What is an insurance ombudsman

In the event of a dispute: the ombudsman as the middle ground between surrender and complaint

What is the ombudsman procedure?

It happens again and again that a customer and his bank, insurance company, building society or other institute have different opinions on a certain matter.

Points of contention are, for example, a fee billed, an insurance benefit not granted or the amount of bonus interest in a building society loan agreement. Before consumers think about enforcing their interests through the legal process, it can be worthwhile to call in an ombudsman. This is possible without representation by a lawyer.

Of course, you can still get advice from a specialized lawyer in advance! This can be particularly useful when it comes to the question of whether and under what conditions the ombudsman procedure has the effect of preventing the statute of limitations. You should point out to the lawyer that you initially only want an appointment and no representation.

Ombudsmen, who exist in many different industries, have the role of mediator. You take action based on a complaint submitted by the consumer, obtain an opinion from the other party and finally make a mediation proposal. This is only binding for the respective institute in a few cases and is never binding for the consumer.

What are the advantages of an ombudsman procedure?

Engaging an ombudsman has several advantages for consumers:

  • He does not incur any costs as the arbitration board is financed by the institutes. Your own costs, such as postage for submitting documents, are excluded. If the arbitrator's verdict is unsatisfactory, legal recourse is still open to the customer. The same applies if the institute rejects the ombudsman's arbitration ruling.
  • Using the ombudsman usually leads to a so-called suspension of the statute of limitations. This means that the claim cannot expire for the duration of the arbitration procedure. Such a limitation-inhibiting effect also has a (more expensive) court procedure. If you initiate the procedure to suspend the statute of limitations, you must first make sure that the suspension can actually occur! Also clarify the date up to which the statute of limitations is suspended in your specific case.

How does an ombudsman procedure work?

It can make perfect sense to contact the respective institute first and clarify your matter directly with them. It is possible that your demands will be met without further discussion. The following illustration gives a rough overview of the course of an ombudsman procedure. The internet portals of the respective arbitration board provide more detailed information, in particular the rules of procedure, which are often available there as a PDF file.

First, find out the ombudsman responsible for your institute. You can usually find the contact details in your contract documents.

Submit your complaint and copies of the relevant documents. In your letter, they should explain the facts and what they want to achieve with your complaint (e.g. reimbursement of a fee). Ombudsmen often keep complaint forms ready on their websites.

First of all, it will be checked whether your complaint is admissible at all. If necessary, you will have the opportunity to submit further documents.

The institute then receives a statement. It can then remedy the complaint. This means that the bank itself is already convinced that your complaint is justified and that it fulfills your claim.

Otherwise, you will usually receive the statement and can comment on it. The ombudsman then makes a decision.

If you do not agree with the arbitration ruling of the ombudsman, you can still go to the courts. The bank, on the other hand, is bound by the arbitrator's verdict - at least if the amount in dispute does not exceed certain amounts.

When is an ombudsman procedure not possible?

The ombudsman does not act in all cases. So the arbitration procedure cannot be used if, for example

  • Customer and institute have agreed
  • the legal process has been taken - i.e. a lawsuit has been brought before the court,
  • another arbitration board has already been engaged,
  • certain amounts in dispute are exceeded,
  • the customer only wants legal advice / legal information or
  • a possible claim has already expired and the institute invokes the statute of limitations.

On what basis does the ombudsman make decisions?

The arbitration boards only decide on the basis of the documents submitted and the descriptions of the facts by those involved. Witnesses, such as employees of the institute, are not heard.

Where can I find the contact details of the responsible ombudsman?

Different ombudsmen are responsible depending on which institute the customer is arguing with. As a rule, it helps to take a look at the contract documents. The responsible ombudsman and the required contact details are often noted here. Corresponding information can also be found on the websites of most institutes under the term "Ombudsman" or "Arbitration". If in doubt, ask your institute which ombudsman is responsible.

Internet research or direct research at an arbitration board also leads to the goal. These often offer a list of the institutes for which they are responsible on their websites. In addition, you can often find the contact details of other arbitration boards there.