Latest publications. Insurance Ombudsman: practice of resolving insurance disputes Insurance Ombudsman

11.05.2020

"Legal and legal work in insurance", 2009, N 4

The article analyzes the practice of using the institution of insurance ombudsmen and insurance arbitration courts in various countries of the world, provides a legal analysis of the concept and objectives of the activity, the organizational and legal form and prerequisites for the introduction of these institutions in Russia.

The need to develop institutions of insurance ombudsmen and insurance arbitration courts

To date, an insurance community system has been formed and operates in Russia, which includes hundreds of insurance and reinsurance companies, insurance brokers, thousands of agents, related organizations, and most importantly - millions of insured clients, which include both legal and individuals. Naturally, when participants in the insurance market interact, disagreements and conflicts often arise, often of the same type.

Since the activities of most insurance organizations are of a massive nature, being associated with insurance of the population, the financial instability of many of them, especially during a crisis, as well as other reasons cause a massive failure to fulfill or improper fulfillment of insurance obligations to clients and subsequently conflicts.

The structures to which clients of insurance companies turn with complaints and demands against insurers are Federal service insurance supervision, as well as the courts. Recently, the practice of filing complaints with such a self-regulatory organization as the Russian Union of Auto Insurers (under OSAGO contracts) has also emerged. Some clients, logically assuming that a suitable authority state control Rospotrebnadzor is responsible for the observance of the rights of policyholders; they do not achieve any results, since the Law of the Russian Federation of 02/07/1992 N 2300-1 “On the Protection of Consumer Rights” does not extend its action and jurisdiction of this body to the insurance market.

At the same time, the number of disputes is growing every year.

The number of complaints received from policyholders to the Federal Insurance Service of Russia in the first quarter of 2008 was 3,475, in the first quarter of 2009 - 6,769.

Compared to the first half of 2008, the number of insurance disputes considered by arbitration courts in the first half of 2009 increased by 400%<1>and amounted to 35 thousand.

<1>See: Selivanova M. Arbitration kicks out debts // RBC daily. 09.09.2009.

Number of collection claims insurance compensation, received by the courts general jurisdiction, for 12 months of 2008 amounted to 58,046, for the first half of 2009 - 49,128<2>.

<2>See: Summary statistical reports on the activities of courts of general jurisdiction for 12 months of 2008; summary statistical reports on the activities of courts of general jurisdiction for the first half of 2009

The situation is worsened by the fact that appeals from clients who have complaints against insurers have taken on a “fan” nature: a dissatisfied person simultaneously contacts several structures that are forced to simultaneously respond to the complaint.

This situation calls into question the effectiveness of resolving conflicts between insurers, on the one hand, and their counterparties, primarily clients, on the other hand. It is extremely difficult for the main market regulator - the Federal Tax Service of Russia - to resolve such conflicts for the following reasons:

The legally established competence of the Federal Tax Service of Russia does not include the function of resolving disputes. The opinion of the insurance supervisory body that examined the client’s complaint is advisory for the insurer, but not mandatory nature, which in the end result in most cases still leads to judicial consideration of the dispute;
There is a shortage of qualified employees in the staff of the insurance supervisory authority, with a growing flow of complaints that distract supervisory authority from work on issues of his competence.

As for the courts, the state judicial system causes significant criticism among members of the insurance community, the reasons for which are:

lack of knowledge among many judges on the specifics of the insurance business and insurance law(as a rule, judges of courts of general jurisdiction who do not specialize, unlike judges of arbitration courts, in disputes of a certain type);
the socio-psychological influence on the impartiality of judges when resolving insurance disputes is, as a rule, not in favor of insurers;
general problems of the judicial system (the “workload” of the courts, lack of time for a comprehensive analysis of the circumstances of the case, the evidence presented; the duration of the consideration of disputes and the legal costs of the parties to the disputes);
other reasons.

It should also be noted: the current practice of bringing disputes to the courts in the overwhelming majority of cases does not allow maintaining the relationship between the insurer and its client, leads to the loss of the client and creates a negative attitude among the general consumer mass towards representatives of the insurance business.

Thus, there is a need for a system that could allow:

outside the state judicial system, fairly, quickly and efficiently resolve disputes and disagreements between insurers and other participants in the insurance market, involving independent professionals in the field of insurance law with a high reputation;
when resolving a dispute, maintain relations between insurers and their counterparties;
form on insurance market unified approaches to problems in the relationship between insurers and their counterparties (prevent disagreements, develop a single reasonable methodology for resolving them, develop and effectively promote proposals for improving regulatory legal documents).

As world practice shows, such an opportunity exists, and it lies in the development of special structures - the institute of insurance ombudsmen and the institute of insurance arbitration courts.

