Source: https://www.fgaromania.ro/en/steps-to-be-taken-for-the-opening-of-the-claim-file-by-the-policyholder-guarantee-fund/
Timestamp: 2020-08-08 11:39:14
Document Index: 137881552

Matched Legal Cases: ['art. 12', 'art. 12', 'art. 12', 'art. 14', 'art. 14', 'art. 16', 'art. 14', 'art. 17', 'art. 13']

Steps to be taken for the opening of the claim file by the Policyholder Guarantee Fund | FGA Romania | Fondul de Garantare a Asiguraților
1. In which cases can the request for opening a claim file be filled?
The request for opening a claim file may be filled in the situation when an insured event covered by a valid insurance policy occurred in the period of time between the publishing date of the decision to close the financial recovery proceedings and the date for denouncement of the contracts, but no later than 90 days from the date the decision to commence the bankruptcy proceedings was pronounced.
2. When can the request for opening a claim file be submitted?
The request for opening a claim file may be submitted in the period of time between the date of publishing the decision to close the financial recovery proceedings and the date for denouncement of contracts, but no later than 90 days from the decision to open the bankruptcy proceedings was pronounced (in compliance with art. 12 para. (1) of Law no. 213/2015)
3. Who can fill the request for opening a claim file?
Any person invoking a claim right against the insurer as a result of the occurrence of risks covered by a valid insurance policy may request the opening of a claim file. (in compliance with art. 12 para. (1) of Law no. 213/2015)
4. How to request the opening of the claim file?
Opening a claim file is done by filling in the Request for opening a claim file provided by Annex no. 7 of Norm no. 24/2019 on Policyholders Guarantee Fund and submitting the Request to the Fund (pursuant to art. 12 of Law no. 213/2015 corroborated with art. 14 of Norm no. 24/2019)
5. How can the request be sent to the Fund?
The request shall be addressed to the Fund and may be submitted directly at the headquarter of the Fund, or sent through postal services, with confirmation receipt, through electronic mail or through other communication means that ensure the transmission of the text and the confirmation of receipt. (pursuant to art. 14 para. (2) of Law no. 213/2015.
6. What are the steps for opening the claim file by the Policyholders Guarantee Fund? (art. 16 of Norm no. 24/2019)
a). following the registration of the Request provided by art. 14, the Fund, either directly or through its agents, contacts the claimant for the purpose of carrying out the ascertainment of damages and valuation of losses;
b). the petitioner shall declare the occurrence of the insured event in writing, by filling in the affidavit concerning the event set out in Annex no. 8;
c). the written statement for the ascertainment of damages is drafted by the specialists of the Fund or by the Fund’s agents, in cases where there are cooperation agreements or conventions, pursuant of the legal provisions in force with respect to mandatory insurance, or pursuant of the insurance conditions relevant to the insurance contract with respect to optional insurance;
d). the ascertainment of losses is done on the basis of documents attesting the occurrence of the insured event, issued by competent public authorities, such as police, firefighting units or by other competent authorities, as well as on the basis of other documents that provide for the causes and circumstances of the event, pursuant to the law;
e). the Fund or its agents shall require the claimant to submit to the claim file the insurance policy/insurance contract, the documents provided by point d)., the documents providing for the extent of the loss, documents providing the material interest, documents justifying the extent of the compensation as well as other documents relevant for the analysis of the claim file;
f). the documents and acts shall be filed in the Romanian language, and if drawn up in a foreign language, they shall be filed together with their certified translation as provided by law;
g). the written statement for the ascertainment of damages shall be handed to the claimant and is to be submitted to the claim file;
h). at the request of the claimant or of the repair shop, the Fund or its agents shall carry out additional ascertainment of the damages which were not possible to identify upon the initial ascertainment;
7. How is compensation established, following the opening of the claim file and the analysis of the annexed documentation? (art. 17 of Norm no. 24/2019)
a). compensation shall be assessed by the Fund, either directly or through its agents, on the basis of the documents provided for the claim file and in accordance with law provisions and insurance conditions;
b). if the analysis of the claim file reveals that additional documents must be submitted, the Fund shall send a written request to the claimant in this respect;
c). after analyzing and examining the claim file, the specialized technical directorate shall prepare a compensation report, which shall be analyzed by the other specialized directorates of the Fund for endorsement, in accordance with the legal provisions;
d). after endorsement by the specialized directorates of the Fund, the claim file shall be forwarded to the special commission assembled in accordance with art. 13 para. (4) of Law no. 213/2015.