The holder of an insurance policy (or the insured) is not always satisfied with the insurance company’s compensation decision. This is particularly understandable if the insurance company refuses to pay for certain damage, if the compensation amount is viewed as being too low, if the decision is based on an insufficient or incorrect investigation or the decision does not contain sufficient reasons.
It is always recommendable to first try to discuss with a representative of the insurance company, who may then revise the decision. If this does not help the remaining alternatives are to appeal the decision officially or to request a statement; however, these alternatives do not exclude each other and one may both file an appeal and request a statement. The insurance decision shall always be accompanied by clear instructions on how to submit a claim for correction.
Officially appealing a compensation decision refers to submitting the matter to court for judicial resolution For example, a disagreement on a compensation decision regarding a voluntary insurance policy or the compulsory motor liability insurance, or another issue related to the content of an insurance policy, may be submitted to a Finnish District Court for review. There is, however, usually a financial risk connected to court proceedings.
Besides the court proceedings the holder of the insurance policy may request a non-binding statement regarding the compensation decision from different boards that operate in the insurance business field. The statements of the boards are not legally binding, but in practice the insurance companies follow them well. Requesting a statement in Finland is free of charge and thus it is always recommendable to request a statement if one is even slightly unsatisfied with the compensation decision.
For example, the Insurance Complaints Board (Finnish: Vakuutuslautakunta) issues statements of recommendation on compensation decisions, which are based on voluntary insurances; it may, for example, be a compensation decision based on a home-, travel-, accident-, or car insurance. If the insured has purchased the insurance as a consumer, he or she may request a statement from the Consumer Disputes Board (Finnish: Kuluttajariitalautakunta). As regards compensations for traffic accidents, it is possible to request a statement from The Traffic Accident Board (Finnish: Liikennevahinkolautakunta).
If the insured has a home insurance, a so-called legal expenses insurance is usually included in the policy. Thus, if the insured wishes that lawyer represents him or her in the matter, it is possible that the legal expenses insurance covers the legal fees – with the exception of the deductible amount – that arise from drawing up the request for a statement.
Please do not hesitate to contact us should you have any questions regarding this topic. We are happy to answer your questions regarding appeals and we are of course willing to assist in drawing up statement requests. We always review on behalf of our clients whether their legal expenses insurance is applicable in the matter.