In this case, it is necessary to initially establish the difference between the concepts of an insurance ombudsman and an insurance arbitration court.

The activities of these institutions have a common goal - resolving disputes between participants in the insurance market. However, these institutions also have differences, discussed below.

Concepts and goals of the activities of ombudsmen and arbitration courts The concept of an insurance ombudsman

To date, the institution of an insurance ombudsman does not exist in Russia. There is no such term in Russian legislation either.

In foreign legislation, as well as in legal and economic dictionaries, you can find several different definitions of the concept "insurance ombudsman"<1>, For example:

insurance commissioner<2>;
an independent individual in his activities who regulates relationships between insurance organizations licensed to carry out compulsory owner liability insurance vehicles, on issues of compulsory insurance of civil liability of vehicle owners<3>.

<1>Even in the vocabulary of the Russian language there is still no certainty - in some cases the word "ombudsman" is used (according to the Swedish pronunciation of the word "ombudsman" - "representative of the people" - based on the Swedish origin of this word and institution), in most cases - "ombudsman" (according to variation on English).
<2>http://mirslovarei.com/content_eco.
<3>Regulations on the activities of the insurance ombudsman for resolving issues regarding compulsory insurance civil liability of vehicle owners (approved by the Decision of the Council of Representatives dated 08/22/2007 N 1 and agreed with the Agency of the Republic of Kazakhstan for Regulation and Supervision of the Financial Market and Financial Organizations (Letter dated 08/23/2007 N 06-01-23/2383)) .

In some countries where ombudsmen work, the official lexicon uses the terms “conciliator” and “conciliation body” to refer to them.

Insurance arbitration court

This body is an arbitration court whose judges specialize in resolving disputes between participants in insurance legal relations. We will talk further about the activities of insurance arbitration courts in Russia.

Objectives of the insurance ombudsman

In foreign practice, the main task of the insurance ombudsman is quite clearly expressed as the protection of rights and legitimate interests clients of insurance companies. In addition to the concept of insurance ombudsmen, there are concepts of banking, pension and other financial ombudsmen, ombudsmen for information disputes in the media and others, but the commonality of all these concepts is that all these persons, called ombudsmen, are “authorized representatives for the protection of rights and interests a certain circle of people." At the same time, such a circle of people for the insurance ombudsman are initially clients of insurance companies (primarily individuals) who do not have the professional knowledge necessary to win a dispute, and from this point of view act as more weak side in a dispute. It should be noted that the ombudsman, of course, in a legal sense, does not act on the side of the policyholder as his representative and defender, but must impartially consider conflicts, guided by current legislation and professional knowledge.

Insurance arbitration court

In turn, the activities of the insurance arbitration court, like any other court, do not imply a focus on protecting the rights of clients of insurance companies. Established Russian practice shows that in the overwhelming majority of cases, opponents of insurance companies in disputes considered by insurance arbitration tribunals are either their counterparties - other professional subjects of the insurance business, or other organizations. Individuals practically do not participate in these disputes.

Thus, there is obviously a difference in the focus, as well as the “clientele” of the insurance ombudsman and the insurance arbitration court: for the first it is in most cases the population (policyholders are individuals), for the second - legal entities, often also being subjects of the insurance business.

Organizational and legal structure

An organization always acts as an arbitration tribunal, and in some cases legal entities act as an insurance ombudsman, and in others - individuals.

Examples of existing insurance ombudsman institutions are presented in Table 1.

