA).
The highest increase of the number of paid damages in this period is recorded in the private health insurance – class with the highest increase during the health pandemic caused by the COVID 19 virus. In the period January – June this year, the total of 9,144 damages covered with insurance contracts were paid, i.e. there is an increase in the number of paid damages by 68% compared to the same period last year. In the first six months of this year, the insured collected the total of MKD 92.6 million (EUR 1.5 million) for private health insurance coverage.
With regards to property insurance, the highest class of voluntary insurance according to the value of investments in policies, the total of 4,022 damages were paid for six months. That is an increase by 3% compared to the same period last year. Based on such damages, the insured collected MKD 292.1 million (EUR 4.75 million).
With regards to the most used voluntary class – accident insurance, the total of 3,573 damage claims were paid, i.e. same as last year. The value paid by the insurance companies to the insured amounts in MKD 249.4 million (EUR 4.05 million).
Based on Casco insurance for motor vehicles, 3,661 damages were paid i.e. by 3% less compared to last year. The insurance companies paid MKD 224.1 million (EUR 3.6 million) to the insured for such damages.
As expected, the highest number of paid damages is for the legally mandatory car liability insurance. The total of 13,603 damages were paid with regards to the aforementioned, which is by 19% more compared to the same period in 2020. The value of the paid damages in this insurance class for this period amounts in MKD 875.9 million (EUR 14.24 million).
The Insurance Supervision Agency (ISA) is an independent regulatory body which regulates the insurance market, supervises the operation of the insurance entities, takes care of the protection of the rights of the insured and contributes to financial education and inclusion of the population.
ISA in cooperation with OECD: The insurance regulators via exchange of experiences to better financial literacy and protection of the insured
The exchange of experiences and good practices for the purpose of increased protection of the insured and continuous raising of the level of their financial education are the key topics discussed with the representatives of the insurance regulatory bodies from the SEE countries, the insurance industry and other included parties on the today’s session organized by the Macedonian Insurance Supervision Agency (ISA) and the Organization for Economic Cooperation and Development (OECD) with the support of the Ministry of Finance of The Kingdom of the Netherlands within the project for financial education.
Today’s online conference titled “Experiences and practices” organized in five sessions was attended by more than fifty participants from the country and SEE countries where experiences, results from the policy analyses, measures and tools used by the insurance regulators for protection of the insured were presented.
The effects from the activities for raising the level of financial education and inclusion of the population in the financial flows of the SEE countries were also discussed. At the event there was also a session about the effects imposed by the pandemic and the measures taken by the regulatory bodies for protection of the insured.
The protection of the rights of the consumers, together with the financial education and access to financial services is a basis for bigger financial inclusion. The protection of the consumers includes: securing accurate and timely information to the consumers for making decisions on the basis of information, non-existing, unfair and fraudulent practices in the contracts, as well as access to mechanisms for resolving violations of consumer rights.
The financial education and protection of consumers i.e. insured are activities prioritized by ISA and continuously taken within its competences for development of the insurance market and raising the awareness of the public about the insurance role. Furthermore, ISA pays special attention to encourage cooperation between the relevant institutions and cooperation with other instances by implementing educational programmes and activities for support and improvement of the financial literacy of the population. At international level, ISA actively participates in bilateral and multilateral projects for financial literacy and inclusion.
ISA in cooperation with other financial regulators: It is a strategic national document which identifies the goals of the regulatory bodies and recognizes the priorities for awarding and determining dynamics, measures and activities for raising the financial literacy of the population, their inclusion and protection of their rights deriving from using the spectrum of financial services, including insurance as well.
The highest amount for insurance of property of natural person is a family house insured in the amount of EUR 3.2 million.
The highest corporate policy issued in this country covers maximum damage up to the amount of EUR 1.26 billion. The maximum insured amount of Casco insurance of vehicles for covering damage is EUR 41 million and such insurance contract is concluded with enterprise for public transport of passengers. The policy with the highest insurance amount for payment of damage for private health insurance covers up to EUR 2.3 million for insurance of almost 800 employees.
The highest amount that can be disbursed for damage of insured property of natural person is MKD 198 million (EUR 3.2 million). The aforementioned insured property is a house – real estate owned by natural person. The official data from the Insurance Supervision Agency (ISA) for the first half of this year show that the insurance companies have over 128,000 active real estate insurance contracts concluded with natural persons.
The highest coverage of property damage in the corporate sector comes from a large company from the power sector. The maximum coverage under this insurance contract that the company may charge is MKD 77.65 billion (EUR 1.26 billion). The corporate sector has over 32,000 active property insurance contracts concluded by 30 June this year.
In accident insurance class, the maximum insured amount per active insurance contract that can be disbursed is MKD 4.26 billion (EUR 69.3 million). The aforementioned refers to collective insurance of over 8,500 employees. By the end of June there were 628,000 active insurance contracts concluded in this insurance class.
In private health insurance class the maximum insured amount per active insurance contract is MKD 142.9 million (EUR 2.3 million). This refers to collective insurance for serious illnesses of almost 800 employees in a public health institute. In this insurance class there were over 12,000 active insurance contracts concluded by the end of June, which provide private health insurance for over 38,000 persons.
