ERGO Insurance SE warned for violations of the procedure for payment of the insurance benefit
The Board of the Bank of Lithuania has issued a warning to ERGO Insurance SE, operating in the Republic of Lithuania through a branch, for failing to pay the insurance benefit within the terms indicated in legal acts and for the unduly discharge of or failure to discharge the obligation set forth in legal acts to provide to policyholders detailed information in writing about the progress of the investigation of the insured event. Such an enforcement measure was imposed taking into consideration the fact that the insurer, on its own initiative, took action to ensure that the violations ascertained during the investigation would not be repeated in the future, i.e. drew up a plan for the implementation of measures to improve the quality of the insured event investigation process.
The Supervision Service of the Bank of Lithuania has carried out an investigation and identified that in administering insured events the insurer was not duly following the procedure for payment of the insurance benefit established in Article 98 of the Republic of Lithuania Law on Insurance.
According to the established procedure, the insurance benefit must be paid within 30 days from the date when the insurer receives all the information important for establishing the fact, circumstances and consequences of the insured event and determining the amount of the insurance benefit. Where the insurer fails to pay the insurance benefit within 30 days from the date of the notice of the insured event due to the fact that the investigation is not finished, each 30 days during the period of investigation the insurer must provide to the policyholder (beneficiary or injured third party) detailed information in writing about the progress of the investigation of the insured event, with the exception of the cases when the documents or information are missing only from the policyholder (beneficiary or injured third party) and the policyholder (beneficiary or injured third party) has already been informed about the documents or information that this person has to submit for the investigation of the insured event.
ERGO Insurance SE Lithuania branch has been requested to submit to the Bank of Lithuania information on the implementation of the plan for the implementation of measures to improve the quality of the insured event investigation process by 8 January 2018.