Table 1

Insurance Ombudsman Institutions

Country	Organizational and legal form and basic principles of construction activities
1	2
Far abroad
England	The Financial Ombudsman Institute has been operating since 1981. financed by 200 insurers but headed by an official. Ombudsmen are specially authorized individuals persons who report to a special agency - Financial Ombudsman Service Limited. According to organizational and legal form the agency is a limited company liability (without shareholder participation). The list of ombudsmen is approved by the agency’s board of directors, whose members cannot be included in this list. In turn, for the appointment of members of the board of directors agency responsible financial regulator(FSA). At the same time the appointment of both the board of directors and ombudsmen is built on the principle of maintaining the independence of these individuals so that they made independent decisions<1>
New Zealand	Institute of Insurance and Savings Ombudsman (The ISO) was created in 1995 by insurance companies to solve disputes arising between insurance and savings companies, on the one hand, and their clients, on the other. This institute is not tied to the government and has no legislative regulation. Its members are financial organizations become voluntary, and its decisions are binding only for participants due to their consent to participate in ISO<2>
Sri Lanka	The insurance ombudsman service is based on a voluntary basis Association of Insurance Bodies of Sri Lanka with the consent of the body insurance supervision<3>
Poland	The Ombudsman is appointed by the Prime Minister. Financing made by transfer by insurance organizations contributions, the amount of which is a certain percentage of the gross amount of collected insurance payments. Main tasks specified in the statutory documents: consideration of claims policyholders to insurance organizations and taking measures to dispute resolution, consultation with the insurance authority supervision of identified violations by insurance companies companies, participation in the interests of consumers of insurance services in legislative process on insurance issues, initiation of information and educational processes, related to insurance, and participation in them
CIS countries
Kazakhstan	The insurance ombudsman is a specially authorized an individual who is elected by representatives of insurance companies companies that signed a special memorandum. Candidacy insurance ombudsman is coordinated with the insurance authority supervision. The creation of this institute in Kazakhstan was due to introduction of direct settlement of losses under compulsory motor liability insurance and pursued the goal of resolving disagreements between insurance companies companies of the victim and the tortfeasor
Ukraine	In Ukraine, the institution of the insurance ombudsman is still not created, although the first steps towards its creation are being taken participants in the insurance market for several years: in particular, in 2004, about 20 Ukrainian insurers announced willingness to finance this institute. As stated then Head of the League of Insurance Organizations of Ukraine A. Filonyuk, "the ombudsman will be a kind of association, established by insurance companies supporting it on the initial stage of formation. It is planned that the Ombudsman will have a separate legal address and independent account" <4>
Armenia	Since January 2009, a structure of financial ombudsmen has been in place, who provide support to clients of various financial organizations. The financial ombudsman institution has an independent advice - supreme body his management. The council consists of seven members who are appointed by unions of financial organizations, and also the government, the Central Bank and the rights protection regulator consumers. Among the functions of the council: appointment chairman, approval of statutory documents, approval budget of the ombudsman (including the procedure and amount of payment for work specialists), reviewing reports. Main cast The staff consists of six people - economists and lawyers. Just as in England, where there is a similar council, the principle of independence applies, which does not allow interfere with the professional activities of ombudsmen<5>. Financing is carried out through financial contributions organizations (participants of controlled markets) their mandatory share according to law
Azerbaijan	The creation of an insurance ombudsman is planned according to statement of the head of the State Agency for Insurance supervision under the Ministry of Finance of Azerbaijan N. Khalilova

<1>http://www.financial-ombudsman.org.uk/ (the official website of the English Financial Ombudsman Service); speech by the Chairman of the Bar Association "Vetta Legal" K.I. Saranchuk at the II practical conference "Insurance and Law". See: Insurance and Law. 2008. N 3.
<2>http://www.iombudsman.org.nz/ (official website of the New Zealand Insurance and Savings Ombudsman Service).
<3>http://www.insuranceombudsman.lk/ (official website of the Insurance Ombudsman Service of Sri Lanka).
<4>Ratnaya V. Insurance arbitrator // Galician contracts. 07/05/2004.
<5>Financial Ombudsman: first results (interview with P. Sargsyan) // Business Express (Express.am). 06/29/2009.

At the same time, based on the world experience described above, ombudsmen reviewing insurance disputes can be divided into:

on organizational and legal education:

specially authorized individuals;
government agency;
non-profit organization (with partial state participation in capital and (or) management or without such participation);

by specialization:

an insurance ombudsman with a narrow specialization in the consideration of disputes arising from insurance contracts of a certain type (insurance ombudsman for compulsory motor liability insurance in Kazakhstan);
an insurance ombudsman whose scope of work is not limited to a specific type of insurance;
financial ombudsman, which is not limited to insurance, but considers complaints against providers of various financial services(banking, insurance, leasing, etc.).

Principles, procedure and legal regulation of activities

The fundamental difference between the institution of insurance ombudsmen and the institution of insurance arbitration court is also the following:

The arbitration court is one of the elements of the judicial system. Arbitration proceedings are subject to the norms of civil procedural law and arbitration procedural law;
The insurance ombudsman is not an element of the judicial system: the consideration of a dispute by the insurance ombudsman should not be classified as a claim or pre-trial procedure settlement of the dispute, but to a special out-of-court procedure. In a number foreign countries the transfer of an insurance dispute to court is possible subject to its preliminary consideration by the insurance ombudsman, which did not lead to agreement between the parties to the dispute.

Let us consider the need for legal regulation of the activities of these institutions at the legislative level.

In international practice there are different levels legal regulation activities of insurance ombudsmen (Table 2).