The highest coverage for Casco insurance of motor vehicles is in the amount up to MKD 2.5 billion (EUR 41 million). The policy is concluded with a public transport enterprise. By the end of June there were 50.000 active insurance contracts for Casco insurance of motor vehicles concluded in this insurance class.
The most valuable cargo policy covers damage up to MKD 3.4 billion (EUR 5.6 million) for insurance of all parcels realized in the validity period of the insurance contract.
The policy with the maximum insured amount (prescribed by law) when it comes to mandatory car liability insurance covers damage up to MKD 93.4 million (EUR 1.5 million). The aforementioned policy is concluded by a company for transport of explosive materials insured against material and non-material damage. By 30 June there were over 611,000 active insurance contracts concluded in this insurance class.
The Insurance Supervision Agency (ISA) is an independent regulatory body which regulates the insurance market, supervises the operation of the insurance entities, takes care of the protection of the rights of the insured and contributes to financial education and inclusion of the population.
Citizens of life insurance collected 4.6 million EUR in six months
At the same time, citizens and companies (for their employees) invested 14.8 million EUR in life insurance policies, or higher by 9.6 percent than the same period in 2020.
Five insurance companies paid 281.3 million MKD (4.57 million EUR) for life insurance to their policyholders in the first six months of this year. Compared to the same period last year, the amounts paid (gross claims paid GCP), for life insurance collected by policyholders, increased by 42 percent or 1.36 million EUR, according to official data from the Insurance Supervision Agency (ISA).
Life insurance policies, depending on the terms of the contract, ie. policy, cover risks of death, disability, but can also often be a way of saving. In addition to the invested funds, the insured can also receive part of the yield (interest) of the invested funds.
The largest share in the total payment have life insurance policies where the insured receives part of the yield (interest) of the invested funds. On that basis, 245.9 million MKD (4 million EUR) were paid in the first half of the year.
It is noteworthy that in this period the companies paid 86.77 million MKD to insured persons who decided before the expiration of the agreed insurance period to withdraw their invested money (so-called “policy purchase”). Compared to the same period last year, this amount this year increased by 36 percent compared to the same period last year. In practice, purchasing policies can often happen if the insured gets better terms for investing in one of the competing life insurance companies.
In the rapidly growing life insurance products, the so-called “Unit Linked Insurance Plan”, when the insured accepts the risk of investing in shares of investment funds, tends to increase payments. For the first six months of this year, holders of such policies collected 10.46 million MKD (170,000 EUR), which is 91 higher than the same period in 2020.
In the first six months of this year, citizens and companies invested 908 million MKD (14.76 million EUR) or higher by 9.6 percent than the same period last year.
The Insurance Supervision Agency (ISA) is an independent regulatory body that regulates the insurance market, supervises the work of insurance entities, takes care of the protection of the rights of the insured and contributes to financial education and inclusion of the population.
Insurance Companies Have Paid 1.9mil. EUR in Hail and Ice Damages, 72% of the Value of All Agricultural Damage
Hail and ice are the most pronounced risks in agricultural insurance. During the first six months of this year, over 70% of the value of all paid damages in agriculture and livestock has been due to the consequences of these natural disasters. Since farmers acknowledge the hail and ice as the biggest dangers, they invest in insurance against these risks the most. For the first six months, the value of purchased policies that insure against hail and ice reached 5 million EUR or 26% more in comparison to the same period last year.
Farmers and stockbreeders have collected a total of 162 million MKD (2.63 million EUR) from damages covered by insurance policies for the first six months of this year. In the total amount of paid agricultural and livestock damages for destroyed crops, fruits and dead cattle, the payment of damages caused by hail and ice continuously dominates, according to the official data of the Insurance Supervision Agency (ISA).
The hail and ice are the biggest enemies of the farmers, they do the biggest damage
Damage caused by hail or ice has continuously the largest share in the amount of damages paid covered by agricultural insurance. For the first six months of these natural disasters, damages for destroyed crops and fruits have been paid, in a total value of 117.85 million MKD (1.9 million EUR). That is 72% of all paid damages in agriculture and livestock during this period. The statistics for the first half of the previous two years are similar. In 2020, farmers collected 99.5 million MKD (1.6 million EUR) or 74% for damages from hail and ice, and in 2019, 78 % of all paid damages in agriculture.
The total amount of damages collected by farmers from insurance companies for the first six months of this year is 162 million MKD (2.63 million EUR). In the same period last year, the amount of claims paid for agricultural insurance was lower by 22% and amounted to 132.4 million MKD (2.15 million EUR). In the first half of 2019, farmers collected 78.4 million MKD (1.27 million EUR) in damages.
What farmers usually insure
The total investments of farmers and stockbreeders in insurance for the first half of this year amount to 398.4 million MKD (6.5 million EUR). That is 20% more compared to the same period in 2020 when investments in crops, fruit and livestock insurance were 331 million MKD (5.38 million EUR). Continuity in the growth of investments is also recorded compared to 2019 when the value of agricultural insurance in the first half of the year amounted to 241.2 million MKD (3.92 million EUR).
The Insurance Supervision Agency (ISA) is an independent regulatory body that regulates the insurance market, supervises the work of insurance entities, takes care of the protection of the rights of the policy holders and contributes to financial education and inclusion of the population.
