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Article (110)

FED LAW 6/2007 Effective from 15/2/2007

1. The insurance company shall manage insurance claims in accordance with the legislation in force and the provisions of the insurance policies, pursuant to the following procedures:

(a) Issuing a decision concerning any insurance claim in accordance with the instructions of professionals rules and code of conduct and ethics.

(b) In case any insurance claim is fully or partially denied, the Company must clarify the reasons for its decision in writing.

(c) In case of a dispute in relation to a claim, the concerned person may submit a written complaint to the Authority, which in turn may request clarification from the Company.

(d) In case the complainant has objection on the clarifications provided by the company, he may request that the dispute be referred to the Committee established pursuant to article No. (110).

2. One or more committees that will be concerned with resolving the disputes arising out of insurance contracts, operations and services shall be formed. The committee (s) shall have the competency to request any official papers or documents and to counsel experts, as well as hearing of witnesses and any other alternatives that need to be used to resolve the disputes before them.

3. Cases resulting from the disputes arising out of insurance contracts, operations and services shall not be accepted, if such disputes are not brought before the committees established in accordance with the provisions of paragraph No. (2) of the article herein.

4.The concerned party shall have the right to appeal against the decisions of the committees before the competent first instance court within thirty days of the day following their notification of the decision, otherwise the decision shall be deemed final and enforceable.

5. The Board shall issue the necessary decisions concerning the composition of the committees established in accordance with the provisions of paragraph No. (2) of the article herein, their competencies, powers, their work system, fees of its members and hired experts, types and classes of insurance for which insurance disputes are resolved before these committees, and other related matters.

 

This article has been amended by Federal Law No. (03) of 2018. You are on the latest version. To view the previous version, click the version box below.
Version 1(effective from 15/02/2007 to 26/04/2018)

 

The company shall make clarifications about the complaints received by the authority from the policyholders, the beneficiaries thereof and others pertaining to the insurance operations conducted by the company inside the State.