In 2020, the insurance mediation service handled 420 disputes, and only 125 in 2021. (Photo: Aca)

In 2020, the insurance mediation service handled 420 disputes, and only 125 in 2021. (Photo: Aca)

Valérie Tollet, mediator at the Luxembourg Insurance and Reinsurance Association (ACA) in collaboration with the Luxembourg Consumers' Union (ULC), provides a bridge between the insured and the insurers in case of a dispute. 

Aurélie Boob: What is the role of the insurance mediator?

Valérie Tollet: It is a person who acts as a link between insurance and reinsurance companies and policyholders in the event of a dispute. I propose an out-of-court, voluntary and amicable settlement between the two parties by trying to restore dialogue. As a mediator, I try to help the parties find a solution, a fair balance on a specific issue. It is a system that tries to avoid going to court. The insurance commission (CAA) also has jurisdiction over out-of-court settlements under the insurance legislation. I intervene within the framework of the consumer code because this is a joint instance, between the ACA and the ULC.

When are you called in?

I intervene once the insured and the insurer have already spoken, exchanged e-mails or met and tried to find a solution. Often, it is the insured who call on me when there is a breakdown in communication.

What is the procedure to follow?

There is a specific procedure which is described on the ACA website and on the ULC website [there is a dedicated to mediation] with a form to fill in, including a description of the dispute and the situation. This allows me to determine whether I am competent [to intervene] or not. Consumers can attach any document useful for studying the case. The mediation procedure is free. All claims are always handled under the supervision of a lawyer who represents the ULC and guarantees that consumers will receive an objective treatment of the claim. It is important to make it clear to the insured that I am not 'on the side of the insurers' because I am employed by the ACA.

Do you have the right to refuse a request for mediation?

There is always a first step, on competence. For example, I am not competent if it concerns an insurance company that is not established in Luxembourg. In this case, I inform the relevant authorities of the country in question. If I am competent, I analyse the case and talk to each party to understand the problem. If there is no common will to reach an agreement, as I have no binding power, I can decide not to go any further.

Can anyone make a request for mediation?

The service concerns disputes between consumers (the insured) and insurance companies, but also disputes between brokers and insurance companies, but not between insured people and brokers. The Luxembourg sector has an international connotation and I can settle disputes for insured individuals who are not Luxembourg residents but are involved with an insurance company established in Luxembourg.

The requests for mediation often stem from a lack of understanding by the insured of what they are signing.
 Valérie Tollet

 Valérie TolletmediatorACA

Can cross-border workers turn to the Luxembourg mediator?

Yes, as long as they have concluded an insurance contract with a company established in Luxembourg.

What is the most common type of dispute?

My experience is still fairly limited since 15 November, but I have already dealt with about forty cases, mainly concerning unpaid premiums, disputes about contract cover or surrender values, the range is very wide. I have recorded, for example, very few cases related to floods. Generally speaking, this may concern life or non-life insurance. The requests may concern the pure understanding or application of the contract. But also an administrative problem such as the non-receipt of an annual statement from one's life insurance. After several requests, the ombudsman can intervene to put pressure on and recover the documents not provided.

Is there a link between the need for mediation and the increase in the number of regulations which has put more weight on the insurance sector in recent years, particularly the general terms and conditions of sale?

The requests for mediation often stem from a lack of understanding by the insured of what they are signing. The best advice is to read everything carefully or to have the contract explained to you, to make sure that the needs of the insured are in line with the insurer's offer. This is particularly true of what is and is not covered in the event of a claim. Certainly the lengthening of the general terms and conditions of sale at the bottom of the contract may discourage the consumer from reading them or be the cause of mediation requests.

Should there be an information service upstream?

Normally not. The aim of any good insurance agent or broker is to explain the contract clearly to the insured. No one is supposed to ignore the law. Signing a contract is never insignificant whatever it may be. It must be done responsibly and with knowledge of one's needs.

In Luxembourg, there were 420 disputes in 2020 and only 125 in 2021.
 Valérie Tollet

 Valérie TolletmediatorACA

Do you have any idea of the amounts that your intervention costs or brings in for the insurance companies?

No, I don't have this information. But in terms of the volume of mediation requests, we can see that communication is relatively good between policyholders and insurers, compared to other countries. In 2020, in Belgium, there were 7,600 requests to the mediator and 17,400 requests in France. Proportionally, in Luxembourg there were 420 disputes in the same year, and only 125 in 2021.

In 2020, of the 420 disputes, 193 were positive for the consumer and 207 negative.

How long does the mediation procedure last?

 On average, the dispute is settled within two months,

What qualities do you need to have to carry out this function?

You have to have legal and technical knowledge, a lot of pedagogy, a certain social sense and be easy to talk to. People who call on the mediator are often dissatisfied, and you also have to be patient, because you have to explain the terms of the contract again, sometimes at length. The choice of words is very important.

This story was first published in French on . It has been translated and edited for Delano.