Table 2

Legal regulation of the activities of insurance ombudsmen

Country	Level of legal regulation
Far abroad
England	Operating procedures of ombudsmen, including rules dispute resolution is broadly and in detail defined by the Law Financial Services and Financial Markets 2000 (FSMA 2000)
Sri Lanka	The activities of the insurance ombudsman service do not have special legislative reinforcement, but is regulated internal documents of this organization
CIS countries
Kazakhstan	The Law of the Republic of Kazakhstan on compulsory motor liability insurance enshrines the legal concept of an insurance ombudsman. However, the procedure of this institution in the said Law, other normative legal acts is not written down, but is determined by the Council representatives appointing the insurance ombudsman, and agreed with the insurance supervisory authority. Basic document In this case, the Regulations on the activities of the insurance ombudsman are used on resolving issues regarding compulsory insurance civil liability of vehicle owners funds (approved by the Decision of the Council of Representatives dated August 22, 2007 No. 1 and agreed with the Agency of the Republic of Kazakhstan for regulation and supervision of the financial market and financial organizations)
Armenia	Currently there is a separately adopted special Law of the Republic of Armenia "On the Financial System Mediator"

Involving insurance market participants in interaction with the institutions under discussion can be carried out using various combinations. However, most combinations fall into one of two models.

The first is on a voluntary basis:

the participants in the insurance (reinsurance) contract, at the stage of signing it or subsequently, come to an agreement to transfer a mutual dispute to a certain institution for consideration;
voluntariness is also expressed in the fact that the consideration by the ombudsman of a dispute between the insurer and its client directly depends on the insurer’s contractual accession to the services of the insurance ombudsman as a result of the voluntary expression of the will of the former;
even after a decision is made by the institution that settles insurance disputes, the policyholder (and in the practice of some states, the insurer) does not lose the right to appeal this decision to the state court.

The second is on a mandatory basis established by law:

Submitting a dispute with a client to the insurance ombudsman does not depend on the consent of the insurance company (for example, in the form of an arbitration clause) - the will of one party to the contract is sufficient. The decisions of the insurance ombudsman become compulsory for insurers by force of law;
if the insurance ombudsman is a government body, then its activities are subject to mandatory legal regulation;
a rule may also be introduced according to which consideration of a dispute in court is possible only if the parties have gone through the procedure for considering the dispute by the insurance ombudsman without reaching an agreement.

Consideration of complaints by insurance ombudsmen is carried out in the manner determined by regulations or other similar normative document. The key rules of regulations in different states have certain similarities and include:

simplified procedure for an applicant to contact the insurance ombudsman and the procedure for filing a complaint (for the purposes of efficiency, an appeal to the ombudsman can be made by telephone, fax or email, and the complaint requires submission in writing with a signature and a mandatory list of answers to a number of questions; the complaint is considered, as a rule, without payment of any fees or contributions by the applicant);
the period within which the Ombudsman sends a request regarding the received complaint to the relevant insurance organization to obtain documentary materials;
the period within which the insurer is obliged to provide materials and explanations;
the procedure and period, guided by which, the insurance ombudsman, after reviewing the materials, makes a decision to satisfy (full or partial) or refuse to satisfy the complaint. Moreover, in most cases, consideration does not require the presence of any of the parties, which reduces their costs;
in some cases - the period during which the applicant of the complaint provides or does not provide his consent with the decision made: the acquisition of legal force by the decision depends on the client’s consent;
rules on the insurer's execution of the decision of the insurance ombudsman.

These rules ensure the advantages of considering a dispute by an ombudsman in comparison with legal proceedings, which consist of a free, simplified and quick consideration of the complaint by a professional specialist in insurance law.

K.A. Gatsalov

Senior Partner

law firm

"LexFinance Group"

In 2017, the courts received more than 390 thousand claims under compulsory motor liability insurance, and the Central Bank received about 38 thousand complaints about incorrect calculations by insurers when settling claims for this type of insurance. During the same period, to the courts for comprehensive insurance and other types property insurance More than 21 thousand claims were filed, and the number of complaints to the Central Bank against insurers (except for MTPL) amounted to 12 thousand.

The new one comes into force on September 3 federal law on the Commissioner for the Rights of Consumers of Financial Services. Work on the bill took a very long time - more than six years in total. In the first reading, the draft law was adopted by the State Duma back in 2014. After that, at various platforms of government bodies and the insurance community, there was a lively discussion about the pros and cons of the institution of a financial ombudsman and, in general, about the need for its introduction in the country.

The original text of the bill has undergone significant changes. Many of its provisions, taking into account the proposals of the insurance company, were finalized, others were rewritten anew. But the idea itself and the goals that were set when preparing the draft law were preserved.

The law provides for the creation of a special Fund for financing the activities of the Financial Ombudsman. There were very heated discussions on the issue of insurers' contributions as one of the sources of financing the activities of the financial ombudsman. As a result, we came to the following design: the size of the financial organization’s contribution will be determined by multiplying the number of applications regarding it accepted for consideration by the financial ombudsman by the rate, which will be determined by the Council of the Financial Ombudsman Service.

In my opinion, this is a fairly balanced and objective approach. By and large, the size of the premium will be largely determined by the quality of settlement of claims submitted directly to the insurer.

