The Rulebook on Insurance Ombudsman in the Republic of Srpska entered into force on January 21, 2018.
The Insurance Ombudsman is established at the Insurance Agency of the Republic of Srpska, and main function of the same is to enable the out-of-court settlement of disputes and disagreements arising from and related to the insurance contract. The Insurance Ombudsman works independently and does not act as a representative of the Insurance Agency.
The procedure before the Insurance Ombudsman shall be initiated by submitting an objection by an eligible applicant, and the same shall also be considered as a request for mediation in order to achieve out-of-court settlement with the insurance company. The objection shall be submitted on the form published at the Agency’s website.
The eligible applicant in terms of this Rulebook understands an individual, in particular, the insurance contractor, the insurer, the beneficiary of the insurance contract and the damaged party based on the insurance from civil liability.
The requirements for initiating proceedings before the Ombudsman are that prior to addressing the Ombudsman an objection against the decision on claims for compensation was submitted to the insurance company, then that no court proceedings were initiated in the case, and that no more than a year had elapsed since the event or receipt of the insurance company’s decision on claims for compensation.
After considering a complaint filed by an eligible applicant, the Ombudsman makes a written recommendation if he/she determines that the insurance company has violated the Code of Conduct, Standards or good practice in the insurance or makes a proposal for mediation if it finds that the Code of Conduct, Standards and good practice were not violated and assesses that there is a reasonable possibility the dispute can be resolved by mediation.
If the insurance company accepts mediation, then the same enters the mediation procedure to resolve the dispute, where a written out-of-court settlement agreement has to be made, of course, with the consent of involved parties.
The Ombudsman’s decisions as well as other legal documents cannot be appealed and used in the evidentiary proceedings before a court or other procedure in connection with the subject of the dispute.
Author: Natasa Skrbic