Introduction
Insurance disputes can lead to complications and differences between policyholders and insurance companies. Resolving these disputes requires a precise understanding of the applicable regulations and the proper procedures for filing an appeal. This article aims to provide a comprehensive overview of the process of resolving insurance disputes.
Processing Insurance Claims
Insurance companies are obligated, under Federal Decree No. 48 of 2023, to process insurance claims in accordance with the terms of the relevant insurance policy and prevailing legislation. Specific procedures, as outlined in Article 101 of the decree, must be followed.
When an insurance claim is partially or fully denied, the insurance company must provide a written explanation detailing the reasons for the decision.
Acceptance of Claims
Claims arising from disputes related to insurance contracts and the services provided by insurance companies are considered acceptable if they have not been submitted to the relevant dispute settlement committees.
Filing a Complaint with the Banking and Insurance Dispute Settlement Unit
Complaints must be filed according to the procedures established by the Banking and Insurance Dispute Settlement Unit.
The Banking and Insurance Dispute Settlement Unit establishes one or more committees responsible for resolving disputes arising from insurance contracts, business transactions, and services. These committees have broad authority to define their jurisdiction, powers, and procedural rules. The committees consist of a neutral judge, another judge as a member, and experts selected by the Central Bank.
This unit, established under Article 121 of Federal Law No. 14 of 2018, is the competent authority for resolving banking and insurance disputes.
Legal Status of Committee Decisions
Decisions issued by dispute settlement committees have the force of executable instruments. However, the execution of these decisions can be suspended if an appeal is filed and the disputed amount exceeds AED 50,000.
How to Appeal Committee Decisions
The General Authority of the Dubai Court of Cassation issued Decision No. 12 of 2023 on December 11, 2023, stating that the provisions governing appeals against decisions issued by dispute settlement committees, until November 30 (in accordance with Article 1 of the Civil Procedure Law), are subject to the repealed Law No. 6 of 2007 on the regulation of insurance business and its amendments. Appeals must be submitted to the Court of First Instance regardless of the date of submission or registration. As for decisions issued by the committee after the enactment of this decree, they are subject to the rules established in the latest decree regarding determining the threshold for appeals for insurance, as follows:
If the disputed amount does not exceed AED 50,000, the insurance company is prohibited from appealing the decisions made by the dispute settlement committee. This decision is considered final and enforceable upon issuance.
If the disputed amount exceeds AED 50,000, the insurance company has the right to appeal the committee’s decision before the Court of Appeal within 30 days from the date of issuance or knowledge of the decision.
Conclusion
The legal regulations governing appeals against decisions of the Banking and Insurance Dispute Settlement Committee have been amended to state that appeals can be directly submitted to the Court of Appeal, provided that the dispute value exceeds fifty thousand dirhams. Appeals must be submitted within thirty days from the date of the decision or knowledge of it. Additionally, the General Authority of the Court of Cassation has decided to apply the previous law to committee decisions until November 30, 2023, without a specific threshold for appeals and added that appeals against committee decisions must be made before the Court of First Instance within thirty days from the date of notification of the decision, regardless of the value of the dispute.
Therefore, dealing with insurance disputes requires a comprehensive understanding of the applicable regulations and the proper procedures for filing an appeal.
For further information or legal assistance please do not hesitate to contact us on he following number or email address: +971 52 757 9381 or reception@alsafarpartners.com – www.alsafarpartners.com
Written By:
Ms. Rana Al Shoufi – Legal Consultant & Head of legal Coordination Department at Al Safar and Partners Law Firm