Procedure for consideration of appeals

The financial ombudsman will consider appeals against insurance organizations if the size of the financial services consumer’s claims for the collection of funds does not exceed 500 thousand rubles. (and for disputes arising from the MTPL agreement - regardless of the amount of the claim). At the same time, no more than three years must pass from the day when the consumer of financial services learned or should have learned about the violation of his rights.

It is important to note that before contacting the financial ombudsman, the consumer of financial services must submit an application in writing or electronic form directly to the insurance company.

Accordingly, the consumer of financial services has the right to contact the financial ombudsman after receiving a response from the insurer with which he does not agree, or in the event of failure to receive a response from the financial organization after the expiration of the period established by law.

Mandatory execution of the decision of the financial ombudsman

The decision of the financial ombudsman comes into force 10 working days after the date of its signing. It must be executed no later than the period specified therein, ranging from 10 to 30 working days.

If the insurer fails to comply with the final decision of the financial commissioner (or the terms of the agreement reached), the commissioner issues a so-called certificate to the consumer of financial services. A certificate is essentially an analogue executive document, the form of which is established by the Government of the Russian Federation.

Based on ID bailiff- the contractor enforces the decision of the financial commissioner or the agreement in accordance with the requirements of the legislation of the Russian Federation.

In this case, the insurer is obliged, and the consumer of financial services only has the right, to inform the financial ombudsman about the execution or refusal to execute the decision made by him.

In turn, the company’s failure to voluntarily comply with the decision of the financial ombudsman or the terms of the agreement, based on the application of the consumer of financial services, entails the collection by court of a fine in favor of the client in the amount of 50% of the amount of the consumer’s claim, which was subject to satisfaction in accordance with the decision of the financial ombudsman or with an agreement.

It should also be noted that the decision of the financial ombudsman, in case of disagreement with it, can be appealed to judicial procedure both the consumer and the insurer. In this case, a claim in court can be filed by the consumer within 30 days after the decision comes into force, and by the insurer - only within 10 days.

Requirements for a financial ombudsman

Quite stringent requirements are imposed on a candidate for the position of financial ombudsman. They can be appointed a citizen of the Russian Federation at least 35 years old with a higher legal or economic education, with experience in the field of financial market, regulation, control and supervision of financial market or protecting the rights of consumers of financial services for a total of at least 5 years, or having worked as a judge for at least 10 years.

At the same time, the financial ombudsman does not have the right to be a member of representative government bodies (both federal and regional levels), as well as engage in other paid activities, with the exception of teaching, scientific and other creative activities.

In addition, the financial ombudsman must have an impeccable business reputation and be independent of the parties when considering a specific request.
The financial ombudsman cannot be a person whose powers are as a judge of a court of law or arbitration court, arbitrator, lawyer, notary, investigator, prosecutor or other law enforcement officer were terminated due to committing acts incompatible with his professional activity misconduct.

A financial ombudsman cannot be a person who has an unexpunged or outstanding conviction for committing an intentional crime, as well as a person against whom a decision has been made to disqualify him, or a person included in the database maintained by the Bank of Russia.

The financial ombudsman also does not have the right to consider applications in the event of personal interest in the execution job responsibilities which leads or may lead to a conflict of interest, and is obliged to take measures to prevent any possibility of a conflict of interest, as well as measures to prevent or resolve conflicts of interest in accordance with the anti-corruption law.

Potential risks and possible problems

Among the main risks for insurance companies associated with the adoption of the law, I would highlight the following:

The most stringent deadlines for processing applications compared to world practice. For example, in the UK, Germany, Denmark, the time frame for making a decision by the financial ombudsman is up to 180 days, in Hungary, Austria - up to 90 days. We have only 15 working days. This imposes additional obligations on insurers to competently organize business processes at the stage of settling claims and interacting with consumers of financial services. In this situation, there is a possible risk of insurers violating the deadlines for considering the flow of claims.
The need to increase the staffing level of insurance organizations and, as a consequence, increased costs. It is obvious that the implementation of the law will require the involvement of additional labor resources for high-quality support of interaction processes both with consumers themselves and with the Financial Ombudsman Service.
Financing. We may be talking about a discrepancy between the expectations of insurers and the actual costs of financing the activities of the Financial Ombudsman Service
Legal conflicts cannot be ruled out. I mean making opposing decisions on similar controversial situations.

Additional responsibilities of insurers in connection with the adoption of the law

On insurance organizations assigned by law a whole series responsibilities:

ensure the preparation of a response to the claim individual within 15 days from the date of its receipt, and at the request of the financial ombudsman - within 5 days;
organize the execution of the decision of the financial ombudsman;
inform the financial ombudsman about the execution of the decision.

For violation of the requirements of the law - in particular, in the case of repeated non-fulfillment or improper fulfillment of prescribed duties by the insurer within one year - the financial ombudsman has the right to post relevant information on its official website and contact the Bank of Russia with a proposal to apply supervisory response measures against this insurance organization .

What should insurers do now?

In my opinion, at the initial stage, before the law comes into force, insurance organizations need to stipulate in their internal regulations:

the procedure for interaction both with the Financial Ombudsman Service and with consumers of financial services,
the procedure for considering requests from consumers of financial services,
the procedure for executing and appealing decisions of the financial ombudsman, the procedure for informing about the execution of the decision, etc.

It is important to ensure connection to electronic document management to interact with the financial ombudsman in order to comply with deadlines for responding to requests, provide consumers with the opportunity to submit a claim electronically.

After the law comes into force and the Financial Ombudsman Service begins its work, it is necessary to create procedures for analyzing the consideration of claims from consumers in order to improve the quality of services provided and control the quality of decisions made, and to constantly improve the mechanisms for independent dispute resolution in order to reduce financial costs.

I would like to note one important detail related to the timing of the law’s entry into force. Yes, indeed, the law comes into force on September 3, 2018. However, at the initial stage, interaction between insurers and the financial ombudsman is assumed to be voluntary. In relation to insurance organizations engaged in compulsory motor liability insurance and insurance of funds ground transport, the law will become mandatory starting from June 1, 2019, and for insurance organizations providing other types of insurance - from November 28, 2019.

In conclusion, I would like to inform you that VSK JSC, together with VSS, plans to hold a training seminar this fall in the interests of the entire insurance community, dedicated to the practical implementation of the institution of a financial ombudsman in the insurance market.

Called to protect the rights of citizens in the insurance market, in the field of lending and placement of funds, explains the head of the Main Directorate of the Bank of Russia for the Central federal district Nadezhda Ivanova.

There are financial ombudsman institutions in many Western countries. Its main task is to resolve disputes between citizens and financial organizations before court in cases where the parties were unable to do so themselves. The relevance of creating the institution of financial ombudsmen is confirmed by the number of claims from consumers of financial services received in the courts: in 2017, there were more than 390 thousand of them on compulsory motor liability insurance issues alone.

What types of disputes does the financial ombudsman have to deal with? First of all, related to violations of citizens’ rights by insurers, including by, as well as consumer lending citizens.

The Financial Ombudsman will consider appeals from citizens if the amount of claims for the collection of monetary amounts does not exceed 500 thousand rubles (and in relation to compulsory motor liability insurance - regardless of the amount of the claim). At the same time, no more than three years must pass from the moment when the consumer of financial services learned or should have learned about the violation of his rights.

Before contacting the financial ombudsman, the consumer must first make a statement in writing or electronically directly to the financial institution whose actions he intends to challenge. Only after receiving a refusal from the financial institution, or not receiving a response to deadline he has the right to contact the financial ombudsman. The law establishes strict deadlines for consideration of a dispute by the ombudsman - 15 days from the date of transfer of the appeal to the financial ombudsman. These deadlines can be extended by ten days if it is necessary to conduct a technical examination. The Financial Ombudsman's decision comes into force ten working days after it is made.

The financial company is obliged to inform the financial ombudsman about the execution of his decision or about the refusal to execute. If the company has not complied with this decision, the commissioner issues the citizen a certificate, which, in essence, is an analogue of a court decision. Based on this certificate, the bailiff enforces the decision of the financial ombudsman.

The decision of the financial ombudsman can be appealed in court either by the consumer himself or by the financial company. In this case, a citizen can go to court within 30 days after the decision enters into force, and finance company- only for ten days. If the court rules in favor of the citizen, the company may also be awarded a fine of 50 percent of the amount of the claim.

The law gives the financial ombudsman independence from federal and regional authorities. there will be a board of directors of the Bank of Russia (upon the proposal of the chairman of the Bank of Russia, agreed with the President of the Russian Federation) for a period of five years. At the same time, it is prohibited to hold the position of financial commissioner for more than three consecutive terms.

Quite stringent requirements are imposed on a candidate for the position of financial ombudsman. They can be a Russian citizen of at least 35 years of age with a higher legal or economic education, who has experience in the financial market, regulation, control and supervision in the financial market or the protection of the rights of consumers of financial services for a total of at least five years, or who has worked as a judge for at least five years. less than ten years.

The financial ombudsman does not have the right to work in government bodies, or engage in commercial activities. He can teach, conduct scientific and other creative activities. Of course, he must have an impeccable business reputation and be independent of the parties when considering a specific request.

At the formation stage, the work of the financial ombudsman service will be financed by the Bank of Russia. Then the source will be contributions from financial organizations, the size of which will depend on the number of disputes lost, the completeness and timeliness of execution of decisions. The final calculation formula will be determined by the Council of the Financial Ombudsman Service and will be made public.

Financial institutions that resolve disputes with a consumer before the consumer contacts the financial ombudsman or before a decision is made will be waived the dispute fee or will pay it at minimum size. Information about such disputes will not be included in the financial ombudsman's public reporting.

The entry into force of the law will be gradual. The preparatory period will begin on September 3. From June 1, 2019, the law will become mandatory for the MTPL segment, and from November 28, 2019 - for other types of insurance.

From January 1, 2020, it will extend to micro financial organizations, and from January 1, 2021 - to banks, credit cooperatives, non-state pension funds, pawn shops.

Voluntary financial organizations can join the system of financial ombudsmen 90 days after the law comes into force - from December 3, 2018 (there are already insurance companies, banks and microfinance organizations that are ready to do this). Voluntary early accession is encouraged and will be taken into account by the Bank of Russia when carrying out supervision.

People who are far from legislation and politics do not know who the ombudsman is and what his functions are. Most citizens, due to their ignorance, do not even suspect that by contacting this official, they can resolve a number of issues that are difficult to resolve with other authorities (prosecutor’s office, court, etc.).

Who is an ombudsman

An ombudsman is an official or official appointed to this position to monitor the activities of ministries, departments and other government bodies. It acts both on complaints from citizens and on its own initiative and is guided not only by legislation, but also by justice.

For example, the ombudsman in Russia is the Commissioner for Human Rights. In principle, in any country where such an office is provided, the ombudsman can deal with issues relating to failure to fulfill his duties or abuse of his powers officials, resulting in disputes between the citizen and the authorities.

The history of the origin of the position of “ombudsman”

According to history, the meaning of “ombudsman” (word) was first deciphered back in the 16th century in Sweden. The official holding this position supervised the work of the court:
transparency of court hearings, fairness of sentencing. After the defeat of the Swedes near Poltava, the competence of the Ombudsman was significantly expanded. Due to the fact that King Charles Xll of Sweden for a long time stayed in Turkey, the management system had fallen into disrepair and required a major restoration of order. An official (the Royal Justice Ombudsman) was appointed to the post of ombudsman, who supervised the activities of government officials. The second ombudsman, whose role was to monitor the royal administration and the judiciary, received the title of Chancellor of Justice. In 1809, Sweden created the institution of the Ombudsman of Justice, which was separate from that which was subordinate to the king.

Thus, the chancellor stood in defense of the king, and the parliamentary ombudsman stood in defense of the interests of peasants and workers. Today, the meaning of the word “ombudsman” is known firsthand by the population of countries such as Denmark, Russia, Ukraine, Sweden, Norway, Italy, Poland, Portugal, Great Britain, France, South Africa, etc.

Who can contact the Ombudsman?

The Human Rights Ombudsman considers complaints from individuals who are citizens of the country, foreign citizens, stateless persons who have a residence permit or are simply located on the territory of the state. Complaints are accepted from people who have previously applied to the court or administrative authorities, but do not agree with the decision or noticed any violations, were discriminated against, or were dissatisfied with complete inaction.

Main tasks of the Commissioner for Human Rights

The main tasks of the ombudsman, regardless of the country in which he holds his position:

Restoring justice and rights that have been violated.
Conducting activities aimed at development international relations in the field of human rights.
Educating citizens about their rights.
Improving the country's legal legislation regarding citizens.
Control over the work of government agencies.

Ombudsman Institute in Russia

The position of Human Rights Commissioner in Russia first appeared in 1994. The first ombudsman of the Russian Federation - Sergei Kovalev - was appointed State Duma. In 1998-2004, this position was held by O. Mironov, and since 2004 - by V. Lukin. In Russia there is a law “On the Commissioner for Human Rights in the Russian Federation”, on the basis of which these specialists perform their duties.

What does ombudsman mean to Russians? In short, this is an intermediary between the victim
party (citizen) and officials who protects the rights and interests of citizens. But its activities are not limited to just considering complaints or applications. The Ombudsman, on his own initiative, conducts an investigation, collecting information about gross violations or complete inaction of any authorities.

Powers of the Human Rights Ombudsman in Russia

The Ombudsman in Russia, who protects the rights of citizens, has a number of powers:

Protects the rights of citizens and monitors their observance government agencies and officials.
He makes a report to the State Duma with a request to organize a parliamentary commission to investigate the facts of mass violations of citizens' rights.
If facts of violation are identified, he applies for the initiation of criminal proceedings or administrative proceedings against the official(s).
Applies with a petition to verify the correctness of a court decision (ruling or sentence) that has entered into force.
Applies to the court with a request to protect the rights and freedoms of citizens that have been violated by unlawful actions or inaction of government agencies or officials.
Appeals to the Constitutional Court regarding violations of the constitutional rights of citizens.

Financial Ombudsman

Who is the financial ombudsman? This is an official who helps resolve a number of controversial issues that have arisen between a citizen and the bank. This could be a refund issue. credit cards, unreasonably inflated penalties and fines on long-term loans, re-issuance of a loan from foreign currency to the national one. Financial ombudsmen also resolve issues regarding unlawful actions of collection agencies and their employees.

But the most common complaints are regarding banks’ refusal to restructure loans. This is due to an increase in the amount of debt along with fines and penalties, which as a result is almost impossible to pay. The ombudsman’s task is to negotiate with the bank and convince it to make concessions in the form of partial withdrawal sanctions subject to payment of the remaining amount according to the agreed schedule.

Insurance Ombudsman

The intervention of an ombudsman (we discussed above who an ombudsman is) in the insurance sector is no less in demand. Some insurance companies violate the terms of the contract if the amount of insurance is insignificant, hoping that the client will not start legal delays. Insurance ombudsmen work in almost all countries where this position is provided. For example, European insurance companies treat them with respect, since the powers of these officials are quite broad and they have enough rights. Moreover, European companies It is unprofitable to save on non-payment of insurance, since the services of the ombudsman are paid for by them, and not by the policyholders.

The institution of ombudsman in Germany is also well developed. The only drawback of the system is that only members of trade unions of insurance organizations can use the services of officials, and when the case is transferred to the prosecutor's office, the ombudsman's influence on the outcome of the case ends.

Ombudsman for entrepreneurs

The Ombudsman for Entrepreneurs appeared as a separate independent position not so long ago. The list of his responsibilities includes:

Innings statements of claim aimed at protecting the rights of entrepreneurs.
Acting as a defense lawyer in business court.
Registration and submission of requests to authorities at the state and local level for the affairs of entrepreneurs.
Visiting and consulting suspected or convicted citizens whose cases are related to business activities.

Features of the institution of ombudsmen for the protection of the rights of the population

Based on the experience of European countries, it becomes clear that by resorting to the help of an ombudsman, a number of minor conflicts can be resolved. But there are also disadvantages to this system. For example, the decision made by the Ombudsman of Ukraine is voluntary for insurance and credit organizations for two years. And only after this time it becomes binding. Also, the Ombudsman cannot consider controversial issues that have been referred to court or for which an arbitration decision has already been made. The advantage of the system is that consumers will no longer need to go to the courts and waste their time (and money on lawyers).

Children's Ombudsman

Children's ombudsmen protect the rights of minor citizens of the country. Their responsibilities include:

Protection and restoration of children's rights.
Consultations, education, training of children regarding their rights.
Working with federal authorities, local and state authorities upon requests and receipt of necessary information or documents.
Visiting organizations and authorities to obtain clarification and check their activities related to the rights and freedoms of children.
Preparation and submission to the relevant authorities of recommendations to improve their work regarding the observance of children's rights.
Involvement of specialists to conduct analytical work related to the protection of children's rights.

Some countries have a school ombudsman position. It provides assistance to all participants in the educational process: children, teachers and parents. Anyone who believes that violations of students’ rights in the learning process can contact him. This may be a misunderstanding between the teacher (school administration, class teacher) and the student, as well as the need for consultation regarding the rights of the child within the school, clarification of organizational issues, hygiene standards, standards, etc. Also, by contacting the Ombudsman, you can make suggestions regarding improving the educational process and institution. The school rights ombudsman works in the following areas:

Active participation in the School Council, the purpose of which is to improve the work of governing bodies.
Work aimed at prevention bad habits schoolchildren.
Monitoring compliance with all rights and freedoms of students.
Work with parents and parent committees aimed at improving family relationships.
Psychological and legal support for school employees aimed at preventing emotional burnout.

How does this system work?

Regardless of the direction in which the ombudsman works, the scheme of his actions is almost standard. As mentioned above, he works on the basis of a complaint received from a private individual or on his own initiative. The Commissioner cannot examine a case that has been referred to court. During the period of consideration of the controversial issue by the Ombudsman, the applicant undertakes not to refer the case to court.

Before contacting this specialist, a citizen must send a complaint in writing to the bank or insurance company and wait for a response within 30 days. A complaint sent to the Ombudsman must be formalized in the form of an application with copies of documents attached to it (agreements, correspondence, receipts, etc.). The specialist considers disputes regarding financial institutions who joined the institute. However, the decision made by him cannot be appealed.

But credit organizations The ombudsman can make proposals for settlement of disputes or send an appeal to the court. The result of the consideration of disputes is a conciliation agreement signed by the parties, or a resolution resolving them.